K Number
K120609
Device Name
VITROS CHEMISTRY PRODUCTS DHDL SLIDES
Date Cleared
2012-09-07

(191 days)

Product Code
Regulation Number
862.1475
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For in vitro diagnostic use only. VITROS Chemistry Products dHDL Slides are used to quantitatively measure HDL cholesterol (HDLC) concentration in serum and plasma using VITROS 250/350/950/5, I FS and 4600 Chemistry Systems and the VITROS 5600 Integrated System. High Density Lipoprotein (HDL) cholesterol is used to evaluate the risk of developing coronary heart disease (CHD). The risk of CHD increases with lower HDL cholesterol concentrations.
Device Description
The VITROS dHDL assay is performed using the VITROS Chemistry Products dHDL Slide and the VITROS Chemistry Products Calibrator Kit 25 on the VITROS Chemistry Systems. The VITROS dHDL Slide is a multi-layered analytical element coated on a polyester support. The method is based on a non-HDL precipitation method followed by an enzymatic detection. All reactions necessary for a single quantitative measurement of HDLC take place within the multi-layered analytical element of a VITROS Chemistry Products dHDL Slide. A drop of sample fluid is metered onto the slide and a reaction occurs which ultimately generates a colored dye. The density of dye formed is proportional to the HDL Cholesterol concentration present in the sample and is measured by reflectance spectrophotometry.
More Information

VITROS 250/350/950/5,1 FS,VITROS 4600,VITROS 5600

No
The summary describes a traditional in vitro diagnostic assay based on enzymatic reactions and spectrophotometry, with no mention of AI or ML technologies.

No.
The device is for in vitro diagnostic use only and measures HDL cholesterol concentration for risk evaluation, not for therapy.

Yes

The "Intended Use / Indications for Use" section explicitly states "For in vitro diagnostic use only" and describes its use for quantitatively measuring HDL cholesterol to evaluate the risk of developing coronary heart disease (CHD), which is a diagnostic purpose.

No

The device description clearly describes a physical, multi-layered analytical element (slide) and its use with hardware systems (VITROS Chemistry Systems) for chemical reactions and spectrophotometry. This is a hardware-based in vitro diagnostic device, not software-only.

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

Here's why:

  • Intended Use: The "Intended Use / Indications for Use" section explicitly states: "For in vitro diagnostic use only."
  • Measurement of Analytes: The device is used to "quantitatively measure HDL cholesterol (HDLC) concentration in serum and plasma." This is a common function of IVD devices, which analyze biological samples outside of the body.
  • Clinical Purpose: The measurement of HDL cholesterol is used to "evaluate the risk of developing coronary heart disease (CHD)," indicating a clinical purpose for the test results.
  • Device Description: The description details how the device analyzes a "drop of sample fluid" (serum or plasma) using chemical reactions to determine the concentration of an analyte. This is characteristic of an in vitro diagnostic test.

N/A

Intended Use / Indications for Use

For in vitro diagnostic use only. VITROS Chemistry Products dHDL Slides are used to quantitatively measure HDL cholesterol (HDLC) concentration in serum and plasma using VITROS 250/350/950/5,1 FS and 4600 Chemistry Systems and the VITROS 5600 Integrated System. High Density Lipoprotein (HDL) cholesterol is used to evaluate the risk of developing coronary heart disease (CHD). The risk of CHD increases with lower HDL cholesterol concentrations.

Product codes

LBS

Device Description

The VITROS dHDL assay is performed using the VITROS Chemistry Products dHDL Slide and the VITROS Chemistry Products Calibrator Kit 25 on the VITROS Chemistry Systems. The VITROS dHDL Slide is a multi-layered analytical element coated on a polyester support. The method is based on a non-HDL precipitation method followed by an enzymatic detection. All reactions necessary for a single quantitative measurement of HDLC take place within the multi-layered analytical element of a VITROS Chemistry Products dHDL Slide. A drop of sample fluid is metered onto the slide and a reaction occurs which ultimately generates a colored dye. The density of dye formed is proportional to the HDL Cholesterol concentration present in the sample and is measured by reflectance spectrophotometry.

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)

K042006

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1475 Lipoprotein test system.

