K Number
K111371
Device Name
ON CALL CHOSEN BLOOD GLUCOSE MONITORING SYSTEM
Date Cleared
2011-10-06

(143 days)

Product Code
Regulation Number
862.1345
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The On Call® Chosen Blood Glucose Monitoring System is an electrochemical enzymatic assay for the quantitative detection of glucose in fresh capillary whole blood from the fingertip by people with diabetes at home as an aid in monitoring the effectiveness of diabetes control programs. Alternate (forearm and palm) testing sites should be used only when blood glucose level is not changing rapidly. The On Call® Chosen Blood Glucose Monitoring System is intended to be used by a single patient and should not be shared. It is for in vitro diagnostic use only. The On Call Chosen Blood Glucose Monitoring System should not be used for the diagnosis of or screening for diabetes mellitus, or use on neonates. The On Call Chosen Blood Glucose Test Strips are used with the On Call Chosen Blood Glucose Meter in the quantitative measurement of glucose in capillary blood from the fingertip, forearm and palm. The On Call Chosen Blood Glucose Control Solution is for use with the On Call Chosen Blood Glucose Meter and Strips as a quality control check to verify that the meter and test strips are working together properly and that the test is performing correctly.
Device Description
The On Call "Chosen Blood Glucose Monitoring System is a quantitative assay for the detection of glucose in capillary whole blood sampled from the fingertip, palm, and forearm. The glucose measurement is achieved by using the amperometric detection method. The test strip has a reagent system including glucose oxidase and a mediator that reacts with glucose in the whole blood sample to produce an electrical current. This current is measured by the meter, and after calculation by the meter, the blood glucose concentration reading is displayed on the meter display, calibrated to a plasma reference.
More Information

No
The description details a standard electrochemical glucose measurement process and does not mention any AI or ML components.

No.
It is an in vitro diagnostic device used for monitoring blood glucose levels, not for treating or providing therapy for diabetes.

Yes

Explanation: The "On Call® Chosen Blood Glucose Monitoring System" is described as an "electrochemical enzymatic assay for the quantitative detection of glucose" and "for in vitro diagnostic use only." It is intended as "an aid in monitoring the effectiveness of diabetes control programs," which are all characteristics of a diagnostic device. However, it explicitly states it is "not for the diagnosis of or screening for diabetes mellitus," indicating it is for monitoring rather than initial diagnosis.

No

The device description explicitly details hardware components like a meter and test strips that perform electrochemical and amperometric measurements, indicating it is a hardware-based system with integrated software.

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

Here's why:

  • Explicit Statement: The "Intended Use / Indications for Use" section explicitly states: "It is for in vitro diagnostic use only."
  • Nature of the Test: The device performs an "electrochemical enzymatic assay for the quantitative detection of glucose in fresh capillary whole blood." This is a test performed in vitro (outside the living body) on a biological sample (blood) to provide diagnostic information (glucose levels).
  • Purpose: The intended use is "as an aid in monitoring the effectiveness of diabetes control programs," which is a diagnostic purpose related to managing a medical condition.

N/A

Intended Use / Indications for Use

The On Call® Chosen Blood Glucose Monitoring System is an electrochemical enzymatic assay for the quantitative detection of glucose in fresh capillary whole blood from the fingertip by people with diabetes at home as an aid in monitoring the effectiveness of diabetes control programs. Alternate (forearm and palm) testing sites should be used only when blood glucose level is not changing rapidly. The On Call® Chosen Blood Glucose Monitoring System is intended to be used by a single patient and should not be shared. It is for in vitro diagnostic use only.

The On Call Chosen Blood Glucose Monitoring System should not be used for the diagnosis of or screening for diabetes mellitus, or use on neonates.

The On Call Chosen Blood Glucose Test Strips are used with the On Call Chosen Blood Glucose Meter in the quantitative measurement of glucose in capillary blood from the fingertip, forearm and palm.

The On Call Chosen Blood Glucose Control Solution is for use with the On Call Chosen Blood Glucose Meter and Strips as a quality control check to verify that the meter and test strips are working together properly and that the test is performing correctly.

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

75 NBW, 75 CGA, 75 JJX

Device Description

The On Call "Chosen Blood Glucose Monitoring System is a quantitative assay for the detection of glucose in capillary whole blood sampled from the fingertip, palm, and forearm. The glucose measurement is achieved by using the amperometric detection method.

The test strip has a reagent system including glucose oxidase and a mediator that reacts with glucose in the whole blood sample to produce an electrical current. This current is measured by the meter, and after calculation by the meter, the blood glucose concentration reading is displayed on the meter display, calibrated to a plasma reference.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Fingertip, palm, and forearm

Indicated Patient Age Range

Not Found

Intended User / Care Setting

People with diabetes at home.

