K Number
K123953
Date Cleared
2013-05-02

(132 days)

Product Code
Regulation Number
862.1160
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The ACE Carbon Dioxide (CO2-LC) Reagent is intended for the quantitative determination of carbon dioxide concentration in serum and lithium heparin plasma using the ACE, ACE Alera, and ACE Axcel Clinical Chemistry Systems. Bicarbonate/carbon dioxide measurements are used in the diagnosis and treatment of numerous potentially serious disorders associated with changes in body acid-base balance. This test is intended for use in clinical laboratories or physician office laboratories. For in vitro diagnostic use only.

The ACE Direct Bilirubin Reagent is intended for the quantitative determination of direct bilirubin concentration in serum and lithium heparin plasma using the ACE, ACE Alera, and ACE Axcel Clinical Chemistry Systems. Measurements of the levels of bilirubin, an organic compound formed during the normal and abnormal destruction of red blood cells, is used in the diagnosis and treatment of liver, hemolytic, hematological and metabolic disorders, including hepatitis and gall bladder block. This test is intended for use in clinical laboratories or physician office laboratories. For in vitro diagnostic use only.

The ACE Total Bilirubin Reagent is intended for the quantitative determination of total bilirubin concentration in serum and lithium heparin plasma using the ACE, ACE Alera and ACE Axcel Clinical Chemistry System. Measurements of the levels of bilirubin, an organic compound formed during the normal and abnormal destruction of red blood cells, is used in the diagnosis and treatment of liver, hemolytic, hematological and metabolic disorders, including hepatitis and gall bladder block. This test is intended for use in clinical laboratories or physician office laboratories. For in vitro diagnostic use only.

The ACE Magnesium Reagent is intended for the quantitative determination of magnesium in serum and lithium heparin plasma using the ACE, ACE Alera and ACE Axcel Clinical Chemistry Systems. Magnesium measurements are used in the diagnosis and treatment of hypomagnesemia (abnormally low plasma levels of magnesium) and hypermagnesemia (abnormally high plasma levels of magnesium). This test is intended for use in clinical laboratories or physician office laboratories. For in vitro diagnostic use only.

Device Description

In the ACE Carbon Dioxide (CO2-LC) Reagent assay, serum carbon dioxide (in the form of bicarbonate) reacts with phosphoenolpyruvate in the presence of phosphoenolpyruvate carboxylase and magnesium to yield oxaloacetic acid and phosphate. In the presence of malate dehydrogenase, the reduced cofactor is oxidized by oxaloacetic acid. The reduced cofactor absorbs strongly at 408 nm whereas its oxidized form does not. The rate of decrease in absorbance, monitored bichromatically at 408 nm/692 nm, is proportional to the carbon dioxide content of the sample.

In the ACE Direct Bilirubin Reagent assay, sodium nitrite added to sulfanilic acid forms diazotized sulfanilic acid. Bilirubin glucuronide in serum reacts with diazotized sulfanilic acid to form azobilirubin, which absorbs strongly at 554 nm. The increase in absorbance, measured bichromatically at 554 nm/692 nm, one minute after sample addition, is directly proportional to the direct bilirubin concentration.

In the ACE Total Bilirubin Reagent assay, sodium nitrite, when added to sulfanilic acid, forms diazotized sulfanilic acid. Bilirubin in serum reacts with diazotized sulfanilic acid to form azobilirubin, which absorbs strongly at 554 nm. The inclusion of dimethyl sulfoxide (DMSO) in the reagent as an accelerator causes both direct and indirect bilirubin to react rapidly. The increase in absorbance, measured bichromatically at 554 nm/692 nm, is directly proportional to the total bilirubin concentration in the sample.

Magnesium ions in serum react with Xylidyl blue-1 in an alkaline medium to produce a red complex which is measured bichromatically at 525 nm/692 nm. The intensity of color produced is directly proportional to the magnesium concentration in the sample. EGTA prevents calcium interference by preferential chelation of calcium present in the sample. A surfactant system is included to remove protein interference.

AI/ML Overview

The provided text describes several in vitro diagnostic reagents (ACE Carbon Dioxide (CO2-LC) Reagent, ACE Direct Bilirubin Reagent, ACE Total Bilirubin Reagent, and ACE Magnesium Reagent) and their associated performance data. There isn't information about an AI-powered device or software. Therefore, questions related to AI aspects like multi-reader multi-case studies, effect size of AI assistance, or standalone algorithm performance are not applicable.

The acceptance criteria are not explicitly stated as clear thresholds in the provided document; rather, the document presents detailed performance data (precision, linearity, interference, and method comparison) that demonstrates the device's capability to perform as intended and to be substantially equivalent to its predicate devices. The "reported device performance" is presented directly through tables and statistical analyses for each reagent.

Here's an attempt to structure the available information based on the request, interpreting "acceptance criteria" as the performance demonstrated to support substantial equivalence:

1. Table of Acceptance Criteria and Reported Device Performance

Since explicit "acceptance criteria" (i.e., predefined thresholds for performance metrics) are not provided in the document, the "Reported Device Performance" below represents the data presented that presumably met the internal criteria for demonstrating substantial equivalence. The document primarily focuses on precision, linearity, interference, and method comparison with predicate devices and between different systems (ACE, ACE Alera, ACE Axcel).

ACE Carbon Dioxide (CO2-LC) Reagent

MetricAcceptance Criteria (Inferred from study design and historical data, not explicitly stated values)Reported Device Performance (Summary of results across systems/sites)
Precision (In-House)(Implied to be comparable to or better than predicate and acceptable for clinical use)Serum: Low: ~1.1-2.5% CV (Within-Run), ~5.6-7.5% CV (Total)Mid: ~1.2-1.5% CV (Within-Run), ~3.3-3.7% CV (Total)High: ~0.6-2.8% CV (Within-Run), ~2.6-3.2% CV (Total)Plasma:Low: ~1.3-3.0% CV (Within-Run), ~3.8-6.1% CV (Total)Mid: ~0.7-1.2% CV (Within-Run), ~5.0-5.5% CV (Total)High: ~1.0% CV (Within-Run), ~2.3-2.5% CV (Total)
Precision (POL sites)(Implied to be comparable to in-house and acceptable for clinical use)ACE: Low (Sample 1): ~1.6-3.3% CV (Within-Run), ~3.0-4.3% CV (Total)Mid (Sample 2): ~1.7-3.1% CV (Within-Run), ~2.7-7.4% CV (Total)High (Sample 3): ~1.8-2.4% CV (Within-Run), ~2.4-6.4% CV (Total)ACE Alera: Low (Sample 1): ~1.3-2.0% CV (Within-Run), ~3.0-6.7% CV (Total)Mid (Sample 2): ~0.9-1.7% CV (Within-Run), ~2.4-3.9% CV (Total)High (Sample 3): ~1.0-1.6% CV (Within-Run), ~3.1-5.8% CV (Total)
Method Comparison (Serum vs. Plasma)(Slope near 1, intercept near 0, high correlation)ACE: Slope: 1.031, Intercept: -1.03, Correlation: 0.9922ACE Alera: Slope: 1.000, Intercept: -0.09, Correlation: 0.9955ACE Axcel: Slope: 0.988, Intercept: -0.35, Correlation: 0.9889
Method Comparison (POL vs. In-House)(Slope near 1, intercept near 0, high correlation)ACE (POL 1-3 vs. In-House ACE): Slopes: 0.963-0.984, Intercepts: -0.71-1.29, Correlations: 0.9530-0.9908 ACE Alera (POL 1-3 vs. In-House ACE): Slopes: 0.972-0.987, Intercepts: 0.10-0.57, Correlations: 0.9767-0.9903
Detection Limits (ACE Alera)(Appropriate for clinical use)LoB: 1.27 mEq/L, LoD: 1.97 mEq/L, LoQ: 3.03 mEq/L
Linearity (ACE Alera)(Linearity up to/beyond desired measuring range)Linear to: 50 mEq/L (Equation: y=1.006x + 0.01)
Interferences (ACE Alera)(No significant interference from common interferents)No significant interference at or below Icterus 58.8 mg/dL, Hemolysis 250 mg/dL, Lipemia 2388 mg/dL, Ascorbic Acid 6 mg/dL

