K Number
K133330
Device Name
C.F.A.S. PROTEINS, C.F.A.S. PAC, PRECICONTROL CLINCHEM MULTI 1 & 2, PRECINORM PROTEIN & PRECIPATH PROTEIN
Manufacturer
Date Cleared
2013-11-26

(25 days)

Product Code
Regulation Number
862.1150
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
C.f.a.s. (Calibrator for automated systems) PAC (Prealbumin-ASLO-Ceruloplasmin) is for use in the calibration of quantitative Roche methods on Roche clinical chemistry analyzers as specified in the value sheets. C.f.a.s. (Calibrator for automated systems) Proteins is for use in the calibration of quantitative Roche methods on Roche clinical chemistry analyzers as specified in the value sheets. PreciControl ClinChem Multi 1 is for the use in quality control by monitoring accuracy and precision for the quantitative methods as specified in the value sheets. PreciControl ClinChem Multi 2 is for the use in quality control by monitoring accuracy and precision for the quantitative methods as specified in the value sheets. Precinorm Protein and Precipath Protein are for the use in quality control by monitoring accuracy and precision for the quantitative methods as specified in the value sheets.
Device Description
C.f.a.s. Proteins is a liquid ready-to-use calibrator based on human serum. The concentrations of the components have been adjusted to ensure optimal calibration of the appropriate Roche methods on clinical chemistry analyzers. C.f.a.s. PAC is a lyophilized calibrator based on human serum. The concentrations of the components have been adjusted to ensure optimal calibration of the appropriate Roche methods on clinical chemistry analyzers. PreciControl ClinChem Multi 1 and 2 are lyophilized controls based on human serum. The adjusted concentrations and activities of the components of PCCC Multi 1 are usually in the normal range or at the normal/pathological threshold. The adjusted concentrations and activities of the components of PCCC Multi 2 are usually in the pathological range. Precinorm Protein and Precipath Protein are liquid ready-for-use control sera based on human serum. The concentrations of the components of Precinorm Protein are usually in the normal range or at the normal/pathological threshold. The concentrations of the components of Precipath Protein are usually in the pathological range.
More Information

Not Found

No
The summary describes calibrators and controls for clinical chemistry analyzers, focusing on their composition, intended use for calibration and quality control, and performance characteristics like stability, method comparison, and precision. There is no mention of AI or ML in the device description, intended use, or performance studies.

No.
The device is described as a calibrator and control for quantitative Roche methods on clinical chemistry analyzers, used for monitoring accuracy and precision, not for treating or diagnosing a disease.

No

This device is described as a calibrator and quality control product for objective methods on clinical chemistry analyzers. It is not used to diagnose a disease or condition itself, but rather to ensure the accurate functioning of diagnostic instruments.

No

The device description clearly states that the devices are based on human serum and are lyophilized or liquid ready-to-use calibrators and controls, indicating they are physical substances, not software.

Based on the provided information, yes, this device is an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use explicitly states that the products are for "calibration of quantitative Roche methods on Roche clinical chemistry analyzers" and "quality control by monitoring accuracy and precision for the quantitative methods". These are activities performed in vitro (outside the body) to analyze samples for diagnostic purposes.
  • Device Description: The description details that the products are based on human serum and are used to calibrate and control quantitative methods on clinical chemistry analyzers. This aligns with the nature of IVD devices used in laboratory settings.
  • Intended User / Care Setting: The intended users are described as being in a setting where Roche clinical chemistry analyzers are used, which are typically found in clinical laboratories performing in vitro diagnostic testing.
  • Performance Studies: The performance studies described (stability, method comparison, lower detection limit, control recovery, precision) are typical evaluations performed for IVD devices to demonstrate their suitability for their intended use in a diagnostic context.
  • Predicate Devices: The listed predicate devices (K numbers) are also IVD devices, indicating that the current submission is for a similar type of product used in in vitro diagnostics.