(a)
Identification. A lipoprotein test system is a device intended to measure lipoprotein in serum and plasma. Lipoprotein measurements are used in the diagnosis and treatment of lipid disorders (such as diabetes mellitus), atherosclerosis, and various liver and renal diseases.(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 § 862.9.

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K120609

SEP 7 2012

i

Special 510(k) SUMMARY

A summary of 510(k) safety and effectiveness information in accordance with the requirements of 21 CFR
807.92.

Submitter Information
NameOrtho Clinical Diagnostics
Address100 Indigo Creek Drive, Rochester, NY 14626, USA
Phone number(585) 453-4041
Fax number(585) 453-3368
Establishment
Registration Number1319809
Name of contact
personMarlene A. Hanna
Date preparedFebruary 24, 2012
Name of device
Trade or proprietary
nameVITROS Chemistry Products dHDL Slide
Common or usual
nameHDL Cholesterol assay
Classification nameLipoprotein test system
Classification panelClinical Chemistry
Regulation21 CFR 862.1475
Product Code(s)LBS
Legally marketed device(s)
to which equivalence is
claimedThe VITROS Chemistry Products dHDL Slide (modified) are substantially
equivalent to the VITROS Chemistry Products dHDL Slides (current slide).
The FDA cleared the VITROS Chemistry Products dHDL Slides on October
26, 2004 (K042006).
Reason for 510(k)
submissionA Special 510(k) for a modification to own device which does not include a change
in intended use or fundamental technology. Each modified VITROS dHDL Slide will
have 30% less ingredients compared to the current VITROS dHDL Slide as a result
of a smaller surface area. Since the reduction in ingredients per slide is due to a
smaller surface area, the concentration of ingredients of the modified slide will be
unchanged compared to the current slide. The device modification results in a
reduction in the sample volume required per test from 10 µL per test to 6 µL per test.
Device descriptionThe VITROS dHDL assay is performed using the VITROS Chemistry Products
dHDL Slide and the VITROS Chemistry Products Calibrator Kit 25 on the VITROS
Chemistry Systems. The VITROS dHDL Slide is a multi-layered analytical element
coated on a polyester support. The method is based on a non-HDL precipitation
method followed by an enzymatic detection. All reactions necessary for a single
quantitative measurement of HDLC take place within the multi-layered analytical
element of a VITROS Chemistry Products dHDL Slide. A drop of sample fluid is
metered onto the slide and a reaction occurs which ultimately generates a colored
dye. The density of dye formed is proportional to the HDL Cholesterol concentration
present in the sample and is measured by reflectance spectrophotometry.
Intended use of the deviceFor in vitro diagnostic use only. VITROS Chemistry Products dHDL Slides are used
to quantitatively measure HDL cholesterol (HDLC) concentration in serum and
plasma using VITROS 250/350/950/5,1 FS and 4600 Chemistry Systems and the
VITROS 5600 Integrated System. High Density Lipoprotein (HDL) cholesterol is
used to evaluate the risk of developing coronary heart disease (CHD). The risk of
CHD increases with lower HDL cholesterol concentrations.
Indications for useHigh Density Lipoprotein (HDL) cholesterol is used to evaluate the risk of developing
coronary heart disease (CHD). The risk of CHD increases with lower HDL
cholesterol concentrations.
Summary of the technological characteristics of the device compared to the predicate device
CharacteristicNew Device[ Modified VITROS dHDL
Slide]Predicate [VITROS dHDL Slide]
[K042006]
Intended UseSameFor in vitro diagnostic use only.
VITROS Chemistry Products
dHDL Slides are used to
quantitatively measure HDL
cholesterol (HDLC) concentration
in serum and plasma using
VITROS 250/350/950 and 5,1 FS
and 4600 Chemistry Systems and
the VITROS 5600 Integrated
System. High Density Lipoprotein
(HDL) cholesterol is used to
evaluate the risk of developing
coronary heart disease (CHD).
The risk of CHD increases with
lower HDL cholesterol
concentrations.
Fundamental technologySameDry, multilayered slide utilizing
method based on a non-HDL
precipitation method followed by
enzymatic detection, measured
by reflectance spectrophotometry.
Sample Volume Required6 μL10 μL
InstrumentationSameVITROS 250/350/950 and 5,1 FS
and 4600 Chemistry Systems and
the VITROS 5600 Integrated
System.
Concentration of dHDL
Slide Reactive Ingredients
per Slide (test)SameEmulgen B-66 0.7 mg;
phosphotungstic acid 0.3 mg;
magnesium chloride 0.2 mg,
cholesterol oxidase
(Cellulomonas, E.C.1.1.3.6) 0.8 U;
cholesterol ester hydrolase
(Candida rugosa, E.C.3.1.1.3) 1.2
U; peroxidase (horseradish root,
E.C.1.11.1.7) 2.2 U; and 2-(3,5-
dimethoxy-4-hydroxyphenyl)-4,5-
bis-(4-dimethylaminophenyl)
imidazole (leuco dye) 0.02 mg
Amount of dHDL Slide ·
Reactive Ingredients per
Slide (test)Emulgen B-66 0.63 mg; phosphotungstic
acid 0.27 mg; magnesium chloride 0.15
mg, cholesterol oxidase (Cellulomonas,
E.C.1.1.3.6) 0.72 U; cholesterol ester
hydrolase (Candida rugosa, E.C.3.1.1.3)
1.10 U; peroxidase (horseradish root,
E.C.1.11.1.7) 2.0 U; and 2- (3,5-
dimethoxy-4-hydroxyphenyl)-4,5-bis-(4-
dimethylaminophenyl) imidazole (leuco
dye) 0.018 mg.Emulgen B-66 0.90 mg;
phosphotungstic acid 0.38 mg;
magnesium chloride 0.22 mg,
cholesterol oxidase
(Cellulomonas, E.C.1.1.3.6) 1.0 U;
cholesterol ester hydrolase
(Candida rugosa, E.C.3.1:1.3)
1.56 U; peroxidase (horseradish
root, E.C.1.11.1.7) 2.82 U; and 2-
(3,5-dimethoxy-4-hydroxyphenyl)-
4,5-bis-(4-dimethylaminophenyl)
imidazole (leuco dye) 0.026 mg
Sample TypeSameSerum, plasma
Measuring RangeSame5.0 - 110.0 mg/dL
CONCLUSIONS DRAWN FROM NON-CLINICAL AND CLINICAL DATA
The information presented in the premarket notification provides a reasonable assurance that the VITROS
Chemistry Products dHDL Slides (modified) for use with human serum and plasma is substantially equivalent
to the predicate (unmodified VITROS dHDL Slide) and is safe and effective for the stated intended use.

