K Number
K103531
Device Name
PRESTIGE 24I; BIOLIS 24I; MGC 240
Date Cleared
2011-12-01

(365 days)

Product Code
Regulation Number
862.1345
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Biolis 24i Clinical Chemistry Analyzer is a discrete photometric clinical chemistry analyzer. The device is intended to duplicate manual analytical procedures by automating various steps such as pipetting, heating, measuring color intensity, and reporting results. The device is intended to be used with certain materials to measure various analytes of diagnostic interest including glucose. The Biolis 24i analyzer with glucose hexokinase assay is intended to measure glucose quantitatively in human serum. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic glycemia, and of the pancreatic islet cell carcinoma.
Device Description
Using photometry, the Biolis 24i instrument measures the glucose concentration in serum by monitoring the change in absorbance at 340 nm. Additionally, the Biolis 24i with Ion-Selective Elective module additionally measures the concentration of the electrolytes, sodium, potassium and chloride in serum, using indirect potentiometry.
More Information

No
The summary describes a standard clinical chemistry analyzer using photometry and potentiometry, with no mention of AI or ML in its operation or analysis.

No
The device is a clinical chemistry analyzer used for diagnostic purposes by measuring analytes like glucose in human serum. It is not designed to provide or administer therapy.

Yes
The document states the device measures analytes "of diagnostic interest including glucose" and that "Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders".

No

The device description clearly states it is an "instrument" that performs physical actions like pipetting, heating, and measuring color intensity using photometry, indicating it is a hardware device with integrated software.

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

Here's why:

  • Intended Use: The "Intended Use / Indications for Use" section explicitly states that the device is intended to "measure various analytes of diagnostic interest including glucose." It also mentions that glucose measurements are "used in the diagnosis and treatment of carbohydrate metabolism disorders." This directly aligns with the definition of an IVD, which is a device intended for use in vitro for the examination of specimens derived from the human body solely or principally for the purpose of providing information concerning a physiological or pathological state, or a congenital abnormality, or to determine the compatibility with potential recipients, or to monitor therapeutic measures.
  • Specimen Type: The device is intended to measure glucose in "human serum," which is a specimen derived from the human body.
  • Diagnostic Purpose: The results obtained from the device are used for "diagnosis and treatment" of various conditions.

Therefore, based on the provided information, the Biolis 24i Clinical Chemistry Analyzer is an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Biolis 24i Clinical Chemistry Analyzer is a discrete photometric clinical chemistry analyzer. The device is intended to duplicate manual analytical procedures by automating various steps such as pipetting, heating, measuring color intensity, and reporting results. The device is intended to be used with certain materials to measure various analytes of diagnostic including glucose. An optional Ion Selective Electrode Module is intended to measure sodium, potassium and chloride.

The Biolis 24i analyzer with glucose hexokinase assay is intended to measure glucose quantitatively in human serum. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic glycemia, and of the pancreatic islet cell carcinoma.

Product codes

CFR, JJE

Device Description

Using photometry, the Biolis 24i instrument measures the glucose concentration in serum by monitoring the change in absorbance at 340 nm. Additionally, the Biolis 24i with Ion-Selective Elective module additionally measures the concentration of the electrolytes, sodium, potassium and chloride in serum, using indirect potentiometry.

Mentions image processing

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Mentions AI, DNN, or ML

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Input Imaging Modality

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Anatomical Site

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Indicated Patient Age Range

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Intended User / Care Setting

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

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

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

Method Comparison: A correlation analysis between the Beckman CX-7 and the Biolis 24i yielded a correlation coefficient of 0.999, a slope of 0.974, and a Y-axis intercept of 2.22 for Glucose (GLU).