The core function of these products is to ensure the accuracy and reliability of quantitative measurements performed on clinical chemistry analyzers, which are used to analyze patient samples in vitro to aid in diagnosis and monitoring. This directly falls under the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

C.f.a.s. (Calibrator for automated systems) PAC (Prealbumin-ASLO-Ceruloplasmin) is for use in the calibration of quantitative Roche methods on Roche clinical chemistry analyzers as specified in the value sheets.
C.f.a.s. (Calibrator for automated systems) Proteins is for use in the calibration of quantitative Roche methods on Roche clinical chemistry analyzers as specified in the value sheets.
PreciControl ClinChem Multi I is for the use in quality control by monitoring accuracy and precision for the quantitative methods as specified in the value sheets. PreciControl ClinChem Multi 2 is for the use in quality control by monitoring accuracy and precision for the quantitative methods as specified in the value sheets.
Precinorm Protein and Precipath Protein are for the use in quality control by monitoring accuracy and precision for the quantitative methods as specified in the value sheets.

Product codes (comma separated list FDA assigned to the subject device)

JIX, JJY

Device Description

C.f.a.s. Proteins is a liquid ready-to-use calibrator based on human serum. The concentrations of the components have been adjusted to ensure optimal calibration of the appropriate Roche methods on clinical chemistry analyzers.
C.f.a.s. PAC is a lyophilized calibrator based on human serum. The concentrations of the components have been adjusted to ensure optimal calibration of the appropriate Roche methods on clinical chemistry analyzers.
PreciControl ClinChem Multi 1 and 2 are lyophilized controls based on human serum. The adjusted concentrations and activities of the components of PCCC Multi 1 are usually in the normal range or at the normal/pathological threshold. The adjusted concentrations and activities of the components of PCCC Multi 2 are usually in the pathological range.
Precinorm Protein and Precipath Protein are liquid ready-for-use control sera based on human serum. The concentrations of the components of Precinorm Protein are usually in the normal range or at the normal/pathological threshold. The concentrations of the components of Precipath Protein are usually in the pathological range.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

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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

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Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Stability: The shelf life stability claim and the open vial stability claims were re- evaluated with real time stability data. Results from all timepoints tested meet the acceptance criterion. The acceptance criterion for C.f.a.s. Proteins, C.f.a.s. PAC, PCCC, PNP, and PPP is that the averaged results must be 90% to 110% recovery of the reference value, except... The acceptance criterion for Antistreptolysin O in PNP/PPP is that the average results must be 85% to 115% recovery of the reference value. Results from all analytes from all four devices range from 91 to 108% recovery.

Method Comparison: Antistreptolysin O method comparison was conducted between the candidate and predicate C.f.a.s. PAC. The Hitachi and INTEGRA analyzer families use different Antistreptolysin O reagent formulations. The cobas c 501 analyzer tested the Hitachi reagent formulation and the INTEGRA 800 tested the INTEGRA reagent formulation. Passing-Bablok linear regression analysis was performed on the data set of human serum samples.
The candidate and predicate C.f.a.s. PAC compare well. Both test systems meet the criteria. There is no evidence of loss to patient sample accuracy as a result of the Antistreptolysin O source change.

Lower Detection Limit: Antistreptolysin O lower detection limit (LDL) was verified using the candidate C.f.a.s. PAC to calibrate the ASLOT cobas c 501 test system. The LDL represents the lowest measurable analyte concentration that can be distinguished from zero. It is calculated as the value lying three standard deviations above that of the lowest standard with n =21. The study showed an LDL of 2 IU/mL which meets the criterion of ≤ 20 IU/mL, thus supported the LDL claim of 20 IU/mL.

Control Recovery: Antistreptolysin O control recovery was tested with both candidate control sets on both the cobas c 501 and the INTEGRA 800 analyzers. Results range from 97 to 104% recovery of the target value. The acceptance criterion is 90 to 110%. All values meet the acceptance criterion. There is no evidence of loss of accuracy due to the Antistreptolysin O source change.

