K Number
K120504
Device Name
LIQUICHEK URINE TOXICOLOGY CONTROL, S10 & S10 MINIPAK, LIQUICHEK URINE TOXICOLOGY CONTROL, LEVEL S20 & LEVEL S20 MINIPAK
Date Cleared
2012-03-27

(35 days)

Product Code
Regulation Number
862.3280
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Liquichek Urine Toxicology Control is intended for use as a quality control urine to monitor the precision of laboratory urine toxicology screening procedures.
Device Description
Liguichek Urine Toxicology Controls are prepared from human urine with added drugs of abuse and metabolites of drugs of abuse, preservatives, stabilizers and constituents of animal origin. The control is provided in liquid form for convenience.
More Information

Not Found

No
The document describes a quality control material for laboratory testing and does not mention any computational or analytical capabilities that would involve AI or ML.

No
This device is a quality control material intended to monitor the precision of laboratory urine toxicology screening procedures, not to treat or diagnose patients.

No.
This device is described as a "quality control urine to monitor the precision of laboratory urine toxicology screening procedures," indicating it is used to assess the performance of diagnostic tests, not to diagnose a condition itself.

No

The device description clearly states the control is prepared from human urine with added substances and is provided in liquid form, indicating it is a physical substance, not software.

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

Here's why:

  • Intended Use: The intended use explicitly states it is for "monitoring the precision of laboratory urine toxicology screening procedures." This indicates it is used in vitro (outside the body) to evaluate the performance of a diagnostic test.
  • Device Description: The description confirms it is a "quality control urine" prepared from human urine with added substances. This is a typical characteristic of an IVD control material.
  • Care Setting: The intended user is described as performing "laboratory urine toxicology screening procedures," which are diagnostic tests performed in a laboratory setting.

The information provided clearly aligns with the definition and characteristics of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

Liquichek Urine Toxicology Control is intended for use as a quality control urine to monitor the precision of laboratory urine toxicology screening procedures.

Product codes

DIF

Device Description

Liguichek Urine Toxicology Controls are prepared from human urine with added drugs of abuse and metabolites of drugs of abuse, preservatives, stabilizers and constituents of animal origin. The control is provided in liquid form for convenience.

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

Stability studies have been performed for Liquichek Urine Toxicology control to determine Stabliky otation have belf life claims. Product claims. Product claims are as follows:
7.1 Open Vial: 30 days at 2 to 8°C.
7.2 Closed Vial (Thawed): 45 days at 2 to 8°C.
7.3 Shelf Life Stability 2 Years at -20°C to -70°C

Key Metrics

Not Found

Predicate Device(s)

K033924

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.3280 Clinical toxicology control material.

(a)
Identification. A clinical toxicology control material is a device intended to provide an estimation of the precision of a device test system and to detect and monitor systematic deviations from accuracy resulting from reagent or instrument defects. This generic type of device includes various single, and multi-analyte control materials.(b)
Classification. Class I (general 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

Summary of Safety and Effectiveness Liquichek Urine Toxicology Control

MAR 2 7 2012

1.0 Submitter

Bio-Rad Laboratories 9500 Jeronimo Road, Irvine, California 92618-2017 Telephone: (949) 598-1200 (949) 598-1557 Fax:

Contact Person

Suzanne Parsons Regulatory Affairs Manager Telephone: (949) 598-1467

Date of Summary Preparation

February 16th, 2012

·2.0 Device Identification

Product Trade Name:

Liquichek Urine Toxicology Control

Liquichek Urine Toxicology Control Level S10

  • Liquichek Urine Toxicology Control Level S20
  • Liquichek Urine Toxicology Control Level S10 Low Opiate
  • Liquichek Urine Toxicology Control Level S2O Low Opiate
Common Name:Drug Mixture Control Materials
Classifications:Class I
Product Code:DIF
Regulation Number:21 CFR 862.3280

3.0 Device to Which Substantial Equivalence is Claimed

Liquichek Urine Toxicology Control (Screen Series) Bio-Rad Laboratories Irvine, California

510 (k) Number: K033924

4.0 Description of Device

Liguichek Urine Toxicology Controls are prepared from human urine with added drugs of abuse and metabolites of drugs of abuse, preservatives, stabilizers and constituents of animal origin. The control is provided in liquid form for convenience.

