K Number
K112029
Device Name
ELITECH CLINICAL SYSTEMS ELICAL 2, ELITECH CLINICAL SYSTEMS ELITROL I, ELITECH CLINICAL SYSTEMS ELITROL II MODEL CALI-05
Manufacturer
Date Cleared
2011-08-30

(46 days)

Product Code
Regulation Number
862.1150
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
ELITech Clinical Systems ELICAL 2 is a multi-parametric calibrator for in vitro diagnostic use in the calibration of quantitative ELITech Clinical Systems methods on ELITech Clinical Systems Selectra Analyzers. ELITech Clinical Systems ELITROL I and ELITROL II are multi-parametric control sera for in vitro diagnostic use in quality control of quantitative ELITech Clinical Systems methods on ELITech Clinical Systems Selectra Analyzers.
Device Description
ELITech Clinical Systems ELICAL 2 is a lyophilized calibrator based on human serum containing constituents to ensure optimal calibration. ELICAL 2 is prepared exclusively from the blood of donors tested individually and found to be negative for HbsAg and to antibodies to HCV and HIV according to FDA-approved methods or methods in compliance with the European Directive 98/79/EC, Annex II, List A. ELITech Clinical Systems ELITROL I and ELITROL II are two level quality control products consisting of lyophilized human serum containing constituents at desired levels. Elitrol I and Elitrol II are prepared exclusively from the blood of donors tested individually and found to be negative for HbsAg and to antibodies to HCV and HIV according to FDA-approved methods or methods in compliance with the European Directive 98/79/EC, Annex II, List A.
More Information

Roche Diagnostics Calibrator for Automated Systems (C.f.a.s) (K033501), Roche Diagnostics Precinorm U (K041227)

No
The summary describes calibrators and control sera for in vitro diagnostic use, which are chemical reagents, not software or systems that would typically incorporate AI/ML. There is no mention of AI, ML, or related terms in the document.

No
The device is described as a calibrator and control serum for in vitro diagnostic use, specifically for quality control and calibration of analytical instruments, not for treating a condition or disease.

No

The devices described are calibrators and control sera, used for the calibration and quality control of other diagnostic methods, not for directly diagnosing medical conditions themselves.

No

The device description clearly states that the devices are lyophilized calibrators and control sera based on human serum, indicating they are physical substances, not software.

Yes, based on the provided text, the ELITech Clinical Systems ELICAL 2, ELITROL I, and ELITROL II devices are IVDs (In Vitro Diagnostics).

Here's why:

  • Intended Use / Indications for Use: The text explicitly states that these devices are for "in vitro diagnostic use".
  • Device Description: The description details that these are calibrators and control sera based on human serum, which are typical components used in in vitro diagnostic testing.
  • Regulatory Compliance: The mention of testing donors according to FDA-approved methods or methods in compliance with the European Directive 98/79/EC, Annex II, List A further indicates their intended use within a regulated diagnostic context.

Therefore, the intended use and description clearly align with the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

ELITech Clinical Systems ELICAL 2 is a multi-parametric calibrator for in vitro diagnostic use in the calibration of quantitative ELITech Clinical Systems methods on ELITech Clinical Systems Selectra Analyzers.

ELITech Clinical Systems ELITROL I and ELITROL II are multi-parametric control sera for in vitro diagnostic use in quality control of quantitative ELITech Clinical Systems methods on ELITech Clinical Systems Selectra Analyzers.

Product codes

JIX, JJY

Device Description

ELITech Clinical Systems ELICAL 2 is a lyophilized calibrator based on human serum containing constituents to ensure optimal calibration. ELICAL 2 is prepared exclusively from the blood of donors tested individually and found to be negative for HbsAg and to antibodies to HCV and HIV ac-cording to FDA-approved methods or methods in compliance with the Euro-pean Directive 98/79/EC, Annex II, List A.

ELITech Clinical Systems ELITROL I and ELITROL II are two level quality control products consisting of lyophilized human serum containing constitu-ents at desired levels. Elitrol I and Elitrol II are prepared exclusively from the blood of donors tested individually and found to be negative for HbsAg and to antibodies to HCV and HIV according to FDA-approved methods or methods in compliance with the European Directive 98/79/EC, Annex II, List A.

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

Not Found

Intended User / Care Setting

Not Found

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)

Roche Diagnostics Calibrator for Automated Systems (C.f.a.s) (K033501), Roche Diagnostics Precinorm U (K041227)

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1150 Calibrator.

