K Number
K123087
Device Name
TYSONBIO AC500, AC800 BLOOD GLUCOSE MONITORING SYSTEM, TYSONBIO AC500 AC800 PRO BLOOD GLUCOSE MONITORING SYSTEM
Date Cleared
2013-06-18

(260 days)

Product Code
Regulation Number
862.1345
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The TysonBio AC500 Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC500 Blood Glucose Monitoring System is intended to be used by a single person and should not be shared. The TysonBio AC500 Blood Glucose Monitoring System is intended for self testing outside the body (in vitro diagnostic use) by people with diabetes at home as an aid to monitor the effectiveness of diabetes control. The TysonBio AC500 Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC500 Test Strips are for use with the TysonBio AC500 Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC500 Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results. The TysonBio AC800 Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC800 Blood Glucose Monitoring System is intended to be used by a single person and should not be shared. The TysonBio AC800 Blood Glucose Monitoring System is intended for self testing outside the body (in vitro diagnostic use) by people with diabetes at home as an aid to monitor the effectiveness of diabetes control. The TysonBio AC800 Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC800 contains a voice function but this function is not intended for users with impaired vision. The TysonBio AC800 Test Strips are for use with the TysonBio AC800 Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC800 Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results. The TysonBio AC500 Pro Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood from fingertip, palm, or forearm. The TysonBio AC500 Pro Blood Glucose Monitoring System is intended for testing outside the body (in vitro diagnostic use) and is intended for multiple-patient use in professional healthcare settings as an aid to monitor the effectiveness of diabetes control program. This system should only be used with single-use, auto-disabling lancing devices. The TysonBio AC500 Pro Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC500 Pro Blood Glucose Test Strips are for use with the TysonBio AC500 Pro Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm, The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC500 Pro Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results. The TysonBio AC800 Pro Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood from fingertip, palm, or forearm. The TysonBio AC800 Pro Blood Glucose Monitoring System is intended for testing outside the body (in vitro diagnostic use) and is intended for multiple-patient use in professional healthcare settings as an aid to monitor the effectiveness of diabetes control program. This system should only be used with single-use, auto-disabling lancing devices. The TysonBio AC800 Pro Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC800 Pro contains a voice function but this function is not intended for users with impaired vision. The TysonBio AC800 Pro Blood Glucose Test Strips are for use with the TysonBio AC800 Pro Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC800 Pro Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.
Device Description
The TysonBio AC500/AC800 Blood Glucose Monitoring System consists of three main products: the meter, test strip, and control solutions. These products have been designed, tested, and proven to work together as a system accurate blood glucose test results. Use only TysonBio AC500/AC800 Test Strips and TysonBio AC500/AC800 Control Solution with the TysonBio AC500/AC800 Blood Glucose Monitoring System. The TysonBio AC500 Pro/AC800 Pro Blood Glucose Monitoring System consists of three main products: the meter, test strip, and control solutions. These products have been designed, tested, and proven to work together as a system accurate blood glucose test results. Use only TysonBio AC500 Pro/AC800 Pro Test Strips and TysonBio AC500/AC800 Control Solution with the TysonBio AC500 Pro/AC800 Pro Blood Glucose Monitoring System. The TysonBio AC500/AC800/AC500 Pro/AC800 Pro Blood Glucose Monitoring System consists of: a. TysonBio AC500/AC800/AC500 Pro/AC800 Pro Blood Glucose Meter b. TysonBio AC500/AC800/AC500 Pro/AC800 Pro Test Strips c. TysonBio AC500/AC800 Control Solution
More Information

Not Found

No
The document describes a standard blood glucose monitoring system that measures glucose levels in blood samples. There is no mention of AI or ML in the intended use, device description, or performance studies. The technology appears to be based on electrochemical measurement, which is typical for these devices.

No
The device is described as a "Blood Glucose Monitoring System" intended for quantitative measurement of glucose and monitoring the effectiveness of diabetes control. It is an in vitro diagnostic device that provides information, rather than directly treating or preventing a disease.

No
The text explicitly states: "The TysonBio AC500 Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use." This indicates it is not intended for diagnostic purposes, but rather for monitoring.

No

The device description explicitly states that the system consists of a meter, test strip, and control solutions, which are hardware components.

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

The intended use statement explicitly states:

  • "The TysonBio AC500 Blood Glucose Monitoring System is intended for self testing outside the body (in vitro diagnostic use)..."
  • "The TysonBio AC800 Blood Glucose Monitoring System is intended for self testing outside the body (in vitro diagnostic use)..."
  • "The TysonBio AC500 Pro Blood Glucose Monitoring System is intended for testing outside the body (in vitro diagnostic use)..."
  • "The TysonBio AC800 Pro Blood Glucose Monitoring System is intended for testing outside the body (in vitro diagnostic use)..."

