K Number
K103484
Device Name
GSP NEONATAL THYROXINE (T4)
Date Cleared
2011-04-22

(147 days)

Product Code
Regulation Number
862.1700
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The GSP Neonatal Thyroxine (T4) kit is intended for the quantitative determination of human thyroxine (T4) in blood specimens dried on filter paper as an aid in screening newborns for congenital (neonatal) hypothyroidism using the GSP instrument.
Device Description
The GSP Neonatal T4 assay is a solid phase time-resolved fluoroimmunoassay based on the competitive reaction between europium-labeled T4 and sample T4 for a limited amount of binding sites on T4 specific monoclonal antibodies (derived from mice). The use of 8-anilino-1-naphthalenesulfonic acid (ANS) and salicylate in the T4 Assay Buffer facilitates the release of T4 from the binding proteins. Thus the assay measures the total amount of T4 in the test specimen. A second antibody, directed against mouse IgG, is coated to the solid phase, and binds the IgG-thyroxine complex, giving convenient separation of the antibody-bound and free antigen. DELFIA Inducer dissociates europium ions from the labeled antibody into solution where they form highly fluorescent chelates with components of DELFIA Inducer. The fluorescence in each well is then measured. The fluorescence of each sample is inversely proportional to the concentration of T4 in the sample.
More Information

Not Found

No
The description details a standard immunoassay technique and does not mention any AI or ML components.

No
This device is for in vitro diagnostic (IVD) use, specifically for screening newborns for congenital hypothyroidism by measuring T4 levels. It does not provide any therapeutic intervention.

Yes
The device is intended for the quantitative determination of human thyroxine (T4) in blood specimens dried on filter paper as an aid in screening newborns for congenital (neonatal) hypothyroidism, which is a diagnostic purpose.

No

The device description clearly outlines a laboratory assay kit involving chemical reactions, antibodies, and fluorescence measurement, which are hardware components and processes, not solely software.

Yes, this device is an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use explicitly states it's for the "quantitative determination of human thyroxine (T4) in blood specimens dried on filter paper." This involves testing a biological sample (blood) in vitro (outside the body).
  • Device Description: The description details a "solid phase time-resolved fluoroimmunoassay," which is a laboratory technique performed in vitro to measure substances in biological samples.
  • Sample Type: The device uses "blood specimens dried on filter paper," which are biological samples collected from the patient for in vitro analysis.
  • Intended User/Care Setting: The intended users are "adequately trained laboratory personnel in laboratories performing newborn screening," indicating a laboratory setting where in vitro testing is conducted.

All these points align with the definition of an In Vitro Diagnostic device, which is used to examine specimens derived from the human body to provide information for diagnostic purposes.

N/A

Intended Use / Indications for Use

The GSP Neonatal IRT kit is intended for the quantitative determination of human thyroxine (T4) in blood specimens dried on filter paper as an aid in screening newborns for congenital (neonatal) hypothyroidism using the GSP® instrument.

The GSP Neonatal Thyroxine (T4) kit is intended for the quantitative determination of human thyroxine (T4) in blood specimens dried on filter paper as an aid in screening newborns for congenital (neonatal) hypothyroidism using the GSP instrument.

Product codes (comma separated list FDA assigned to the subject device)

KLI

Device Description

The GSP Neonatal T4 assay is a solid phase time-resolved fluoroimmunoassay based on the competitive reaction between europium-labeled T4 and sample T4 for a limited amount of binding sites on T4 specific monoclonal antibodies (derived from mice). The use of 8-anilino-1-naphthalenesulfonic acid (ANS) and salicylate in the T4 Assay Buffer facilitates the release of T4 from the binding proteins. Thus the assay measures the total amount of T4 in the test specimen. A second antibody, directed against mouse IgG, is coated to the solid phase, and binds the IgG-thyroxine complex, giving convenient separation of the antibodybound and free antigen. DELFIA Inducer dissociates europium ions from the labeled antibody into solution where they form highly fluorescent chelates with components of DELFIA Inducer. The fluorescence in each well is then measured. The fluorescence of each sample is inversely proportional to the concentration of T4 in the sample.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

newborns

Intended User / Care Setting

Adequately trained laboratory personnel in laboratories performing newborn screening.

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Not Found

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K943416

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 862.1700 Total thyroxine test system.

(a)
Identification. A total thyroxine test system is a device intended to measure total (free and protein bound) thyroxine (thyroid hormone) in serum and plasma. Measurements obtained by this device are used in the diagnosis and treatment of thyroid diseases.(b)
Classification. Class II (special controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.

0

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR § 807.92.

