K Number
K130915
Device Name
XL-200 CLINICAL CHEMISTRY ANALYZER, JAS GLUCOSE REAGENT, ISE REAGENT PACK
Date Cleared
2014-05-15

(408 days)

Product Code
Regulation Number
862.2160
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The XL-200 Clinical Chemistry Analyzer is an automated random access, computer controlled, bench top, clinical analyzer for clinical chemistry tests. The instrument provides in vitro quantitative measurements for glucose, sodium, potassium and chloride in serum. This device is intended for clinical laboratory use. The JAS Glucose Reagent is intended for the in vitro quantitative measurement of glucose in serum on the XL-200 clinical chemistry analyzer. This device is intended for clinical laboratory use. 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. The ISE Reagent Pack is intended for the in vitro quantitative measurement of sodium, and chloride concentrations in serum on the XL-200 clinical chemistry analyzer. This device is intended for clinical laboratory use. Sodium measurements are used in the diagnosis and treatment of aldosteronism, diabetes insipidus and other diseases involving electrolyte imbalance. Potassium measurements are used to monitor electrolyte balance in the diagnosis and treatment of disease conditions characterized by low or high blood potassium levels. Chloride measurements are used in the diagnosis and treatment of electrolyte and metabolic disorders such as cystic fibrosis and diabetic acidosis.
Device Description
The XL-200 Clinical Chemistry Analyzer is an automated bench top, random access, open analyzer for clinical chemistry and immunoturbidimetric analysis on serum, urine, and other body fluids. The analyzer mainly uses colorimetric, turbidimetric, and ion selective electrode methods for analysis of samples. The instrument includes of the following main parts; - . Sampling Arm (for sample addition to cuvettes) - Reagent Arm (for reagent addition to cuvettes) . - Reaction Station (cuvettes) . - Sample Plate Station (for loading samples) . - Reagent Plate Station (for on board reagents) . - . Photometer (for reaction analysis reading) - Wash Station (for cleaning of reaction cuvettes) . - Electronic Boards (for controlling the open functions) . The JAS Glucose Reagent is intended for the quantitative measurement of glucose in serum on the XL-200 Clinical Chemistry Analyzer. The Reagent is a single vial liquid that is placed for use on the XL-200 Clinical Chemistry Analyzer reagent carousel. The reagent uses the enzymatic (Hexokinase/G-6-P) UV (340nm) method. This device is for clinical laboratory use. The JAS ISE Module consists of ion selective electrodes for sodium, potassium, and chloride, a reference electrode and accessory reagents.
More Information

Not Found

No
The document describes a standard automated clinical chemistry analyzer using established methods (colorimetric, turbidimetric, ion selective electrode) and does not mention any AI or ML components.

No
This device is an in vitro diagnostic (IVD) device used to quantitatively measure various substances in serum for diagnostic purposes; it is not a therapeutic device.

Yes
The device provides quantitative measurements of various analytes (glucose, sodium, potassium, chloride) that are explicitly stated to be used in the "diagnosis and treatment" of various conditions, such as "carbohydrate metabolism disorders including diabetes mellitus," "aldosteronism, diabetes insipidus and other diseases involving electrolyte imbalance," and "cystic fibrosis and diabetic acidosis." This clearly indicates its role in aiding medical diagnosis.

No

The device description clearly outlines multiple hardware components (Sampling Arm, Reagent Arm, Reaction Station, etc.) that are integral to the device's function as a clinical chemistry analyzer. It is not solely software.