ACE Direct Bilirubin Reagent

MetricAcceptance Criteria (Inferred from study design and historical data, not explicitly stated values)Reported Device Performance (Summary of results across systems/sites)
Precision (In-House)(Implied to be comparable to or better than predicate and acceptable for clinical use)Serum: Low: ~12.5-24.5% CV (Within-Run), ~14.0-30.0% CV (Total)Mid: ~0.9-1.6% CV (Within-Run), ~1.2-2.2% CV (Total)High: ~0.6-1.5% CV (Within-Run), ~1.1-1.7% CV (Total)Plasma:Low: ~16.6-26.6% CV (Within-Run), ~19.7-35.4% CV (Total)Mid: ~0.8-2.4% CV (Within-Run), ~1.1-2.8% CV (Total)High: ~0.7-1.9% CV (Within-Run), ~1.1-2.3% CV (Total)
Precision (POL sites)(Implied to be comparable to in-house and acceptable for clinical use)ACE: Low (Sample 1): ~2.9-4.2% CV (Within-Run), ~2.9-4.9% CV (Total)Mid (Sample 2): ~1.0-1.8% CV (Within-Run), ~1.3-2.1% CV (Total)High (Sample 3): ~1.3-2.3% CV (Within-Run), ~2.0-2.3% CV (Total)ACE Alera: Low (Sample 1): ~2.5-5.1% CV (Within-Run), ~2.5-5.4% CV (Total)Mid (Sample 2): ~1.0-1.5% CV (Within-Run), ~1.0-1.9% CV (Total)High (Sample 3): ~0.6-2.6% CV (Within-Run), ~1.3-2.6% CV (Total)
Method Comparison (Serum vs. Plasma)(Slope near 1, intercept near 0, high correlation)ACE: Slope: 1.021, Intercept: 0.00, Correlation: 0.9982ACE Alera: Slope: 1.005, Intercept: 0.01, Correlation: 0.9978ACE Axcel: Slope: 1.004, Intercept: 0.00, Correlation: 0.9983
Method Comparison (POL vs. In-House)(Slope near 1, intercept near 0, high correlation)ACE (POL 1-3 vs. In-House ACE): Slopes: 1.003-1.022, Intercepts: 0.04-0.11, Correlations: 0.9984-0.9986 ACE Alera (POL 1-3 vs. In-House ACE): Slopes: 0.969-0.995, Intercepts: 0.09-0.11, Correlations: 0.9984-0.9991
Detection Limits (ACE Alera)(Appropriate for clinical use)LoB: 0.06 mg/dL, LoD: 0.08 mg/dL, LoQ: 0.12 mg/dL
Linearity (ACE Alera)(Linearity up to/beyond desired measuring range)Linear to: 14.0 mg/dL (Equation: y=1.015x + 0.16)
Interferences (ACE Alera)(No significant interference from common interferents)Not Applicable (Icterus), No significant interference at or below Hemolysis 62.5 mg/dL, Lipemia 782 mg/dL, Ascorbic Acid 6 mg/dL

ACE Total Bilirubin Reagent

MetricAcceptance Criteria (Inferred from study design and historical data, not explicitly stated values)Reported Device Performance (Summary of results across systems/sites)
Precision (In-House)(Implied to be comparable to or better than predicate and acceptable for clinical use)Serum: Low: ~11.0-21.3% CV (Within-Run), ~13.9-21.3% CV (Total)Mid: ~1.0-1.1% CV (Within-Run), ~1.0-1.1% CV (Total)High: ~0.4-0.7% CV (Within-Run), ~0.5-0.8% CV (Total)Plasma:Low: ~20.3-23.7% CV (Within-Run), ~21.3-29.4% CV (Total)Mid: ~0.5-1.0% CV (Within-Run), ~0.5-1.1% CV (Total)High: ~0.5-0.6% CV (Within-Run), ~0.5-0.7% CV (Total)
Precision (POL sites)(Implied to be comparable to in-house and acceptable for clinical use)ACE: Low (Sample 1): ~3.4-5.5% CV (Within-Run), ~3.7-5.8% CV (Total)Mid (Sample 2): ~0.5-1.7% CV (Within-Run), ~1.3-3.7% CV (Total)High (Sample 3): ~1.0-1.2% CV (Within-Run), ~1.2-2.1% CV (Total)ACE Alera: Low (Sample 1): ~4.2-4.9% CV (Within-Run), ~4.5-5.2% CV (Total)Mid (Sample 2): ~0.7-2.0% CV (Within-Run), ~0.8-2.1% CV (Total)High (Sample 3): ~0.5-1.4% CV (Within-Run), ~0.6-1.7% CV (Total)
Method Comparison (Serum vs. Plasma)(Slope near 1, intercept near 0, high correlation)ACE: Slope: 1.017, Intercept: 0.01, Correlation: 0.9996ACE Alera: Slope: 1.020, Intercept: 0.00, Correlation: 0.9993ACE Axcel: Slope: 1.008, Intercept: 0.00, Correlation: 0.9995
Method Comparison (POL vs. In-House)(Slope near 1, intercept near 0, high correlation)ACE (POL 1-3 vs. In-House ACE): Slopes: 0.979-1.000, Intercepts: 0.00-0.04, Correlations: 0.9995-0.9998 ACE Alera (POL 1-3 vs. In-House ACE): Slopes: 0.957-1.020, Intercepts: 0.01-0.07, Correlations: 0.9991-0.9998
Detection Limits (ACE Alera)(Appropriate for clinical use)LoB: 0.11 mg/dL, LoD: 0.14 mg/dL, LoQ: 0.14 mg/dL
Linearity (ACE Alera)(Linearity up to/beyond desired measuring range)Linear to: 40.0 mg/dL (Equation: y=1.004x + 0.03)
Interferences (ACE Alera)(No significant interference from common interferents)Not Applicable (Icterus), No significant interference at or below Hemolysis 62.5 mg/dL, Lipemia 951 mg/dL, Ascorbic Acid 6 mg/dL