Precision:
Repeatability (n=60 for each sample):

  • Serum 1: Mean 60.3, SD 0.8, CV 1.3%
  • Serum 2: Mean 106.4, SD 1.4, CV 1.3%
  • Serum 3: Mean 116.8, SD 1.4, CV 1.2%
  • Serum 4: Mean 192.1, SD 2.2, CV 1.1%
  • Serum 5: Mean 446.2, SD 6.8, CV 1.5%

Total Imprecision Study (n=80 for each sample):
Analyzer s/n 2229450610:

  • Control 1: Mean 63.2, SD 1.5, %CV 2.4%
  • Serum Pool 1: Mean 118.1, SD 2.9, %CV 2.5%
  • Serum Pool 2: Mean 188.8, SD 4.1, %CV 2.1%
  • Control 2: Mean 447.0, SD 10.5, %CV 2.3%
    Analyzer s/n 2227671109:
  • Control 1: Mean 63.2, SD 1.2, %CV 1.9%
  • Serum Pool 1: Mean 117.6, SD 2.7, %CV 2.3%
  • Serum Pool 2: Mean 186.9, SD 3.6, %CV 1.9%
  • Control 2: Mean 445.9, SD 9.8, %CV 2.2%

Linearity:

  • Correlation: 0.9982
  • Slope: 0.948
  • Intercept: 2.45
  • Range: 25 - 500 mg/dL

Sensitivity:

  • LoB (Limit of Blank): 3.64 mg/dL
  • LoD (Limit of Detection): 5.64 mg/dL
  • LoQ (Limit of Quantitation): 10 mg/dL

Interferences:

  • Ascorbic acid (30 mg/L) at 75 mg/dL and 140 mg/dL Glucose: none observed.
  • Bilirubin (4.8 mg/dL) at 90 mg/dL Glucose: -3.3 mg/dL interference; (6.4 mg/dL) at 146 mg/dL Glucose: -3.6% interference.
  • Hemoglobin (240 mg/dL) at 76 mg/dL Glucose: -3.6 mg/dL interference; (160 mg/dL) at 139 mg/dL Glucose: -3.8%* interference.
  • Lipemia (from Intralipid) (600 mg/dL) at 72 mg/dL Glucose: +4 mg/dL interference; (80 mg/dL) at 142 mg/dL Glucose: +3.9% interference.
  • Metronidazole (24 mg/L) at 76 mg/dL Glucose: +2.4 mg/dL interference; (48 mg/L) at 139 mg/dL Glucose: +3.1% interference.
  • Tetracycline (15 mg/L) at 76 mg/dL and 141 mg/dL Glucose: none observed.

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

Sensitivity: LoB 3.64 mg/dL, LoD 5.64 mg/dL, LoQ 10 mg/dL

Predicate Device(s)

SYNCHRON CX 7 (K904219)

Reference Device(s)

K802810

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1345 Glucose test system.

(a)
Identification. A glucose test system is a device intended to measure glucose quantitatively in blood and other body fluids. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic hypoglycemia, and of pancreatic islet cell carcinoma.(b)
Classification. Class II (special controls). The device, when it is solely intended for use as a drink to test glucose tolerance, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.

0

K103531

Tokyo Boeki Medisys Inc. 1-14-21 Higashi-Toyoda, Hino, Tokyo 191-0051, Japan Phone: +81-42-587-2965 Fax: +81-42-587-7781

DEC - 1 2011

5. 510(k) SUMMARY

Submitter's Name/Address

Submitter's Name:Tokyo Boeki Medisys Inc.
Submitter's Address:1-14-21 Higashi-Toyota, Hino
Tokyo 191-0052
Phone:+81-42-587-2965
Fax:+81-42-587-7781
Establishment Registration Number:3004378324
Owner/Operator Number:9060135

Contact Person (United States Agent)

Name of Agent:James M. Clinton
Agent's Business Name:Quality and Regulatory Consulting, LLC
Street Address:5105 Fairoaks Road
Durham, NC 27712-2078
Phone:919-247-0479
Fax:919-287-2551
E-mail address:clintonjm@earthlink.net

Date of Preparation of this Summary:

Device Trade or Proprietary Name:

Device Common Name:

October 25, 2011

Biolis 24i, MGC 240 and Prestige 24i, (These are the same models except the names)

Clinical Chemistry Analyzer (with optional ISE Module)

Classification Numbers/Class:

75JJE, Class I 75CFR Class II

1

vo Boeki Medisv

1-14-21 Higashi-Tovoda. Hino. Tokvo 191-0 Phone: +81-42-587-2965 Fax: +81-42-587-7

510(k) Summary:

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 : K103531

Description:

Using photometry, the Biolis 24i instrument measures the glucose concentration in serum by monitoring the change in absorbance at 340 nm. Additionally, the Biolis 24i with lon-Selective Elective module additionally measures the concentration of the electrolytes, sodium, potassium and chloride in serum, using indirect potentiometry.

