K Number
K121533
Device Name
ST AIA-PACK HOMOCYSTEINE; ST AIA-PACK HOMOCYSTEINE CALIBRATOR SET; AIA-PACK HOMOCYSTEINE CONTROL SET
Date Cleared
2012-06-15

(22 days)

Product Code
Regulation Number
862.1377
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Reagents: ST AIA-PACK Homocysteine is designed for IN VITRO DIAGNOSTIC USE ONLY for the quantitative measurement of homocysteine in human serum, heparinized plasma or EDTA plasma using a Tosoh AlA System Analyzer. Homocysteine measurements are used in the diagnosis and treatment of hyperhomocysteinemia or homocystinuria. Calibrators: ST AIA-PACK Homocysteine Calibrator Set is intended for IN VITRO DIAGNOSTIC USE ONLY for the callbration of the ST AIA PACK Homocysteine assay using a Tosoh AIA System Analyzer. Controls: The AIA-PACK Homocysteine Control Set is intended for IN VITRO DIAGNOSTIC USE ONLY for performing quality control procedures with the ST AIA-PACK Homocysteine Assay.
Device Description
The ST AIA-PACK Homocysteine is a competitive enzyme immunoassay which, after sample pretreatment, is performed entirely in the ST AIA-PACK Homocysteine test cups. Oxidized homocysteine is reduced by tris (2-carboxyethyl) phosphine (TCEP) to the free form and converted to S-adenosyl-L-homocysteine (SAH) by the SAH hydrolase and excess adenosine prior to the immunoassay. SAH present in the pretreated sample competes with immobilized SAH on magnetic beads for binding sites of the enzyme-labeled anti-SAH mouse monoclonal antibody. The magnetic beads are washed to remove unbound anti-SAH mouse monoclonal antibody and are then incubated with a fluorogenic substrate, 4-methylumbelliferyl phosphate (4MUP). The rate of fluorescence produced by the enzyme reaction indicates the amount of enzyme-labeled anti-SAH mouse monoclonal antibody. The amount of antibody that binds to the beads is inversely proportional to the homocysteine concentration in the test sample. A standard curve is constructed, and unknown sample concentrations are calculated using this curve.
More Information

Not Found

No
The device description details a standard enzyme immunoassay and the performance studies focus on traditional analytical validation metrics. There is no mention of AI or ML in the text.

No
The device is an in vitro diagnostic (IVD) test for measuring homocysteine levels, which is used for diagnosis and treatment monitoring, not for direct therapeutic intervention.

Yes

The "Intended Use / Indications for Use" section explicitly states that the device is "designed for IN VITRO DIAGNOSTIC USE ONLY for the quantitative measurement of homocysteine" and that "Homocysteine measurements are used in the diagnosis and treatment of hyperhomocysteinemia or homocystinuria."

No

The device description clearly outlines a competitive enzyme immunoassay involving reagents, test cups, magnetic beads, and a fluorogenic substrate, indicating a physical, in vitro diagnostic device, not software.

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

Here's why:

  • Explicit Statement: The "Intended Use / Indications for Use" section clearly states: "Reagents: ST AIA-PACK Homocysteine is designed for IN VITRO DIAGNOSTIC USE ONLY..." and "Calibrators: ST AIA-PACK Homocysteine Calibrator Set is intended for IN VITRO DIAGNOSTIC USE ONLY..." and "Controls: The AIA-PACK Homocysteine Control Set is intended for IN VITRO DIAGNOSTIC USE ONLY...". This is the most direct and definitive indicator.
  • Purpose: The device is used for the "quantitative measurement of homocysteine in human serum, heparinized plasma or EDTA plasma". This is a laboratory test performed on biological samples outside of the body.
  • Clinical Application: The results of the test are used "in the diagnosis and treatment of hyperhomocysteinemia or homocystinuria". This indicates the test provides information used for medical diagnosis and management.
  • Device Description: The description details a laboratory assay (competitive enzyme immunoassay) performed on samples, further supporting its use in a diagnostic laboratory setting.