The Assigned 510(k) Number is:

Date: April 12, 2011

Submitted by:

Wallac Oy, subsidiary of PerkinElmer 940 Winter Street Waltham, MA 02451 USA

Contact Person: Susan K. Hamann Primary: Tel: 781-663-5872 Fax: 781-663-5983

Secondary:

Kay A. Taylor Tel: 317-418-1735 Fax: 317-536-3064

Trade Name:

Common Name: GSP Neonatal Thyroxine (T4) kit

Regulation: 21 CFR 862.1700

Classification Name: Total Thyroxine Test System

Product Code:

AutoDELFIA® Neonatal Thyroxine T4 Predicate Device: 510(k) Number (K943416)

KLI

Device Description: The GSP Neonatal T4 assay is a solid phase time-resolved fluoroimmunoassay based on the competitive reaction between europium-labeled T4 and sample T4 for a limited amount of binding sites on T4 specific monoclonal antibodies (derived from mice). The use of 8-anilino-1-naphthalenesulfonic acid (ANS) and salicylate in the T4 Assay Buffer facilitates the release of T4 from the binding proteins. Thus the assay measures the total amount of T4 in the test specimen. A second antibody, directed against mouse IgG, is coated to the solid phase, and binds the IgG-thyroxine complex, giving convenient separation of the antibodybound and free antigen.

GSP® Neonatal Thyroxine (T4) kit (3302-001U)

DELFIA Inducer dissociates europium ions from the labeled antibody into solution where they form highly fluorescent chelates with components of DELFIA Inducer.

1

The fluorescence in each well is then measured. The fluorescence of each sample is inversely proportional to the concentration of T4 in the sample.

Intended Use:

The GSP Neonatal IRT kit is intended for the quantitative determination of human thyroxine (T4) in blood specimens dried on filter paper as an aid in screening newborns for congenital (neonatal) hypothyroidism using the GSP® instrument.

Substantial Equivalence:

The GSP® Neonatal Thyroxine (T4) kit is substantially equivalent to our currently marketed AutoDELFIA® Neonatal Thyroxine T4 (K943416). There are the following similarities and differences between the two kits:

2

| Predicate

DeviceFEATURESimilarities (AutoDELFIA T4)Differences (GSP T4)
AutoDELFIA
Neonatal T4 KitIntended UserAdequately trained laboratory personnel in
laboratories performing newborn screening.Same
AutoDELFIA
Neonatal T4 KitIntended useThis kit is intended for the quantitative
determination of human thyroxine (T4) in
blood specimens dried on filter paper as an
aid in screening newborns for congential
(neonatal) hypothyroidism using the
AutoDELFIA automatic immunoassay
system.The kit is intended for the quantitative
determination of human thyroxine (T4) in blood
specimens dried on filter paper as an aid in
screening newborns for congenital (neonatal)
hypothyroidism using the GSP instrument.
AutoDELFIA
Neonatal T4 KitChemical
PrincipleThe Neonatal T4 assay is a solid phase
time-resolved fluoroimmunoassay based on
the competitive reaction between europium-
labeled T4 and sample T4 for a limited
amount of binding sites on T4 specific
monoclonal antibodies (derived from mice).
The use of 8-anilino-1-naphthalenesulfonic
acid (ANS) and salicylate in the T4 Assay
Buffer facilitates the release of T4 from the
binding proteins. Thus the assay measures
the total amount of T4 in the test specimen.
A second antibody, directed against mouse
IgG, is coated to the solid phase, and binds
the IgG-thyroxine complex, giving
convenient separation of the antibody-bound
and free antigen.Same
AutoDELFIA
Neonatal T4 KitChemical
PrincipleEuropium ions are dissociated from the
labeled antibody into solution where they
form highly fluorescent chelates with
components of the dissociation solution.

