AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The illumigene® Pertussis DNA Amplification Assay, performed on the illumipro-10™, is a qualitative in vitro diagnostic test for the direct detection of Bordetella pertussis in human nasopharyngeal swab samples taken from patients suspected of having respiratory tract infection attributable to Bordetella pertussis.

The illumigene Pertussis assay utilizes loop-mediated isothermal DNA amplification (LAMP) technology to detect Bordetella pertussis by targeting the IS481 insertional element of the Bordetella pertussis genome. The IS481 insertional element can also be found in Bordetella holmesii and Bordetella bronchiseptica strains. Respiratory infection with Bordetella pertussis, Bordetella bronchiseptica may yield positive test results in IS481 assays. B. holmesii infection may cause clinical illness similar to B. pertussis, and mixed outbreaks involving both B. pertussis and B. holmesii infection have been reported. Additional testing should be performed if necessary to differentiate B. holmesii and B. pertussis. B. bronchiseptica is a rare cause of infection in humans. When clinical factors suggest that B. pertussis may not be the cause of respiratory infection, other clinically appropriate investigation(s) should be carried out in accordance with published guidelines.

Negative results for the illumigene Pertussis DNA Amplification Assay do not preclude Bordetella pertussis infection and positive results do not rule out co-infection with other respiratory pathogens. Results from the illumigene Pertussis assay should be used in conjunction obtained during the patient's clinical evaluation as an aid in diagnosis of Bordetella pertussis infection and should not be used as for treatment or other patient management decisions.

illumigene Pertussis is intended for use in hospital, reference or state laboratory settings. The device is not intended for point-of-care use.

Device Description

The illumigene Molecular Diagnostic Test System is comprised of the illumigene® Pertussis DNA Amplification Assay Test Kit, the illumigene® Pertussis External Control Kit and the illumipro-10™ Automated Isothermal Amplification and Detection System.

The illumigene Pertussis assay utilizes loop-mediated isothermal amplification (LAMP) technology to detect the presence of Bordetella pertussis in human nasopharyngeal swab specimens. Each illumigene Pertussis assay is completed using an illumigene Assay Control Reagent containing Control material, an illumigene Sample Buffer, an illumigene Pertussis Test Device and Mineral Oil. Nasopharyngeal swab specimens are eluted with illumigene Sample Buffer. The illumigene Assay Control Reagent is added to the eluted sample and heat-treated. Target and Control DNA are made available for isothermal amplification via heat-treatment. The heat-treated Specimen/Control sample is added to the illumigene Test Device. Mineral oil is added to the illumigene Test Device to prevent evaporation. DNA amplification occurs in the illumigene Test Device.

The illumipro-10 heats each illumigene Pertussis Test Device containing prepared Sample and Control material, facilitating amplification of target DNA. When B. pertussis is present in the specimen, a 198 base pair sequence located within the IS481 insertional element of the B. pertussis genome is amplified and magnesium pyrophosphate is generated. Magnesium pyrophosphate forms a precipitate in the reaction mixture.

The illumipro-10 monitors the absorbance characteristics of the reaction solutions at the assay Run Start (Signal Initial or Si) and at the assay Run End (Signal final or Sf). The illumipro-10 calculates the ratio of the Run End (Signal final or Sf) reads with the Run Start (Signal Initial or Si) reads and compares the ratio to an established cut-off value. The illumipro-10 performs this ratio calculation to both the TEST chamber and the CONTROL chamber.

Fixed cut-off values for the CONTROL chamber are used to determine validity. CONTROL chamber Sf:Si ratios less than 90% are considered valid and allow for reporting of TEST chamber results (POSITIVE, NEGATIVE). CONTROL chamber Sf:Si ratios greater than or equal to 90% are considered invalid. Results are reported as 'INVALID'; Test chamber results are not reported. More stringent cut-off criteria are applied to the Control chamber reaction to ensure amplification is not inhibited, reagents are performing as intended and that sample processing was performed appropriately.

Fixed cut-off values for the TEST chamber are used to report sample results. TEST chamber Sf:Si ratios less than 82% are reported as 'POSITIVE'; TEST chamber Sf:Si ratios greater than or equal to 82% are reported as 'NEGATIVE'. Numerical values are not reported.

The illumigene Pertussis External Control Kit contains a Positive Control Reagent. The illumigene Assay Control/Negative Control Reagent provided in the illumigene Pertussis kit serves as the External Negative Control Reagent. External Control reagents are provided to aid the user in detection of reagent deterioration, adverse environmental or test conditions, or variance in operator performance that may lead to test errors. External Control reagents are provided for use in routine Quality Control testing.

