K Number
K131307
Date Cleared
2014-01-24

(262 days)

Product Code
Regulation Number
864.7470
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The ADVIA® Chemistry Fructosamine (FRUC) Assay For in vitro diagnostic use in the quantitative measurement of glycated protein (fructosamine) in human serum or plasma on the ADVIA® Chemistry systems. Measurement of fructosamine is representative of blood glucose levels over the preceding 2-3 weeks, and is useful for monitoring diabetic patients. ADVIA® Chemistry Fructosamine Calibrator For in vitro diagnostic use in the calibration of the ADVIA® Chemistry Fructosanine (FRUC) assay on ADVIA® Chemistry systems.

Device Description

The ADVIA® Chemistry Fructosamine reagents are ready-to-use liquid packaged for use on ADVIA® 1650 Chemistry system. The reagents are supplied as 100 tests/wedge, with two (2) wedges in each kit. Reagent 1 (R1) contains Tris Buffer (0.2 mol/L, pH 8.0), Proteinase-K (≥ 1 kU/mL) 4-. Aminoantipyrine (5 mmol/L) and Stabilizers. . Reagent 2 (R2) contains Tris Buffer (0.2 mol/L, pH 8.65), Fructosaminase (≥ 0.5 kU/mL), Peroxidase (horseradish) (0.5 kU/mL) N-ethyl-N-sulphohydroxypropyl-mtoluidine (TOOS) ( 10 mmol/L ) and Stabilizers. The ADVIA® Chemistry Fructosamine Calibrator is a single analyte and single level calibrator. It is lyophilized human serum containing pure fructosamine antigen. There are three (3) vials in each kit. Each vial contains 0.08g. The volume per vial (after reconstitution with deionized water) is 1.0 mL.

AI/ML Overview

Acceptance Criteria and Device Performance Study for ADVIA® Chemistry Fructosamine (FRUC) Assay

1. Table of Acceptance Criteria and Reported Device Performance:

The document describes several performance characteristics without explicitly stating pre-defined "acceptance criteria" in a singular table for all performance metrics. However, it indicates that "All of the evaluation studies gave acceptable results when compared to the predicate device" and that the studies "support that the ADVIA® Chemistry Fructosamine Assay... are substantially equivalent to the Diazyme Glycated Serum Protein Assay". Based on the provided data, I will infer the acceptance criteria from the reported performance and the context of substantial equivalence to the predicate device.

Performance CharacteristicAcceptance Criteria (Inferred from Predicate/Study Goals)Reported Device Performance (ADVIA® Chemistry Fructosamine Assay)Met?
Imprecision (Total CV)Comparable to predicate device; generally low CV values for clinical assaysRange: 0.8% - 3.5% across various concentrations (39-731 µmol/L)Yes
Linearity/Reportable RangeDeviation from linearity < 10% across the intended rangeLinear from 30-1000 µmol/L with deviation < 10%. R-value = 1.000Yes
Limit of Blank (LoB)< Limit of Quantitation (LoQ)15 µmol/LYes
Limit of Detection (LoD)Higher than LoB, clinical relevance for detection21 µmol/LYes
Limit of Quantitation (LoQ)Clinically relevant for low-end measurements30 µmol/L (based on 30.0% total error goal)Yes
Method Comparison (Correlation with Predicate)High correlation (r > 0.95 or similar) and acceptable regression equationr = 0.99; Regression: Y = 0.99x - 13.1 µmol/LYes
Matrix Comparison (Plasma vs. Serum)High correlation (r > 0.95 or similar) and acceptable regression equationLithium Heparin Plasma: r = 0.995; Y = 1.00x + 3.5. Potassium EDTA Plasma: r = 0.994; Y = 1.00x - 4.6Yes
Analytical Specificity (Interference)Bias < 10% for common interferents at specified levels (tolerance for some bias beyond specific levels)Most common interferents (Bilirubin, Hemolysis, Lipemia, Ascorbic Acid, Glucose, Uric Acid, Albumin, Total Protein) showed NSI (No Significant Interference) or bias < 10% at relevant concentrations. Some showed >10% bias at higher, specified levels (e.g., Bilirubin 10 mg/dL, Hemolysis 500 mg/dL, Ascorbic Acid 15 mg/dL). This outcome is typical and implies these are noted as potential interferences, not necessarily a failure to meet acceptance criteria for the intended use given typical clinical concentrations.Yes (Potential interferences noted for extremely high levels)
Reagent and Calibrator StabilityStated stability period achieved (e.g., 60 days on system, 12 months shelf life)Reagent: 60 days on system, 12 months shelf life. Calibrator: 28 days opened, 12 months shelf life.Yes
Traceability/Value AssignmentTraceable to an internal standard, consistent with established protocolTraceable to an internal standard, value assignment by nested testing protocol.Yes

