K Number
K122141
Device Name
IDS-ISYS IGF-I CALIBRATION VERIFIERS
Date Cleared
2012-08-07

(19 days)

Product Code
Regulation Number
862.1660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The IDS-iSYS IGF-I Calibration Verifier is a device intended for verification of calibration of the IDS-iSYS IGF-I Assay when performed on the IDS-iSYS Multi-Discipline Automated Analyzer.
Device Description
The IDS-iSYS IGF-I calibration verifer matrix is composed of a buffer solution containing bovine serum albumin with sodium azide as a preservative. The IGF-I peptide is added to this matrix and the resulting solution is lyophilised.
More Information

Not Found

No
The summary describes a calibration verifier solution for an assay, not a device with computational capabilities. There are no mentions of AI, ML, image processing, or data sets typically associated with AI/ML development.

No.
The device is a calibration verifier for an assay, not a device used for treating a disease or condition.

No
The device is described as a "Calibration Verifier" for an assay, not for diagnosing a condition directly. It's used to verify the calibration of an existing diagnostic assay.

No

The device description clearly states the device is a physical substance (lyophilised solution) used for calibration verification, not a software program.

Based on the provided information, the device is an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use explicitly states it's for "verification of calibration of the IDS-iSYS IGF-I Assay". Assays performed on automated analyzers to measure substances in biological samples (like IGF-I) are classic examples of in vitro diagnostics.
  • Device Description: The description mentions a "buffer solution containing bovine serum albumin" and the addition of an "IGF-I peptide". These are components used in laboratory tests performed outside the body (in vitro).
  • Predicate Device: The mention of a predicate device (K103221 Elecsys hGH CalCheck 5) which is also a calibration verification product for an assay, further supports its classification as an IVD. Calibration verifiers are a type of IVD used to ensure the accuracy of diagnostic tests.

While the document doesn't explicitly state "In Vitro Diagnostic Device", the intended use and nature of the product clearly align with the definition of an IVD.

N/A

Intended Use / Indications for Use

The IDS-iSYS IGF-I calibration verifier is a device intended for the verification of calibration of the IDS-iSYS IGF-I assay when performed on the IDS-iSYS multi-disciplined automated analyzer.

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

JJX

Device Description

The IDS-iSYS IGF-I calibration verifer matrix is composed of a buffer solution containing bovine serum albumin with sodium azide as a preservative. The IGF-I peptide is added to this matrix and the resulting solution is lyophilised.

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)

The ID-iSYS IGF-I Calibration Verifier was evaluated for value assignment and stability.

Value Assignment: For each lot of the IDS-iSYS IS-3900 IGF-I assay kit available, a minimum of 15 assay runs is requested. Those runs must be performed using at least 3 independent iSYS machines. A minimum of 3 assay runs per iSYS machine is required. Reagents, controls and samples are prepared according to the IDS-iSYS IGF-I Assay Instructions for Use IS-3900 and the IDS-iSYS IGF-I Control Set Instructions for Use IS-3930. Each run consists of one iSYS calibration using the IDS-iSYS IGF-I IS-3900 Assay Reagent Cartridge, IDS-iSYS IGF-I IS-3900 Calibrators and the IDS-iSYS IS-3930 Control Set followed by samples (Calibration verifiers to test) and controls. Samples and controls are tested in triplicate. For each Calibration Verifier, the final result reported is the mean value of all valid runs. The customer acceptance range is calculated from the mean value based on 8% (standard deviation) for all Calibration Verifier.

Stability: IDS-iSYS IGF-I Calibration Verifiers stability testing was/is performed on the IDS-iSYS automated analyzer. Shelf-life stability: The accelerated stability testing supports an initial shelf-life claim of 6 months at 2-8°C. Real time testing at 2-8°C is on-going. Stability after reconstitution: Real time testing was performed and supports the following claims: Reconstituted IDS-iSYS IGF-I calibration verifiers are stable for up to 2.5 hours on the board the IDS-iSYS. The IDS-iSYS IGF-I calibration verifiers are not stored on board the analyzer.

