K Number
K123965
Manufacturer
Date Cleared
2013-02-28

(64 days)

Product Code
Regulation Number
862.1110
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

COBAS INTEGRA Bilirubin Direct Gen.2 is an in vitro test for the quantitative determination of direct bilirubin in human serum and plasma on COBAS INTEGRA systems. Measurement 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.

Device Description

COBAS INTEGRA Bilirubin Direct Gen.2 reagent provides quantitative measurement of the direct bilirubin that is present in a human serum or human plasma sample. Reagents are packaged in a cassette with two bottles labeled with their instrument positioning, R1 and SR. R1, or Reagent 1, contains Phosphoric acid 85 mmol/L, NaCl 50 mmol/L, and HEDTA 4.0 mmol/L at pH 1.9. SR, or Start Reagent, is a 3,5-dichlorophenyl diazonium salt at 1.5 mmol/L in acid buffer, pH 1.3.

AI/ML Overview

Here's a summary of the acceptance criteria and study information for the COBAS INTEGRA Bilirubin Direct Gen.2 reagent, based on the provided text:

Acceptance Criteria and Device Performance

Acceptance Criteria CategorySpecific Acceptance CriteriaReported Device Performance (COBAS INTEGRA Bilirubin Direct Gen.2)
Precision/ReproducibilityBased on CLSI EP5-A2 guidelines.Repeatability:- Human Serum 1 (0.12 mg/dL): SD 0.01 mg/dL, CV 7.4%- Human Serum 2 (3.8 mg/dL): SD 0.01 mg/dL, CV 0.4%- Human Serum 3 (13.2 mg/dL): SD 0.04 mg/dL, CV 0.3%Intermediate Precision:- Human Serum 1 (0.12 mg/dL): SD 0.01 mg/dL, CV 7.7%- Human Serum 2 (3.8 mg/dL): SD 0.04 mg/dL, CV 1.0%- Human Serum 3 (13.2 mg/dL): SD 0.05 mg/dL, CV 0.4%
Measuring Range (Linearity)Based on CLSI EP6-A guidelines.Plasma: Range tested 0.01 - 19.5 mg/dL, Range found 0.01 - 19.5 mg/dL, Recommended measuring range 0.07 - 13.8 mg/dLSerum: Range tested 0.02 - 19.4 mg/dL, Range found 0.02 - 17.4 mg/dL, Recommended measuring range 0.07 - 13.8 mg/dLBoth showed a significant quadratic model, with linear regression for serum y = 1.0000x + 0.0000 (r² = 0.9944) and for plasma y = 1.0000x - 0.0000 (r² = 0.9977).
Detection Limits (LoB, LoD, LoQ)Based on CLSI EP17-A2 guidelines.LoB claim: 0.05 mg/dLLoD claim: 0.07 mg/dLLoQ claim: 0.07 mg/dL (based on 20% CV)
Analytical Specificity (Endogenous Substances)"No significant interference"Lipemia: No significant interference up to an L index of 750 (reported lowest L index for no interference was 1098).Hemolysis: No significant interference up to an H index of 25 (reported lowest H index for no interference was 25).
Analytical Specificity (Common Drugs)"No interference" from specific drugs.Phenylbutazone causes falsely low bilirubin results (stated in labeling). The other 17 tested drugs (e.g., Acetylcystein (150 mg/L), Ampicillin - Na (1000 mg/L), Ascorbic acid (300 mg/L), Heparin - Na (5000 U)) produce no interference.
Method Comparison with Predicate DeviceSubstantial equivalence to predicate device (COBAS INTEGRA Bilirubin Direct).Passing/Bablok regression with predicate device showed: y = 1.0490x + 0.0699 mg/dL with R² = 0.9979.
Matrix Comparison (Anticoagulants)Median recovery: 90 to 110%Median absolute deviation: < 0.20 mg/dLLi-Heparin: 102% recovery (+0.02 to -0.05 mg/dL MAD)K2-EDTA: 101% recovery (+0.00 to -0.02 mg/dL MAD)K3-EDTA: 100% recovery (-0.00 to -0.03 mg/dL MAD)Gel Separation Tube: 104% recovery (+0.02 mg/dL MAD)Regression analysis: Serum vs. Li-heparin (y = 0.01 + 1.0179x, r = 0.9988), Serum vs. K2-EDTA (y = -0.01 + 1.0120x, r = 0.9988), Serum vs. K3-EDTA (y = -0.03 + 1.0095x, r = 0.9988).
Expected Values/Reference RangeTo be established or confirmed.≤ 0.20 mg/dL