Intended Use:

The Biolis 24i Clinical Chemistry Analyzer is a discrete photometric clinical chemistry analyzer. The device is intended to duplicate manual analytical procedures by automating various steps such as pipetting, heating, measuring color intensity, and reporting results. The device is intended to be used with certain materials to measure various analytes of diagnostic including glucose. An optional lon Selective Electrode Module is intended to measure sodium, potassium and chloride.

The Biolis 24i analyzer with glucose hexokinase assay is intended to measure glucose quantitatively in human serum. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic glycemia, and of the pancreatic islet cell carcinoma.

Substantial Equivalence:

Substantial equivalence has been demonstrated between the Beckman CX-7 (K904219) and the Biolis 24i. These analyzers are calibrated with known concentration calibrator material and both measure specific concentrations using photometry.

| Item | New Device
Biolis 24i | Predicate
SYNCHRON CX 7 (K904219) |
|-------------------|----------------------------------------------------------|----------------------------------------------|
| General | | |
| System Principle | Discrete, single line random access, multi-test analysis | Discrete, random access, multi-test analysis |
| Throughput | 240 tests | 225 tests/hr (photometric only) |
| Configuration | Analytical unit, Control unit | Analytical unit, Control unit |
| Measurement modes | Absorbance | Absorbance |

Comparison with predicate:

2

Tokyo Boeki Medisys Inc.

1-14-21 Higashi-Toyoda, Hino, Tokyo 191-0051, Japan
Phone: +81-42-587-2965

DetectorPhoto-diodeDiffraction grating, photodiode array
Optical systemWavelength range of 340 to 800nm340, 380, 410, 470, 520, 560, 600, 650, 670, 700 nm
Light sourceTungsten halogen lampxenon
Reaction cuvettesPlastics, semi disposalquartz
Path length8mm5 mm
Reaction timeMaximum 10min.Maximum 12 min.
Incubation temperature37°C +/- 0.1°Csame
GlucoseGlucose hexokinase 510(k): K802810
Intended useQuantitative determination of glucose in serumQuantitative determination of glucose in serum plasma, urine, CSF
MethodPhotometric endpoint using glucose hexokinase.Same
Sample typeSerumSerum, plasma, urine, CSF
Sample Volume3 uLsame
Reaction Time5 min
` Analysis time
Read period: 52 - 54 points
(15 seconds per point)5 min

The validated system is described below.

.. .

.

| Analyzer: | Tokyo Boeki BioLis 24i Analyzer, software revision: 1.26
Serial numbers are listed on individual data sheets. | | |
|----------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--|--|
| Reagent: | Carolina Liquid Chemistries Glucose Reagent, Kit product no. BL-208 (also
packaged as AU-208). Lot numbers are listed on individual data sheets. | | |
| Application
parameters: | Sample volume: 3 µL
Reagent volume: 310 µL
Wavelengths: 340 / 405 nm
Reaction type: Endpoint
Read period: 52 - 54 | | |
| Calibrator: | Pointe Scientific Chemistry Calibrator
product no. C7506-50, lot 11802, exp. March 2014
Premarket clearance reference no.: K070207 | | |
| | The 185 mg/dL glucose set point for the Pointe Calibrator was verified for the
Carolina Liquid Chemistries Glucose Reagent by comparing the calibrator to NIST
SRM 965b, Glucose in Frozen Serum. The Pointe Calibrator was assayed eight
times over each of four analytical runs against NIST standard levels 3 and 4 which
were each assayed in duplicate. The glucose concentration of the Pointe Calibrator
was calculated for each run by linear interpolation the NIST assay values and their
respective certified values of 118.5 mg/dL and 294.5 mg/dL. The mean glucose
result of the Pointe Calibrator over the four runs was 185.6 mg/dL. | | |

3

Tokyo Boeki Medisys Inc.