ACE Magnesium Reagent

MetricAcceptance Criteria (Inferred from study design and historical data, not explicitly stated values)Reported Device Performance (Summary of results across systems/sites)
Precision (In-House)(Implied to be comparable to or better than predicate and acceptable for clinical use)Serum: Low: ~3.1-5.1% CV (Within-Run), ~4.3-5.9% CV (Total)Mid: ~1.7-2.6% CV (Within-Run), ~1.8-3.0% CV (Total)High: ~1.0-1.4% CV (Within-Run), ~1.6-1.7% CV (Total)Plasma:Low: ~2.4-4.7% CV (Within-Run), ~4.1-6.8% CV (Total)Mid: ~2.4-2.8% CV (Within-Run), ~2.6-3.7% CV (Total)High: ~0.9-1.6% CV (Within-Run), ~1.8-1.9% CV (Total)
Precision (POL sites)(Implied to be comparable to in-house and acceptable for clinical use)ACE: Low (Sample 1): ~3.3-4.6% CV (Within-Run), ~5.0-6.3% CV (Total)Mid (Sample 2): ~1.3-2.5% CV (Within-Run), ~2.8-3.5% CV (Total)High (Sample 3): ~1.1-1.8% CV (Within-Run), ~1.4-3.1% CV (Total)ACE Alera: Low (Sample 1): ~3.0-6.0% CV (Within-Run), ~4.5-8.4% CV (Total)Mid (Sample 2): ~2.0-2.9% CV (Within-Run), ~2.5-5.2% CV (Total)High (Sample 3): ~0.9-1.9% CV (Within-Run), ~1.6-4.8% CV (Total)
Method Comparison (Serum vs. Plasma)(Slope near 1, intercept near 0, high correlation)ACE: Slope: 0.957, Intercept: 0.04, Correlation: 0.9765ACE Alera: Slope: 0.986, Intercept: 0.05, Correlation: 0.9817ACE Axcel: Slope: 0.986, Intercept: 0.025, Correlation: 0.9892
Method Comparison (POL vs. In-House)(Slope near 1, intercept near 0, high correlation)ACE (POL 1-3 vs. In-House ACE): Slopes: 0.970-1.026, Intercepts: -0.04-0.16, Correlations: 0.9902-0.9927 ACE Alera (POL 1-3 vs. In-House ACE): Slopes: 0.990-1.010, Intercepts: -0.11-0.00, Correlations: 0.9870-0.9930
Detection Limits (ACE Alera)(Appropriate for clinical use)LoB: 0.26 mg/dL, LoD: 0.37 mg/dL, LoQ: 0.37 mg/dL
Linearity (ACE Alera)(Linearity up to/beyond desired measuring range)Linear to: 6.1 mg/dL (Equation: y=0.959x + 0.27)
Interferences (ACE Alera)(No significant interference from common interferents)No significant interference at or below Icterus 50 mg/dL, Hemolysis 500 mg/dL, Lipemia 620 mg/dL, Ascorbic Acid 6 mg/dL

2. Sample Size Used for the Test Set and the Data Provenance

The document describes several types of studies:

  • In-House Precision:

    • CO2-LC: Low, Mid, High serum and plasma samples were tested (number of replicates per sample and runs is implicitly part of SD/CV calculation, but not explicitly stated).
    • Direct Bilirubin: Low, Mid, High serum and plasma samples.
    • Total Bilirubin: Low, Mid, High serum and plasma samples.
    • Magnesium: Low, Mid, High serum and plasma samples.
    • Data Provenance: In-house (Alfa Wassermann Diagnostic Technologies, LLC, West Caldwell, NJ), prospective testing.
  • POL (Physician Office Laboratory) Precision: Studies conducted at 3 POL sites.

    • CO2-LC: 3 samples at each of 3 POL sites and in-house.
    • Direct Bilirubin: 3 samples at each of 3 POL sites and in-house.
    • Total Bilirubin: 3 samples at each of 3 POL sites and in-house.
    • Magnesium: 3 samples at each of 3 POL sites and in-house.
    • Data Provenance: Not explicitly stated but inferred to be from POLs in the USA (prospective testing under typical POL conditions).
  • In-House Matrix Comparison (Serum vs. Plasma):

    • CO2-LC: 53-54 pairs (serum/plasma) on ACE and ACE Alera; 51 pairs on ACE Axcel.
    • Direct Bilirubin: 102 pairs on ACE; 101 pairs on ACE Alera; 56 pairs on ACE Axcel.
    • Total Bilirubin: 102 pairs on ACE and ACE Alera; 56 pairs on ACE Axcel.
    • Magnesium: 101 pairs on ACE and ACE Alera; 55 pairs on ACE Axcel.
    • Data Provenance: In-house, retrospective (presumably collected for a range of values).
  • POL Method Comparison (In-House ACE vs. POL ACE/Alera):

    • CO2-LC: 45-46 samples per POL site comparison.
    • Direct Bilirubin: 49-51 samples per POL site comparison.
    • Total Bilirubin: 48-50 samples per POL site comparison.
    • Magnesium: 50-52 samples per POL site comparison.
    • Data Provenance: Not explicitly stated but inferred to be from POLs in the USA (prospective testing under typical POL conditions) compared against in-house data.
  • Detection Limits (LoB, LoD, LoQ), Linearity, Interferences (ACE Alera):

    • Sample sizes for detection limits and linearity: Not explicitly stated, typically involves multiple replicates at various concentrations.
    • Sample sizes for interferences: Not explicitly stated, typically involves samples spiked with various concentrations of interferents.
    • Data Provenance: In-house.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and the Qualifications of Those Experts

This information is not provided in the document. For in vitro diagnostic assays, the "ground truth" is typically the reference method or established clinical laboratory results obtained from a highly accurate and calibrated instrument or laboratory using validated methods, rather than human expert consensus for image or clinical interpretation. The document compares performance against other (presumably established) methods and predicate devices.

4. Adjudication Method for the Test Set

This concept (e.g., 2+1, 3+1 for resolving discrepancies) is not applicable to these types of in vitro diagnostic device studies. Performance is measured numerically and objectively.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No. This is an in vitro diagnostic assay, not an AI-powered diagnostic imaging device.

6. Standalone (i.e., algorithm only without human-in-the-loop performance) was done

Not applicable. This is not an AI algorithm. The performance data presented are for the reagent and instrument system.

7. The Type of Ground Truth Used

For precision studies, the "ground truth" is the true concentration of the analyte in the control material or patient sample, which is established by reference methods or manufacturing specifications of the control materials. For method comparison studies, the predicate device's results or an established in-house method are used as the comparative reference. The document states the intended use is for "quantitative determination" of analytes, implying comparison to a quantitative gold standard.

8. The Sample Size for the Training Set

Not applicable. This is not a machine learning device and therefore does not have a "training set" in that context. The development of reagents and the establishment of their performance characteristics do not involve machine learning training sets.

9. How the Ground Truth for the Training Set was Established

Not applicable, as there is no "training set" for these reagents in the context of AI/ML.