(a)
Identification. A calibrator is a device intended for medical purposes for use in a test system to establish points of reference that are used in the determination of values in the measurement of substances in human specimens. (See also § 862.2 in this part.)(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

SECTION 8 - 510(k) Summary

AUG 3 0 2011

| Introduction | According to the requirements of 21 CFR 807.92, the following information
provides sufficient detail to understand the basis for a determination of sub-
stantial equivalence. |
|-------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| | The assigned 510(k) number is: K112029 |
| Submitter | SEPPIM S.A.S. |
| Address | Zone Industrielle, 61500 SEES, FRANCE |
| Phone number | + 33 (0)2 33 81 21 00 |
| Fax number | + 33 (0)2 33 28 77 51 |
| Contact | Valérie GOURDON (Email: v.gourdon@elitechgroup.com) |
| Date of Preparation | July 14, 2011 |
| Device names | |
| CALIBRATOR | |
| Trade/proprietary Name: | ELITech Clinical Systems ELICAL 2 |
| Common or Usual Name: | Calibrator, multi-analyte mixture, "ELICAL 2" |
| Device Class | Class II |
| Classification name | Calibrator (21 CFR 862.1150) |
| Product code | JIX- Calibrator, multi-analyte mixture |
| Predicate device | Roche Diagnostics Calibrator for Automated Systems (C.f.a.s) (K033501) |
| Device description | ELITech Clinical Systems ELICAL 2 is a lyophilized calibrator based on
human serum containing constituents to ensure optimal calibration.
ELICAL 2 is prepared exclusively from the blood of donors tested individually
and found to be negative for HbsAg and to antibodies to HCV and HIV ac-
cording to FDA-approved methods or methods in compliance with the Euro-
pean Directive 98/79/EC, Annex II, List A. |
| Intended Use | ELITech Clinical Systems ELICAL 2 is a multi-parametric calibrator for in vitro
diagnostic use in the calibration of quantitative ELITech Clinical Systems
methods on ELITech Clinical Systems Selectra Analyzers |

Comparison to Predicate device

| | ELITech Clinical Systems Device
(ELICAL 2) | Predicate device
(Roche Calibrator f.a.s. K033501) |
|--------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Intended use | ELITech Clinical Systems ELICAL 2 is a multi-parametric calibrator
for in vitro diagnostic use in the
calibration of quantitative ELITech
Clinical Systems methods on
ELITech Clinical Systems Selec-
tra Analyzers. | For in vitro diagnostic use in the
calibration of quantitative Roche
methods on Roche clinical chemis-
try analysers as specified in the
value sheets. |
| Format | Lyophilized calibrator based on
human serum with constituents
added as required to obtain desired
components levels | Lyophilized calibrator based on
human serum with constituents
added as required to obtain desired
components levels |
| | ELITech Clinical Systems Device
(ELICAL 2) | Predicate device
(Roche Calibrator f.a.s. K033501) |
| Level | Single level | Single level |
| Handling | Carefully open the vial, avoiding the
loss of lyophilizate, and pipette in
exactly 3 mL of distilled/deionized
water. Carefully close the vial and
dissolve the contents completely by
occasional gentle swirling within 30
minutes avoiding the formation of
foam. | Carefully open one bottle, avoiding
the loss of lyophilizate, and pipette
in exactly 3 mL of distilled/deionized
water. Carefully close the bottle and
dissolve the contents completely by
occasional gentle swirling within 30
minutes. Avoid the formation of
foam. |
| Traceability | Traceability information is given in
the value sheet included in the box. | Traceability of the target value is
given in the respective instruction
for use of the system reagents. |
| Stability | Lyophilized:
To store at 2-8°C and protected
from light until the expiry date | Lyophilized:
Stable at 2-8°C up to expiration
date. |
| | After reconstitution, the stabilities
are : | After reconstitution, the stabilities*
are : |
| | Between 15-25 °C:
8 hours | - 8 hours at 15-25 °C. |
| | Between 2-8 °C:
2 days
Between (-25)-(-15) °C: 4 weeks
(when frozen once) | - 2 days at 2-8 °C.