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

  • Imprecision: 80 replicates (N=80) for each of 8 samples/controls (total 640 measurements for precision evaluation across various concentrations).
  • Linearity/Assay Reportable Range: Assessed by assaying "equally spaced dilutions across the measuring range." The exact number of samples/dilutions used is not specified.
  • Limit of Detection (LoD)/Limit of Blank (LoB)/Limit of Quantitation (LoQ): 160 replicates of blank ("zero") serum pool, and several serum pools with fructosamine concentration, with 160 low-level sample replicates for LoD. LoQ based on 160 determinations.
  • Method Comparison: 113 human serum samples tested. 3 samples excluded, so 110 samples used for calculations.
  • Matrix Comparison: 152 Lithium Heparin plasma samples and 128 Potassium EDTA plasma samples, compared against serum.
  • Analytical Specificity (Interference): Not specified per interferent, but implies testing of various interferent levels across different fructosamine sample concentrations.

Data Provenance: The document does not explicitly state the country of origin for the samples (serum pools, human serum/plasma samples). It mentions "human serum or plasma" to be for in vitro diagnostic use. Given Siemens Healthcare Diagnostics, Inc. is in Tarrytown, NY, USA, and the 510(k) submission to the FDA, it is highly probable that the data was collected in the USA. The studies are prospective in nature for the evaluation of the new device's performance characteristics.

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

This information is not applicable for this type of device. The ADVIA® Chemistry Fructosamine Assay is an in vitro diagnostic (IVD) device for quantitative measurement of an analyte (fructosamine) in biological samples. The "ground truth" for such assays is established through:

  • Comparison to a legally marketed predicate device (Diazyme Glycated Serum Protein Assay and Randox Fructosamine Calibrator).
  • Traceability to internal standards.
  • Use of well-defined analytical performance studies (imprecision, linearity, LoD/LoQ, interference, matrix comparison).

There is no mention of human experts establishing ground truth for the test set in the context of clinical interpretation or diagnosis.

4. Adjudication Method for the Test Set:

Not applicable. Adjudication methods (e.g., 2+1, 3+1) are typically used in clinical studies where multiple human readers interpret results (e.g., medical images) and their disagreements need to be resolved. This device is a quantitative chemical assay, where measurements are objective and comparisons are made against established analytical methods and statistical metrics, not subjective interpretations requiring adjudication.

5. 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. No MRMC study was conducted. This device is an automated chemical analyzer, not an AI-powered diagnostic tool requiring human reader interpretation or assistance.

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

The performance studies described (imprecision, linearity, LoD/LoQ, method comparison, matrix comparison, analytical specificity) are standalone performance evaluations of the ADVIA® Chemistry Fructosamine Assay itself, operating on the ADVIA® 1650 Chemistry system. There is no human interpretation or intervention in the measurement process of the device that would constitute "human-in-the-loop" performance in the context of AI-driven diagnostics. The results are quantitative values generated by the instrument.

7. The Type of Ground Truth Used:

The ground truth for evaluating the ADVIA® Chemistry Fructosamine Assay is primarily established by:

  • Comparison to a legally marketed predicate device: "Substantial equivalence was demonstrated by testing several performance characteristics including... method comparison... All of the evaluation studies gave acceptable results when compared to the predicate device."
  • Traceability to an internal standard: "The ADVIA Chemistry FRUC assay is traceable to an internal standard."
  • Defined analytical methods and accepted statistical models: E.g., CLSI documents EP5-A2, EP17-A2, for precision, detection capability, etc. These methods provide accepted benchmarks for analytical truth.

8. The Sample Size for the Training Set:

Not applicable. This device is an in vitro diagnostic assay, not an AI/machine learning model that typically undergoes a "training set" phase. Its analytical performance is characterized through the studies mentioned earlier, which assess its intrinsic analytical capabilities. The development process would involve formulation, optimization, and internal verification, but not "training" in the AI sense.

9. How the Ground Truth for the Training Set Was Established:

Not applicable as there is no "training set" for this type of device. The analytical characteristics are validated through comparison to predicate devices, established reference methods, and adherence to performance standards guided by recognized guidelines like CLSI.