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

Here's why:

  • Intended Use: The intended use explicitly states that the XL-200 Clinical Chemistry Analyzer, the JAS Glucose Reagent, and the ISE Reagent Pack are for "in vitro quantitative measurements" of various analytes (glucose, sodium, potassium, chloride) in "serum". This means they are used to test samples taken from the human body outside of the body to provide information about a person's health.
  • Device Description: The description details how the analyzer and reagents work to perform these measurements on biological samples.
  • Clinical Laboratory Use: The intended use and device description both state that the device is intended for "clinical laboratory use," which is a common setting for IVD devices.
  • Performance Studies: The performance studies described are typical for validating the accuracy and reliability of IVD devices for clinical use.
  • Predicate Device: The mention of a predicate device (Olympus AU400 Clinical Chemistry Analyzer) which is also a clinical chemistry analyzer, further supports its classification as an IVD.

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

N/A

Intended Use / Indications for Use

The XL-200 Clinical Chemistry Analyzer is an automated, random access, computer controlled, bench top clinical chemistry analyzer for clinical chemistry tests. The instrument provides in vitro quantitative measurements for glucose, sodium, potassium, and chloride in serum. This device is intended for clinical laboratory use.

The JAS Glucose Reagent in intended for the in vitro quantitative measurement of glucose in serum on the XL-200 Clinical Chemistrv Analyzer. This device is intended for clinical laboratory use. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders, including diabetes mellitus, neonatal hypoglycemia and of pancreatic islet cell carcinoma.

The ISE Reagent Pack is intended for the in vitro quantitative measurement of sodium, potassium, and chloride concentrations in serum on the XL-200 Clinical Chemistry Analyzer. This device is intended for clinical laboratory use.

Sodium measurements are used in the diagnosis and treatment of aldosteronism, diabetes insipidus and other diseases involving electrolyte imbalance.

Potassium measurements are used to monitor electrolyte balance in the diagnosis and treatment of disease conditions characterized by low or high blood potassium levels.

Chloride measurements are used in the diagnosis and treatment of electrolyte and metabolic disorders such as cystic fibrosis and diabetic acidosis.

Product codes

JJE, CFR, JGS, CEM, CGZ

Device Description

The XL-200 Clinical Chemistry Analyzer is an automated bench top, random access, open analyzer for clinical chemistry and immunoturbidimetric analysis on serum, urine, and other body fluids. The analyzer mainly uses colorimetric, turbidimetric, and ion selective electrode methods for analysis of samples.

The instrument includes of the following main parts;

  • Sampling Arm (for sample addition to cuvettes)
  • Reagent Arm (for reagent addition to cuvettes)
  • Reaction Station (cuvettes)
  • Sample Plate Station (for loading samples)
  • Reagent Plate Station (for on board reagents)
  • Photometer (for reaction analysis reading)
  • Wash Station (for cleaning of reaction cuvettes)
  • Electronic Boards (for controlling the open functions)

The JAS Glucose Reagent is intended for the quantitative measurement of glucose in serum on the XL-200 Clinical Chemistry Analyzer. The Reagent is a single vial liquid that is placed for use on the XL-200 Clinical Chemistry Analyzer reagent carousel. The reagent uses the enzymatic (Hexokinase/G-6-P) UV (340nm) method. This device is for clinical laboratory use.

The JAS ISE Module consists of ion selective electrodes for sodium, potassium, and chloride, a reference electrode and accessory reagents.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Photometric, Ion Selective Electrodes

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

clinical laboratory use

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)

Glucose Performance Characteristics

  • Linearity: Protocol involved 9 serial dilutions of a 500 mg/dL Glucose Standard run on the XL-200. Results yielded an acceptable Slope of 1.001 and Intercept of -0.1mg/dL, with linearity within 3mg/dL or 5% nonlinearity, validating the claimed range of 9 to 500mg/dL.
  • Calibrator Traceability: Protocol included running Verichem Laboratories Matrix Plus Chemistry Reference Kit (9500) on the XL-200. Results showed accuracy test passed with a slope of 0.972, intercept of 2.1mg/dL, and error of 1.4%.
  • Interferences: Protocol used serial dilutions of a high interferent sample and a spiked sample without interferent. Acceptable interference level was defined as 0.95, Slope between 0.90 and 1.10, Intercept close to 0). For Sodium (101 sample pairs, Range 103-193 mmol/L (x method) and 101-190 mmol/L (y method), R 0.9917, Slope 0.984, Intercept 2.256 mmol/L). For Potassium (90 sample pairs, Range 1.2-9.90 mmol/L (x method) and 1.1-10.0 mmol/L (y method), R 0.9954, Slope 0.999, Intercept 0.05 mmol/L). For Chloride (88 sample pairs, Range 51-140 mmol/L (x method) and 51-145 mmol/L (y method), R 0.9856, Slope 1.070, Intercept -4.3 mmol/L).