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)

Laboratory Testing:
The performance characteristics of the On Call Chosen Blood Glucose Monitoring System were evaluated by performing the following studies: repeatability precision, intermediate precision, linearity, interfering agents, hematocrit effect, temperature effect evaluation - blood & control solution, low battery effect, altitude effect, sample volume, humidity effect, simulated shipping study - test strip & control solution, control value assignment, meter testing, software validation testing, electromagnetic compatibility and electrical safety testing as part of meter and strip validation testing.

Clinical Tests Performed:
Clinical studies were conducted with lay persons and trained laboratory technicians using the On Call Chosen Blood Glucose Monitoring System. The study data were presented evaluating the system accuracy of the On Call Chosen Blood Glucose Monitoring System compared to the YSI Model 2300 STAT PLUS (K913806) per the ACON Clinical Study Protocol for the Blood Glucose Monitoring System. Study results indicate that nonprofessional, inexperienced lay persons were able to obtain comparable blood glucose readings when using the On Call Chosen Blood Glucose Monitoring System as compared to the results obtained by the trained technicians. In addition, the participating lay persons were questioned and responded as satisfied with the ease of operation by following the Instructions for Use in the User's Manual and the overall performance of the On Call Chosen Blood Glucose Monitoring System.

Conclusion:
The laboratory testing and clinical study results demonstrate that the On Call Chosen Blood Glucose Monitoring System is safe, effective and easy-to-use. It also demonstrates that the On Call Chosen Blood Glucose Monitoring System meets the accuracy requirements per EN ISO 15197 and as such is substantially equivalent to the One Touch Ultra Blood Glucose Monitoring System, currently sold on the U.S. market (K002134).

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.

K002134

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.

K913806

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

§ 862.1345 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

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 K111371 - .

Submitter's Identification:

ACON Laboratories, Inc. 10125 Mesa Rim Road San Diego, California 92121

Tel.: 858-875-8019 Fax: 858-875-8099

Date Prepared: May 14, 2011

Contact Person:

Oivi Xie Senior Staff, Clinical & Regulatory Affairs

Proprietary Name of the Device:

On Call Chosen Blood Glucose Monitoring System

Common Name:

Glucose Test System

Classification Name:

Class II §862.1345 Glucose Test System

Predicate Device:

One Touch Ultra Blood Glucose Monitoring System Lifescan, Inc., located at 1000 Gibraltar Dr., Milpitas, CA 95035, USA. 510(k) Number: K002134

1

| Proprietary Name | Classification | Product
Code | Description | Common Name |
|-----------------------------------------------------------------------------------------------|----------------------|-----------------|-----------------------------------------------------|--------------------------------|
| On Call® Chosen
Blood Glucose
Monitoring System | 862.1345
Class II | 75 NBW | System, Test,
Blood Glucose,
Over The Counter | Glucose Test
System |
| On Call® Chosen
Blood Glucose
Meter and On Call®
Chosen Blood
Glucose Test Strips | 862.1345
Class II | 75 CGA | Glucose Monitor | Glucose Meter &
Test Strips |
| On Call® Chosen
Glucose Control
Solution | 862.1660
Class I | 75 JJX | Single Analyte
Control | Control Solution |

Device Name: On Call Chosen Blood Glucose Monitoring System

Description:

The On Call "Chosen Blood Glucose Monitoring System is a quantitative assay for the detection of glucose in capillary whole blood sampled from the fingertip, palm, and forearm. The glucose measurement is achieved by using the amperometric detection method.

The test strip has a reagent system including glucose oxidase and a mediator that reacts with glucose in the whole blood sample to produce an electrical current. This current is measured by the meter, and after calculation by the meter, the blood glucose concentration reading is displayed on the meter display, calibrated to a plasma reference.

Intended Use:

The On Call® Chosen Blood Glucose Monitoring System is an electrochemical enzymatic assay for the quantitative detection of glucose in fresh capillary whole blood from the fingertip by people with diabetes at home as an aid in monitoring the effectiveness of diabetes control programs. Alternate (forearm and palm) testing sites should be used only when blood glucose level is not changing rapidly. The On Call® Chosen Blood Glucose Monitoring System is intended to be used by a single patient and should not be shared. It is for in vitro diagnostic use only.

The On Call Chosen Blood Glucose Monitoring System should not be used for the diagnosis of or screening for diabetes mellitus, or use on neonates.