All of these points align with the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

Reagents: ST AIA-PACK Homocysteine is designed for IN VITRO DIAGNOSTIC USE ONLY for the quantitative measurement of homocysteine in human serum, heparinized plasma or EDTA plasma using a TOSOH AIA System Analyzer. Homocysteine measurements are used in the diagnosis and treatment of hyperhomocysteinemia or homocysteinuria. Calibrators: ST AIA-PACK Homocysteine Calibrator Set is intended for IN VITRO DIAGNOSTIC USE ONLY for the calibration of the ST AIA-PACK Homocysteine assay using a Tosoh AIA System Analyzer. Controls: The AIA-PACK Homocysteine Control Set is intended for IN VITRO DIAGNOSTIC USE ONLY for performing quality control procedures with the ST AIA-PACK Homocysteine Assay.

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

LPS, JIT, JJX

Device Description

The ST AIA-PACK Homocysteine is a competitive enzyme immunoassay which, after sample pretreatment, is performed entirely in the ST AIA-PACK Homocysteine test cups. Oxidized homocysteine is reduced by tris (2-carboxyethyl) phosphine (TCEP) to the free form and converted to S-adenosyl-L-homocysteine (SAH) by the SAH hydrolase and excess adenosine prior to the immunoassay. SAH present in the pretreated sample competes with immobilized SAH on magnetic beads for binding sites of the enzyme-labeled anti-SAH mouse monoclonal antibody. The magnetic beads are washed to remove unbound anti-SAH mouse monoclonal antibody and are then incubated with a fluorogenic substrate, 4-methylumbelliferyl phosphate (4MUP). The rate of fluorescence produced by the enzyme reaction indicates the amount of enzyme-labeled anti-SAH mouse monoclonal antibody. The amount of antibody that binds to the beads is inversely proportional to the homocysteine concentration in the test sample. A standard curve is constructed, and unknown sample concentrations are calculated using this curve.

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

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Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

  1. Analytical Performance: a. Precision/Reproducibility: The precision for ST AIA-PACK Homocysteine was determined based on guidance from CLSI Protocol EP5-A2. Within run precision was determined using nine pooled samples (3 each of EDTA plasma, heparinized plasma and serum) in a total of 20 runs. The total precision was determined by the duplicate assay of nine pooled samples (3 each of EDTA plasma, heparinized plasma and serum) in 20 separate runs. The means of each run were used to calculate the pooled standard deviation (SD) and coefficient of variation (CV). b. Linearity/assay reportable range: The linearity for the ST AIA-PACK Homocysteine was determined, based on guidance from CLSI Protocol EP6-A. The linearity was measured on the AIA-2000 instrument and has been demonstrated to be linear from 0.5 to 50.0 µmol/L. c. Traceability: The calibrators in this set are referred to NIST (National Institute of Standards & Technology) Standard Reference Material 1955. d. Stability: Shelf life is 12 months when stored at 2-8°C. In-use stability for test cups is 40 hours at 18-25°C or up to 30 days at 2-8°C. Calibrator Set in-use stability is 1 day at 2-8°C. Sample Diluting Solution in-use stability is 9 days for automatic dilutions at 18-25°C, or 90 days for manual dilutions. Pretreatment Reagent in-use stability is 20 hours at 18-25°C or 1 day at 2-8°C for manual pretreatment. Control in-use stability is 14 days at 2-8°C or 1 day at 18-25°C. e. Detection limit: Determined based on CLSI guideline EP17-A. A blank sample was measured in 60 replicates. Six low level samples were measured in 10 replicates each. The limit of detection was estimated to be 0.334 umol/L. The reportable range for the assay is 0.5 to 50.0 umol/L. f. Interference/Analytical specificity: Interference defined as recovery outside of 100 +/-10% of the known concentration. Hemoglobin (up to 1445 mg/dL), free bilirubin (up to 18 mg/dL), conjugated bilirubin (up to 18 mg/dL), Lipemia (up to 1667 mg/dL triglyceride), Added protein (up to 50 mg/ml as human g-globulin for total protein of approximately 120 mg/ml), Ascorbic acid (up to 20 mg/dL), EDTA-2K (up to 5.0 mg/mL), and Heparin (up to 100 U/mL) do not interfere with the assay. Cross-reactivity was tested for Adenosine (0.045%), S-Adenosyl-L-methionine (1.26%), L-Cystathionine (0.159%), L-Cysteine (0.003%), L-Glutathione (0.005%), L-Methionine (0.059%), DL-Homocysteine thiolactone (6.99%).
  2. Comparison Studies: a. Method comparison: Study developed with reference to CLSI protocol EP9-A2. A total of 138 unaltered EDTA plasma specimens were assayed in singleton utilizing the ST AIA-PACK Homocysteine assay on the AIA-2000 analyzer and the alternate method. Regression analysis resulted in a slope of 1.079, intercept of 0.193, standard error estimate of 2.268, and correlation coefficient (R) of 0.984 with result ranges from 2.8 to 48.3 µmol/L. b. Matrix comparison: Correlation between EDTA plasma (x) and heparinized plasma (y) on the ST AIA-PACK Homocysteine was carried out using 98 unaltered specimens. Deming regression: Slope 1.007, Intercept -0.235, Standard Error Estimate 0.682, Corr Coef(R) 0.991. Result Ranges: EDTA 6.25-38.3 µmol/L, Heparin 6.15 - 37.5 µmol/L. Correlation between EDTA plasma (x) and serum (y): The table provided is identical to the EDTA plasma vs heparinized plasma section.
  3. Clinical Studies: Not applicable.
  4. Clinical cut-off: Not applicable.
  5. Expected values/Reference range: Determined in unaltered EDTA plasma samples from 130 apparently healthy individuals based on CLSI Protocol C28-A2. The reference interval is 6.6 - 17.8 µmol/L.