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. K123953

510(k) SUMMARY

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MAY 2 2013

510(k) Owner:Alfa Wassermann Diagnostic Technologies, LLC4 Henderson DriveWest Caldwell, NJ 07006
Contact:Hkatz@AlfaWassermannUS.comHyman Katz, Ph.D.Phone: 973-852-0158Fax: 973-852-0237
Date Summary Prepared:April 25, 2013
Device:Trade Name:ACE Carbon Dioxide (CO2-LC) Reagent
Classification:Class 2
Common/Classification Name:Enzymatic, Carbon-Dioxide(21 C. F.R. § 862.1160)Product Code KHS
Trade Name:ACE Direct Bilirubin Reagent
Classification:Class 2
Common/Classification Name:Diazo Colorimetry, Bilirubin(21 C. F.R. § 862.1110)Product Code CIG
Trade Name:ACE Total Bilirubin Reagent
Classification:Class 2
Common/Classification Name:Diazo Colorimetry, Bilirubin(21 C. F.R. § 862.1110)Product Code CIG
Trade Name:ACE Magnesium Reagent
Classification:Class 1, reserved
Common/Classification Name:Photometric Method, Magnesium(21 C. F.R. § 862.1495)Product Code JGJ

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PredicateDevices:Alfa Wassermann ACE Carbon Dioxide (CO2-LC) Reagent, ACE Direct BilirubinReagent, ACE Total Bilirubin Reagent, and ACE Magnesium Reagent(K931786)Intended Use:Indications for Use:
DeviceDescriptions:In the ACE Carbon Dioxide (CO2-LC) Reagent assay, serum carbon dioxide (in theform of bicarbonate) reacts with phosphoenolpyruvate in the presence ofphosphoenolpyruvate carboxylase and magnesium to yield oxaloacetic acid andphosphate. In the presence of malate dehydrogenase, the reduced cofactor is oxidized byoxaloacetic acid. The reduced cofactor absorbs strongly at 408 nm whereas its oxidizedform does not. The rate of decrease in absorbance, monitored bichromatically at 408nm/692 nm, is proportional to the carbon dioxide content of the sample.In the ACE Direct Bilirubin Reagent assay, sodium nitrite added to sulfanilic acid formsdiazotized sulfanilic acid. Bilirubin glucuronide in serum reacts with diazotizedsulfanilic acid to form azobilirubin, which absorbs strongly at 554 nm. The increase inabsorbance, measured bichromatically at 554 nm/692 nm, one minute after sample addi-tion, is directly proportional to the direct bilirubin concentration.In the ACE Total Bilirubin Reagent assay, sodium nitrite, when added to sulfanilic acid,forms diazotized sulfanilic acid. Bilirubin in serum reacts with diazotized sulfanilic acidto form azobilirubin, which absorbs strongly at 554 nm. The inclusion of dimethylsulfoxide (DMSO) in the reagent as an accelerator causes both direct and indirectbilirubin to react rapidly. The increase in absorbance, measured bichromatically at 554 nm/692 nm, is directly proportional to the total bilirubin concentration in the sample.Magnesium ions in serum react with Xylidyl blue-1 in an alkaline medium to produce ared complex which is measured bichromatically at 525 nm/692 nm. The intensity ofcolor produced is directly proportional to the magnesium concentration in the sample.EGTA prevents calcium interference by preferential chelation of calcium present in thesample. A surfactant system is included to remove protein interference.The ACE Carbon Dioxide (CO2-LC) Reagent is intended for the quantitativedetermination of carbon dioxide concentration in serum and lithium heparin plasmausing the ACE, ACE Alera®, and ACE Axcel Clinical Chemistry Systems.Bicarbonate/carbon dioxide measurements are used in the diagnosis and treatment ofnumerous potentially serious disorders associated with changes in body acid-basebalance. This test is intended for use in clinical laboratories and physician officelaboratories. For in vitro diagnostic use only.
The ACE Direct Bilirubin Reagent is intended for the quantitative determination ofdirect bilirubin concentration in serum and lithium heparin plasma using the ACE,ACE Alera, and ACE Axcel Clinical Chemistry Systems. Measurements of the levels ofbilirubin, an organic compound formed during the normal and abnormal destruction ofred blood cells, is used in the diagnosis and treatment of liver, hemolytic, hematologicaland metabolic disorders, including hepatitis and gall bladder block. This test is intendedfor use in clinical laboratories and physician office laboratories. For in vitro diagnosticuse only
The ACE Total Bilirubin Reagent is intended for the quantitative determination of totalbilirubin concentration in serum and lithium heparin plasma using the ACE, ACEAlera and ACE Axcel Clinical Chemistry System. Measurements of the levels ofbilirubin, an organic compound formed during the normal and abnormal destruction ofred blood cells is used in the diagnosis and treatment of liver, hemolytic, hematologicaland metabolic disorders, including hepatitis and gall bladder block. This test is intendedfor use in clinical laboratories and physician office laboratories. For in vitro diagnosticuse only.
The ACE Magnesium Reagent is intended for the quantitative determination ofmagnesium in serum and lithium heparin plasma using the ACE, ACE Alera andACE Axcel Clinical Chemistry Systems. Magnesium measurements are used in thediagnosis and treatment of hypomagnesemia (abnormally low plasma levels ofmagnesium) and hypermagnesemia (abnormally high plasma levels of magnesium).This test is intended for use in clinical laboratories and physician office laboratories. Forin vitro diagnostic use only.

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TechnologicalCharacteristics:The ACE Carbon Dioxide (CO2-LC) Reagent consists of a single reagent bottle. Thereagent contains Phosphoenolpyruvate, nicotinamide adenine dinucleotide, analog,reduced, phosphoenol pyruvate carboxylase and malate dehydrogenase.
The ACE Direct Bilirubin Reagent is composed of two reagent bottles (Direct BilirubinReagent and Sodium Nitrite Reagent). The reagents contain Sulfanilic Acid,hydrochloric acid, and sodium nitrite.
The ACE Total Bilirubin Reagent is composed of two reagent bottles (Total BilirubinReagent and Sodium Nitrite Reagent). The reagents contain sulfanilic acid, hydrochloricAcid, DMSO and sodium Nitrite.
The ACE Magnesium Reagent is composed of a single reagent bottle. The reagentcontains Xylidyl blue-1 and EGTA.

. . .

DeviceComparisonwith PredicateComparison of similarities and differences with predicatedeviceACE Carbon Dioxide (CO2-LC) Reagent
CO2-LCCandidate DevicePredicateK9317(ACE CO2
Intended UseThe ACE Carbon Dioxide (CO2-LC) Reagent isintended for the quantitative determination of carbondioxide concentration.Same
PlatformsACE, ACE Alera®, and ACE Axcel Clinical ChemistrySystemsACE ClinicalChemistry System
MethodPhotometricSame
Calibration Stability7 daysSame
On-Board Stability14 daysSame
Sample TypeSerum and lithium heparin plasmaSerum
Sample Volume6 µLSame
Reaction Volume156 µLSame
Expected Values23 - 29 mEq/LSame
Measuring Range4 - 50 mEq/LSame
Sample StabilitySeparated from cells, carbon dioxide is stable for 7Same