Study Information

  1. Sample size used for the test set and the data provenance:

    • Precision/Reproducibility: Not explicitly stated, but samples were "human sera samples (0.12, 3.76, and 13.2 mg/dL)" and "two serum-based control samples." Samples were tested for 21 days with 2 aliquots per run, 2 runs per day.
    • Linearity: Not explicitly stated, but "two separate dilution series differing by sample type (serum and plasma) were prepared with thirteen levels each." "High analyte native samples" were spiked with ditaurobilirubin.
    • Detection Limits (LoB): One blank sample (n=5) tested on two analyzers with three reagent batches for two runs per day across three days.
    • Detection Limits (LoD): Five low-analyte samples measured in singlicate on two analyzers with three reagent batches for two runs per day across three days.
    • Detection Limits (LoQ): A low-level sample set of nine measured in singlicate, using three reagent batches on two analyzers for two runs per day across three days.
    • Analytical Specificity (Endogenous Substances): One pool of human serum spiked with interferent, a second pool without, and then mixed in different ratios to create a dilution series (0 to 10 concentrations).
    • Analytical Specificity (Common Drugs): Eighteen commonly used drugs added to native patient samples. Serum sample pools were at two target concentrations (~1.8 mg/dL and ~4.9 mg/dL).
    • Method Comparison: n=71 human sera samples.
    • Matrix Comparison: 32 tubes collected per anticoagulant (Li-heparin, K2-EDTA, K3-EDTA).
    • Data Provenance: Not explicitly stated, but implies clinical lab settings ("human sera samples," "native patient samples"). The text does not specify country of origin or whether the studies were retrospective or prospective, though typical analytical validation studies are prospective.
  2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

    • This is an in vitro diagnostic (IVD) reagent for quantitative determination of a chemical substance. The "ground truth" for such devices is typically established through reference methods or highly accurate laboratory technologies, not expert human readers/adjudicators as would be common for imaging or pathology devices.
    • The predicate device's traceability is stated as "Standardized against the Doumas manual reference method." The candidate device claims the same traceability. The Doumas method serves as the ground truth reference.
  3. Adjudication method (e.g., 2+1, 3+1, none) for the test set:

    • Not applicable as this is a quantitative chemical assay, not an interpretative task requiring human adjudication of results.
  4. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:

    • Not applicable. This is a laboratory diagnostic reagent, not an AI-assisted diagnostic imaging or pathology device that would involve human readers.
  5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

    • Yes, this is implicitly a standalone device. The COBAS INTEGRA Bilirubin Direct Gen.2 Reagent, when run on the COBAS INTEGRA system, performs the measurement automatically without human interpretative input for the actual bilirubin value. The studies presented (precision, linearity, detection limits, interference, method comparison, matrix comparison) are all "standalone" performance evaluations of the reagent/analyzer system.
  6. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):

    • The ground truth for the analytical performance characteristics is established by highly controlled laboratory measurements using validated reference methods (e.g., the Doumas method for bilirubin), highly characterized samples, and adherence to CLSI (Clinical and Laboratory Standards Institute) guidelines (EP5-A2, EP6-A, EP17-A2), which are standard for IVD device validation.
  7. The sample size for the training set:

    • Not applicable. This is a chemical reagent, not a machine learning model that requires a "training set" in the conventional sense. The "training" here would be the development and optimization of the reagent formulation and assay parameters based on extensive chemical and analytical research and development.
  8. How the ground truth for the training set was established:

    • Not applicable (see point 7). The "ground truth" during the development phase would involve using highly accurate and precise analytical techniques to characterize various bilirubin concentrations and interfering substances to optimize the reagent's performance against these known values.