This repeated phrase clearly indicates that the device is intended for use outside of the body to diagnose or monitor a condition, which is the definition of an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

TysonBio AC500 Blood Glucose Monitoring System: The TysonBio AC500 Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC500 Blood Glucose Monitoring System is intended to be used by a single person and should not be shared. The TysonBio AC500 Blood Glucose Monitoring System is intended for self testing outside the body (in vitro diagnostic use) by people with diabetes at home as an aid to monitor the effectiveness of diabetes control. The TysonBio AC500 Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC500 Test Strips are for use with the TysonBio AC500 Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC500 Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.

TysonBio AC800 Blood Glucose Monitoring System: The TysonBio AC800 Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC800 Blood Glucose Monitoring System is intended to be used by a single person and should not be shared. The TysonBio AC800 Blood Glucose Monitoring System is intended for self testing outside the body (in vitro diagnostic use) by people with diabetes at home as an aid to monitor the effectiveness of diabetes control. The TysonBio AC800 Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC800 contains a voice function but this function is not intended for users with impaired vision. The TysonBio AC800 Test Strips are for use with the TysonBio AC800 Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC800 Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.

TysonBio AC500 Pro Blood Glucose Monitoring System: The TysonBio AC500 Pro Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood from fingertip, palm, or forearm. The TysonBio AC500 Pro Blood Glucose Monitoring System is intended for testing outside the body (in vitro diagnostic use) and is intended for multiple-patient use in professional healthcare settings as an aid to monitor the effectiveness of diabetes control program. This system should only be used with single-use lancing devices. The TysonBio AC500 Pro Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC500 Pro Blood Glucose Test Strips are for use with the TysonBio AC500 Pro Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC500 Pro Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.

TysonBio AC800 Pro Blood Glucose Monitoring System: The TysonBio AC800 Pro Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood from fingertip, palm, or forearm. The TysonBio AC800 Pro Blood Glucose Monitoring System is intended for testing outside the body (in vitro diagnostic use) and is intended for multiple-patient use in professional healthcare settings as an aid to monitor the effectiveness of diabetes control program. This system should only be used with single-use lancing devices. The TysonBio AC800 Pro Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC800 Pro contains a voice function but this function is not intended for users with impaired vision. The TysonBio AC800 Pro Blood Glucose Test Strips are for use with the TysonBio AC800 Pro Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC800 Pro Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.

Product codes

NBW, CGA, JJX

Device Description

The TysonBio AC500/AC800 Blood Glucose Monitoring System consists of three main products: the meter, test strip, and control solutions. These products have been designed, tested, and proven to work together as a system accurate blood glucose test results. Use only TysonBio AC500/AC800 Test Strips and TysonBio AC500/AC800 Control Solution with the TysonBio AC500/AC800 Blood Glucose Monitoring System. The TysonBio AC500 Pro/AC800 Pro Blood Glucose Monitoring System consists of three main products: the meter, test strip, and control solutions. These products have been designed, tested, and proven to work together as a system accurate blood glucose test results. Use only TysonBio AC500 Pro/AC800 Pro Test Strips and TysonBio AC500/AC800 Control Solution with the TysonBio AC500 Pro/AC800 Pro Blood Glucose Monitoring System. The TysonBio AC500/AC800/AC500 Pro/AC800 Pro Blood Glucose Monitoring System consists of: a. TysonBio AC500/AC800/AC500 Pro/AC800 Pro Blood Glucose Meter b. TysonBio AC500/AC800/AC500 Pro/AC800 Pro Test Strips c. TysonBio AC500/AC800 Control Solution.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Fingertips, forearm, palm

Indicated Patient Age Range

Not Found

Intended User / Care Setting

TysonBio AC500 Blood Glucose Monitoring System: single person, self-testing, at home.
TysonBio AC800 Blood Glucose Monitoring System: single person, self-testing, at home.
TysonBio AC500 Pro Blood Glucose Monitoring System: multiple-patient use, professional healthcare settings.
TysonBio AC800 Pro Blood Glucose Monitoring System: multiple-patient use, professional healthcare settings.

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 performance of TysonBio AC500/AC800/AC500 Pro/AC800 Pro Blood Glucose Monitoring System was studied in the laboratory and in clinical settings by healthcare professionals and lay users. The studies demonstrated that the performance of this system meets its intended use.

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

Not Found

Predicate Device(s)

K101543

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1345 Glucose test system.