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DeviceComparisonwith PredicateACE Direct Bilirubin Reagent
Direct BilirubinCandidate DevicePredicate DeviceK931786(ACE DirectBilirubin)
Intended Use/Indications for UseThe ACE Direct Bilirubin Reagent is intended for thequantitative determination of direct bilirubinconcentration.Same
PlatformsACE, ACE Alera®, and ACE Axcel ClinicalChemistry SystemsACE ClinicalChemistry System
MethodPhotometricSame
Calibration Stability30 daysSame
On-Board Stability30 daysSame
Sample TypeSerum and lithium heparin plasmaSerum
Sample Volume20 µLSame
Reaction Volume355 µLSame
Expected Values<0.2 mg/dLSame
Measuring Range0.1 - 14.0 mg/dLSame
Sample StabilitySamples must be stored away from sunlight orfluorescent lights because bilirubin is subject tophotodegradation. Specimens may be stored at 4-8°Cfor 7 months or 6 months at -20°C.Same
Total BilirubinACE Total Bilirubin ReagentCandidate DevicePredicate Device .K931786(ACE TotalBilirubin)
Intended Use/Indications for UseThe ACE Total Bilirubin Reagent is intended for thequantitative determination of total bilirubinconcentration.Same
PlatformsACE, ACE Alera®, and ACE Axcel ClinicalChemistry SystemsACE ClinicalChemistry System
MethodPhotometricSame
Calibration Stability30 DaysSame
On-Board Stability30 DaysSame
Sample TypeSerum and lithium heparin plasmaSerum
Sample Volume20 µLSame
Reaction Volume380 µLSame
Expected Values0.3 - 1.2 mg/dLSame
Measuring Range0.2 - 40.0 mg/dLSame
Sample StabilitySamples must be stored away from sunlight orSame

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DeviceComparisonwith PredicateMagnesiumCandidate DevicePredicate DeviceK931786(ACE Magnesium)
Intended Use/Indications for UseACE Magnesium Reagent is intended for thequantitative determination of magnesium.Same
PlatformsACE, ACE Alera®, and ACE Axcel ClinicalChemistry SystemsACE ClinicalChemistry System
MethodPhotometricSame
Calibration Stability30 DaySame
On-Board Stability30 DaysSame
Sample TypeSerum and lithium heparin plasmaSerum
Sample Volume3 µLSame
Reaction Volume488 µLSame
Expected Values1.6 - 2.6 mg/dLSame
Measuring Range0.4 - 6.1 mg/dLSame
Sample StabilitySerum magnesium is stable for 7 days at 4-8°C and1 year at -20 °C if the serum is separated from theerythrocytes.Same

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Performance Data:

.

In-House Precision -Serum vs.

Plasma

Performance data for the Alfa Wassermann ACE Reagents run on the Alfa Wassermann ACE, ACE Alera and ACE Axcel Clinical Chemistry Systems

In-House Precision: Serum vs. Plasma - ACE CO2-LC Reagent

Precision (SD, %CV)
CO2-LCmEq/LACEMeanWithin-RunTotalAleraMeanWithin-RunTotalAxcelMeanWithin-RunTotal
SerumLow24.00.27,1.1%1.34,5.6%24.60.61,2.5%1.85,7.5%23.90.48,2.0%1.56,6.5%
SerumMid34.10.72,1.2%1.22,3.6%35.70.41,1.2%1.17,3.3%34.30.52,1.5%1.26,3.7%
SerumHigh45.60.57,2.8%2.7,3.2%47.00.55,1.2%2.7,3.2%45.40.25,0.6%1.19,2.6%
PlasmaLow22.90.29,1.3%0.86,3.8%23.30.71,3.0%1.43,6.1%23.10.29,1.3%0.86,3.8%
PlasmaMid33.70.41,1.2%1.85,5.5%34.80.34,1.0%1.77,5.1%33.80.24,0.7%1.69,5.0%
PlasmaHigh45.60.46,1.0%1.14,2.5%46.90.46,1.0%1.10,2.4%45.30.47,1.0%1.05,2.3%

In-House Precision: Serum vs. Plasma – ACE Direct Bilirubin Reagent

DirectBilirubinmg/dLACEAleraAxcel
MeanWithin-RunTotalMeanWithin-RunTotalMeanWithin-RunTotal
SerumLow0.20.04,24.5%0.05,30.0%0.20.03,16.0%0.04,20.1%0.10.02,12.5%0.02,14.0%
SerumMid4.70.04,0.9%0.06,1.2%4.70.06,1.4%0.10,2.2%4.70.08,1.6%0.08,1.6%
SerumHigh8.40.05,0.6%0.09,1.1%8.30.06,0.8%0.09,1.1%8.30.13,1.5%0.14,1.7%
PlasmaLow0.10.03,26.6%0.03,26.6%0.10.03,23.4%0.05,35.4%0.10.02, 16.6%0.02,19.7%
PlasmaMid4.80.04,0.8%0.05,1.1%4.80.08,1.7%0.13,2.8%4.80.11,2.4%0.11,2.4%
PlasmaHigh8.50.09,1.1%0.14,1.6%8.50.06,0.7%0.10,1.1%8.50.16,1.9%0.20,2.3%

{7}------------------------------------------------

In-House Precision: Serum vs. Plasma – ACE Total Bilirubin Reagent

Performance Data:

In-House Precision -Serum vs. Plasma

.

TotalBilirubinmg/dLACEMeanWithin-RunTotalAleraMeanWithin-RunTotalAxcelMeanWithin-RunTotal
Precision (SD, %CV)
SerumLow0.30.07,21.3%0.07,21.3%0.30.04,11.0%0.05,15.7%0.30.04,13.4%0.04,13.9%
SerumMid13.30.13,1.0%0.13,1.0%13.00.14,1.1%0.14,1.1%13.30.13,1.0%0.13,1.0%
SerumHigh26.10.18,0.7%0.21,0.8%25.50.12,0.5%0.12,0.5%26.10.11,0.4%0.17,0.7%
PlasmaLow0.20.04,20.3%0.05,21.3%0.20.06,23.7%0.07,29.4%0.20.04,20.6%0.05,23.9%
PlasmaMid13.20.11,0.8%0.12,0.9%13.00.13,1.0%0.14,1.1%13.20.06,0.5%0.07,0.5%
PlasmaHigh26.20.15,0.6%0.17,0.6%25.60.12,0.5%0.18,0.7%26.10.13,0.5%0.14,0.5%

In-House Precision: Serum vs. Plasma -- ACE Magnesium Reagent

Precision (SD, %CV)
Magnesiummg/dLACEMeanWithin-RunTotalAleraMeanWithin-RunTotalAxcelMeanWithin-RunTotal
SerumLow2.00.10,5.1%0.12,5.9%2.10.06,3.1%0.09,4.3%1.90.07,3.6%0.08,4.3%
SerumMid3.70.09,2.5%0.11,3.0%3.80.06,1.7%0.07,1.8%3.70.09,2.6%0.09,2.6%
SerumHigh5.60.05,1.0%0.10,1.7%5.60.08,1.4%0.09,1.6%5.50.08,1.4%0.09,1.7%
PlasmaLow1.70.08,4.7%0.11,6.2%1.70.06,3.5%0.07,4.1%1.70.04,2.4%0.11,6.8%
PlasmaMid3.50.09,2.7%0.10,2.8%3.50.09,2.4%0.09,2.6%3.40.09,2.8%0.13,3.7%
PlasmaHigh5.30.04,0.9%0.10,1.9%5.40.09,1.6%0.10,1.8%5.30.05,1.0%0.09,1.8%