5.0 Intended Use

Liguichek Urine Toxicology Control is intended for use as a quality control urine to monitor the precision of laboratory urine toxicology screening procedures.

1

Comparison of the new device with the Predicate Device 6.0

Liquichek Urine Toxicology Control claims substantial equivalence to the Liquichek Urine Toxicology Control (Screen Series) currently in commercial distribution (K033924). Table 1 (below) contains comparison information of similarities and differences between the new and predicate device to which substantial equivalence is claimed.

| Characteristics | Liquichek Urine Toxicology Control
(New Device) | Liquichek Urine Toxicology Control
(Screen Series)
(Predicate Device, K033924) |
|---------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| | Similarities | |
| Intended Use | Liquichek Urine Toxicology Control is
intended for use as a quality control urine
to monitor the precision of
laboratory urine toxicology screening
procedures. | Liquichek Urine Toxicology Control is
intended for use as a quality control urine
to monitor the performance of laboratory
urine toxicology screening procedures. |
| Matrix | Human Urine | Human Urine |
| Form | Liquid | Liquid |
| Open Vial Stability | 30 days at 2°C to 8 °C | 30 days at 2°C to 8 °C |

Table 1. Similarities and Differences between new and predicate device.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Differences
Storage unopened (Shelf Life)-20 to -70°C until expiration date2 to 8°C until expiration date
Closed Vial (Thawed) Stability45 days at 2°C to 8 °CNo Claim
LevelsLevel S1O, S2O, S1O Low Opiate, S2O
Low OpiateLevels S1, S2, S3, S1 Low Opiate and
S2 Low Opiate
AnalytesContains:
11-Nor-Δ-9-THC-9-COOH
Benzoylecgonine
Ethanol
Lysergic Acid Diethylamide (LSD)
Methadone
Methaqualone
Morphine (Free)
Oxazepam
Phencyclidine (PCP)
Propoxyphene
Secobarbital
d-Methamphetamine
Does not contain:
Nordiazepam
Nortriptyline
d-AmphetamineContains:
11-Nor-Δ-9-THC-9-COOH
Benzoylecgonine
Ethanol
Lysergic Acid Diethylamide (LSD)
Methadone
Methaqualone
Morphine (Free)
Nordiazepam
Nortriptyline
Phencyclidine (PCP)
Propoxyphene
Secobarbital
d-Amphetamine
Does not contain:
d-Methamphetamine
Oxazepam

.

2

7.0 Statement of Supporting Data

Stability studies have been performed for Liquichek Urine Toxicology control to determine Stabliky otation have belf life claims. Product claims. Product claims are as follows:

7.1 Open Vial:30 days at 2 to 8°C.
7.2 Closed Vial (Thawed):45 days at 2 to 8°C.
7.3 Shelf Life Stability2 Years at -20°C to -70°C

3

Food and Drug Administration

10903 New Hampshire Avenue Silver Spring, MD 20993

Bio-Rad Laboratories, QSD Ms. Elizabeth Platt Regulatory Affairs Manager/Quality Assurance 9500 Jeronimo Road Irvine, CA 92618-2017

MAR 2 7 2012

K120504 Re:

Trade/Device Name: Liquichek Urine Toxicology Control Regulation Number: 21 CFR 862.3280 Regulation Name: Clinical toxicology control material Regulatory Class: Class I (Reserved) Product Code: DIF Dated: February 17, 2012 Received: February 21, 2012

Dear Ms. Platt:

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); and good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820).

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

Image /page/3/Picture/13 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized depiction of a human figure, with three abstract shapes representing the head, body, and legs. The figure is positioned to the right of the department's name, which is written in a circular pattern around the logo. The text reads "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA".

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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

Courney 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

5

Indications for Use Form

510(k) Number (if known):

Device Name:

Liquichek Urine Toxicology Control

  • · Liquichek Urine Toxicology Control Level S10
  • Liquichek Urine Toxicology Control Level S2O
  • Liquichek Urine Toxicology Control Level S10 Low Opiate .
  • Liquichek Urine Toxicology Contro! Level S2O Low Opiate .

Indications for Use:

Liquichek Urine Toxicology Control is intended for use as a quality control urine to monitor the precision of laboratory urine toxicology screening procedures.

Prescription Use × (Part 21 CFR 801 Subpart D) AND/OR

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

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

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

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Division Sign-Off Office of In Vitro Diagnostic Device Evaluation and Safety 510(K) K120504

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