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.

K003597 Siemens IMMULITE 2000 Homocysteine Immunoassay

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.

Not Found

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

§ 862.1377 Urinary homocystine (nonquantitative) test system.

(a)
Identification. A urinary homocystine (nonquantitative) test system is a device intended to identify homocystine (an analogue of the amino acid cystine) in urine. The identification of urinary homocystine is used in the diagnosis and treatment of homocystinuria (homosystine in urine), a heritable metabolic disorder which may cause mental retardation.(b)
Classification. Class II.

0

K121533

510(k) Summary

JUN 1 5 2012

ST AIA-PACK HOMOCYSTEINE

    1. Date:

2. Submitter:

    1. Contact Person:
  1. Device Name:

Device Name: Classification

Device Name: Classification

  1. Predicate Device:

May 17, 2012 Tosoh Bioscience, Inc 3600 Gantz Road Grove City, OH 43123

Judith K. Ogden Director, Compliance and Market Development 6000 Shoreline Ct., Ste. 101 South San Francisco, CA 94080 Phone: 650-636-8112 Fax: 650-636-8113 Email: Judy.Ogden@tosoh.com

ST AIA-PACK Homocysteine Classification: Class II LPS Clinical Chemistry 21 CFR 862.1377

ST AIA-PACK Homocysteine Calibrator Set Class II JIT Clinical Chemistry 21 CFR 862.1150

AIA-PACK Homocysteine Control Set Class I, Reserved JX Clinical Chemistry 21 CFR 862.1660

k 003597 Siemens IMMULITE 2000 Homocysteine Immunoassay

1

6. Intended Use

Reagents:

ST AIA-PACK Homocysteine is designed for IN VITRO DIAGNOSTIC USE ONLY for the quantitative measurement of homocysteine in human serum, heparinized plasma or EDTA plasma using a TOSOH AIA System Analyzer. Homocysteine measurements are used in the diagnosis and treatment of hyperhomocysteinemia or homocysteinuria.

Calibrators:

ST AIA-PACK Homocysteine Calibrator Set is intended for IN VITRO DIAGNOSTIC USE ONLY for the calibration of the ST AIA-PACK Homocysteine assay using a Tosoh AIA System Analyzer.

Controls:

The AIA-PACK Homocysteine Control Set is intended for IN VITRO DIAGNOSTIC USE ONLY for performing quality control procedures with the ST AIA-PACK Homocysteine Assay.