{8}------------------------------------------------

PerformanceData:Performance data for the Alfa Wassermann ACE Reagents run on the
In-HouseAlfa Wassermann ACE, ACE Alera and ACE Axcel Clinical Chemistry
MatrixSystems
Comparison -Serum vs.PlasmaIn-House Matrix Comparison: Serum vs. Plasma – ACE CO2-LC Reagent
SystemRangeResults - Serum vs. Plasma
ACE53 pairs4.9-47.9 mEq/LSlope: 1.031Intercept: -1.03Correlation: 0.9922Std. Error Est: 1.13Confidence Interval Slope: 0.995 to 1.067Confidence Interval Intercept: -2.11 to 0.04
ACE Alera54 pairs4.7-48.2 mEq/LSlope: 1.000Intercept: -0.09Correlation: 0.9955Std. Error Est: 0.86Confidence Interval Slope: 0.974 to 1.027Confidence Interval Intercept: -0.81 to 0.64
ACE Axcel51 pairs5.5-47.9 mEq/LSlope: 0.988Intercept: -0.35Correlation: 0.9889Std. Error Est: 1.12Confidence Interval Slope: 0.946 to 1.031Confidence Interval Intercept: -1.29 to 0.60
In-House Matrix Comparison: Serum vs. Plasma – ACE Direct Bilirubin Reagent
SystemRangeResults - Serum vs. Plasma
ACE102 pairs0.1-10.8 mg/dLSlope: 1.021Intercept: 0.00Correlation: 0.9982Std. Error Est: 0.10Confidence Interval Slope: 1.009 to 1.033Confidence Interval Intercept: -0.02 to 0.03
ACE Alera101 pairs0.1-11.0 mg/dLSlope: 1.005Intercept: 0.01Correlation: 0.9978Std. Error Est: 0.11Confidence Interval Slope: 0.992 to 1.018Confidence Interval Intercept: -0.02 to 0.03
ACE Axcel56 pairs0.1-13.1 mg/dLSlope: 1.004Intercept: 0.00Correlation: 0.9983Std. Error Est: 0.16Confidence Interval Slope: 0.988 to 1.020Confidence Interval Intercept: -0.04 to 0.05
SystemRangeResults - Serum vs. Plasma
ACE102 pairs0.1-37.2 mg/dLSlope: 1.017Intercept: 0.01Correlation: 0.9996Std. Error Est: 0.15Confidence Interval Slope: 1.011 to 1.022Confidence Interval Intercept: -0.03 to 0.04
ACE Alera102 pairs0.2-36.7 mg/dLSlope: 1.020Intercept: 0.00Correlation: 0.9993Std. Error Est: 0.20Confidence Interval Slope: 1.012 to 1.028Confidence Interval Intercept: -0.05 to 0.04
ACE Axcel56 pairs0.2-35.5 mg/dLSlope: 1.008Intercept: 0.00Correlation: 0.9995Std. Error Est: 0.22Confidence Interval Slope: 1.000 to 1.017Confidence Interval Intercept: -0.06 to 0.07

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and the comments of the comments of the comments of

ACE101 pairs1.2-5.8 mg/dLCorrelation: 0.9765Std. Error Est: 0.19Confidence Interval Slope: 0.902 to 0.994Confidence Interval Intercept: -0.02 to 0.18
ACE Alera101 pairs1.0-5.9 mg/dLSlope: 0.986Intercept: 0.05Correlation: 0.9817Std. Error Est: 0.15Confidence Interval Slope: 0.948 to 1.024Confidence Interval Intercept: -0.06 to 0.10
ACE Axcel55 pairs1.2-5.8 mg/dLSlope: 0.986Intercept: 0.025Correlation: 0.9892Std. Error Est: 0.125Confidence Interval Slope: 0.947 to 1.026Confidence Interval Intercept: -0.61 to 0.111

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Performance Data:Precision - POLPOL - Precision studies at 3 POC sites for ACE Alera Clinical Chemistry System(ACE system was also tested concurrently and comparable precision was obtainedDBILIACE Resultmg/dL SD, %CVACE Alera Resultmg/dL SD, %CV
CO2_LCACE ResultACE Alera ResultLabSampleMeanWithin-RunTotalMeanWithin-RunTotal
LabSampleMeanmEq/L SD, %CVMeanmEq/L SD, %CVIn-House11.00.03 SD2.90%0.03 SD2.90%1.00.05 SD5.10%0.05 SD5.40%
Within-RunTotalWithin-RunTotalPOL 110.90.04 SD4.20%0.05 SD4.90%0.90.04 SD4.80%0.05 SD5.40%
In-House121.20.33 SD1.60%0.63 SD3.00%21.10.43 SD2.00%0.81 SD3.90%POL 210.90.03 SD3.30%0.05 SD5.20%0.90.02 SD2.50%0.02 SD2.50%
POL 1120.30.68 SD3.30%0.88 SD4.30%22.30.28 SD1.30%0.67 SD3.00%POL 310.90.03 SD3.50%0.03 SD3.50%0.90.00 SD0.00%0.00 SD0.00%
POL 21230.55 SD2.40%1.54 SD6.70%22.40.59 SD2.60%0.84 SD3.80%In-House25.00.05 SD1.00%0.07 SD1.30%4.90.07 SD1.50%0.09 SD1.90%
POL 3122.30.42 SD1.90%1.10 SD4.90%24.30.37 SD1.50%1.53 SD6.30%POL 124.90.09 SD1.80%0.10 SD2.10%4.80.05 SD1.00%0.05 SD1.00%
In-House224.20.46 SD1.90%0.66 SD2.70%24.20.42 SD1.70%0.77 SD3.20%POL 224.80.07 SD1.50%0.12 SD2.50%4.80.07 SD1.50%0.08 SD1.70%
POL 1224.90.77 SD3.10%1.38 SD5.60%25.60.32 SD1.30%0.63 SD2.40%POL 324.70.10 SD2.10%0.11 SD2.40%4.90.10 SD2.00%0.10 SD2.00%
POL 2226.20.43 SD1.70%1.92 SD7.40%260.24 SD0.90%1.00 SD3.90%In-House38.00.18 SD2.30%0.18 SD2.30%7.80.20 SD2.60%0.20 SD2.60%
POL 3225.90.34 SD1.30%1.08 SD4.20%27.80.29 SD1.10%1.60 SD5.80%POL 137.90.16 SD2.00%0.17 SD2.20%7.90.06 SD0.80%0.07 SD0.90%
In-House327.30.49 SD1.80%0.65 SD2.40%270.43 SD1.60%0.83 SD3.10%POL 237.70.10 SD1.30%0.16 SD2.00%7.80.04 SD0.60%0.10 SD1.30%
POL 1330.40.73 SD2.40%1.75 SD5.80%28.40.39 SD1.40%0.94 SD3.30%POL 337.70.09 SD1.20%0.12 SD1.50%8.00.08 SD1.00%0.08 SD1.10%
POL 2329.60.62 SD2.10%1.88 SD6.40%29.30.48 SD1.60%0.94 SD3.20%
POL 3329.50.26 SD0.90%1.08 SD3.60%30.70.29 SD1.00%1.60 SD5.20%

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Performance Data at POL:

Precision -

POL

100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000

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TBILIACE Resultmg/dL SD, %CVACE Alera Resultmg/dL SD, %CV
PerformanceData at POL:Precision - POLLabSampleMeanWithin-RunTotalMeanWithin-RunTotal
In-House11.20.04 SD3.40%0.04 SD3.70%1.20.05 SD4.20%0.05 SD4.50%
POL 111.20.07 SD5.50%0.07 SD5.80%1.20.04 SD3.20%0.04 SD3.70%
POL 211.10.05 SD4.00%0.07 SD6.40%1.20.06 SD4.90%0.06 SD5.00%
POL 311.10.04 SD3.40%0.05 SD4.40%1.10.05 SD4.80%0.06 SD5.20%
In-House211.50.20 SD1.70%0.20 SD1.80%11.30.23 SD2.00%0.24 SD2.10%
POL 1211.20.05 SD0.50%0.42 SD3.70%11.40.07 SD0.70%0.09 SD0.80%
POL 2211.30.05 SD0.50%0.15 SD1.30%11.30.17 SD1.50%0.17 SD1.50%
POL 3210.90.09 SD0.80%0.11 SD1.00%11.20.09 SD0.80%0.09 SD0.80%
In-House320.90.24 SD1.10%0.27 SD1.30%20.60.27 SD1.30%0.35 SD1.70%
POL 1320.00.24 SD1.20%0.24 SD1.20%20.70.11 SD0.50%0.12 SD0.60%
POL 2320.30.21 SD1.00%0.42 SD2.10%20.50.11 SD0.50%0.15 SD0.70%
POL 3319.90.24 SD1.20%0.26 SD1.30%20.30.28 SD1.40%0.28 SD1.40%
MGACE Resultmg/dL SD, %CVACE Alera Resultmg/dL SD, %CV
LabSampleMeanWithin-RunTotalMeanWithin-RunTotal
In-House11.70.05 SD3.30%0.09 SD5.70%1.70.05 SD3.00%0.07 SD4.50%
POL 111.70.05 SD3.30%0.11 SD6.30%1.70.07 SD4.20%0.10 SD5.90%
POL 211.80.08 SD4.60%0.09 SD5.00%1.50.09 SD6.00%0.13 SD8.40%

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PerformanceData at POL:Precision -POL
In-House23.70.09 SD2.50%0.12 SD3.30%3.60.07 SD2.00%0.09 SD2.50%
POL 123.70.05 SD1.30%0.11 SD3.00%3.80.11 SD2.80%0.13 SD3.60%
POL 223.70.07 SD1.90%0.13 SD3.50%3.50.10 SD2.90%0.18 SD5.20%
POL 323.60.09 SD2.50%0.10 SD2.80%3.70.08 SD2.10%0.13 SD3.60%
In-House35.60.10 SD1.80%0.14 SD2.60%5.50.05 SD1.00%0.10 SD1.80%
POL 135.70.09 SD1.60%0.11 SD1.90%5.80.08 SD1.40%0.12 SD2.10%
POL 235.60.09 SD1.60%0.17 SD3.10%5.40.10 SD1.90%0.26 SD4.80%
POL 335.50.06 SD1.10%0.08 SD1.40%5.50.05 SD0.90%0.09 SD1.60%

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Performance Data: Method

POL – Method Comparison for ACE Clinical Chemistry System

Comparison -POL on ACE

ReagentStatisticIn-House ACE (x) vs. POL 1 ACE (y)In-House ACE (x) vs. POL 2 ACE (y)In-House ACE (x) vs. POL 3 ACE (y)
CO2-LCn464545
Range3.6 to 42.53.6 to 46.23.6 to 46.2
Regression$y = 0.963x - 0.71$$y = 0.976x + 1.29$$y = 0.984x + 0.42$
Correlation0.97100.95300.9908
Std. Error Est.1.382.100.94
CI Slope0.893 to 1.0340.884 to 1.0690.943 to 1.025
CI Intercept-2.34 to 0.92-0.91 to 3.49-0.56 to 1.40
DirectBilirubinn494949
Range0.1 to 12.40.1 to 12.40.1 to 12.4
Regression$y = 1.022x + 0.04$$y = 1.003x + 0.11$$y = 1.012x + 0.06$
Correlation0.99860.99850.9984
Std. Error Est.0.140.140.14
CI Slope1.006 to 1.0380.987 to 1.0190.995 to 1.029
CI Intercept0.00 to 0.080.07 to 0.150.02 to 0.11
TotalBilirubinn485049
Range0.2 to 39.30.2 to 39.30.2 to 39.3
Regression$y = 0.979x + 0.00$$y = 1.000x + 0.04$$y = 1.000x + 0.01$
Correlation0.99950.99980.9998
Std. Error Est.0.270.180.17
CI Slope0.970 to 0.9890.994 to 1.0060.994 to 1.006
CI Intercept-0.08 to 0.08-0.01 to 0.09-0.05 to 0.06
Magnesiumn515251
Range0.6 to 6.10.6 to 6.10.6 to 6.1
Regression$y = 0.970x + 0.12$$y = 0.975x + 0.16$$y = 1.026x - 0.04$
Correlation0.99020.99270.9925
Std. Error Est.0.130.110.12
CI Slope0.931 to 1.0090.941 to 1.0080.989 to 1.062
CI Intercept0.03 to 0.210.08 to 0.23-0.13 to 0.04

{15}------------------------------------------------

POL – Method Comparison (performed at POC sites) for ACE Alera ClinicalChemistry System against the predicate device tested in-house
ReagentStatisticIn-House ACE (x) vs.POL 1 Alera (y)In-House ACE (x) vs.POL 2 Alera (y)In-House ACE (x) vs.POL 3 Alera (y)
CO2-LCn454546
Range2.0 to 46.02.0 to 46.02.0 to 46.0
Regression$y = 0.984x + 0.15$$y = 0.972x + 0.57$$y = 0.987x + 0.10$
Correlation0.99030.97670.9790
Std. Error Est.0.951.451.38
CI Slope0.941 to 1.0260.908 to 1.0370.926 to 1.049
CI Intercept-0.81 to 1.12-0.90 to 2.05-1.30 to 1.50
DirectBilirubinn515151
Range0.1 to 12.40.1 to 12.40.1 to 12.4
Regression$y = 0.995x + 0.09$$y = 0.969x + 0.11$$y = 0.991x + 0.10$
Correlation0.99910.99840.9990
Std. Error Est.0.100.140.11
CI Slope0.983 to 1.0070.953 to 0.9850.979 to 1.004
CI Intercept0.05 to 0.120.07 to 0.150.06 to 0.13
Total Bilirubinn505050
Range0.2 to 39.40.2 to 39.40.2 to 39.4
Regression$y = 1.020x + 0.02$$y = 0.957x + 0.07$$y = 0.981x + 0.01$
Correlation0.99980.99910.9998
Std. Error Est.0.180.340.16
CI Slope1.013 to 1.0260.945 to 0.9680.976 to 0.987
CI Intercept-0.03 to 0.08-0.03 to 0.17-0.04 to 0.06
Magnesiumn505050
Range0.7 to 5.90.7 to 5.90.7 to 5.9
Regression$y = 1.010x + 0.00$$y = 1.004x - 0.11$$y = 0.990x - 0.07$
Correlation0.98700.98860.9930
Std. Error Est.0.120.110.09
CI Slope0.963 to 1.0570.960 to 1.0480.956 to 1.024
CI Intercept-0.10 to 0.10-0.20 to -0.02-0.14 to 0.00

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and the same of the same

: : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : :

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Performance Data:

ACE Alera

Performance data for the Alfa Wassermann ACE Reagents run on the Alfa Wassermann ACE Alera Clinical Chemistry Systems

Detection Limits - ÀCE Alera Clinical Chemistry System

ACE AleraCO2(mEq/L)DBILI(mg/dL)TBILI(mg/dL)MG(mg/dL)
LoB1.270.060.110.26
LoD1.970.080.140.37
LoQ3.030.120.140.37