AI/ML Overview

illumigene® Pertussis DNA Amplification Assay - Acceptance Criteria and Study Summary

Here's an analysis of the illumigene® Pertussis DNA Amplification Assay's acceptance criteria and the study data presented:

1. Table of Acceptance Criteria and Reported Device Performance

The document does not explicitly state formal "acceptance criteria" with numerical thresholds for Positive Percent Agreement (PPA) and Negative Percent Agreement (NPA). However, the device's performance is compared against a Composite Comparator Reference Method. Based on the clinical study results, the reported performance is:

Acceptance Criteria (Implied)Reported Device Performance (illumigene® Pertussis)
High PPA (Overall)87.8% (95% CI: 75.8 - 94.3%)
High NPA (Overall)97.8% (95% CI: 96.3 - 98.7%)

Note: The document presents separate performance for prospective, retrospective (all comers), and retrospective (selected) samples. The "Overall" values for PPA and NPA (based on "Composite Method Comparator, All Comers" Total) are used here as the primary performance metrics from the clinical study.

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

The test set refers to the clinical study samples used for performance evaluation.

  • Sample Size: A total of 729 qualified nasopharyngeal (NP) swab specimens.

    • Prospective: 508 specimens (69.7%)
    • Retrospective: 221 specimens (30.3%) (includes "all comers" and "selected" retrospective samples)
  • Data Provenance:

    • Country of Origin: The samples were collected from four independent clinical test sites located in the Midwestern, Northern, and Eastern regions of the United States.
    • Retrospective or Prospective: Both retrospective and prospective specimens were included in the clinical study.

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

The document does not specify a number of "experts" in the traditional sense (e.g., radiologists) for establishing ground truth. Instead, the ground truth was established using a Composite Comparator Reference Method:

  • This method involved two manufacturer-validated, real-time PCR Assays (PCR1 and PCR2).
  • These were followed by bi-directional sequencing.
  • Qualifications (Implied): The PCR assays were "manufacturer validated," implying they were developed and verified by experts in molecular diagnostics. Bi-directional sequencing is a standard molecular biology technique, performed and interpreted by trained personnel.

4. Adjudication Method for the Test Set

The adjudication method for the ground truth was as follows:

  • Sequential Adjudication (Implicit):
    • Initial screening by two manufacturer-validated, real-time PCR Assays (PCR1 and PCR2), both targeting unique sequences within the IS481 insertional element.
    • Specimens producing positive Bordetella pertussis results from either comparator PCR assay were then sent for bi-directional sequencing.
    • Final Ground Truth Definition: Only samples that matched sequences within the Bordetella pertussis genome with pre-defined quality scores (PHRED20 and E-values) were considered true positives. Samples were considered negative when neither comparator PCR assay returned positive Bordetella pertussis results.

This can be seen as a form of "consensus with confirmation" or a multi-step adjudication process.

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

No. A Multi-Reader Multi-Case (MRMC) comparative effectiveness study, as typically understood for evaluating human reader performance with and without AI assistance, was not performed. This study evaluated the automated device's performance against a reference method, not against human readers.

6. Standalone Performance

Yes. The study primarily evaluated the standalone performance of the illumigene® Pertussis DNA Amplification Assay (algorithm only, with instrumentation for detection) without human-in-the-loop adjustments, beyond the initial sample preparation and loading. The results reported (PPA, NPA) directly reflect the device's accuracy in identifying Bordetella pertussis from nasopharyngeal swab samples.

7. Type of Ground Truth Used

The type of ground truth used was expert consensus / reference method based on molecular testing. Specifically:

  • A Composite Comparator Reference Method was used.
  • This involved two manufacturer-validated, real-time PCR Assays (PCR1 and PCR2).
  • Confirmation of positive results was done via bi-directional sequencing with pre-defined quality scores.

This is a robust method leveraging highly sensitive and specific molecular techniques, which is considered a strong proxy for definitive diagnosis in this context.

8. Sample Size for the Training Set

The document does not specify a sample size for a "training set." This type of diagnostic assay, particularly for molecular tests, often relies on wet-lab optimization and development using characterized samples, rather than a distinct "training set" in the machine learning sense. The "Development optimization" section mentions "evaluation of characterized positive and negative clinical specimens" but without quantifying these for a training set.

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

As no specific "training set" is described, the method for establishing its ground truth is also not explicitly stated. However, the "Assay cut-off" section mentions:

  • "Development optimization includes evaluation of characterized positive and negative clinical specimens."
  • "Amplification reagent concentrations are adjusted during design as needed to ensure illumigene results are aligned with clinical specimen reported results."

This implies that the assay's parameters (like cut-off values) were refined using characterized clinical specimens, presumably with their Bordetella pertussis status determined by established laboratory methods, potentially similar to or derivative of the Composite Comparator Reference Method used for the main clinical study, or other well-accepted diagnostic techniques.