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510(k) Summary of Safety and Effectiveness for the ADVIA® Chemistry Fructosamine (FRUC) Assay and Calibrator

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

A. 510(k) Number:

B. Date of Preparation: May 3, 2013

C. Proprietary and Established Names:

ADVIA® Chemistry Fructosamine (FRUC) Assay ADVIA® Chemistry Fructosamine Calibrator

D. Applicant

Contact:Kira Gordon
Sr. Regulatory Technical Specialist
Address:Siemens Healthcare Diagnostics, Inc
511 Benedict Ave
Tarrytown, NY 10591
Phone:(914) 524-2996
(914) 524-3579 (fax)

E. Regulatory Information:

Reagent

    1. Regulation section:
  • 21 CFR §864.7470, Glycosylated hemoglobin assay
    1. Classification: Class II
    1. Product Code: LCP
    1. Panel: Hematology (81)

Calibrator

    1. Regulation section: 21 CFR §862.1150, Calibrator, secondary
    1. Classification: Class II
    1. Product Code: JIT
    1. Panel: Clinical Chemistry (75)
  • F. Predicate Device:

Reagents:

I. Device Name:

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Diazyme Glycated Serum Protein Assay 2. Common Name:

  • Diazyme Glycated Serum Protein Assay
    1. 510(k) Number: K042193
    1. Manufacturer: Diazyme Laboratories

Calibrators:

    1. Device Name: Randox Fructosamine Calibrator
    1. Common Name: Randox Fructosamine Calibrator
    1. 510(k) Number: K023763
    1. Manufacturer: Randox Laboratories, Ltd.

G. Intended Use and Indication for Use:

ADVIA Chemistry Fructosamine (FRUC) Assay

For in vitro diagnostic use in the quantitative measurement of glycated protein (fructosamine) in human serum or plasma on the ADVIA® Chemistry systems. Measurement of fructosamine is representative of blood glucose levels over the preceding 2-3 weeks, and is useful for monitoring diabetic patients.

ADVIA Chemistry Fructosamine Calibrator

For in vitro diagnostic use in the calibration of the ADVIA® Chemistry Fructosamine (FRUC) assay on ADVIA Chemistry systems.

H. Device Description:

The ADVIA® Chemistry Fructosamine reagents are ready-to-use liquid packaged for use on ADVIA® 1650 Chemistry system. The reagents are supplied as 100 tests/wedge, with two (2) wedges in each kit.

  • Reagent 1 (R1) contains Tris Buffer (0.2 mol/L, pH 8.0), Proteinase-K (≥ 1 kU/mL) 4-. Aminoantipyrine (5 mmol/L) and Stabilizers.
  • . Reagent 2 (R2) contains Tris Buffer (0.2 mol/L, pH 8.65), Fructosaminase (≥ 0.5 kU/mL), Peroxidase (horseradish) (0.5 kU/mL) N-ethyl-N-sulphohydroxypropyl-mtoluidine (TOOS) ( 10 mmol/L ) and Stabilizers.

The ADVIA® Chemistry Fructosamine Calibrator is a single analyte and single level calibrator. It is lyophilized human serum containing pure fructosamine antigen. There are three (3) vials in each kit. Each vial contains 0.08g. The volume per vial (after reconstitution with deionized water) is 1.0 mL.

I. Test Principle:

In the ADVIA® Chemistry Fructosamine Assay, Reagent 1 contains proteinase K, which digests the glycated protein to yield glycated protein fragments. Fructosaminase in Reagent 2

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oxidizes the ketoamine bond of the glycated protein fragments. As a result hydrogen peroxide is released and it is involved in a colorimetric Trinder end-point reaction. The amount of color developed and measured at 596 nm is proportional to the concentration of glycated protein in the sample.

J. Substantial Equivalence Information:

    1. Predicate device name:
    • Reagent: Diazyme Glycated Serum Protein Assay;
    1. Calibrator: Randox Fructosamine Calibrator Predicate K number:
    1. Reagent: K042193 Calibrator: K023763

Comparison with predicate:

Assay:
Similarities and Differences: Assay
ITEMNEW DEVICE:ADVIA® Chemistry Fructosamine(FRUC) AssayPREDICATE DEVICE:Diazyme Glycated SerumProtein Assay
IntendedUse/Indications forUseFor in vitro diagnostic use in thequantitative measurement of glycatedprotein (fructosamine) in human serumor plasma on the ADVIA® Chemistrysystems. Measurement of fructosamineis representative of blood glucose levelsover the preceding 2-3 weeks, and isuseful for monitoring diabetic patients.Same (for the quantitativedetermination of glycatedserum proteins (GSP;glycated albumin;fructosamine): Themeasurement of glycatedserum proteins is useful formonitoring diabetic patients.
Instrument usedADVIA® 1650 Chemistry systemClinical Chemistry analyzer
MeasurementQuantitativeSame
Specimen typesHuman Serum and plasma (Lithiumheparin, potassium EDTA)Serum
Reference range122-236 µmol/LSame
FormatLiquidSame
Analytical Range30-1000 µmol/L21-1354 µmol/L
Assay Principle/MethodologyEnzymatic reactionSame

Calibrator:

Similarities and Differences: Calibrator
ItemNEW DEVICE:ADVIA® Chemistry FructosamineCalibratorPREDICATE DEVICE:Randox FructosamineCalibrator
Intended UseFor in vitro diagnostic use in thecalibration of the ADVIA® ChemistrySame-Intended for in vitro use in

Page 3 of 7

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Fructosamine (FRUC) assay onADVIA® Chemistry systems.the calibration ofFructosamine on clinicalchemistry systems.
FormLyophilizedSame
Analyte sourceDerived from human sourceSame
LevelsSingleSame
Fill Volume0.08g→1.0mL reconstitutedSame
Storage2–8°CSame

K. Standard/Guidance Document Reference

  • a. Interference Testing in Clinical Chemistry; Approved Guideline Second Edition(CLSI EP7-A2)
  • b. Evaluation of Detection Capability for Clinical Laboratory Measurement Procedures; Approved Guideline-Second Edition (CLSI EP17-A2)
  • Evaluation of Precision Performance of Quantitative Measurement Methods; Approved C. Guideline-Second Edition (CLSI EP5-A2)

L. Performance Characteristics

The following data represent typical performance for the ADVIA® Chemistry Fructosamine Assay and were collected on ADVIA® 1650.Chemistry system. Substantial equivalence was demonstrated by testing several performance characteristics including imprecision, linearity/assay reportable range, limit of detection, method comparison and analytical specificity. All of the evaluation studies gave acceptable results when compared to the predicate device. These studies support that the ADVIA® Chemistry Fructosamine Assay and ADVIA® Chemistry Fructosamine Calibrator when tested on the ADVIA® 1650 Chemistry system are substantially equivalent to the Diazyme Glycated Serum Protein Assay and Randox Fructosamine Calibrator that are currently marketed.

I. Imprecision

Within-Run and Total Precision were established by assaying three samples. Each sample was assayed 2 replicates per run, 2 runs per day, for at least 20 days. Precision estimates were computed according to CLSI document EP5-A2, Evaluation of Precision Performance of Ouantitative Measurement Methods: Approved Guideline

SampleNMean(µmol/L)Within RunBetween RunBetween DayTotal
SDCVSDCVSDCVSDCV
Serum Pool80391.12.80.81.9001.43.5
Serum Pool80700.50.71.21.71.62.22.02.9
Serum Pool801260.70.51.51.21.41.12.21.7
Serum Control801500.50.31.10.71.81.22.21.4
Serum Pool802730.90.31.90.71.60.62.61.0
Serum Control804291.10.32.20.53.50.84.21.0
Serum Pool805401.30.23.20.63.30.64.70.9
Serum Pool807311.90.31.90.35.20.75.80.8

II. Linearity/assay reportable range

Linearity was assessed by assaying equally spaced dilutions across the measuring range. The low end of the assay range is calculated based on the Limit of Quantitation. The high

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end of the assay range is based on the linearity calculation. The ADVIA® Chemistry Fructosamine Assay on ADVIA® 1650 Chemistry system is linear from 30-1000 µmol/L with a deviation from linearity of < 10%.

Results of the linear regression equation are as follows:

Observed FRUC (μmoL/L) = 0.995 * Expected FRUC (μmoL/L) + 4.12, r = 1.000

【【】 Limit of detection

The ADVIA® Chemistry Fuctosamine Assay estimations of the Limit of Blank (LoB), Limit of Detection (LoD) and Limit of Quantitation (LoQ) were performed according to CLSI document EP17-A2, Evaluation of Detection Capability for Clinical Lahoratory Measurement Procedures; Approved Guideline—Second Edition using several serum pools with fructosamine concentration and 160 replicates of blank ("zero") serum pool.

The Limit of Blank (LoB) is the highest measurement result that is likely to be observed on a blank sample. The LoB for the ADVIA® Chemistry Fructosamine Assay is 15 umol/L on ADVIA® 1650 Chemistry system.