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Image /page/3/Picture/1 description: The image shows the logo for the Department of Health & Human Services (HHS). The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of an eagle.

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-002

November 26, 2012

Ortho-Clinical Diagnostics, Inc. c/o Marlene Hanna 100 Indigo Creek Drive Rochester, NY 14626-5101

K120609 Trade Name: VITROS Chemistry Products dHDL Slides Regulation Number: 21 CFR §862.1475 Regulation Name: Lipoprotein Test System Regulatory Class: Class I, meets limitations of exemption 862.9 (c)(4) Product Codes: LBS Dated: August 9, 2012 Received: August 10, 2012

Dear Ms. Hanna:

Re:

This letter corrects our substantially equivalent letter of September 7, 2012.

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 (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 additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. 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 Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

4

Page 2 - Marlene Hanna

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 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/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours.

Carol C. Benson

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

for

Enclosure

5

Indication for Use

510(k) Number (if known): 长 \ 2 こ こ こ こ こ こ こ こ こ こ こ こ こ こ こ こ こ こ 。

Device Name: VITROS Chemistry Products dHDL Slides

Indication For Use: For in vitro diagnostic use only. VITROS Chemistry Products dHDL Slides are used to quantitatively measure HDL cholesterol (HDLC) concentration in serum and plasma using VITROS 250/350/950/5, I FS and 4600 Chemistry Systems and the VITROS 5600 Integrated System. High Density Lipoprotein (HDL) cholesterol is used to evaluate the risk of developing coronary heart disease (CHD). The risk of CHD increases with lower HDL cholesterol concentrations.

Prescription Use _ X (21 CFR Part 801 Subpart D) And/Or

Over the Counter Use (21 CFR Part 801 Subpart C)

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

Concurrence of CDRH, Office of In Vitro Diagnostic Device Evaluation and Safety (OVD)

R. t. Chisholm

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

510(k) K120609

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