  • 4 weeks at Between (-25)-(-15) °C
    (when frozen once) |
    | | Exceptions :
  • Stability of direct bilirubin (when
    stored protected from light): | Exception for bilirubin total & direct
  • Stability of direct bilirubin (when
    stored protected from light): |
    | | Between 15-25 °C:
    3 hours | Between 15-25 °C:
    3 hours |
    | | Between 2-8 °C:
    8 hours
    Between (-25)-(-15) °C: 2 weeks
    (when frozen once)
  • Stability of total bilirubin (when
    stored protected from light): | Between 2-8 °C
    8 hours
    Between (-25)-(-15) °C: 2 weeks
    (when frozen once)
  • Stability of total bilirubin (when
    stored protected from light): |
    | | Between 15-25 °C:
    6 hours | Between 15-25 °C:
    6 hours |
    | | Between 2-8 °C:
    1 day
    Between (-25)-(-15) °C: 2 weeks
    (when frozen once) | Between 2-8 °C:
    1 day
    Between (-25)-(-15) °C: 2 weeks
    (when frozen once) |

·

1

2

Device name
CONTROLS
Trade/proprietary Name:
Common or Usual Name:
Device Class
Classification name
Product codeELITech Clinical Systems ELITROL I and ELITROL II
Multi-analyte controls - all kinds, "ELITROL I"- "ELITROL II"
Class I
Quality control material (assayed and unassayed). (21 CFR 862.1660)
JJY- Multi-analyte controls - all kinds
Predicate deviceRoche Diagnostics Precinorm U (K041227)
Roche Diagnostics Precipath U (K041227)
Device descriptionELITech Clinical Systems ELITROL I and ELITROL II are two level quality
control products consisting of lyophilized human serum containing constitu-
ents at desired levels.

Elitrol I and Elitrol II are prepared exclusively from the blood of donors tested
individually and found to be negative for HbsAg and to antibodies to HCV and
HIV according to FDA-approved methods or methods in compliance with the
European Directive 98/79/EC, Annex II, List A. |
| Intended Use | ELITech Clinical Systems ELITROL I and ELITROL II are multi-parametric
control sera for in vitro diagnostic use in quality control of quantitative ELITech
Clinical Systems methods on ELITech Clinical Systems Selectra Analyzers. |

Comparison to Predicate device

| | ELITech Clinical Systems Device
(ELITROL I / ELITROL II) | Predicate Device
(Roche Precinorm U / Precipath U
K041227) |
|--------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Intended use | ELITech Clinical Systems ELITROL
I and ELITROL II are multi-
parametric control sera for in vitro
diagnostic use in accuracy control
of quantitative ELITech Clinical
Systems methods on ELITech Clin-
ical Systems Selectra Analyzers. | For in vitro diagnostic use in quality
control by monitoring accuracy and
precision for the quantitative meth-
ods as specified in the value sheet |
| Format | Lyophilized human sera with con-
stituents added as required to ob-
tain desired components levels | Lyophilized human sera with con-
stituents added as required to ob-
tain desired components levels |
| Levels | Two levels | Two levels |
| Handling | Carefully open the vial, avoiding the
loss of lyophilizate, and pipette in
exactly 5 mL of distilled/deionized
water. Carefully close the vial and
dissolve the contents completely by
occasional gentle swirling within 30
minutes avoiding the formation of
foam. | Carefully open the bottle, avoiding
the loss of lyophilizate, and pipette
in exactly 5 mL of distilled/deionized
water. Carefully close the bottle and
dissolve the contents completely by
occasional gentle swirling within 30
minutes. Avoid the formation of
foam. |

3

| | ELITech Clinical Systems Device
(ELITROL I / ELITROL II) | Predicate Device
(Roche Precinorm U / Precipath U
K041227) |
|-----------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Stability | Lyophilized:
To store at 2-8°C and protected
from light until the expiry date | Lyophilized:
Stable at 2-8°C up to expiration
date. |
| | After reconstitution, the stabilities
are :
Between 15-25 °C :
12 hours
Between 2-8 °C :
5 days
Between (-25)-(-15) °C : 4 weeks
(when frozen once) | After reconstitution, the stabilities*
are :