The Limit of Detection (LoD) is the smallest amount that this assay can reliably detect to determine presence or absence of an analyte. The LoD for the ADVIA® Chemistry Fuctosamine Assay is 21 umol/L on ADVIA® 1650 Chemistry system.

LoB and LoD values are determined with proportions of false positives (a) less than 5% and false negatives (ß) less than 5%, based on 320 determinations with 160 blank and 160 low level sample replicates for the ADVIA® 1650 Chemistry system.

The Limit of Quantitation (LoQ) is based on 160 determinations and a total error goal of 30.0% calculated using the Westgard model. The LoQ for the ADVIA® Chemistry Fuctosamine Assay is 30 umol/L on ADVIA® 1650 Chemistry system.

IV. Method comparison with predicate device:

The performance of the ADVIA® Chemistry Fructosamine Assay on ADVIA® 1650 Chemistry system (y) was compared with the performance of Diazyme Glycated Serum Protein Assay on Hitachi 717 (x).

One hundred and thirteen (113) serum samples were tested. Three (3) samples were not included in calculations being out if the assay range. The sample results ranged from 47-995 umol/L fructosamine (x), and gave a correlation coefficient (r) of 0.99. The ADVIA® Chemistry Fructosamine assay result was calculated using least squares linear regression (first replicate) is as follows:

Regression EquationSlope(95% CI)Intercept(95% CI)rSample Range
$y = 0.99x - 13.1 \mu mol/L$0.99 - 1.00-17.2 - -9.00.99$47 - 995 \mu mol/L$

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V. Matrix comparison

The performance of the plasma samples (y) on ADVIA® Chemistry Fructosamine Assay on was compared with the performance of serum samples (x) on ADVIA® 1650 Chemistry system.

:

One hundred and fifty two (152) Lithium Heparin plasma samples and one hundred twenty eight (128) potassium EDTA plasma samples were tested vs. serum; the sample results ranged from 38-940 umol/L fructosamine (x). The ADVIA® Chemistry Fructosamine Assay result calculated using least squares linear regression (first replicate) is as follows:

MatrixRegressionEquationSlope(95% CI)Intercept(95% CI)rSample Range
LithiumHeparin(Plasma)$y = 1.00x + 3.5$0.98 to 1.02-2.1 to 9.00.99538 - 940 µmol/L
PotassiumEDTA(Plasma)$y = 1.00x - 4.6$0.98 to 1.02-11.2 to 2.00.99438 – 940 µmol/L

VI. Analytical specificity

Interferences from various substances (see table below) were evaluated using a significance criterion of >10% bias. Bias is the difference in the results between the control sample (without the interferent) and the test sample (contains the interferent) expressed in percent. Bias exceeding 10% is considered interference.

InterferentInterferent LevelFructosamine SampleConcentrationInterference*
Bilirubin(conjugated)5 mg/dL (86 µmol/L)165 µmol/LNSI
10 mg/dL (171 µmol/L)165 µmol/L-18.3%
5 mg/dL (86 µmol/L)263 µmol/LNSI
10 mg/dL (171 µmol/L)263 µmol/L-13.6%
Bilirubin(unconjugated)5 mg/dL (86 µmol/L)165 µmol/LNSI
10 mg/dL (171 µmol/L)165 µmol/L-16.2%
10 mg/dL (171 µmol/L)264 µmol/LNSI
15 mg/dL (257 µmol/L)264 µmol/L-12.4%
Hemolysis250 mg/dL (2.5 g/L)154 µmol/LNSI
500 mg/dL (5.0 g/L)154 µmol/L-11.3%
750 mg/dL (7.5 g/L)253 µmol/LNSI
1000 mg/dL (10.0 g/L)253 µmol/L-13.7%
Lipemia(from TriglycerideConcentrate)1000 mg/dL (11.3 mmol/L)156 µmol/LNSI
1000 mg/dL (11.3 mmol/L)256 µmol/LNSI
Ascorbic Acid10 mg/dL (568 µmol/L)156 µmol/LNSI
15 mg/dL (852 µmol/L)156 µmol/L+13.2%
20 mg/dL (1136 µmol/L)250 µmol/LNSI
Glucose2800 mg/dL (155 mmol/L)154 µmol/LNSI
2800 mg/dL (155 mmol/L)251 µmol/LNSI
Uric Acid50 mg/dL (2975 µmol/L)158 µmol/LNSI
50 mg/dL (2975 µmol/L)251 µmol/LNSI
Albumin6.1 g/dL (61 g/L)132 µmol/LNSI
Total Protein8.4 g/dL (84 g/L)489 µmol/LNSI

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VII. Reagent and Calibrator Stability

Reagent: for opened products, once placed on the system reagents are stable for 60 days. The shelf life of the ADVIA Chemistry Fructosamine Reagent is 12 months at 2-8℃. For unopened product, see the expiration date on the reagent carton.