2

7. Device Description

The ST AIA-PACK Homocysteine is a competitive enzyme immunoassay which, after sample pretreatment, is performed entirely in the ST AIA-PACK Homocysteine test cups.

Oxidized homocysteine is reduced by tris (2-carboxyethyl) phosphine (TCEP) to the free form and converted to S-adenosyl-L-homocysteine (SAH) by the SAH hydrolase and excess adenosine prior to the immunoassay. SAH present in the pretreated sample competes with immobilized SAH on magnetic beads for binding sites of the enzyme-labeled anti-SAH mouse monoclonal antibody. The magnetic beads are washed to remove unbound anti-SAH mouse monoclonal antibody and are then incubated with a fluorogenic substrate, 4-methylumbelliferyl phosphate (4MUP). The rate of fluorescence produced by the enzyme reaction indicates the amount of enzyme-labeled anti-SAH mouse monoclonal antibody. The amount of antibody that binds to the beads is inversely proportional to the homocysteine concentration in the test sample. A standard curve is constructed, and unknown sample concentrations are calculated using this curve.

8. Substantial Equivalence Information

    1. Predicate Device Name:
      IMMULITE 2000 Homocysteine
    1. K003597
    1. Comparison with predicate

Similarities

| Parameter | ST AIA-PACK
Homocysteine | IMMULITE 2000
Homocysteine |
|---------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Intended use | ST AIA-PACK Homocysteine is
designed for IN VITRO
DIAGNOSTIC USE ONLY for the
quantitative measurement of
homocysteine in human EDTA
plasma, heparinized plasma or
serum on TOSOH AIA System
Analyzers. | For in vitro diagnostic use with
the IMMULITE 2000 Analyzer —
for the quantitative determination
of L-homocysteine in human
plasma or serum. This device
can assist in the diagnosis and
treatment of patients suspected
of having hyperhomocysteinemia
or homocystinuria |
| Specimen type | EDTA plasma, heparinized
plasma or serum | EDTA plasma, heparinized
plasma or serum |
| Assay range | 0.50 to 50.0 µmol/L | 0.5 to 50 µmol/L |
| Sensitivity | 0.50 µmol/L | 0.50 µmol/L |

3

Differences

| Parameter | ST AIA-PACK
Homocysteine | IMMULITE 2000
Homocysteine |
|-----------------------|----------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------|
| Interference | Hb, Biliirubin, Lipemia, Protein,
Ascorbic Acid, Trisodium Citrate,
EDTA, Heparinized Sodium, RH
factor tested with no interference | Bilirubin, Hb and Lipemia tested
with no interference |
| Reference Range | 6.6 - 17.8 µmol/L | 5 - 12 µmol/L |
| Assay Technology | Immunofluorescence | Chemiluminescent |
| Limit of detection | 0.334 µmol/L | 0.5 µmol/L |
| Incubation Time | 10 minute cycle | 60 Minute Cycle |
| Calibration | Calibrators at 0,2,4,8,15 and 55
µmol/L | Calibration Adjusters range of 2
to 50 µmol/L |
| Calibration Frequency | 90 Days | 28 Days |

9. Standard/Guidance Document Reference

  • User Evaluation of Precision Performance of Clinical Chemistry Devices: Approved . Guideline (CLSI EP5-A2)
  • . Evaluation of the Linearity of Quantitative Measurement Procedures: a Statistical Approach: Approved Guideline (CLSI EP6-A2)
  • . How to Define and Determine Reference Intervals in the Clinical Laboratory: Approved Guideline (C28-A2)
  • . Protocols for Determination of Limits of Detection and Limits of Quantitation; Approved Guideline (CLSI EP17-A).
  • Method Comparison and Bias Estimation Using Patient Samples; Approved Guideline-. Second Edition (CLSI EP9-A2)
  • Estimation of Total Analytical Error for Clinical Laboratory Methods (CLSI EP21-A) .

10. Test Principle

The ST AIA-PACK Homocysteine is a competitive enzyme immunoassay which, after sample pretreatment, is performed entirely in the ST AIA-PACK Homocysteine test cups.