Precision: The potential loss to reproducibility is evaluated by testing the precision of Antistreptolysin O in both candidate control sets, PCCC and PNP/PPP, and of Ferritin in PCCC. Antistreptolysin O precision data are collected using one reagent batch on two analyzers, the cobas c 501 and the COBAS INTEGRA 800. Ferritin precision data are collected using one reagent batch on the cobas c 501 analyzer because there is no Ferritin application on the COBAS INTEGRA in the U.S. For each test system, 21 replicates were measured in a single run in a single day. The coefficient of variation (%CV) was calculated.
Antistreptolysin O and Ferritin precision results range from 0 to 2% CV. All Antistreptolysin O results must produce a CV ≤ 4%. All Ferritin results must produce a CV ≤ 5%. All results meet the criterion. Therefore, there is no evidence of loss to reproducibility as a result of the device modifications.

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.

K080607, K040245, K102016, K981401

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

§ 862.1150 Calibrator.

(a)
Identification. A calibrator is a device intended for medical purposes for use in a test system to establish points of reference that are used in the determination of values in the measurement of substances in human specimens. (See also § 862.2 in this part.)(b)
Classification. Class II (special controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.

0

510(k) #K133330
ApplicantThe submission was prepared by Susan Hollandbeck from Roche Professional Diagnostics Regulatory Affairs and submitted on October 31, 2013.
Roche Diagnostics Operations c/o Susan Hollandbeck 9115 South Hague Road; PO Box 50416; Indianapolis, IN 46250 Phone Number: 317-521-3380 Fax Number: 317-521-2324 e-mail: susan.hollandbeck@roche.com
Candidate deviceThere are four candidate devices: two calibrators and two control sets. Proprietary Names C.f.a.s. (Calibrator for automated systems) ProteinsC.f.a.s. (Calibrator for automated systems) PAC (Prealbumin- Antistreptolysin-Ceruloplasmin)PreciControl ClinChem Multi 1 and 2Precinorm Protein and Precipath Protein
Common Names C.f.a.s. ProteinsC.f.a.s. PACPCCCPNP and PPP
Submission purposeRoche Diagnostics submits this Bundled Special 510(k) as notification of device modifications. All four candidate devices bear the same modification; the Antistreptolysin O analyte source material, common to the two calibrators and two controls sets, has been changed from human serum to sheep serum to eliminate conflict associated with human sourcing.C.f.a.s. PAC and PCCC have changed their biological additives.C.f.a.s. PAC has two fewer because they are not needed and PCCC has one more because its levels were at risk of being too low.
MeasurandThere are multiple constituents for each of the four devices. They are listed in the corresponding device labeling.

NOV 2 6 2013

1

The four candidate devices are modifications of the corresponding predicate Predicate device devices. The device names are unchanged. They and their most recent 510(k) submissions are summarized in the table below.

Table 1: Predicate Device Clearances

Device510(k) Submission
C.f.a.s. ProteinsK080607
C.f.a.s. PACK040245
PreciControl ClinChem Multi 1 and 2K102016
Precinorm Protein and Precipath ProteinK981401

Regulatory classification of device

able 2: Regulatory Classification of Candidate Devices
DeviceC.f.a.s. Proteins and C.f.a.s. PACPCCC and PNP/PPP
Product CodeJIXJJY
Device ClassIII
Regulation862.1150862.1660
DescriptionCalibratorQuality Control Material
PanelClinical Chemistry (75)

Device description

C.f.a.s. Proteins is a liquid ready-to-use calibrator based on human serum. The concentrations of the components have been adjusted to ensure optimal calibration of the appropriate Roche methods on clinical chemistry analyzers.

C.f.a.s. PAC is a lyophilized calibrator based on human serum. The concentrations of the components have been adjusted to ensure optimal calibration of the appropriate Roche methods on clinical chemistry analyzers.

PreciControl ClinChem Multi 1 and 2 are lyophilized controls based on human serum. The adjusted concentrations and activities of the components of PCCC Multi 1 are usually in the normal range or at the normal/pathological threshold. The adjusted concentrations and activities of the components of PCCC Multi 2 are usually in the pathological range.

Precinorm Protein and Precipath Protein are liquid ready-for-use control sera based on human serum. The concentrations of the components of Precinorm Protein are usually in the normal range or at the normal/pathological threshold. The concentrations of the components of Precipath Protein are usually in the pathological range.

