K Number
K112356
Device Name
GLUCOSE METER-CHECK CONTROL SOLUTION FOR AGAMATRIX WAVESENSE
Manufacturer
Date Cleared
2011-09-19

(34 days)

Product Code
Regulation Number
862.1660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Glucose Meter-Check Control Solution for AgaMatrix is intended for use to verify the performance and correct operation of the AgaMatrix blood glucose monitoring test systems utilizing the WaveSense family of blood glucose test strips. Glucose Meter-Check Control Solution for AgaMatrix is intended for use by healthcare professionals and people with diabetes mellitus at home.
Device Description
Glucose Meter-Check Control Solution for AgaMatrix is a buffered aqueous solution with glucose containing no ingredients of biological origin, or in concentrations qualifying as a controlled product under the Controlled Products Regulation. The Glucose Meter-Check Control Solution is formulated for optimal performance on AgaMatrix glucose meters utilizing the WaveSense family of test strips.
More Information

No
The document describes a control solution for a glucose meter, which is a chemical solution used for calibration and verification. There is no mention of any software, algorithms, or data processing that would suggest the use of AI or ML. The performance studies focus on the stability and response of the chemical solution.

No.
The device is a control solution for verifying the performance of a glucose meter, not for directly treating a medical condition.

No
Explanation: This device is a control solution used to verify the performance of blood glucose monitoring systems, not to diagnose a medical condition in a patient.

No

The device description clearly states it is a "buffered aqueous solution with glucose," indicating it is a physical liquid, not software.

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

Here's why:

  • Intended Use: The intended use explicitly states it's for "verifying the performance and correct operation of the AgaMatrix blood glucose monitoring test systems utilizing the WaveSense family of blood glucose test strips." This is a classic example of an in vitro diagnostic use, as it's used to check the functionality of a device that measures a substance (glucose) in a biological sample (blood).
  • Device Description: The description states it's a "buffered aqueous solution with glucose." This is a reagent used in the diagnostic process.
  • Predicate Device: The predicate device listed is "WaveSense Control Solution," which is also an IVD used for similar purposes.

Control solutions like this are essential components of in vitro diagnostic systems, used to ensure the accuracy and reliability of the test results.

N/A

Intended Use / Indications for Use

The Glucose Meter-Check Control Solution for AgaMatrix is intended for use to verify the performance and correct operation of the AgaMatrix blood glucose monitoring test systems utilizing the WaveSense family of blood glucose test strips. Glucose Meter-Check Control Solution for AgaMatrix is intended for use by healthcare professionals and people with diabetes mellitus at home.

Product codes

JJX

Device Description

Glucose Meter-Check Control Solution for AgaMatrix is a buffered aqueous solution with glucose containing no ingredients of biological origin, or in concentrations qualifying as a controlled product under the Controlled Products Regulation. The Glucose Meter-Check Control Solution is formulated for optimal performance on AgaMatrix glucose meters utilizing the WaveSense family of test strips.

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

healthcare professionals and people with diabetes mellitus 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)

Tests were conducted to verify specific performance requirements:

  • a) Closed bottle stability (Shelf-life)
  • b) Stability after opening (Use-life)
  • c) Transport Stability
  • d) Test response

Comparison of technological characteristics, formulation and intended use to predicate devices listed in this summary support the claim of substantial equivalence.

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

Not Found

Predicate Device(s)

K052762

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1660 Quality control material (assayed and unassayed).

(a)
Identification. A quality control material (assayed and unassayed) for clinical chemistry is a device intended for medical purposes for use in a test system to estimate test precision and to detect systematic analytical deviations that may arise from reagent or analytical instrument variation. A quality control material (assayed and unassayed) may be used for proficiency testing in interlaboratory surveys. This generic type of device includes controls (assayed and unassayed) for blood gases, electrolytes, enzymes, multianalytes (all kinds), single (specified) analytes, or urinalysis controls.(b)
Classification. Class I (general controls). Except when intended for use in donor screening tests, quality control materials (assayed and unassayed) are 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) Summary1

SEP 1 9 2011

  • (a) (1) Submitter's name, address Bionostics, Inc. 7 Jackson Road Devens, MA 01434
    Contact Person Randy Byrd VP, Chief Technical Officer (978) 772-7070 x 272

Date of preparation of this summary: 15 August 2011

  • (2) Device trade or proprietary name: Glucose Meter-Check Control for AgaMatrix

Device common or usual name or classification name:

אר Single (Specified) Analyte Control, All Types, Assayed and Unassayed

| 11 11 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

REGULATION MEDICALREGULATION
SPECIALTYNUMBER
A BREAK SERVICE - In The CONSULT - In Comments of Children Comments of ChildrenCLASSREGULATION DESCRIPTION
Chemistry862.1660Glucose Control

l. Substantial Equivalence

Glucose Meter-Check Control Solution for AgaMatrix substantially equivalent in function, safety and efficacy to currently marketed devices for the same intended use as shown in the following tables:

CharacteristicPredicate DeviceModified Device
Name:WaveSense Control SolutionGlucose Meter-Check Control Solution for AgaMatrix
510(k), Date:K052762, Jan 23 2006
Number of levels:2, typical fasting glucose and high, elevated blood glucose1, typical fasting glucose
Target ranges:111-169 and 298-448 mg/dL105-158 mg/dL
Analytes:glucoseglucose
Container:6 mL LDPE vial with dispensing tip and cap6 mL LDPE vial with dispensing tip and cap
Fill volume:4 mL4 mL
Color:blueblue
Matrix:Buffered, aqueous solution of D-Glucose, viscosity modifier, preservatives and other, non-reactive ingredients.Buffered, aqueous solution of D-Glucose, viscosity modifier, preservatives and other, non-reactive ingredients.
Brands:WaveSenseGlucose Meter-Check

1 This summary of safety and effectiveness is submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

K112356

1

II. Description of the new device

Glucose Meter-Check Control Solution for AgaMatrix is a buffered aqueous solution with glucose containing no ingredients of biological origin, or in concentrations qualifying as a controlled product under the Controlled Products Regulation. The Glucose Meter-Check Control Solution is formulated for optimal performance on AgaMatrix glucose meters utilizing the WaveSense family of test strips.

(a) (1) Intended use of the device

The Glucose Meter-Check Control Solution for AgaMatrix is intended for use to verify the performance and correct operation of the AgaMatrix blood glucose monitoring test systems utilizing the WaveSense family of blood glucose test strips. Glucose Meter-Check Control Solution for AgaMatrix is intended for use by healthcare professionals and people with diabetes mellitus at home.

(a) (2) Technological characteristics of the device.

This material consists of viscosity-adjusted, aqueous glucose control solution prepared with a single concentration of D-glucose with recovery on the test systems in the range typically considered normal, fasting glucose for a non-diabetic person. This solution has been optimized to simulate the response of whole blood on the blood glucose test systems manufactured by AgaMatrix and utilizing the WaveSense family of blood glucose test strips. The solution contains no hazardous, human or animal derived components.

(b) (1) Summary of non-clinical tests submitted with the premarket notification for the device.

Tests were conducted to verify specific performance requirements:

  • a) Closed bottle stability (Shelf-life)
  • b) Stability after opening (Use-life)
  • c) Transport Stability
  • d) Test response
  • (b) (2) Summary of clinical tests submitted with the premarket notification for the device. N/A

(b) (3) Conclusions drawn from the clinical and non-clinical trials.

Comparison of technological characteristics, formulation and intended use to predicate devices listed in this summary support the claim of substantial equivalence.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows a circular logo with a stylized bird in the center. The bird is depicted with three curved lines representing its wings, suggesting a sense of flight or movement. The text is arranged around the circumference of the circle, but it is too small to read. The logo has a simple, minimalist design.

Public Health Service

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

Bionostics, Inc. c/o Mr. Randy Byrd Chief Technical Officer 7 Jackson Road Devens. MA 01434

SEP 1 9 2017

Re: K112356

Trade Name: Glucose Meter-Check Control Solution for AgaMatrix Regulation Number: 21 CFR 862.1660 Regulation Name: Quality control material Regulatory Class: Class I. reserved Product Codes: JJX Dated: August 15. 2011 Received: August 16, 2011

Dear Mr. Byrd,

We have reviewed vour 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 vour 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 Imited to: registration and listing (21 CFR Part 807); labeling (21 CFR Parts 801 and 809): medical device 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).

3

Page 2 -

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), picase contact the Office of In Viro 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 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.

signature

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

4

Indications for Use

510(k) Number: Device Name: Indications for Use:

K112356 Glucose Meter-Check® Control Solution for AgaMatrix The Glucose Meter-Check Control Solution for AgaMatrix is intended for use to verify the performance and correct operation of the AgaMatrix blood glucose monitoring test systems utilizing the WaveSense family of blood glucose test strips. Glucose Meter-Check Control Solution for AgaMatrix is intended for use by healthcare professionals and people with diabetes mellitus at home.

: -

For In Vitro Diagnostic Use

Prescription Use (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 IF NEEDED)

AND/OR

Concurrent of CDRH, Office of Device Evaluation (OIVD)

Signature

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

510(k) K112356

Page 1 of 1