Oxidized homocysteine is reduced by tris (2-carboxyethyl) phosphine (TCEP) to the free form and converted to S-adenosyl-L-homocysteine (SAH) by the SAH hydrolase and excess adenosine prior to the immunoassay. SAH present in the pretreated sample competes with immobilized SAH on magnetic beads for binding sites of the enzyme-labeled anti-SAH mouse monoclonal antibody. The magnetic beads are washed to remove unbound anti-SAH mouse monoclonal antibody and are then incubated with a fluorogenic substrate, 4-methylumbelliferyl phosphate (4MUP). The rate of fluorescence produced by the enzyme reaction indicates the amount of enzyme-labeled anti-SAH mouse monoclonal antibody. The amount of antibody that binds to the beads is inversely proportional to the homocysteine concentration in the test sample. A standard curve is constructed, and unknown sample concentrations are calculated using this curve.

WARNING: Specimens from patients who are on drug therapy involving S-adenosyl-methionine may show falsely elevated levels of homocysteine. Specimens from patients taking methotrexate, carbamazepine, phenytoin, nitrous oxide or 6-azauridine triacetate may have elevated levels of homocysteine due to their effect on the metabolic pathway.

4

11. Performance Characteristics

1. Analytical Performance:

a. Precision/Reproducibility

The precision for ST AIA-PACK Homocysteine was determined based on guidance from CLSI Protocol EP5-A2.

Within run precision was determined using nine pooled samples (3 each of EDTA plasma, heparinized plasma and serum) in a total of 20 runs. Within each run, one set of duplicates per sample was assayed. The mean of each duplicate was used to obtain the pooled standard deviation (SD), which was then used to calculate the coefficient of variation (CV).

StandardCoefficient
MeanDeviationof Variation
Sample(μmol/L)(μmol/L)(%)
EDTA Plasma A37.40.23.3
EDTA Plasma B317.40.73.9
EDTA Plasma C344.01.43.1
HEP Plasma A37.00.23.2
HEP Plasma B314.40.53.4
HEP Plasma C332.21.13.5
Serum A35.60.24.3
Serum B314.30.53.6
Serum C340.91.33.2

Intra-assay (within run) Precision

5

| | Mean | Standard
Deviation | Coefficient
of Variation |
|----------------|--------------|-----------------------|-----------------------------|
| Sample | ( $μmol/L$ ) | ( $μmol/L$ ) | (%) |
| EDTA Plasma A3 | 7.4 | 0.3 | 4.1 |
| EDTA Plasma B3 | 17.4 | 0.8 | 4.5 |
| EDTA Plasma C3 | 44.0 | 1.6 | 3.6 |
| HEP Plasma A3 | 7.0 | 0.3 | 4.4 |
| HEP Plasma B3 | 14.4 | 0.6 | 4.0 |
| HEP Plasma C3 | 32.2 | 1.6 | 4.9 |
| Serum A3 | 5.6 | 0.3 | 5.0 |
| Serum B3 | 14.3 | 0.7 | 4.7 |
| Serum C3 | 40.9 | 1.8 | 4.4 |

The total precision was determined by the duplicate assay of nine pooled samples (3 each of EDTA plasma, heparinized plasma and serum) in 20 separate runs. The means of each run were used to calculate the pooled standard deviation (SD) and coefficient of variation (CV).

Linearity/assay reportable range b.

The linearity for the ST AIA-PACK Homocysteine was determined, based on guidance from CLSI Protocol EP6-A. The linearity was measured on the AIA-2000 instrument and has been demonstrated to be linear from 0.5 to 50.0 µmol/L.

  • Traceability, C.
    The ST AIA-PACK Homocysteine Calibrator Set contains assigned concentrations of Sadenosyl -L-homocysteine. The assigned value is determined on a lot-by-lot basis and is designed to provide an assay calibration range of 0.5 to 50.0 µmol/L of homocysteine. The calibrators in this set are referred to NIST (National Institute of Standards & Technology) Standard Reference Material 1955.

The Tosoh AIA-PACK Control Set contains two controls of buffered bovine serum albumin with each control containing approximately 12 umol/L and 25 umol/L of homocysteine with sodium azide as a preservative.