1-14-21 Higashi-Toyoda, Hino, Tokyo 191-0051, Japan Phone: +81-42-587-2965 Fax: +81-42-587-7781

Performance Characteristics

Method Comparison

A correlation analysis between the Beckman CX-7 and the Biolis 24i yielded the following results:

| Representative
Method | Correlation
Coefficient | Slope
(Least-Squares) | Y-axis intercept |
|--------------------------|----------------------------|--------------------------|------------------|
| GLU | 0.999 | 0.974 | 2.22 |

Precision

Repeatability

SampleNMeanSDCV(%)
Serum 1રેત્વે છે. વિશ્વિત દિવસ (Career) તાલુકાઓ પૈકીના એક એવા ગામના લોકોનો મુખ્ય વ્યવસાય ખેતી, ખેતમજૂરી તેમ જ પશુપાલન છે. આ ગામનાં લોકોનો મુખ્ય વ્યવસાય ખેતી, ખેતમજૂરી તેમ જ પશુપાલ60.30.81.3%
Serum 260106.41.41.3%
Serum 360116.81.41.2%
Serum 460192.12.21.1%
Serum 560446.26.81.5%

Total Imprecision Study

Analyzer s/nSamplenmeanSD%CV
2229450610Control 18063.21.52.4%
2229450610Serum Pool 180118.12.92.5%
2229450610Serum Pool 280188.84.12.1%
2229450610Control 280447.010.52.3%
2227671109Control 18063.21.21.9%
2227671109Serum Pool 180117.62.72.3%
2227671109Serum Pool 280186.93.61.9%
2227671109Control 280445.99.82.2%

Linearity

The linearity test yielded the following results:

Correlation0.9982
Slope0.948
Intercept2.45
Range25 - 500 mg/dL

4

Tokyo Boeki Medisys Inc.

1-14-21 Higashi-Toyoda, Hino, Tokyo 191-0051, Japan Phone: +81-42-587-2965 Fax: +81-42-587-7781

Sensitivity

mg/dL
LoB3.64
LoD5.64
LoQ10

Interferences

| Interferent | Interferent
Concentration | Glucose
Concentration | Observed
Interference |
|------------------------------|------------------------------|--------------------------|--------------------------|
| Ascorbic acid | 30 mg/L | 75 mg/dL
140 mg/dL | none |
| Bilirubin | 4.8 mg/dL
6.4 mg/dL | 90 mg/dL
146 mg/dL | -3.3 mg/dL
-3.6% |
| Hemoglobin | 240 mg/dL
160 mg/dL | 76 mg/dL
139 mg/dL | -3.6 mg/dL
-3.8%* |
| Lipemia
(from Intralipid) | 600 mg/dL
80 mg/dL | 72 mg/dL
142 mg/dL | + 4 mg/dL

  • 3.9% |
    | Metronidazole | 24 mg/L
    48 mg/L | 76 mg/dL
    139 mg/dL | + 2.4 mg/dL
  • 3.1% |
    | Tetracycline | 15 mg/L | 76 mg/dL
    141 mg/dL | none |

Conclusion

The data demonstrates that Biolis 241 is substantially equivalent to Beckman SYNCHRON CX 7 (K904219) and that the CLC Glucose Reagent is substantially equivalent to Beckman Glucose Reagent (K802810).

5

Image /page/5/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of a caduceus, a symbol often associated with healthcare, featuring a staff with a serpent entwined around it.

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993

Tokyo Boeki Medisys Inc. c/o James M Clinton US Agent 5105 Fairoaks Road, Durham, NC 27712

DEC - 1 2011

Re: K103531

Trade/Device Name: Biolis 24i Clinical Chemistry Analyzer Regulation Number: 21 CFR 862.1345 Regulation Name:Glucose test system Regulatory Class: II Product Code: CFR, JJE Dated: November 4, 2011 Received: November 8, 2011

Dear Mr. Clinton:

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).

6

Page 2

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), 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 postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at (301) 796-5760. For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/Medical

Devices/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) 796-5680 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm

Sincerely yours,

N

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

Enclosure

7

INDICATIONS FOR USE

510(k) Number (if known): K103531

Device Name: Biolis 24i Clinical Chemistry Analyzer

Indications for Use:

The Biolis 24i Clinical Chemistry Analyzer is a discrete photometric clinical chemistry analyzer. The device is intended to duplicate manual analytical procedures by automating various steps such as pipetting, heating, measuring color intensity, and reporting results. The device is intended to be used with certain materials to measure various andytes af diagnostic interest including glucose.

The Biolis 24i analyzer with glucose hexokinase assay is intended to measure glucose quantitatively in human serum. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic glycemia, and of the pancreatic isle cell carcinoma.

Prescription Use (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

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

Ruth Clark

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

510(k) 103531

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