The fluorescence in each well is then
measured. The fluorescence of each sample
is inversely proportional to the concentration
of T4 in the sample | Same |
| AutoDELFIA
Neonatal T4 Kit | Dissociation
Solution | Enhancement Solution. | DELFIA Inducer |
| AutoDELFIA
Neonatal T4 Kit | Detection
Principle | Time-resolved fluorescence | Same |
| AutoDELFIA
Neonatal T4 Kit | Specimen | Dried blood on filter paper disks with a
diameter of approximately 3.2 mm (1/8 inch) | Same |
| AutoDELFIA
Neonatal T4 Kit | Antibodies | Primary mouse monoclonal antibody and | Same |
| | FEATURE | Similarities (AutoDELFIA T4) | Differences (GSP T4) |
| DELFIA
Neonatal T4 Kit | Calibrators | Six levels of T4 calibrators | Same |
| DELFIA
Neonatal T4 Kit | Source | Human blood with a hematocrit value of 50-55% | Same |
| DELFIA
Neonatal T4 Kit | Matrix | Filter paper sheets
(Whatman no. 903) | Filter paper cassettes (Whatman no.903) |
| DELFIA
Neonatal T4 Kit | Calibrator
Concentrations | A 0 µg/dL serum
B 2 µg/dL serum
C 4 µg/dL serum
D 8 µg/dL serum
E 16 µg/dL serum
F 30 µg/dL serum | Same |
| DELFIA
Neonatal T4 Kit | Controls | Three levels of T4 controls | Same |
| DELFIA
Neonatal T4 Kit | Control
Concentrations | Approx. values:
C1 3 µg/dL serum
C2 7 µg/dL serum
C3 12 µg/dL serum | Same |
| DELFIA
Neonatal T4 Kit | Tracer | T4-Eu (~25 nmol/L);
6 vials, lyophilized | T4-Eu (~10 nmol/L);
3 vials, 2.8 mL |
| DELFIA
Neonatal T4 Kit | Antibody | T4 antibody stock solution (~40 nmol/L);
6 vials, 1.5 mL | T4 antibody (~12 nmol/L);
3 vials, 2.8 mL |
| DELFIA
Neonatal T4 Kit | Assay Buffer | T4 Assay Buffer
3 bottles, 110 mL | Same |
| DELFIA
Neonatal T4 Kit | Plates | Anti-Mouse IgG Microtitration strips (Nunc
PolySorb); 12 plates | Anti-Mouse IgG Microtitration strips (Nunc
MaxiSorb); 12 plates |
| DELFIA
Neonatal T4 Kit | Detection | Defined by analyte specific protocol | Same |
| DELFIA
Neonatal T4 Kit | Calculation | Multicalc, X- axis LOG, Y-axis B/BMax;
fitting algorithm spline smoothed | GSP Workstation software,
X-axis Hyberbolic,
Y-axis Bound2Max; fitting algorithm spline
smoothed |
| DELFIA
Neonatal T4 Kit | Incubation Detail | 11min + 2 hours, 25°C | 10 min + 2 hours, 25°C |
| DELFIA
Neonatal T4 Kit | Precision
(levels/CVs) | Full standard curve on each plate:
Control 1; 3.95 µg/dL serum
Intra-assay variation 14.9 %
Inter-assay variation 10.0 %
Total variation 18.0 % | Full calibration curve on each plate:
Sample 1; 2.0 µg/dL
Within run 1.0%
Within lot 15.5%
Total variation 15.8% |
| Predicate Device | FEATURE | Similarities (AutoDELFIA T4) | Differences (GSP T4) |
| | | Control 2; 8.08 µg/dL serum
Intra-assay variation 10.6 %
Inter-assay variation 7.1 %
Total variation 12.7 % | Sample 2; 4.8 µg/dL
Within run 7.3%
Within lot 10.7%
Total variation 11.4% |
| | | Control 3; 18.2 µg/dL serum
Intra-assay variation 8.2%
Inter-assay variation 4.3%
Total variation 9.3 % | Sample 3; 7.5 µg/dL
Within run 6.5%
Within lot 8.4%
Total variation 8.6% |
| | | | Sample 4; 16.6 µg/dL
Within run 4.5%
Within lot 7.8%
Total variation 8.5% |
| | | | Sample 5; 19.8 µg/dL
Within run 7.2%
Within lot 9.9%
Total variation 10.3% |
| | | | Sample 6; 21.4 µg/dL
Within run 7.1%
Within lot 9.8%
Total variation 10.1% |
| AutoDELFIA
Neonatal T4 Kit | Measuring Range | 1.5 µg/dL to the highest level calibrator | 1.6 to 30 µg/dL serum |
| AutoDELFIA
Neonatal T4 Kit | Limit of Blank | Trade Name: GSP Neonatal Thyroxine (T4) kit Regulation Number: 21 CFR §862.1700 Regulation Name: Total thyroxine test system. Regulatory Class: Class II Product Code: KLI Dated: November 24, 2010 Received: February 24, 2011

Dear Ms. Hamann:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in Title 21, Code of Federal Regulations (CFR), Parts 800 to 895. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Parts 801 and 809); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); and good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820).

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If you desire specific advice for your device on our labeling regulation (21 CFR Parts 801 and 809), please contact the Office of In Vitro Diagnostic Device Evaluation and Safety at (301) 796-5450. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours.

C.C.

Courtney Harper, Ph.D. Director Division of Chemistry and Toxicology Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

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Indications for Use Form

510(k) Number (if known): __K103484

Device Name: The GSP Neonatal Thyroxine (T4) kit (3302-001U)

Indications for Use:

The GSP Neonatal Thyroxine (T4) kit is intended for the quantitative determination of human thyroxine (T4) in blood specimens dried on filter paper as an aid in screening newborns for congenital (neonatal) hypothyroidism using the GSP instrument.

Prescription Use ਮ (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (21 CFR 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)

Concurrence of CDRH, Office of In Vitro Diagnostic Devices (OIVD)

Carol C. Benson

Division Sign Off Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) K103484

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