  • ದ. Stability
    The shelf life of the ST AIA-PACK Homocysteine test cups. ST AIA-PACK Homocysteine Calibrator Set, ST AIA-PACK Homocysteine Sample Diluting Solution, ST AIA-PACK Homocysteine Pretreatment Set and the AIA PACK Homocysteine Control Set is 12 months from the date of manufacture when stored at 2-8° C.

6

The in-use stability of the ST AIA-PACK Homocysteine test cups, is 40 hours at a room temperature of 18-25°C. When stored at 2-8°C, the test cups can be used for up to 30 days.

The in-use stability of the ST AIA-PACK Homocysteine Calibrator Set is 1 day when stored at 2 - 8° C.

The in-use stability of the ST AIA-PACK Homocysteine Sample Diluting Solution is 9 days provided: 1) it is used for automatic dilutions, 2) it is at 18-25° C for only 8 hours per day, and 3) the vials are closed and kept refrigerated immediately after use. In-use stability is 90 days provided: 1) it is used for manual dilutions ONLY, and 2) the vials are closed and refrigerated immediately after use.

The in-use stability of the ST AIA-PACK Homocysteine Pretreatment Reagent is stable at 18-25° C for 20 hours. The in-use stability is stable at 2-8° C for 1 day provided: 1) it is used for manual pretreatment ONLY, and 2) the bottles are closed and refrigerated immediately after use.

The in-use stability of the AIA-PACK Homocysteine CONTROL is 14 days at 2-8° C. If stored at 18-25 degree C the in-use stability is 1 day.

e. Detection limit:

Limit of detection: The limit of detection of the ST AIA-PACK Homocysteine was determined based on CLSI guideline EP17-A. A blank sample was measured in 60 replicates. Six low level samples were measured in 10 replicates each. As a result, the limit of detection was estimated to be 0.334 umol/L.

The reportable range for the assay is 0.5 to 50.0 umol/L.

f. Interference/Analytical specificity:

Interference

Interference is defined, for the purposes of this study, with recovery outside of 100 +/-10% of the known concentration of the specimen after the following substances are added to human specimens. Three studies were conducted using EDTA plasma, heparinized plasma and serum

  • Hemoglobin (up to 1445 mg/dL),
  • . free bilirubin (up to 18 mg/dL) and conjugated bilirubin (up to 18 mg/dL) do not interfere with the assay.
  • Lipemia, as indicated by triglyceride concentration (up to 1667 mg/dL), does not interfere with the assay.

7

  • . Added protein (up to 50 mg/ml), as indicated by human g-globulin concentrations, for a total protein concentration of approximately 120 mg/ml, does not interfere with the assay.
  • . Ascorbic acid (up to 20 mg/dL) does not interfere with the assay
  • EDTA-2K (up to 5.0 mg/mL) does not interfere with the assay. 트
  • Heparin (up to 100 U/mL) does not interfere with the assay.

Specificity

The following substances were tested for cross-reactivity. The cross-reactivity (%) is the percent of the compound which will be identified as Homocysteine. If these compounds are present in the specimen at the same concentration as Homocysteine, the final result will be increased by these percentages.

| Compound | Concentration
(µmol/L) | Cross-reactivity (%) |
|--------------------------------|---------------------------|----------------------|
| Adenosine | 5.10 | 0.045 |
| S-Adenosyl-L-
methionine | 4.74 | 1.26 |
| L-Cystathionine | 0.486 | 0.159 |
| L-Cysteine | 103 | 0.003 |
| L-Glutathione | 99.6 | 0.005 |
| L-Methionine | 0.399 | 0.059 |
| DL-Homocysteine
thiolactone | 0.257 | 6.99 |

  • Assay cut off g. Not applicable

2. Comparison Studies:

  • Method comparison a.
    The methods comparison study was developed with the reference to the CLSI protocol entitled: Method Comparison and Bias Estimation Using Patient Samples; Approved Guideline (EP9-A2).