2

Intended useThe intended uses of the modified devices, as described in their labeling, have not changed as a result of the modifications. C.f.a.s. Proteins is for use in the calibration of quantitative Roche methods on Roche clinical chemistry analyzers as specified in the value sheets. C.f.a.s. PAC is for use in the calibration of quantitative Roche methods on Roche clinical chemistry analyzers as specified in the value sheets. PreciControl ClinChem Multi 1 and 2 are for use in quality control by monitoring accuracy and precision for the quantitative methods as specified in the value sheets. Precinorm Protein and Precipath Protein are for use in quality control by monitoring accuracy and precision for the quantitative methods as specified in the value sheets.
Special
conditions for
useFor prescription use only
Special
instruments
requiredThese calibrators and controls are designed for use with Roche clinical chemistry analyzers in the Roche/Hitachi and COBAS INTEGRA analyzer families.
Continued on next page

3

Similarities -The following table compares the similar features of the candidate device, C.f.a.s. Proteins C.f.a.s. Proteins, to the predicate device that was cleared in 510(k) K080607.

the submit and the submit of the subject of the subject of

FeaturePredicate DeviceCandidate Device
Intended useC.f.a.s. Proteins is for use in the
calibration of quantitative Roche
methods on Roche clinical
chemistry analyzers as specified in
the value sheets.Same
Levels1Same
FormLiquid ready-to-useSame
MatrixHuman serum with chemical and
biological additivesSame
Constituents16 constituents
(complete list is in Table 11)Same
TraceabilityTraceability of the target values is
given in the respective instructions
for use of the system reagents.Same
Value assignmentTraceable through master lot to
reference methods or materialsSame
Unopened stability2 - 8 °C until expirationSame
Opened stability4 weeks at 2 - 8 °C, provided that
dispensing of the calibrator occurs
without microbial contaminationSame

Table 3: Similarities between Predicate and Candidate C.f.a.s. Proteins

Differences -The following table distinguishes the candidate device, C.f.a.s. Proteins, from C.f.a.s. Proteins the predicate device that was cleared in 510(k) K080607.

Table 4: Differences between Predicate and Candidate C.f.a.s. Proteins

FeaturePredicate DeviceCandidate Device
Source materialHuman Antistreptolysin OSheep Antistreptolysin O

4

The following table compares the similar features of the candidate device, Similarities -C.f.a.s. Proteins, to the predicate device that was cleared in 510(k) K080607. C.f.a.s PAC

FeaturePredicate DeviceCandidate Device
Intended useC.f.a.s. PAC is for use in the
calibration of quantitative Roche
methods on Roche clinical
chemistry analyzers as specified in
the value sheets.Same
Levels1Same
FormLyophilized, requires reconstitution
with 1.0 mL waterSame
MatrixHuman serum with chemical and
biological additivesSame
Constituents3 constituents
(complete list is in Table 11)Same
TraceabilityTraceability of the target values is
given in the respective instructions
for use of the system reagents.Same
Value assignmentTraceable through master lot to
reference methods or materialsSame
Unopened stability2-8 °C until expirationSame
Reconstituted
stability• 8 hours at 15 to 25 °C
• 2 days at 2 to 8 °C
• 2 weeks at -15 to -25 °C
(when frozen once)Same

Table 5: Similarities between Predicate and Candidate C fass PAC

Differences -C.f.a.s. PAC

The following table distinguishes the candidate device, C.f.a.s. PAC, from the predicate device that was cleared in 510(k) K040245.

Table 6: Differences between Predicate and Candidate C.f.a.s. PAC

FeaturePredicate DeviceCandidate Device
Source materialHuman Antistreptolysin OSheep Antistreptolysin O
Biological
additivesIncludes Ceruloplasmin and
PrealbuminExcludes Ceruloplasmin
and Prealbumin

5

The following table compares the similar features of the candidate device, Similarities -PCCC PreciControl ClinChem Multi 1 and 2 (PCCC), to the predicate device that was cleared in 510(k) K102016.