The On Call Chosen Blood Glucose Test Strips are used with the On Call Chosen Blood Glucose Meter in the quantitative measurement of glucose in capillary blood from the fingertip, forearm and palm.

The On Call Chosen Blood Glucose Control Solution is for use with the On Call Chosen Blood Glucose Meter and Strips as a quality control check to verify that the meter and test strips are working together properly and that the test is performing correctly.

2

Technological Characteristics:

:

Specification of Blood Glucose Meter:

FeatureSpecification
Measurement Range20 to 600 mg/dL (1.1-33.3 mmol/L)
Result CalibrationPlasma-equivalent
SampleFresh capillary whole blood
Minimum Sample Size0.8 uL
Test Time5 seconds
Power SourceTwo (2) CR 2032 3.0V coin cell batteries
Battery LifeMinimum of 3,000 measurements (without considering data
transfer and test reminder alarms)
Glucose Units of
MeasureThe meter is pre-set at time of manufacturing to either
millimoles per liter (mmol/L) or milligrams per deciliter
(mg/dL) depending on the standard of your country. The meter
will be set to mg/dL by default when sold in the United States.
MemoryUp to 300 records with time and date
Meter Size3.58" x 2.28" x 0.83"
Display Size1.58" x 1.42"
WeightApproximately 60 g (without battery installed)
Operating
Temperature5-45°C (41-113°F)
Operating
RelativeHumidity10-90% (non-condensing)
Hematocrit Range20-70%
Data Port9600 baud, 8 data bits, 1 stop bit, no parity

3

Comparison to Predicate Devices:

."

The On Call" Chosen Blood Glucose Monitoring System is substantially equivalent to One Touch Ultra Blood Glucose Monitoring System, K002134.

| Features | On Call® Chosen Blood Glucose
Monitoring System | One Touch Ultra Blood
Glucose Monitoring System
(K002134) |
|------------------------------------------|--------------------------------------------------------------------------------------------------|-----------------------------------------------------------------|
| Similarities | | |
| Assay Method | Glucose oxidase biosensor | Same |
| Strip Chemical
Composition | | Same |
| Result Calibration | Plasma-equivalent | Same |
| Test Time | 5 seconds | Same |
| Sample Type | Fresh capillary whole blood | Same |
| Glucose Units of
Measure | mg/dL | Same |
| Operating Relative
Humidity | 10-90% | Same |
| Data Port | One Serial data port | Same |
| Automatic Shutoff | Two minutes after last user action | Same |
| Measurement Range | 20 to 600 mg/dL (1.1-33.3 mmol/L) | Same |
| Differences | | |
| Minimum Sample
Size | 0.8 µL | 1.0 µL |
| Hematocrit Range | 20-70% | 30-55% |
| Operating
Temperature | 5-45°C (41-113°F) | 6-44°C (43-111°F) |
| Alternative Sample
Site for Capillary | Palm and forearm in addition to
fingertip | Fingertip and forearm |
| Meter Memory | Up to 300 records with time and date | 150 blood glucose and control
solution tests |
| Battery Life | Minimum of 3,000 measurements
(without considering data transfer and
test reminder alarms) | 1,000 tests |
| Power Source | Two (2) CR 2032 3.0V coin cell
batteries | One (1) CR 2032 3.0V coin cell
battery |
| Meter Size | 3.58" x 2.28" x 0.83" | 3.12" x 2.25" x 0.85" |
| Meter Weight | Approx. 60 g (without battery
installed) | 1.5 ounces with battery
(Approximately 42 g) |

4

The On Call " Chosen Blood Glucose Monitoring System Control Solution is substantially equivalent to One Touch Ultra Blood Glucose Monitoring System Control Solution, K002134.

| Features | On Call® Chosen Blood Glucose
Monitoring System
Control Solution | One Touch Ultra Blood Glucose
Monitoring System Control
Solution (K002134) |
|--------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Intended Use | On Call® Chosen Control Solution
contains a known concentration of
glucose and it is used to confirm the
test strips and the blood glucose meter
are working together properly and
that you are performing the test
correctly. | To check that the meter and test
strips are working together as a
system and that you are
performing the test correctly. It is
very important that you do control
solution tests routinely to make
sure you are getting accurate
results. |
| Format | Liquid solution
On Call® Chosen Control solution 1
has less than 0.2% glucose (active
ingredient). Control Solution 2 has
less than 0.4% glucose (active
ingredient). Both solutions have
preservatives in water based mixture. | Liquid solution
OneTouch® Ultra™ Control
Solution is a red solution that
contains about 0.11% D-glucose.
It also contains: Sodium benzoate
0.2%; Disodium EDTA 0.1%;
FD&C red Dye 0.2%;
Viscosity-adjusting agent 8.0% |
| Stability | 6 Months after first opening | 3 Months after first opening |

5

Discussion of Non-Clinical Tests Performed for Determination of Substantial Equivalence are as follows:

Guidance documents included the "FDA Guidance for Industry In Vitro Diagnostic Glucose Test System" and "FDA Guidance for Total Product Life Cycle for Portable Invasive Blood Glucose Monitoring Systems" as well as "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices."