A total of 138 unaltered EDTA plasma specimens were assayed in singleton utilizing the ST AIA-PACK Homocysteine assay on the AIA-2000 analyzer and the alternate method. The regression analysis for the correlation between the alternate method (x) and the ST AIA-PACK Homocysteine is as follows:

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DemingRegular
Slope:1.0791.061
Intercept:0.1930.499
Standard Error Estimate:2.2682.257
Corr Coef( R):0.984
Points (Plotted/Total):138/138
Result Ranges:2.8 to 48.3 µmol/L

b. Matrix comparison

The correlation between EDTA plasma (x) and heparinized plasma (y) on the ST AlA-PACK Homocysteine was carried out using 98 unaltered specimens.

DemingRegular
Slope:1.007(0.979 to 1.035)0.998(0.970 to 1.025)
Intercept:-0.235(-0.591 to 0.121)-0.124(-0.480 to 0.231)
Standard Error
Estimate:0.6820.680
Corr Coef(R):0.991
Result RangesEDTA6.25-38.3 μmol/LHeparin6.15 - 37.5 μmol/L

The correlation between EDTA plasma (x) and serum (y) on the ST AIA-PACK Homocysteine was carried out using 98 unaltered specimens.

DemingRegular
Slope:1.007 (0.979 to 1.035)0.998 (0.970 to 1.025)
Intercept:-0.235 (-0.591 to 0.121)-0.124 (-0.480 to 0.231)
Standard Error
Estimate:0.6820.680
Corr Coef(R):0.991
Result RangesEDTA 6.25-38.3 µmol/LHeparin 6.15 - 37.5 µmol/L

నే. Clinical Studies:

Not applicable .

  1. Clinical cut-off: Not applicable
    1. Expected values/Reference range: The interval given here was determined in unaltered EDTA plasma samples from 130 apparently healthy individuals.
      A reference range study was conducted based on guidance from Clinical and Laboratory Standards Institute (CLSI) Protocol C28-A2.

Number of Samples (n) 130 6.6 - 17.8 umol/L Reference Interval

The central 95% of the reference range was used to determine the reference interval.

9

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/9/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features a stylized eagle with its wings spread, facing to the right. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle. The seal is black and white.

Public Health Service

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

Tosoh Bioscience, Inc c/o Judith K. Ogden 6000 Shoreline Court Suite 101 South San Francisco, CA 94080

JUN 1 5 2012

Re: K121533

Trade Name: ST AIA-PACK Homocysteine,

ST AIA-PACK Homocysteine Calibrator Set

AIA-PACK Homocysteine Control Set

Regulation Number: 21 CFR §862.1377 Regulation Name: Urinary homocysteine (non-quantitative) test system Regulatory Class: Class II Product Codes: LPS, JIT, JJX Dated: May 22, 2012 Received: May 25, 2012

Dear Ms. Ogden:

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); medical device reporting (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).

10

Page 2

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please 11 you deally 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 prease note the roganized on regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at (301) 01160 of Dar remestions 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 Tou may 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.

signature

Countney 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

11

Indications for Use Form

510(k) Number (if known): K121533

Device Name: ST AIA-PACK Homocysteine; ST AIA-PACK Homocysteine Calibrator Set; AIA-PACK Homocysteine Control Set

Indications for Use:

Reagents:

ST AIA-PACK Homocysteine is designed for IN VITRO DIAGNOSTIC USE ONLY for the quantitative measurement of homocysteine in human serum, heparinized plasma or EDTA plasma using a Tosoh AlA System Analyzer. Homocysteine measurements are used in the diagnosis and treatment of hyperhomocysteinemia or homocysteinuria. Calibrators:

ST AIA-PACK Homocysteine Calibrator Set is intended for IN VITRO DIAGNOSTIC USE ONLY for the callbration of the ST AIA PACK Homocysteine assay using a Tosoh AIA System Analyzer.

Controls:

The AIA-PACK Homocysteine Control Set is intended for IN VITRO DIAGNOSTIC USE ONLY for performing quality control procedures with the ST AIA-PACK Homocysteine Assay.

Over-The-Counter Use Prescription Use AND/OR (Part 21 CFR 801 Subpart D (21 CFR 801 Subpart C)

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

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

Buttle Chube

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

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