  • 12 hours at 15-25 °C.
  • 5 days at 2-8 °C.
  • 4 weeks at (-25)-(-15) °C (when
    frozen once) |
    | | Exceptions:
  • Stability of direct bilirubin (when
    stored protected from light):
    Between 15-25 °C:
    4 hours
    Between 2-8 °C:
    8 hours
    Between (-25)-(-15) °C: 2 weeks
    (when frozen once) | *Exception for bilirubin total & direct
    as noted in package insert:
  • Stability of direct bilirubin (when
    stored protected from light):
    Between 15-25 °C:
    4 hours
    Between 2-8 °C:
    8 hours
    Between (-25)-(-15) °C: 2 weeks
    (when frozen once) |
    | | - Stability of total bilirubin (when
    stored protected from light):
    Between 15-25 °C:
    8 hours
    Between 2-8 °C:
    1 day
    Between (-25)-(-15) °C: 2 weeks
    (when frozen once) | - Stability of total bilirubin (when
    stored protected from light):
    Between 15-25 °C:
    8 hours
    Between 2-8 °C:
    24 hours
    Between (-25)-(-15) °C: 2 weeks
    (when frozen once) |

Conclusion

The performance data and other information demonstrate that the safety and effectiveness of these devices versus the predicate devices are not compromised, and that they met all acceptance criteria, demonstrating that the device is substantially equivalent to its respective predicate device.

4

Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular arrangement of text that reads "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA". Inside the circle is a stylized image of an eagle.

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

ELITechGroup SEPPIM S.A.S. Epoch Biosciences c/o Ms. Debra K. Hutson 21720 23 rd Dr SE Suite 150 Bothell, Washington 98021

AUG 300 2011

Re: K112029

Trade Name: ELITech Clinical Systems ELICAL 2 ELITech Clinical Systems ELITROL I /II Regulation Number: 21 CFR §862.1150 Regulation Name: Calibrator Regulatory Class: Class II Product Codes: JIX, JJY Dated: July 14, 2011 Received: July 15, 2011

Dear Ms. Hutson:

We have reviewed your Section 510(k) premarket notification of intent to market the indication We have reviewed your Section 310(x) prematic is substantially equivalent (for the indications
referenced above and have determined the device is desires marketed in intersta for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for use stated in the encrossile) to regally manage province and one of the Enderal Food. Drug commerce prior to May 20, 1970, the chacinent with the provisions of the Federal Food, Drug, devices that have been reclassified in accordance with as personal application (PMA).
and Cosmetic Act (Act) that do not require approval of a provisions of the Act. The and Cosment Act (Act) that do not require subject to the general controls provisions of the Act. The You may, therefore, market the device, subject to the gentration, listing of the arguint misting and general controls provisions of the received requirementibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), if your device is classified (see adove) into online sits). The subjecting your device
it may be subject to such additional controls. Existing marts 800 to 805. In additio it may be subject to such additional controllar controllers (CFR), Parts 800 to 895. In addition, FDA
can be found in Title 21, Code of Federal Regulations (CFR), Parts 800 can be found in Thic 21, Code of I occrain concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean Please be advised that FDA s Issuality of a subscribe with other requirements of the Act
that FDA has made a determination that your device of the requirements of the Act that FDA nas made a decirimation in and regulations administered by other Federal agencies. You must or any Federal statutes and regulations dominations on registration and listing (21
comply with all the Act's requirements, including, assocting (reporting (reporting of comply with all the Act 3 requirements 801 and 809); medical device reporting of
CFR Part 807); labeling (21 CFR Parts (11 and 800); and monufacturing practice CFR Part 807); labeling (21 CFR 803); and good manufacturing practice medical device-iclated adverse ovelity systems (QS) regulation (21 CFR Part 820).

5

Page 2 -

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,

G.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

6

Indications for Use Form

510(k) Number (if known): K112029

ELITech Clinical Systems ELICAL 2 Device Name: _

Indications for Use:

ELITech Clinical Systems ELICAL 2 is a multi-parametric calibrator for in vitro diagnostic use in the calibration of quantitative ELITech Clinical Systems methods on ELITech Clinical Systems Selectra analyzers.

Prescription Use X (Part 21 CFR 801 Subpart D) Over-The-Counter Use (21 CFR 801 Subpart C)

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

AND/OR

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

Signature

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

510(k) K112029

Page 1 of

7

Indications for Use Form

510(k) Number (if known): K 11 JD2

ELITech Clinical Systems ELITROL I & ELITROL II Device Name:

Indications for Use:

ELITech Clinical Systems ELITROL I & ELITROL II are multi-parametric control sera for in vitro diagnostic use in quality control of quantitative ELITech Clinical Systems methods on ELITech Clinical Systems Selectra analyzers.

Prescription Use X (Part 21 CFR 801 Subpart D) Over-The-Counter Use (21 CFR 801 Subpart C)

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

AND/OR

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

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

510(k) k