FeaturePredicate DeviceCandidate Device
Intended usePreciControl ClinChem Multi 1 and
2 are for use in quality control by
monitoring accuracy and precision
for the quantitative methods as
specified in the value sheets.Same
Levels2Same
FormLyophilized, requires reconstitution
with 5.0 mL waterSame
MatrixHuman serum with chemical and
biological additivesSame
Constituents49 constituents
(complete list is in Table 11)Same
TraceabilityTraceability of the target values is
given in the respective instructions
for use of the system reagents.Same
Value assignmentTraceable through master lot to
reference methods or materialsSame
Unopened stability2-8 °C until expirationSame
Reconstituted
stability• 12 hours at 15 to 25 °C
• 5 days at 2 to 8 °C
• 4 weeks at -15 to -25 °C
(when frozen once)Same

Table 7: Similarities between Predicate and Candidate PCCC

The following table distinguishes the candidate device, PCCC, from the Differences -PCCCC predicate device that was cleared in 510(k) K102016.

Table 8: Differences between Predicate and Candidate PCCC

Predicate DeviceCandidate Device
Human Antistreptolysin OSheep Antistreptolysin O
Excludes FerritinIncludes Ferritin

6

The following table compares the similar features of the candidate devices, Similarities -PNP/PPPP Precinorm Protein (PNP) and Precipath Protein (PPP) to the predicate devices that were cleared in 510(k) K981401.

FeaturePredicate DeviceCandidate Device
Intended usePrecinorm Protein and
Precipath Protein Controls are
intended for use as controls in
the immunoturbidimetric
assay of serum proteins.Precinorm Protein and
Precipath Protein are for use
in quality control by
monitoring accuracy and
precision for the quantitative
methods as specified in the
value sheets.
Levels2Same
FormLiquid ready-to-useSame
MatrixHuman serum with chemical
and biological additivesSame
Constituents18 constituents
(complete list is in Table 11)Same
TraceabilityTraceability of the target
values is given in the
respective instructions for
use of the system reagents.Same
Value assignmentTraceable through master lot
to reference methods or
materialsSame
Unopened stability2 - 8 o C until expirationSame
Opened stability1 month after first opening at
2 - 8 oC providing that
contamination by
microorganisms is avoided.4 weeks at 2 - 8 oC,
provided that dispensing of
the control occurs without
microbial contamination.

Table 9: Similarities between Predicate and Candidate PNP/PPP

The following table distinguishes the candidate devices, PNP and PPP, from Differences -PNP/PPP the predicate devices that were cleared in 510(k) K981401.

Table 10: Differences between Predicate and Candidate PNP/PPP
-------------------------------------------------------------------------
FeaturePredicate DeviceCandidate Device
Source materialHuman Antistreptolysin OSheep Antistreptolysin O

7

Constituents

The four candidate devices include the listed constituent analytes. The list of constituents is unchanged between candidate and predicate devices. Table 11: Constituent Analytes of the Candidate Devices