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K981743

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 862.2160 Discrete photometric chemistry analyzer for clinical use.

(a)
Identification. A discrete photometric chemistry analyzer for clinical use is a device intended to duplicate manual analytical procedures by performing automatically various steps such as pipetting, preparing filtrates, heating, and measuring color intensity. This device is intended for use in conjunction with certain materials to measure a variety of analytes. Different models of the device incorporate various instrumentation such as micro analysis apparatus, double beam, single, or dual channel photometers, and bichromatic 2-wavelength photometers. Some models of the device may include reagent-containing components that may also serve as reaction units.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 862.9.

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1 5 2014

510(k) Summary

1.) Safety and effectiveness as required by 21 CFR 807.92 STATEMENT

This summary of the 510(k) safety and effectiveness information is being submitted in accordance with the requirement 21 CFR 807,92.

2.) Submitter's / Owner of the 510(k) and Contact Information

Name: JAS Diagnostics

Address: 14100 N.W. 57th Court Miami Lakes, FL 33014

Phone: 305 418-2320 Fax: 305 418-2321

Official Correspondent David Johnston

E-mail: djohnston@jasdiagnostics.com

Date of Preparation April 14, 2014

510(k) Application Number K130915

3.) 510k Number, Device, Proprietary Name, Common Name, Purpose for Submission, Regulatory Classification, Panel, Product Code And CFR Number

Regulation Number:Device Description
21CFR Sec. - 862.2160Discrete Photometric Chemistry Analyzer for Clinical Use
21CFR Sec. - 862.1345Glucose Test System
21CFR Sec. - 862.1665Sodium Test System
21CFR Sec. - 862.1600Potassium Test System
21CFR Sec. - 862.1170Chloride Test System

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MOT A : YAM

Classifications:

Class II and Class I (Analyzer)

Product Codes

  • JJE Analyzer, Chemistry (Photometric, Discrete), for Clinical Use
  • CFR Hexokinase, Glucose

JGS - Electrode, Ion Specific, Sodium

CEM - Electrode, Ion Specific, Potassium

  • CGZ Electrode, Chloride

Panel

Chemistry (75)

4.) Proprietary Name and Common Name

Trade/Proprietary Name

XL-200 Clinical Chemistry Analyzer, JAS Glucose Reagent, ISE Reagent Pack

Common Name/Usual Name

XL-200 Clinical Chemistry Analyzer, JAS Glucose Reagent, ISE Reagent Pack

5.) Indications for Use

The XL-200 Clinical Chemistry Analyzer is an automated, random access. computer controlled, bench top clinical chemistry analyzer for clinical chemistry tests. The instrument provides in vitro quantitative measurements for glucose, sodium, potassium, and chloride in serum. This device is intended for clinical laboratory use.

The JAS Glucose Reagent in intended for the in vitro quantitative measurement of glucose in serum on the XL-200 Clinical Chemistrv Analyzer. This device is intended for clinical laboratory use. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders, including diabetes mellitus, neonatal hypoglycemia and of pancreatic islet cell carcinoma.

The ISE Reagent Pack is intended for the in vitro quantitative measurement of sodium, potassium, and chloride concentrations in serum on the XL-200 Clinical Chemistry Analyzer. This device is intended for clinical laboratory use.