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.

K103221

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

§ 862.1660 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

K122141

AUG

.

IntroductionAccording to the requirements of 21CFR807.92, the following information provides sufficient detail to understand the basis for a determination of substantial equivalence.
SubmitterImmunodiagnostic Systems Ltd
10 Didcot Way
Boldon Business Park
Boldon
Tyne and Wear
NE35 9PD
United Kingdom
Contact Person: Mick Fenton
Phone: +44 191 5190660
Fax: +44 191 5190760
Email: Michael.fenton@idsplc.com
Secondary Contact: Dave Mullington
Phone: +44 191 5190660
Fax: +44 191 5190760
Email: david.mullington@sky.com
Date prepared: August 03, 2012
Device NameProprietary name: IDS-iSYS IGF-I Calibration Verifier
Common name: IGF-I Calibration Verifier
Classification: 21CFR862.1660, Single (specific) analyte controls (assayed and unassayed),
Regulatory Class: Class I, reserved
Product Code: JJX
Predicate DeviceThe IDS-ISYS IGF-I Calibration Verifier is substantially equivalent to other products in commercial distribution intended for similar use. We claim equivalency to the currently marketed Elecsys hGH CalCheck 5 (K103221)
Device DescriptionThe IDS-iSYS IGF-I calibration verifer matrix is composed of a buffer solution containing bovine serum albumin with sodium azide as a preservative. The IGF-I peptide is added to this matrix and the resulting solution is lyophilised.

1

510(k) Summary continued

Intended Use The IDS-iSYS IGF-I calibration verifier is a device intended for the verification of calibration of the IDS-iSYS IGF-I assay when performed on the IDS-iSYS multi-disciplined automated analyzer.

Comparison Table

| Characteristic | IDS-iSYS IGF-I
Calibration Verifiers
(New Device) | Elecsys hGH CalCheck 5
(Predicate Device)
K103221 |
|--------------------------------------|---------------------------------------------------------|---------------------------------------------------------|
| Similarities | | |
| Intended use/
Indications for use | Same | Used for assay calibration
verification. |
| Format | Same | Lyophilized |
| Unopened Stability | Same | Store at 2-8°C until
expiration date |
| Differences | | |
| Analyte | IGF-I | hGH |
| Levels | 4 | 5 |
| Matrix | Buffered protein | Human serum matrix |
| Reconstituted
Stability | On the analyzer:
• up to 2.5 hours | On the analyzer:
• up to 5 hours |

| Performance
Characteristics | The ID-iSYS IGF-I Calibration Verifier was evaluated for value
assignment and stability. See the following section for details. |
|--------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Traceability | The IDS-iSYS IGF-I calibration verifier is traceable to the NIBSC
code: 02/254 international standard. |
| Value Assignment | IDS-iSYS IGF-I Calibration Verifiers value assignment is performed
as follows.

For each lot of the IDS-iSYS IS-3900 IGF-I assay kit available, a
minimum of 15 assay runs is requested. Those runs must be performed
using at least 3 independent iSYS machines. A minimum of 3 assay
runs per iSYS machine is required.

Reagents, controls and samples are prepared according to the IDS-
iSYS IGF-I Assay Instructions for Use IS-3900 and the IDS-iSYS
IGF-I Control Set Instructions for Use IS-3930. |


2

510(k) Summary continued

Each run consists of one iSYS calibration using the IDS-iSYS IGF-I IS-3900 Assay Reagent Cartridge, IDS-iSYS IGF-I IS-3900 Calibrators and the IDS-iSYS IS-3930 Control Set followed by samples (Calibration verifiers to test) and controls. Samples and controls are tested in triplicate.

For each Calibration Verifier, the final result reported is the mean value of all valid runs.

The customer acceptance range is calculated from the mean value based on 8% (standard deviation) for all Calibration Verifier.