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510(k) Summary for COBAS INTEGRA Bilirubin Direct Gen.2

510(k) numberK123965
Purpose of submissionRoche Diagnostics hereby submits this 510(k) to provide FDA with notification of intent to market a new device named COBAS INTEGRA Bilirubin Direct Gen.2 reagent.This candidate device is a new reagent that was developed by Roche Diagnostics. The previous generation of reagent, COBAS INTEGRA Bilirubin Direct, was cleared in 510(k) K063543 and serves as the predicate device. The candidate and predicate devices use the same calibrator and controls. Only the reagents differ. This submission presents data to support clearance of this new reagent.
MeasurandDirect Bilirubin
Type of testQuantitative diazo colorimetric method
ApplicantRoche Diagnostics
Candidate device namesProprietary name:COBAS INTEGRA Bilirubin Direct Gen.2Common name:Bilirubin Direct Gen.2
Regulatory informationProduct CodeClassificationRegulationPanelCIGClass II21 CFR 862.1110 (Bilirubin (total or direct) test system)Clinical Chemistry (75)Product CodeClassificationRegulationPanelCIGClass II21 CFR 862.1110 (Bilirubin (total or direct) test system)Clinical Chemistry (75)
Product CodeClassificationRegulationPanel
CIGClass II21 CFR 862.1110 (Bilirubin (total or direct) test system)Clinical Chemistry (75)

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Intended useIn vitro test for the quantitative determination of direct bilirubin in humanserum and plasma on COBAS INTEGRA systems.
Indications foruseCOBAS INTEGRA Bilirubin Direct Gen.2 is an in vitro test for thequantitative determination of direct bilirubin in human serum and plasma onCOBAS INTEGRA systems. Measurement of the levels of bilirubin, anorganic compound formed during the normal and abnormal destruction of redblood cells, is used in the diagnosis and treatment of liver, hemolytic,hematological, and metabolic disorders, including hepatitis and gall bladderblock.
Specialconditions foruseFor prescription use only
SpecialinstrumentrequirementsFor use on the COBAS INTEGRA clinical chemistry analyzer
CandidatedevicedescriptionCOBAS INTEGRA Bilirubin Direct Gen.2 reagent provides quantitativemeasurement of the direct bilirubin that is present in a human serum orhuman plasma sample.Reagents are packaged in a cassette with two bottles labeled with theirinstrument positioning, R1 and SR. R1, or Reagent 1, contains Phosphoricacid 85 mmol/L, NaCl 50 mmol/L, and HEDTA 4.0 mmol/L at pH 1.9. SR,or Start Reagent, is a 3,5-dichlorophenyl diazonium salt at 1.5 mmol/L in acidbuffer, pH 1.3.
PredicatedeviceRoche Diagnostics claims substantial equivalence to the COBAS INTEGRABilirubin Direct reagent that was cleared with the Special 510(k) K063543.
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The following table compares the identical features of the candidate device to Substantial equivalence the predicate device that was cleared in 510(k) K063543. similarities

FeaturePredicate Device:Bilirubin DirectCandidate Device:Bilirubin Direct Gen.2
Sample TypesSerum and plasmaSame
Reference MethodDiazo colorimetric methodSame
CalibratorCalibrator for automated systems(C.f.a.s.) and deionized water as thezero calibratorSame
Calibration StabilityRecalibrate with each lot as andrequired following quality controlproceduresSame
Calibration ModeLinear regressionSame
TraceabilityStandardized against the Doumasmanual reference methodSame

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The following table compares the different features of the candidate device to Substantial the predicate device that was cleared in 510(k) K063543. equivalence differences .