(a)
Identification. A glucose test system is a device intended to measure glucose quantitatively in blood and other body fluids. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic hypoglycemia, and of pancreatic islet cell carcinoma.(b)
Classification. Class II (special controls). The device, when it is solely intended for use as a drink to test glucose tolerance, is 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) SUMMARY

JUN 1 8 2013

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of 21 CFR 807.92.

    1. Date prepared May 8, 2013

2. Sponsor information Tyson Bioresearch, Inc. 5 F., # 22, Ke E. Road III., science based industrial park Chun-Nan, Miao-Li county, Taiwan 350

Correspondent: WEN-HAI TSAI Phone: 886-37-585988 EXT 720 Facsimile: 886-37-585996

3. Device name and classification

Device Name:

TysonBio AC500 Blood Glucose Monitoring System TysonBio AC800 Blood Glucose Monitoring System TysonBio AC500 Pro Blood Glucose Monitoring System TysonBio AC800 Pro Blood Glucose Monitoring System TysonBio AC500/AC800 Control Solution TysonBio AC500 Test Strip TysonBio AC800 Test Strip TysonBio AC500 Pro Test Strip TysonBio AC800 Pro Test Strip

Common Names:

Blood Glucose Monitoring System

Classification:

Classification Regulation: 21 CFR 862.1345 and 21CFR 862.1660 Classification: Class II (Glucose Test System)

Class I (Quality control material )

Product Code:

NBW- System, Test, Blood Glucose, Over-the-counter

CGA - Glucose Oxidase, Glucose

  • JJX Single (specified) analyte controls (assayed and unassayed)
  • Panel Clinical Chemistry and Toxicology

1

4. Device description

The TysonBio AC500/AC800 Blood Glucose Monitoring System consists of three main products: the meter, test strip, and control solutions. These products have been designed, tested, and proven to work together as a system accurate blood glucose test results. Use only TysonBio AC500/AC800 Test Strips and TysonBio AC500/AC800 Control Solution with the TysonBio AC500/AC800 Blood Glucose Monitoring System.

The TysonBio AC500 Pro/AC800 Pro Blood Glucose Monitoring System consists of three main products: the meter, test strip, and control solutions. These products have been designed, tested, and proven to work together as a system accurate blood glucose test results. Use only TysonBio AC500 Pro/AC800 Pro Test Strips and TysonBio AC500/AC800 Control Solution with the TysonBio AC500 Pro/AC800 Pro Blood Glucose Monitoring System.

The TysonBio AC500/AC800/AC500 Pro/AC800 Pro Blood Glucose Monitoring System consists of:

  • a. TysonBio AC500/AC800/AC500 Pro/AC800 Pro Blood Glucose Meter
  • b. TysonBio AC500/AC800/AC500 Pro/AC800 Pro Test Strips
  • c. TysonBio AC500/AC800 Control Solution

5. Intended use

TysonBio AC500 Blood Glucose Monitoring System :

The TysonBio AC500 Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC500 Blood Glucose Monitoring System is intended to be used by a single person and should not be shared.

The TysonBio AC500 Blood Glucose Monitoring System is intended for self testing outside the body (in vitro diagnostic use) by people with diabetes at home as an aid to monitor the effectiveness of diabetes control. The TysonBio AC500 Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly).

The TysonBio AC500 Test Strips are for use with the TysonBio AC500 Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm.

The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC500 Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.

2

TysonBio AC800 Blood Glucose Monitoring System :

The TysonBio AC800 Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC800 Blood Glucose Monitoring System is intended to be used by a single person and should not be shared.

The TysonBio AC800 Blood Glucose Monitoring System is intended for self testing outside the body (in vitro diagnostic use) by people with diabetes at home as an aid to monitor the effectiveness of diabetes control. The TysonBio AC800 Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC800 contains a voice function but this function is not intended for users with impaired vision.

The TysonBio AC800 Test Strips are for use with the TysonBio AC800 Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm.

The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC800 Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.

TysonBio AC500 Pro Blood Glucose Monitoring System :

The TysonBio AC500 Pro Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood from fingertip, palm, or forearm. The TysonBio AC500 Pro Blood Glucose Monitoring System is intended for testing outside the body (in vitro diagnostic use) and is intended for multiple-patient use in professional healthcare settings as an aid to monitor the effectiveness of diabetes control program. This system should only be used with single-use lancing devices.

The TysonBio AC500 Pro Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly).

The TysonBio AC500 Pro Blood Glucose Test Strips are for use with the TysonBio AC500 Pro Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm.

The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC500 Pro Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.