| al-Acid glycoprotein
al-Antitrypsin
Antistreptolysin O1
C3c
C4
Ceruloplasmin
C-Reactive Protein
Ferritin
Haptoglobin
10. IgA
11. IgG | | ı. Prealbumin
2. Antistreptolysin O
3. Ceroluplasmin | 1.
2.
3.
4.
5.
6.
7. | C3c
C4 | al-Acid glycoprotein
al-Antitrypsin
Albumin
Antistreptolysin O |
|--------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------|------------------------------------------------------------|---------------------------------------------------------------------|-----------------------|-------------------------------------------------------------------------|
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | Ceruloplasmin' |
| | | | 8. | | C-reactive protein |
| | | | | 9. Ferritin | |
| | | | | | 10. Haptoglobin |
| | | | | 11. IgA | |
| 12. IgM | | | | 12. IgG | |
| 13. Kappa | | | | 13. IgM | |
| | | | | | |
| 15. Prealbumin' | | | | | |
| 16. Transferrin | | | | | 16. Prealbumin' |
| | | | | | 17. Total Protein |
| | | | | | 18. Transferrin |
| | | | | | |
| PCCC | | | | | |
| Alanine aminotransferase | 18. | Ceruloplasmin | | ડર. | Lactate |
| Albumin | 19. | Chloride | | | dehydrogenase |
| Alkaline phosphatase | | Cholesterol | | 36. | LDL-Cholesterol |
| al-Acid glycoprotein | 21. | Cholinesterase | | 37. | Lipase |
| al-Antitrypsin | 22. | Creatine kinase | | 38. | Lithium |
| Amylase | 23. | Creatine kinase MB | | 39. | Magnesium |
| Amylase pancreatic | 24. | Creatinine | | 40. | Phosphate |
| Antisteptolysin O | 25. | Ferritin | | 41. | Potassium |
| Apolipoprotein A-1 | 26. | | | 42. | Prealbumin |
| Apolipoprotein B | 27. | Glucose | | 43. | Sodium |
| Aspartate aminotransferase | 28. | Haptoglobin | | 44. | Total protein |
| Bilirubin direct | 29. | HDL-Cholesterol | | 45. | Transferrin |
| Bilirubin total | 30. | IgA | | 46. | Triglycerides |
| C-Reactive protein | 31. | lgG | | 47. | Unsaturated |
| C3c | 32. | IgM | | | iron-binding |
| C4 | 33. | Iron | | | capacity |
| Calcium | 34. | Lactate | | 48. | Urea |
| | | | | 49. | Uric acid |
| | 14. Lambda | | The devices are not promoted in the U.S. for these analytes.
20. | y-GlutamyItransferase | 14. Kappa
15. Lambda |

Continued on next page

·

8

| Performance

characteristicsThese changes are supported by demonstrating no adverse impact to stability, method comparison, lower detection limit, control recovery, and precision.
StabilityThe shelf life stability claim and the open vial stability claims were re- evaluated with real time stability data. Results from all timepoints tested meet the acceptance criterion. The acceptance criterion for C.f.a.s. Proteins, C.f.a.s. PAC, PCCC, PNP, and PPP is that the averaged results must be 90% to 110% recovery of the reference value, except... The acceptance criterion for Antistreptolysin O in PNP/PPP is that the average results must be 85% to 115% recovery of the reference value. Results from all analytes from all four devices range from 91 to 108% recovery. The open vial stability claims appear in the device package inserts. They are supported with the new data. The unopened stability claim, or shelf life claim is seen by the user only as an expiration date on the device.
Method
comparisonAntistreptolysin O method comparison was conducted between the candidate and predicate C.f.a.s. PAC. The Hitachi and INTEGRA analyzer families use different Antistreptolysin O reagent formulations. The cobas c 501 analyzer tested the Hitachi reagent formulation and the INTEGRA 800 tested the INTEGRA reagent formulation. Passing-Bablok linear regression analysis was performed on the data set of human serum samples. The x-axis was set to C.f.a.s. PAC with the current calibrator formulation; the y-axis was set to the modified one. The table below summarizes results.
Table 12: Antistreptolysin O Method Comparison Results for C.f.a.s. PAC
Test SystemCriteriaResults
ASLOT c 501Slope = 1.00 ± 0.10
Intercept ≤ ± 20 IU/mL
R value ≥ 0.975Slope = 1.00
Intercept = -2 IU/mL
R value = 0.998
ASO 1800Slope = 1.00
Intercept = 0 IU/mL
R value = 1.000

The candidate and predicate C.f.a.s. PAC compare well. Both test systems meet the criteria. There is no evidence of loss to patient sample accuracy as a result of the Antistreptolysin O source change.

Continued on next page

.