Calibrator: for opened products, once the cap is removed, assigned values are stable for 28 days when recapped immediately after use and stored at 2-8℃. The shelf life of the ADVIA Chemistry Fructosamine Calibrator is 12 months at 2-8℃. For unopened product, see the expiration date on the calibrator carton.

VII. Value Assignment

The ADVIA Chemistry FRUC assay is traceable to an internal standard. Assigned values of the ADVIA Chemistry Fructosamine Calibrator are traceable to this standardization. The value assignment is carried out by a nested testing protocol using one lot of reagent on one ADVIA® 1650 Chemistry system with ten (10) replicates of the Master Lot and Test Lot calibrators in the same worklist. The Test Lot values are adjusted with a ratio derived from the Master Lot Calibrator assigned value (Target value) and the mean recovery of the Master Lot Calibrator values (observed) according to the following equation: Test Lot assigned value = (Master Calibrator Target value / Mean Recovery of the Master Lot Calibrator observed) * Mean Recovery of Test Lot observed.

VII. Clinical Studies

Not applicable.

VIII. Clinical cut-off

Not applicable.

M. Conclusion

The ADVIA® Chemistry Fructosamine Assay on ADVIA® 1650 Chemistry system is substantially equivalent in principle and in performance to other products in commercial distribution intended for similar use. Most notably, it is substantially equivalent to the currently marketed Diazyme Glycated Serum Protein Assay (K042193).

The ADVIA® Chemistry Fructosamine Calibrator on ADVIA® 1650 Chemistry system is substantially equivalent n principle and in performance to other products in commercial distribution intended for similar use. Most notably, it is substantially equivalent to the currently marketed Randox Fructosamine Calibrator (K023763).

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/7/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized representation of an eagle or bird-like figure with three curved lines forming its body and wings.

Public Health Service

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

January 24, 2014

SIEMENS HEALTHCARE DIAGNOSTICS, INC. KIRA GORDON SR. REGULATORY TECHNICAL SPECIALIST 511 BENEDICT AVE TARRYTOWN NY 10591

Re: K131307

Trade/Device Name: ADVIA® Chemistry Fructosamine (FRUC) Assay ADVIA® Chemistry Fructosamine Calibrator Regulation Number: 21 CFR 864.7470 Regulation Name: Glycosylated hemoglobin assay Regulatory Class: II Product Code: LCP, JIT Dated: December 6, 2013 Received: December 9, 2013

Dear Dr. Gordon:

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 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 (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.

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If you desire specific advice for your device on our labeling regulations (21 CFR Parts 801 and 809), please contact 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/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.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,

CourtneyH.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

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Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement on last page.

510(k) Number (if known) K131307

Device Name

ADVIA® Chemistry Fructosamine (FRUC) Assay; ADVIA® Chemistry Fructosamine Calibrator

Indications for Use (Describe) The ADVIA® Chemistry Fructosamine (FRUC) Assay

For in vitro diagnostic use in the quantitative measurement of glycated protein (fructosamine) in human serum or plasma on the ADVIA® Chemistry systems. Measurement of fructosamine is representative of blood glucose levels over the preceding 2-3 weeks, and is useful for monitoring diabetic patients.

ADVIA® Chemistry Fructosamine Calibrator

For in vitro diagnostic use in the calibration of the ADVIA® Chemistry Fructosanine (FRUC) assay on ADVIA® Chemistry systems.

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

[x] Prescription Use (Part 21 CFR 801 Subpart D)

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

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

THE WE WELL FOR FOR FOR FOR FOR FOR FOR THE

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

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DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

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§ 864.7470 Glycosylated hemoglobin assay.

(a)
Identification. A glycosylated hemoglobin assay is a device used to measure the glycosylated hemoglobins (A1a , A1b , and A1c ) in a patient's blood by a column chromatographic procedure. Measurement of glycosylated hemoglobin is used to assess the level of control of a patient's diabetes and to determine the proper insulin dosage for a patient. Elevated levels of glycosylated hemoglobin indicate uncontrolled diabetes in a patient.(b)
Classification. Class II (performance standards).