TysonBio AC800 Pro Blood Glucose Monitoring System :

The TysonBio AC800 Pro Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood from fingertip, palm, or forearm. The TysonBio AC800 Pro Blood Glucose Monitoring System is intended for testing outside the body (in vitro diagnostic use) and is intended for multiple-patient use in professional healthcare settings as an aid to monitor the

3

effectiveness of diabetes control program. This system should only be used with single-use lancing devices.

The TysonBio AC800 Pro Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC800 Pro contains a voice function but this function is not intended for users with impaired vision.

The TysonBio AC800 Pro Blood Glucose Test Strips are for use with the TysonBio AC800 Pro Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm.

The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC800 Pro Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.

6. Test principle

The test principle is based on electrochemical biosensor technology using glucose oxidase. There has been no change to the fundamental scientific technology.

7. Predicate device

TysonBio AC100 Blood Glucose Monitoring System (K101543)

Proposed DevicePredicate Device
ItemTysonBio AC500TysonBio AC800TysonBio AC100
Meter appearanceImage: TysonBio AC500 meterImage: TysonBio AC800 meterImage: TysonBio AC100 meter
BacklightNASelectable backlight
on/off by userNA
Voice guidanceNASelectable on/off
voice guidanceIDENTICAL
Hematocrit range20~60%20~60%35-55%
Meal flagAppleAppleHamburger

Difference:

4

Image /page/4/Picture/0 description: The image shows three digital displays, likely from a medical device such as a glucose meter. The first two displays show similar readings with the time as 88-88 and a value of 88.8 mg/dL. The third display shows a similar time, but the value is 888 mg/dL.

.

Similarities:

.

Proposed DevicePredicate Device
ItemTysonBio AC500TysonBio AC800TysonBio AC100
Test principleElectrochemical
biosensor with
glucose oxidase.IDENTICALIDENTICAL
Blood sampleFingertip, palm and
forearmIDENTICALIDENTICAL
Sample volume0.5uLIDENTICALIDENTICAL
Test time5 secondsIDENTICALIDENTICAL
Detecting range20 ~ 600 mg/dLIDENTICALIDENTICAL
Unit of measurementmg/dL or mmol/LIDENTICALIDENTICAL
CodingAuto coding by
inserting the test stripIDENTICALIDENTICAL
Operating temperature10 to 40 °C (50-104
°F)IDENTICALIDENTICAL
Operating humidity10 to 90%IDENTICALIDENTICAL
Average result7,14, 30 days pre
meal and post meal
test averageIDENTICALIDENTICAL
Hypoglycemic and
hyperglycemic alarm2 user setting alarmsIDENTICALIDENTICAL
Reminder alarm4 user setting alarmsIDENTICALIDENTICAL
PC link ProtocolUSB protocolIDENTICALIDENTICAL
Control solution3 Levels availableIDENTICALIDENTICAL
Strip storage
temperature4 to 30 °C (40-86°F)IDENTICALIDENTICAL
Memory capacity500 test result
memoriesIDENTICALIDENTICAL
Supply powerTwo AAA batteriesIDENTICALIDENTICAL
ButtonThree operating
button (M, up and
down)
One ejection buttonIDENTICALIDENTICAL

5

The hematocrit range of proposed devices is 20%~60% by sensing voltage and algorithm change from predicted device.

8. Performance characteristic summary

The performance of TysonBio AC500/AC800/AC500 Pro/AC800 Pro Blood Glucose Monitoring System was studied in the laboratory and in clinical settings by healthcare professionals and lay users. The studies demonstrated that the performance of this system meets its intended use.

9. Conclusion

The TysonBio AC500/AC800/AC500 Pro/AC800 Pro Blood Glucose Monitoring System is substantially equivalent to the predicate device.

6

Image /page/6/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo consists of a stylized eagle with three tail feathers, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circle around the eagle. The text is in all caps and is relatively small compared to the eagle symbol.

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

June 18, 2013

Tyson Bioresearch. Inc. C/O Wen-Hai Tsai, Ph.D. 5F., #22, Ke E.Road III., Science-Based Industrial Park CHUN-NAN, MIAO-LI COUNTY, TAIWAN, R.O.C. 350

Re: K123087

Trade/Device Name: TysonBio AC500 Blood Glucose Monitoring System TysonBio AC800 Blood Glucose Monitoring System Tyson Bio AC500 Pro Blood Glucose Monitoring System TysonBio AC800 Pro Blood Glucose monitoring System Regulation Number: 21 CFR 862.1345 Regulation Name: Glucose test system Regulatory Class: II Product Code: NBW, CGA, JJX Dated: May 18, 2013

Received: May 23, 2013

Dear Dr. Tsai:

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.off devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

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 (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

7

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/CDRHQffices/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/Resourcesfor You/Industry/default.htm.