Compliance to applicable voluntary standards includes EN ISO 15197:2003 "In vitro diagnostic test systems - Requirements for in vitro whole blood glucose monitoring systems intended for use by patients for self testing in management of diabetes mellitus."

Laboratory Testing:

The performance characteristics of the On Call Chosen Blood Glucose Monitoring System were evaluated by performing the following studies: repeatability precision, intermediate precision, linearity, interfering agents, hematocrit effect, temperature effect evaluation - blood & control solution, low battery effect, altitude effect, sample volume, humidity effect, simulated shipping study - test strip & control solution, control value assignment, meter testing, software validation testing, electromagnetic compatibility and electrical safety testing as part of meter and strip validation testing.

Discussion of Clinical Tests Performed:

Clinical studies were conducted with lay persons and trained laboratory technicians using the On Call Chosen Blood Glucose Monitoring System. The study data were presented evaluating the system accuracy of the On Call Chosen Blood Glucose Monitoring System compared to the YSI Model 2300 STAT PLUS (K913806) per the ACON Clinical Study Protocol for the Blood Glucose Monitoring System. Study results indicate that nonprofessional, inexperienced lay persons were able to obtain comparable blood glucose readings when using the On Call Chosen Blood Glucose Monitoring System as compared to the results obtained by the trained technicians. In addition, the participating lay persons were questioned and responded as satisfied with the ease of operation by following the Instructions for Use in the User's Manual and the overall performance of the On Call Chosen Blood Glucose Monitoring System.

Conclusion:

The laboratory testing and clinical study results demonstrate that the On Call Chosen Blood Glucose Monitoring System is safe, effective and easy-to-use. It also demonstrates that the On Call Chosen Blood Glucose Monitoring System meets the accuracy requirements per EN ISO 15197 and as such is substantially equivalent to the One Touch Ultra Blood Glucose Monitoring System, currently sold on the U.S. market (K002134).

6

Image /page/6/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the circumference. Inside the circle is a stylized image of an eagle or bird with outstretched wings, which is a common symbol associated with the department.

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

Acon Laboratories Inc. c/o Mr. Qiyi Xie Sr. Staff Regulatory/Clinical Affairs 10125 Mesa Rim Rd., San Diego, CA 92121

OCT - 6 2011

રિણ: K111371

Trade Name: On-Call Chosen Blood Glucose Monitoring System Regulation Number: 21 CFR §862.1345 Regulation Name: Glucose Test System Regulatory Class: Class II Product Codes: CGA, NBW, JJX Dated: September 21, 2011 Received: September 22, 2011

Dear Mr. Xie:

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 approvat 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 ther 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) (2) CFR 803); and good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820).

7

Page 2 -

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of In Virro 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 reportine 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 ) 796-5680 or at its Internet address http://www.fda.gov/MedicalDevicesforYou/Industry/default.htm.

Sincerely yours,

z

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

Enclosure

8

Indications for Use Form

510(k) Number (if known):

Device Name: On Call Chosen Blood Glucose Monitoring System

Indications for Use:

The On Call® Chosen Blood Glucose Monitoring System is an electrochemical enzymatic assay for the quantitative detection of glucose in fresh capillary whole blood from the fingertip by people with diabetes at home as an aid in monitoring the effectiveness of diabetes control programs. Alternate (forearm and palm) testing sites should be used only when blood glucose level is not changing rapidly. The On Call® Chosen Blood Glucose Monitoring System is intended to be used by a single patient and should not be shared. It is for in vitro diagnostic use only.

The On Call Chosen Blood Glucose Monitoring System should not be used for the diagnosis of or screening for diabetes mellitus, or use on neonates.

The On Call Chosen Blood Glucose Test Strips are used with the On Call Chosen Blood Glucose Meter in the quantitative measurement of glucose in capillary blood from the fingertip, forearm and palm.

The On Call Chosen Blood Glucose Control Solution is for use with the On Call Chosen Blood Glucose Meter and Strips as a quality control check to verify that the meter and test strips are working together properly and that the test is performing correctly.

Prescription Use (Part 21 CFR 801 Subpart D)

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

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

AND/OR

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

CARS

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

510(k)k11137
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