FeaturePredicate Device:Bilirubin DirectCandidate Device:Bilirubin Direct Gen.2
Intended UseCOBAS INTEGRA BilirubinDirect (BIL-D) contains an invitro diagnostic reagent systemintended for use on COBASINTEGRA systems for thequantitative determination of thedirect (conjugated) bilirubinconcentration in serum andplasma.In vitro test for the quantitativedetermination of direct bilirubin inhuman serum and plasma onCOBAS INTEGRA systems.
Indications for UseThe cassette COBAS INTEGRABilirubin Direct (BIL-D) containsan in vitro diagnostic reagentsystem intended for use onCOBAS INTEGRA systems forthe quantitative determination ofthe direct (conjugated) bilirubinconcentration in serum andplasma (test BIL-D, 0-049).Measurement of the levels ofbilirubin, an organic compoundformed during the normal andabnormal destruction of red bloodcells, is used in the diagnosis ofliver, hemolytic, hematological,and metabolic disorders, includinghepatitis and gall bladder block.COBAS INTEGRA BilirubinDirect Gen.2 is an in vitro test forthe quantitative determination ofdirect bilirubin in human serumand plasma on COBAS INTEGRAsystems.Measurement 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.
PermissibleAnticoagulantsLi-heparin
Instrument PlatformCOBAS INTEGRA 400,400 Plus, 700, and 800COBAS INTEGRA 800

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Substantial equivalence - differences continued

FeaturePredicate Device:Bilirubin DirectCandidate Device:Bilirubin Direct Gen.2
Reagent CompositionR1:Sulfanilic acid 35 mmol/L,Oxalic acid 40 mmol/L,HEDTA 4.0 mmol/L, andpH 1.2R2:Sodium nitrite 3.9 mmol/L andpH 6.0Sulfanilic acid reacts with sodiumnitrite to form diazotizedsulfanilic acid.R1:Phosphoric acid 85 mmol/L,NaCl 50 mmol/L,HEDTA 4.0 mmol/L, andpH 1.9SR:3,5-DPD 1.5 mmol/L andpH 1.3
Reagent Shelf LifeStability15-25 °C until expiration date2-8 °C until expiration date
Reagent On-BoardStabilityCOBAS INTEGRA 700/800:8 °C for 12 weeksCOBAS INTEGRA 400/400 plus:10-15 °C for 8 weeksCOBAS INTEGRA 800:8 °C for 6 weeks
ControlsPrecinorm U plus,Precipath U plus,Precinorm U,Precipath UPrecinorm U plus,Precipath U plus,PreciControl ClinChem Multi 1A,PreciControl ClinChem Multi 2AAThese two new controls werecleared for use with bilirubindirect with 510(k) # K102016.
Measuring Range0.10 – 25 mg/dL0.07 – 13.8 mg/dL
Expected Values0 to 0.2 mg/dL≤ 0.20 mg/dL
Lower Limits ofMeasureLDL = 0.10 mg/dLLoB = 0.05 mg/dLLoD = 0.07 mg/dLLoQ = 0.07 mg/dL

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Test principleCOBAS INTEGRA Bilirubin Direct Gen.2 measures direct bilirubin byemploying the diazo colorimetric method. Conjugated bilirubin and δ-bilirubin (direct bilirubin) react directly with 3,5-dichlorophenyl diazoniumsalt in acid buffer to form the red-colored azobilirubin. The color intensity ofthe red azobilirubin formed is directly proportional to the direct bilirubinconcentration. The color intensity is measured photometrically by a COBASINTEGRA clinical chemistry analyzer.
Precision/reproducibilityPrecision was determined according to CLSI EP5-A2. The study includedhuman sera samples (0.12, 3.76, and 13.2 mg/dL) and two serum-basedcontrol samples in two aliquots per run and two runs per day for 21 days.Here are summaries of the repeatability and intermediate precision data.
Repeatability Summary
SpecimenPNUPPUHuman Serum 1Human Serum 2Human Serum 3
Total Mean (mg/dL)0.751.90.123.813.2
Within Run ImprecisionSD (mg/dL)0.010.010.010.010.04
Within Run ImprecisionCV%1.20.67.40.40.3
Min (mg/dL)0.721.90.093.713.1
Max (mg/dL)0.782.00.133.813.3

Intermediate Precision

SpecimenPNUPPUHuman Serum 1Human Serum 2Human Serum 3
Total Mean (mg/dL)0.751.90.123.813.2
Total ImprecisionSD (mg/dL)0.010.020.010.040.05
Total ImprecisionCV%1.61.07.71.00.4
Min (mg/dL)0.721.90.093.713.1
Max (mg/dL)0.782.00.133.813.3

Values that appear in bold type also appear in the labeling.