Sincerely yours,

Carol C. Benson -S for

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

Enclosure

8

Indications for Use Form

510(k) Number (if known): K123087

Device Name: TysonBio AC500 Blood Glucose Monitoring System

Indications for Use:

The TysonBio AC500 Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC500 Blood Glucose Monitoring System is intended to be used by a single person and should not be shared.

The TysonBio AC500 Blood Glucose Monitoring System is intended for self testing outside the body (in vitro diagnostic use) by people with diabetes at home as an aid to monitor the effectiveness of diabetes control. The TysonBio AC500 Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly).

The TysonBio AC500 Test Strips are for use with the TysonBio AC500 Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm.

The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC500 Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.

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

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

Concurrence of CDRH, Office of In Vitro Diagnostics and Radiologic Health (OIR)

Katherine /Serrano

Division Sign-Off Office of In Vitro Diagnostics and Radiologic Health

510(k) K123087

9

Indications for Use Form

510(k) Number (if known): K123087

Device Name: TysonBio AC800 Blood Glucose Monitoring System

Indications for Use:

The TysonBio AC800 Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC800 Blood Glucose Monitoring System is intended to be used by a single person and should not be shared.

The TysonBio AC800 Blood Glucose Monitoring System is intended for self testing outside the body (in vitro diagnostic use) by people with diabetes at home as an aid to monitor the effectiveness of diabetes control. The TysonBio AC800 Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC800 contains a voice function but this function is not intended for users with impaired vision.

The TysonBio AC800 Test Strips are for use with the TysonBio AC800 Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm.

The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC800 Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.

Prescription UseAND/OR Over-The-Counter Use X
(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 Diagnostics and Radiologic Health (OlR)

Katherine //Serrano

Division Sign-Off Office of In Vitro Diagnostics and Radiologic Health

Page 2 of 4

10

510(k) K123087

Indications for Use Form

510(k) Number (if known): K123087

Device Name: TysonBio AC500 Pro Blood Glucose Monitoring System

Indications for Use:

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The TysonBio AC500 Pro Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood from fingertip, palm, or forearm. The TysonBio AC500 Pro Blood Glucose Monitoring System is intended for testing outside the body (in vitro diagnostic use) and is intended for multiple-patient use in professional healthcare settings as an aid to monitor the effectiveness of diabetes control program. This system should only be used with single-use, auto-disabling lancing devices.

The TysonBio AC500 Pro Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC500 Pro Blood Glucose Test Strips are for use with the TysonBio AC500 Pro Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm,

The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC500 Pro Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.

Prescription Use X (Part 21 CFR 801 Subpart D)


AND/OR Over-The-Counter Use X_ (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 Diagnostics and Radiologic Health (OIR)

Katherine /Serrano

Division Sign-Off Office of In Vitro Diagnostics and Radiologic Health

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510(k) K123087

Indications for Use Form

510(k) Number (if known): K123087

Device Name: TysonBio AC800 Pro Blood Glucose Monitoring System

Indications for Use:

The TysonBio AC800 Pro Blood Glucose Monitoring System is intended to be used for the quantitative measurement of glucose (sugar) in fresh capillary whole blood from fingertip, palm, or forearm. The TysonBio AC800 Pro Blood Glucose Monitoring System is intended for testing outside the body (in vitro diagnostic use) and is intended for multiple-patient use in professional healthcare settings as an aid to monitor the effectiveness of diabetes control program. This system should only be used with single-use, auto-disabling lancing devices.

The TysonBio AC800 Pro Blood Glucose Monitoring System should not be used for the diagnosis of or screening of diabetes or for neonatal use. Alternative site testing should be done only during steady - state times (when glucose is not changing rapidly). The TysonBio AC800 Pro contains a voice function but this function is not intended for users with impaired vision.

The TysonBio AC800 Pro Blood Glucose Test Strips are for use with the TysonBio AC800 Pro Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertips, forearm or palm. The TysonBio AC500/AC800 Control Solutions is for use on the TysonBio AC800 Pro Blood Glucose Monitoring Systems to check that the meter and test strips are working together properly and providing accurate results.

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

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

Concurrence of CDRH, Office of In Vitro Diagnostics and Radiologic Health (OIR)

Katherine Serrano

Division Sign-Off Office of In Vitro Diagnostics and Radiologic Health

510(k) K123087