Sodium measurements are used in the diagnosis and treatment of aldosteronism, diabetes insipidus and other diseases involving electrolyte imbalance.

2

Potassium measurements are used to monitor electrolyte balance in the diagnosis and treatment of disease conditions characterized by low or high blood potassium levels.

Chloride measurements are used in the diagnosis and treatment of electrolyte and metabolic disorders such as cystic fibrosis and diabetic acidosis.

6.) Device Description: JAS XL-200 Clinical Chemistry Analyzer

The XL-200 Clinical Chemistry Analyzer is an automated bench top, random access, open analyzer for clinical chemistry and immunoturbidimetric analysis on serum, urine, and other body fluids. The analyzer mainly uses colorimetric, turbidimetric, and ion selective electrode methods for analysis of samples.

The instrument includes of the following main parts;

  • . Sampling Arm (for sample addition to cuvettes)
  • Reagent Arm (for reagent addition to cuvettes) .
  • Reaction Station (cuvettes) .
  • Sample Plate Station (for loading samples) .
  • Reagent Plate Station (for on board reagents) .
  • . Photometer (for reaction analysis reading)
  • Wash Station (for cleaning of reaction cuvettes) .
  • Electronic Boards (for controlling the open functions) .

7.) Substantial Equivalence Information:

  • 1.) Predicate 510(k) number: K981743
  • 2.) Olympus AU400 Clinical Chemistry Analyzer:
  • 3.) Comparison to predicate:

| | Device Name | Device:
XL-200
Clinical Chemistry
Analyzer | Predicate Device:
OLYMPUS AU400
Clinical Chemistry
Analyzer |
|---|-------------|-----------------------------------------------------|----------------------------------------------------------------------|
| 1 | 510(k) | Pending | K981743 |

3

2System Principles
QC/CalibrationAutomatic and ManualAutomatic and Manual
LIS external connectivityYESYES
BarcodeSamplesSamples
ReagentsReagents
Re-dilution on abnormalsYESYES
3Throughput200 test/hour400 test/hour
400 with ISE800 with ISE
4Principle of analysis
Mode of detectionPhotometric / ISEPhotometric / ISE
Analytical MethodsEndpoint, Kinetic, Ion
Selective ElectrodesEndpoint, Kinetic, Ion
Specific Electrodes
CalibrationLinear and non linearLinear and non linear
5Optical
measurement unit
Measurement modesAbsorbanceAbsorbance
Optical modesBichromatic,
turbidimetricBichromatic, turbidimetric
Wavelengths340nm, 405nm,
505nm, 546nm,
578nm, 600nm,
660nm, 700nm340nm, 380nm, 410nm,
450 nm, 480nm, 520nm,
540nm, 570nm, 600nm,
660nm , 700nm, 750nm
800nm
Linear absorbance range0.0 to 2.5 A0 to 2.5 A
Light sourcehalogen lamphalogen lamp
DetectorSilicone photodiode
arraySilicon photodiodes
6Reaction unit
Reaction cuvettes45 quartz semi-disposable88 quartz semi-disposable
Reaction volume180 to 570 uL180 to 610 uL
Path lengthCalculated at 10mm10mm conversion
TemperatureRoom, 30°C, 37°CRoom, 30°C, 37°C
7Sample and
reagent unit
Reagent positions25 for Rgt1, 50mL
bottles
25 for Rgt2, 20mL
bottles38 for Rgt1, 60mL bottles
38 for Rgt2, 15 & 30mL
bottles
Sample positions3948
Pipetter systemplunger, stepper motor
drivenMicro-syringe, motor
driven
MixingImmersion mixing by
rotating mixersRotating mix bar
Reagent refrigerationYESYES
Sample dispensing2 - 70 microliters2 - 50 microliters
8PowerAC220V. 50 Hz or
110v, 60HzAC210V, 60Hz (U.S.)
9Environmental15 to 30°C,
Humidity 40 to 80%15 to 30°C,
Humidity 40 to 80%
conditionsHumidity 40 to 80%Humidity 40 to 80%
10ISE PrincipleIon selective, direct
measurementIon selective, direct
measurement
11ISE sample typeSerumSerum, Urine
12Available testsNa, K, ClNa, K, Cl
13ISE calibrationTwo-point and single pointTwo-point and single point
14Sample size70 uL70 uL