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Linearity/ assay reportable range

Linearity was assessed according to CLSI EP6-A with one batch of reagent, in one run, and with samples measured in triplicate. Two separate dilution series differing by sample type (serum and plasma) were prepared with thirteen levels each. Lithium-heparin was used to prepare the plasma sample series. The highest concentration samples exceed the desired measuring range. The highest concentration samples were created by taking low analyte native samples and spiking them with ditaurobilirubin.

Measuring Ranges that are Supported by the Linearity Data

PlasmaSerum
Range tested (mg/dL)0.01 - 19.50.02 - 19.4
Range found (mg/dL)0.01 - 19.50.02 - 17.4
Recommended measuring range (mg/dL)0.07 - 13.80.07 - 13.8

The quadratic model is significant for both sample types.

Linear Regression Equation for Serum y = 1.0000x ~ 0.0000 r2 = 0.9944

Linear Regression Equation for Plasma r2 = 0.9977 y = 1.0000x - 0.0000

Traceability, stability, and expected values

This method has been standardized against the manual test performance using the Doumas method.

The reagent has been evaluated for transport, shelf-life, open on-board, and calibration stability.

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Detection limit LoB. LoD, and LoO studies were performed based upon CLSI EP17-A2.

LoB Protocol: One blank sample was tested in n=5 with two analyzers with three reagent batches for two runs per day across three days.

LoD Protocol: Five low-analyte samples were measured in singlicate on two analyzers with three reagent batches for two runs per day across three days.

LoO Protocol: A low-level sample set of nine was measured in singlicate, using three reagent batches on two analyzers for two runs per day across three days. The LoQ is determined based on precision at 20% CV.

The LoB, LoD, and LoQ claims represent the specifications for each.

LoB claim = 0.05 mg/dL LoD claim = 0.07 mg/dL LoQ claim = 0.07 mg/dL

Analytical specificity interference from endogenous substances

The reagent was evaluated with two endogenous substances, hemoglobin and lipids, for potential interference with the measurement of direct bilirubin.

One pool of human serum was spiked with the interferent. A second pool of human serum contained none. The two pools were mixed in different ratios to yield a dilution series with varying concentrations of the interferent (from 0 to 10).

The endogenous interference data are summarized in the table. The labeling claims the specification, "No significant interference up to an H index of 25," and "No significant interference up to an L index of 750."

Endogenous Interference Summary Data

no interference up to this concentration (mg/dl)
Lipemia low analyte1098
Lipemia high analyte1100
Hemolysis low analyte35
Hemolysis high analyte25

The lowest L index for which there is no significant interference is 1098. The lowest H index for which there is no significant interference is 25.

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Analytical specificity interference from common drugs

Eighteen commonly used drugs were added to native patient samples and examined for potential interference on measurement with COBAS INTEGRA Bilirubin Direct reagent.

Drug interference testing was performed with serum sample pools at two target concentrations of direct bilirubin, one at a low concentration of ~ 1.8 mg/dL and the second one at a high concentration of ~ 4.9 mg/dL.

Direct bilirubin concentration in all aliquots is measured in triplicate on the COBAS INTEGRA analyzer. The mean value among the triplicates for each aliquot is determined. From the mean values, the percent recovery to the initial value is calculated.

"Phenylbutazone causes falsely low bilirubin results." This statement appears in the labeling. The remaining 17 commonly used drugs produce no interference with BILD2 measurement.