Linearity - ACE Alera Clinical Chemistry System

ACEReagentsLow leveltestedUpper leveltestedLinear to:Linear RegressionEquation
CO2(mEq/L)0.153.050y=1.006x + 0.01
DBILI(mg/dL)0.116.014.0y=1.015x + 0.16
TBILI(mg/dL)0.141.640.0y=1.004x + 0.03
MG(mg/dL)0.46.46.1y=0.959x + 0.27

{17}------------------------------------------------

Performance

Data:

ACE Alera

Interferences - ACE Alera Clinical Chemistry System

ACEAleraIcterusHemolysisLipemia(Intralipid)/TriglyceridesAscorbic Aci
C02No significantinterferenceat or below58.8 mg/dLNo significantinterferenceat or below250 mg/dLNo significantinterferenceat or below2388 mg/dLTriglyccridesNo significantinterferenceat or below6 mg/dL
DBiliNot ApplicableNo significantinterferenceat or below62.5 mg/dLNo significantinterferenceat or below782 mg/dLTriglyceridesNo significantinterferenceat or below6 mg/dL
TBiliNot ApplicableNo significantinterferenceat or below62.5 mg/dLNo significantinterferenceat or below951 mg/dLTriglyceridesNo significantinterferenceat or below6 mg/dL
MGNo significantinterferenceat or below50 mg/dLNo significantinterferenceat or below500 mg/dLNo significantinterference at orbelow620 mg/dLTriglyceridesNo significantinterferenceat or below6 mg/dL

{18}------------------------------------------------

Precision - ACE Alera Clinical Chemistry System

Performance Data:

ACE Alera

on ACE AleraPrecision (SD, %CV)PerformanceData:Method Comparison - ACE Alera Clinical Chemistry System
MeanWithin-RunTotalACE AleraIn-House ACE (x) vs. In-House ACE Alera (y)
CO2mEq/LLow12.80.55, 4.3%1.20, 9.4%CO2(mEq/L)DBILI (mg/dL)TBILI(mg/dL)MG(mg/dL) '
Mid15.20.48, 3.2%1.49, 9.8%n46494950
High21.70.82, 3.8%2.58, 11.9%Range3.6 to 46.20.1 to 12.40.2 to 39.30.6 to 6.1
DBILImg/dLLow0.30.02, 5.3%0.02, 6.5%Slope0.9810.9981.0010.960
Mid1.70.04, 2.6%0.11, 6.6%Intercept-0.60.000.000.12
High3.20.08, 2.7%0.18, 5.6%CorrelationCoefficient0.99740.999991.0000.9906
TBILImg/dLLow0.50.03, 5.7%0.04, 8.5%Std. Error1.450.040.06(). 1()
Mid3.10.04, 1.2%0.13, 4.1%CI Slope0.918 to 1.0450.993 to 1.0030.999 to 1.0030.922 to 0.998
High7.70.08, 1.1%0.28, 3.7%CI Intercept-2.12 to 0.91-0.01 to 0.01-0.02 to 0.020.04 to 0.21
MGmg/dLLow1.60.07, 4.3%0.08, 5.1%
Mid2.50.07, 2.6%0.09, 3.7%
High3.60.10, 2.7%0.12, 3.3%

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/20/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo consists of a stylized caduceus symbol, which is a staff with two snakes coiled around it, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged in a circular fashion around the symbol. The logo is black and white.

Public Health Service

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

May 2, 2013

LLC

Alfa Wasserman Diagnostic Technologies, LLC C/O Hyman Katz, Ph.D. 4 Henderson Drive WEST CALDWELL NJ 07006

Re: K123953

Trade/Device Name: ACE Carbon Dioxide (CO2-LC) Reagent ACE Direct Bilirubin Reagent ACE Total Bilirubin Reagent ACE Magnesium Reagent Regulation Number: 21 CFR 862.1160

Regulation Name: Bicarbonate/carbon dioxide test system Regulatory Class: II Product Code: KHS, CIG, JGJ Dated: March 22, 2013 Received: March 25, 2013

Dear Dr. Katz:

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. 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

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Page 2-Dr. Katz

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.

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/Resourcesfor You/Industry/default.htm.

Sincerely yours, Carol C. Benson -S

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

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Indications for Use

510(k) Number (if known): K123953

Device Name:ACE Carbon Dioxide (CO2-LC) Reagent
Indications for Use:The ACE Carbon Dioxide (CO2-LC) Reagent is intended for the quantitative determination of carbon dioxide concentration in serum and lithium heparin plasma using the ACE, ACE Alera, and ACE Axcel Clinical Chemistry Systems. Bicarbonate/carbon dioxide measurements are used in the diagnosis and treatment of numerous potentially serious disorders associated with changes in body acid-base balance. This test is intended for use in clinical laboratories or physician office laboratories. For in vitro diagnostic use only.
Device Name:ACE Direct Bilirubin Reagent
Indications for Use:The ACE Direct Bilirubin Reagent is intended for the quantitative determination of direct bilirubin concentration in serum and lithium heparin plasma using the ACE, ACE Alera, and ACE Axcel Clinical Chemistry Systems. Measurements of the levels of bilirubin, an organic

compound formed during the normal and abnormal destruction of red blood cells, is used in the diagnosis and treatment of liver, hemolytic, hematological and metabolic disorders, including hepatitis and gall bladder block. This test is intended for use in clinical laboratories or physician office laboratories. For in vitro diagnostic use only

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 Devices or Radiological Health (OIR)

YungW.Chan -S

Division Sign-Off Office of In Vitro Devices or Radiological Health 510(k) K123953

Page 1 of 2

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Indications for Use

510(k) Number (if known): K123953

Device Name: ACE Total Bilirubin Reagent

Indications for Use: The ACE Total Bilirubin Reagent is intended for the quantitative determination of total bilirubin concentration in serum and lithium heparin plasma using the ACE, ACE Alera and ACE Axcel Clinical Chemistry System. Measurements of the levels of bilirubin, an organic compound formed during the normal and abnormal destruction of red blood cells, is used in the diagnosis and treatment of liver, hemolytic, hematological and metabolic disorders, including hepatitis and gall bladder block. This test is intended for use in clinical laboratories or physician office laboratories. For in vitro diagnostic use only.

Device Name: ACE Magnesium Reagent

Indications for Use: The ACE Magnesium Reagent is intended for the quantitative determination of magnesium in serum and lithium heparin plasma using the ACE, ACE Alera and ACE Axcel Clinical Chemistry Systems. Magnesium measurements are used in the diagnosis and treatment of hypomagnesemia (abnormally low plasma levels of magnesium) and hypermagnesemia (abnormally high plasma levels of magnesium). This test is intended for use in clinical laboratories or physician office laboratories. For in vitro diagnostic use only.

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 Devices or Radiological Health (OIR)

YungW.Chan -S

Division Sign-Off Office of In Vitro Devices or Radiological Health 510(k) = K123953

Page 2 of 2

§ 862.1160 Bicarbonate/carbon dioxide test system.

(a)
Identification. A bicarbonate/carbon dioxide test system is a device intended to measure bicarbonate/carbon dioxide in plasma, serum, and whole blood. Bicarbonate/carbon dioxide measurements are used in the diagnosis and treatment of numerous potentially serious disorders associated with changes in body acid-base balance.(b)
Classification. Class II.