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8.) Device Description: JAS Glucose Reagent

The JAS Glucose Reagent is intended for the quantitative measurement of glucose in serum on the XL-200 Clinical Chemistry Analyzer. The Reagent is a single vial liquid that is placed for use on the XL-200 Clinical Chemistry Analyzer reagent carousel. The reagent uses the enzymatic (Hexokinase/G-6-P) UV (340nm) method. This device is for clinical laboratory use.

9.) Substantial Equivalence Information:

Predicate 510(k) number: K981743

  • Olympus AU400 Clinical Chemistry Analyzer, Glucose Reagent

10.) Comparison to predicate:

Manufacturer:JAS DiagnosticsBeckman Coulter Olympus
Device NameJAS Glucose Reagent for
XL-200 Clinical
Chemistry AnalyzerOlympus Glucose Reagent for
Olympus AU 400 & 600
series Chemistry Analyzers
JAS DiagnosticsBeckman Coulter (Olympus)
FDA 510k #K130915 (CFR)
(Pending)K981743 (CFR)
ClassificationModerate
(Pending)Moderate

6

| Intended Use | quantitative measurement
of glucose in serum
on the XL-200 Clinical
Chemistry analyzer
For clinical laboratory use | quantitative measurement
of glucose in serum, plasma
urine, on Beckman Coulter
clinical chemistry analyzers
For clinical laboratory use |
|-----------------------|--------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------|
| Methodology | enzymatic (Hexokinase /
G-6-P), UV (340nm) | enzymatic (Hexokinase /
G-6-P), UV (340nm) |
| Reagent Description | Single vial liquid reagent | Two vial liquid reagent |
| Normal Range
Adult | 74 - 106 mg/dL | 70 - 105 mg/dL |

11.) Performance Characteristics - Glucose .

Linearity

Protocol: 9 Serial Dilutions of a 500 mg/dL Glucose Standard were prepared and run on the XL-200, along with the 500 mg/dL stock Standard. Results were then plotted as a regression graph against theoretical recovery.

Results: Acceptable Slope 1.001 and Intercept of -0.1mg/dL, and data linear within allowable nonlinearity of 3mg/dL or 5% resulted; validating the product's claimed linearity range of 9 to 500mg/dL.

Calibrator Traceability:

Protocol: Verichem Laboratories Matrix Plus Chemistry Reference Kit (9500) five level reference material was run on the XL-200 Clinical Chemistry Analyzer, using JAS Glucose Reagent. This material is "Verified and lot certified using available standard reference materials for the National Institute of Standards and Technology (NIST)."

Results:

Program's Evaluation of glucose Results states accuracy test passed and results linear; with a slope of 0.972 and intercept of 2.1mg/dL, with error of 1.4%.

Interferences

Protocol: Serial dilutions were prepared using a high interferent sample material, with the same sample material (glucose level) without the interferent spiked. Acceptable interference level is the is the highest interferent sample level were the glucose values remains within 10% of the sample value unspiked with the intereferent.

Results: The following highest interferent levels for the sample, with 0.95, Slope between 0.90 and 1.10, and intercept close to 0 mg/dL level.

JAS Glucose reagent on the XL-200 Clinical Chemistry Analyzer versus Olympus glucose reagent of Olympus 400:

Number of sample pairs:103
Range tested: x method11 to 497 mg/dL
y method9 to 501 mg/dL
Corr. Coef. (R)0.9970
Slope1.002
Intercept1.8 mg/dL

Precision/Reproducibility:

Protocol: Precision was performed using "EP Evaluator's NCCLS EP5-T2 Precision document (NCCLS.EP5)" program. Three glucose sample levels were run 20 times in duplicate, using 20 runs over a 20 day period on the XL-200 Clinical Chemistry Analyzer, for within run and for total imprecision calculation/determination.