9

| Lower
detection limit | Antistreptolysin O lower detection limit (LDL) was verified using the
candidate C.f.a.s. PAC to calibrate the ASLOT cobas c 501 test system. The
LDL represents the lowest measurable analyte concentration that can be
distinguished from zero. It is calculated as the value lying three standard
deviations above that of the lowest standard with n =21. The study showed
an LDL of 2 IU/mL which meets the criterion of ≤ 20 IU/mL, thus supported
the LDL claim of 20 IU/mL. |
|--------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Control
recovery | Antistreptolysin O control recovery was tested with both candidate control
sets on both the cobas c 501 and the INTEGRA 800 analyzers. Results range
from 97 to 104% recovery of the target value. The acceptance criterion is 90
to 110%. All values meet the acceptance criterion. There is no evidence of
loss of accuracy due to the Antistreptolysin O source change. |
| Precision | The potential loss to reproducibility is evaluated by testing the precision of
Antistreptolysin O in both candidate control sets, PCCC and PNP/PPP, and of
Ferritin in PCCC. Antistreptolysin O precision data are collected using one
reagent batch on two analyzers, the cobas c 501 and the COBAS INTEGRA
800. Ferritin precision data are collected using one reagent batch on the
cobas c 501 analyzer because there is no Ferritin application on the COBAS
INTEGRA in the U.S. For each test system, 21 replicates were measured in a
single run in a single day. The coefficient of variation (%CV) was calculated. |
| | Antistreptolysin O and Ferritin precision results range from 0 to 2% CV. All Antistreptolysin O results must produce a CV ≤ 4%. All Ferritin results must produce a CV ≤ 5%. All results meet the criterion. Therefore, there is no evidence of loss to reproducibility as a result of the device modifications. |
| Conclusion | The submitted information in this premarket notification supports a substantial equivalence decision. The differences between predicate and candidate do not impact the indications for use or technological characteristics. |

. · ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

10

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/10/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with its wings spread, and the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circle around the eagle. The eagle is black, and the text is also black. The logo is simple and recognizable.

Public Health Service

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

November 26, 2013

ROCHE DIAGNOSTICS SUSAN HOLLANDBECK 9115 SOUTH HAGUE ROAD INDIANAPOLIS IN 46250

Re: K133330

Trade/Device Name: C.f.a.s. PAC; C.f.a.s. Proteins: Precicontrol ClinChem Multi 1 & 2; Precinorm Protein & Precipath Protein Regulation Number: 21 CFR 862.1150 Regulation Name: Calibrator Regulatory Class: II Product Code: JIX, JJY Dated: October 31, 2013 Received: November 1, 2013

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. 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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Page 2-Ms. Hollandbeck

If you desire specific advice for your device on our labeling regulations (2) 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/Resources/orYou/Industrv/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/ReportalProblem/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/ResourcesforYou/Industry/default.htm.

Sincerely yours.

Carol C. Benson -S for

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

Enclosure

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510(k) Number (if known): K133330

C.f.a.s. PAC Device Name:

Indications for Use:

C.f.a.s. (Calibrator for automated systems) PAC (Prealbumin-ASLO-Ceruloplasmin) is for use in the calibration of quantitative Roche methods on Roche clinical chemistry analyzers as specified in the value sheets.

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)

Ruth A. Chesler -S

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

K133330 510(k)

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510(k) Number (if known): K133330

Device Name: C.f.a.s. Proteins

Indications for Use:

C.f.a.s. (Calibrator for automated systems) Proteins is for use in the calibration of quantitative Roche methods on Roche clinical chemistry analyzers as specified in the value sheets.

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 UELOW THIS LINE; CONTINUE ON ANOTHER PAGE IF NEEDED)

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

Ruth A. Chesler -S

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

K133330 510(k)

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510(k) Number (if known): K133330

Device Name:

PreciControl ClinChem Multi 1 and 2

Indications for Use:

PreciControl ClinChem Multi I is for the use in quality control by monitoring accuracy and precision for the quantitative methods as specified in the value sheets. PreciControl ClinChem Multi 2 is for the use in quality control by monitoring accuracy and precision for the quantitative methods as specified in the value sheets.

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)

Ruth A. Chesler -S

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

K133330 510(k)

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510(k) Number (if known): K133330

Precinorm Protein and Precipath Protein Device Name:

Indications for Use:

Precinorm Protein and Precipath Protein are for the use in quality control by monitoring accuracy and precision for the quantitative methods as specified in the value sheets.

Prescription Use X (21 CFR Part 801 Subpart D) Over the Counter Use (21 CFR Part 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE; CONTINUE ON ANOTHER PAGE IF NEEDED)

And/Or

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

Ruth A. Chesler -S

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

K133330 510(k)

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