Stability IDS-iSYS IGF-I Calibration Verifiers stability testing was/is performed on the IDS-iSYS automated analyzer. Shelf-life stability . The accelerated stability testing supports an initial shelf-life claim of 6 months at 2-8°C. Real time testing at 2-8°C is on-going. . Stability after reconstitution: Real time testing was performed and supports the following claims: Reconstituted IDS-iSYS IGF-I calibration verifiers are stable for up to 2.5 hours on the board the IDS-iSYS. The IDS-iSYS IGF-I calibration verifiers are not stored on board the analyzer. Conclusion The submitted information in this premarket notification is complete and supports a substantial equivalence decision.

.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized symbol that resembles an abstract human figure with three arms or branches extending upwards.

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

Immunodiagnostic Systems, Ltd. c/o Mick Fenton 10 Didcot Way Boldon Business Park Boldon, Tyne and Wear United Kingdom, NE35 9PD

AUG 7 2012

K122141 Re: K122141
Trade Name: IDS-iSYS IGF-I Calibration Verifier
Trade Name: IDS-iSYS IGF-I CEP 8862 1660 Trade Name: 1D CFR §862.1660 Regulation Name: Quality Control Material (assayed and unassayed)
Regulation Name: Quality Control Material (assayed and unassayed)
1997 Name: Quality Control Material (assay Regulatory Class: Class I, reserved Product Codes: JJX Dated: July 16, 2012 Received: July 19, 2012

Dear Mr. Fenton:

Dour Court Section 510(k) premarket notification of intent to market the device is We have reviewed your Section SIU(K) premarket in substantially equivalent (for the
referenced above and have determined the device is substantially equivalent (for the referenced above and have detemined the device is substanced one ( - ) = ( = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = indications for use stated in the enclosure) in tegality the Medical Device in the Medical Device
interstate comments of the been been reclassified in accordance with the pro interstate commerce prior to May 28, 1976, the miaculies with the provisions of
Amendments, or to devices that have been recuassified in accordance with the provisions of Amendments, or to devices that have been reculass intention in and the premaikel
the Federal Food, Drug, and Cosmetic Act (Act (hat do not require approval of a premaint Paterial Food, Drug, and Cosmetic Act (Act) that do not require, subject to the peneral
approval Food, Drug, and Cosmetic Act (Act (Act its device, subject to the general approval application (PMA). You may, increity, innsvisions of the Act include
controls provisions of the Act. The general controls provisions of the Acti controls provisions of the Act. The general controls povisions of the more
requirements for annual registration, listing of devices, good manufacturing practice, for requirements for annual registration, noring of

on class III (see above) into either class II (Special Controls) on class III
n affective in the same and colditional controls. Existing major regulations affective If your device is classified (see above) into either class in (special or more)
(PMA), it may be subject to such additional controls. Existing major regulations affecting (PMA), it may be subject to such additional controls. Existing inalyon varios on 895.
your device can be found in Title 21, Code of Federal Regulations (CFR), Parts 800 to 8 (111), world in Title 21, Code of Federal Regulations (Cricy), Farmer (1)
your device can be found in Title 21, Code of Federal Regulations (Crice in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not Please be advised that FDA's issuance of a substantial equirements with requirements
mean that FDA has made a determination that your device with other requirements. Fread that FDA has made a determination that your receral agencies.
of the Act or any Federal stations administered by other Federal agencies.
In registration block the Actil of the Act or any Eederal stantes and regulations administered by online of the Act of any the Act of any the Act of any the Act of any the You must comply with all the Act's requirements, including, our and listing (21 CFR Part 807); labeling (21 CFR 803); marting of the sola); and good
reporting (21 CFR Part 807); labeling (21 CFR 803); and good and hims (reporting of medical device-related adverse evenis) (21 CFR 000), and go
manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820).

4

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,

signature

Counney 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

K122141 K number

Device

IDS-iSYS IGF-I Calibration Verifier

The IDS-iSYS IGF-I Calibration Verifier is a device intended for verification of calibration of the IDS-iSYS IGF-I Assay when performed on the IDS-iSYS Multi-Discipline Automated Analyzer.

Prescription Use X (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)

Division Sign-Off

Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) = 1 2214