Results: Results were entered into Rhoads EP Evaluator Software for determining precision S.D. and CV levels. All results below meet requirement of CV (%) 0.95, Slope between 0.90 and 1.10, and intercept close to 0 mg/dL level

Sodium

Number of sample pairs:101
Range tested: x method103 to 193 mmol/L
Range tested: y method101 to 190 mmol/L
Correlation Coefficient0.9917
Slope:0.984
Intercept:2.256 mmol/L

Potassium

Number of sample pairs:90
Range tested: x method1.2 to 9.90 mmol/L
Range tested: y method1.1 to 10.0 mmol/L
Correlation Coefficient0.9954
Slope:0.999
Intercept:0.05 mmol/L

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Chloride

88 Number of sample pairs: 51 to 140 mmol/L Range tested: x method Range tested: y method 51 to 145 mmol/L Correlation Coefficient 0.9856 Slope: 1.070 - 4.3 mmol/L Intercept:

The submitted information in this pre-market notification is complete and supports a substantial equivalence decision.

I .

14

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/14/Picture/1 description: The image shows the logo for the Department of Health & Human Services USA. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" around the perimeter. Inside the circle is an abstract image of an eagle with three lines representing its wings.

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G60 Silver Spring, MI) 20993-00002

May 15, 2014

JAS DIAGNOSTICS. INC. DAVID JOHNSTON VP. RESEARCH AND DEVELOPMENT 14100 N.W. 57TH COURT MIAMI LAKES FL 33014

Re: K130915 Trade/Device Name: JAS Glucose Reagent ISE Reagent Pack XL-200 Clinical Chemistry Analyzer Regulation Number: 21 CFR 862.1345 Regulation Name: Glucose test system Regulatory Class: II Product Code: CFR, JGS. CEM. CGZ. JJE Dated: April 30, 2014 Received: May 2. 2014

Dear Mr. David Johnston:

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 docs 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 Parts 801 and 809): medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the

15

Page 2-Mr. David Johnston

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 regulations (21 CFR Parts 801 and 809), please contact the Division of Industry and Consumer Education at its toll-five number (800) 638 2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. 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.lda.gov/MedicalDevices/Safety/ReportalProblem/defiult.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 Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/Resources/or You/Industry/default.htm.

Sincerely yours,

Courtney H. Lias -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

Enclosure

16

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K130915

Device Name

XL-200 Clinical Chemistry Analyzer, JAS Glucose Reagent, ISE Reagent Pack

Indications for Use (Describe)

The XL-200 Clinical Chemistry Analyzer is an automated random access, computer controlled, bench top, clinical analyzer for clinical chemistry tests. The instrument provides in vitro quantitative measurements for glucose, sodium, potassium and chloride in serum. This device is intended for clinical laboratory use.

The JAS Glucose Reagent is intended for the in vitro quantitative measurement of glucose in serum on the XL-200 clinical chemistry analyzer. This device is intended for clinical laboratory use. 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.

The ISE Reagent Pack is intended for the in vitro quantitative measurement of sodium, and chloride concentrations in serum on the XL-200 clinical chemistry analyzer. This device is intended for clinical laboratory use.

Sodium measurements are used in the diagnosis and treatment of aldosteronism, diabetes insipidus and other diseases involving electrolyte imbalance.

Potassium measurements are used to monitor electrolyte balance in the diagnosis and treatment of disease conditions characterized by low or high blood potassium levels.

Chloride measurements are used in the diagnosis and treatment of electrolyte and metabolic disorders such as cystic fibrosis and diabetic acidosis.

Type of Use (Select one or both, as applicable)

2 Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

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PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY :

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

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