DrugHighest Concentration ShownNot to Interfere with BILD2(mg/L, except Heparin)
1Acetylcystein150
2Ampicillin - Na1000
3Ascorbic acid300
4Ca - Dobesilate200
5Cyclosporine A5
6Cefoxitin2500
7Heparin - Na5000 U
8Intralipid10000
9Levodopa20
10Methyldopa + 1.520
11Metronidazole200
12Doxycyclin50
13Acetylsalycilic acid1000
14Rifampicin60
15Acetaminophen200
16Ibubrofen500
17Theophylline100

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Method comparison with predicate device

Direct bilirubin values for n=71 human sera samples were obtained using the candidate reagent (y-axis) to the predicate reagent (x-axis) on the COBAS INTEGRA 800 clinical chemistry analyzer. Samples ranged from 0.083 to 13.762 mg/dL and were tested in singlicate. The values were regressed using the Passing/Bablok model to produce the following equation. R2 = 0.9979

y = 1.0490x + 0.0699 mg/dL

Matrix comparison Lithium-heparin, K2-EDTA, and K3-EDTA are permissible anticoagulants for use with this reagent because they do not interfere with recovery of direct bilirubin. 32 tubes were collected per anticoagulant. Plasma results were compared to serum results and percent recovery was determined.

Median Values for Anticoagulant Comparisons

anticoagulantsmedian recoverymedian absolutedeviation(mg/dL)
Li-Heparin (full)102%+0.02
Li-Heparin (half)102%-0.05
K2-EDTA (full)101%+0.00
K2-EDTA (half)101%-0.02
K3-EDTA (full)100%-0.00
K3-EDTA (half)100%-0.03
Gel Separation Tube104%+0.02
Criteria90 to 110%<0.20

Comparisons were also regressed.

Serum vs. Li-heparinP/B: y = 0.01 + 1.0179x,r = 0.9988
Serum vs. K2-EDTAP/B: y = -0.01 + 1.0120x,r = 0.9988
Serum vs. K3-EDTAP/B: y = -0.03 + 1.0095x,r = 0.9988

Expected values/

Direct bilirubin ≤ 0.20 mg/dL

reference range

Balisteri WF, Shaw LM. Liver function. In: Tietz NW, ed. Fundamentals of Clinical Chemistry. 3th ed. Philadelphia: WB Saunders 1987; 729-761.

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510(k) Summary for COBAS INTEGRA Bilirubin Direct Gen.2, Continued and the same of the same of the same of the same of the same of the same of the states of the states of the states of the states of the states of the states of the states of

and the contraction of the comments of the comments of the contraction of the control of

The submitted information in this premarket notification supports a Conclusion substantial equivalence decision.

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Image /page/11/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features the department's name in a circular arrangement around an emblem. The emblem is a stylized representation of an eagle, with three distinct lines forming its body and wings. The eagle is oriented to the right, symbolizing strength and national identity.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

February 28, 2013

Roche Diagnostics c/o Susan Hollandbeck Regulatory Affairs Consultant 9115 South Hague Road Indianapolis, IN 46250

Re: K123965

Trade/Device Name: COBAS INTEGRA Bilirubin Direct Gen. 2 Reagent Regulation Number: 21 CFR 862.1110 Regulation Name: Bilirubin (total or direct) test system Regulatory Class: Class II Product Code: CIG Dated: December 21, 2012 Received: December 26, 2012

Dear Ms. Hollandbeck:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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 - Susan Hollandbeck

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.

If you desire specific advice for your device on our labeling regulation (21 CFR Parts 801 and 809), please contact the Office of In Vitro Diagnostics and Radiological Health at (301) 796-5450. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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/cdrh/industry/support/index.html.

Sincerely yours,
Carol C. Benson -
S for

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

Enclosure

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Indications for Use

510(k) Number (if known): K123965

Device Name: COBAS INTEGRA Bilirubin Direct Gen.2

Indications for Use:

COBAS INTEGRA Bilirubin Direct Gen.2 is an in vitro test for the quantitative determination of direct bilirubin in human serum and plasma on COBAS INTEGRA systems. Measurement 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.

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 Diagnostics and Radiological Health (OIR)

YungW.Chan -S

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

K123965 510(k)

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§ 862.1110 Bilirubin (total or direct) test system.

(a)
Identification. A bilirubin (total or direct) test system is a device intended to measure the levels of bilirubin (total or direct) in plasma or serum. Measurements of the levels of bilirubin, an organic compound formed during the normal and abnormal distruction of red blood cells, if used in the diagnosis and treatment of liver, hemolytic hematological, and metabolic disorders, including hepatitis and gall bladder block.(b)
Classification. Class II.