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mar 2 5 2014

Image /page/0/Picture/1 description: The image contains the logo for Meridian Bioscience, Inc. The logo features a globe graphic on the left, followed by the word "Meridian" in a bold, sans-serif font. Below "Meridian" is "Bioscience, Inc." with "Inc." in a smaller font and a trademark symbol. The tagline "Inspired Science. Trusted Solutions." is located beneath the company name.

illumigene® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014

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510(k) Summary

510(k) number:K133673Date of Preparation: March 19, 2014
Owner:Meridian Bioscience, Inc.3471 River Hills DriveCincinnati, Ohio 45244 USAPhone: (513) 271-3700Fax: (513) 272-5213
Contact:Primary Contact:Michelle L. SmithSr. Director, Regulatory Affairs & Design AssuranceSecondary Contact:Susan D. RolihExecutive Vice President, Regulatory and Quality Systems
Trade Name:illumigene® Pertussis DNA Amplification Assayillumigene® Pertussis External Controls
Common Name:Respiratory Viral Panel Multiplex Nucleic Acid Assay
Classification Name:Bordetella Pertussis DNA Assay System(21 CFR 866.3980, Product Code OZZ)
Predicate Device:FilmArray® Respiratory Panel (RP), Catalog RFIT-ASY-001K123620. K120267. K110764 and K103175.

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Image /page/1/Picture/0 description: The image shows the logo for Meridian Bioscience, Inc. The logo features a globe graphic on the left, followed by the word "Meridian" in a bold, sans-serif font. Below "Meridian" is "Bioscience, Inc." in a smaller, also bolded, font. The tagline "Inspired Science. Trusted Solutions." is located beneath the company name.

illumigene® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014

Device Description:

The illumigene Molecular Diagnostic Test System is comprised of the illumigene® Pertussis DNA Amplification Assay Test Kit, the illumigene® Pertussis External Control Kit and the illumipro-10™ Automated Isothermal Amplification and Detection System.

The illumigene Pertussis assay utilizes loop-mediated isothermal amplification (LAMP) technology to detect the presence of Bordetella pertussis in human nasopharyngeal swab specimens. Each illumigene Pertussis assay is completed using an illumigene Assay Control Reagent containing Control material, an illumigene Sample Buffer, an illumigene Pertussis Test Device and Mineral Oil. Nasopharyngeal swab specimens are eluted with illumigene Sample Buffer. The illumigene Assay Control Reagent is added to the eluted sample and heat-treated. Target and Control DNA are made available for isothermal amplification via heat-treatment. The heat-treated Specimen/Control sample is added to the illumigene Test Device. Mineral oil is added to the illumigene Test Device to prevent evaporation. DNA amplification occurs in the illumigene Test Device.

The illumipro-10 heats each illumigene Pertussis Test Device containing prepared Sample and Control material, facilitating amplification of target DNA. When B. pertussis is present in the specimen, a 198 base pair sequence located within the IS481 insertional element of the B. pertussis genome is amplified and magnesium pyrophosphate is generated. Magnesium pyrophosphate forms a precipitate in the reaction mixture.

The illumipro-10 monitors the absorbance characteristics of the reaction solutions at the assay Run Start (Signalmore) S.) and at the assay Run End (Signalman Sp). The illumipro-10™ catio of the Run End (Signal final or Sy) reads with the Run Start (Signal Initial or S) reads and compares the ratio to an established cut-off value. The illumipro-10 performs this ratio calculation to both the TEST chamber and the CONTROL chamber.

Fixed cut-off values for the CONTROL chamber are used to determine validity. CONTROL chamber Sp. S ratios less than 90% are considered valid and allow for reporting of TEST chamber results (POSITIVE, NEGATIVE). CONTROL chamber S; S; ratios greater than or equal to 90% are considered invalid. Results are reported as 'INVALID'; Test chamber results are not reported. More stringent cut-off criteria are applied to the Control chamber reaction to ensure amplification is not inhibited, reagents are performing as intended and that sample processing was performed appropriately.

Fixed cut-off values for the TEST chamber are used to report sample results. TEST chamber Sy:S, ratios less than 82% are reported as 'POSITIVE'; TEST chamber S;:S, ratios greater than or equal to 82% are reported as 'NEGATIVE'. Numerical values are not reported.

The illumigene Pertussis External Control Kit contains a Positive Control Reagent. The illumigene Assay Control/Negative Control Reagent provided in the illumigene Pertussis kit serves as the External Negative Control Reagent. External Control reagents are provided to aid the user in detection of reagent deterioration, adverse environmental or test conditions, or variance in operator performance that may lead to test errors. External Control reagents are provided for use in routine Quality Control testing.

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Image /page/2/Picture/0 description: The image shows the logo for Meridian Bioscience, Inc. The logo features a stylized globe on the left, followed by the word "Meridian" in a bold, sans-serif font. Below "Meridian" is the word "Bioscience, Inc." and the tagline "Inspired Science. Trusted Solutions."

illumigene® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014

Intended Use:

The illumigene® Pertussis DNA Amplification Assay, performed on the illumipro-10™, is a qualitative in vitro diagnostic test for the direct detection of Bordetello pertussis in human nasopharyngeal swab samples taken from patients suspected of having respiratory tract infection attributable to Bordetella pertussis.

The illumigene Pertussis assay utilizes loop-mediated isothermal DNA amplification (LAMP) technology to detect Bordetella pertussis by targeting the IS481 insertional element of the Bordetella pertussis genome. The IS481 insertional element can also be found in Bordetello holmesii and Bordetello bronchiseptica strains. Respiratory infection with Bordetella pertussis, Bordetella bronchiseptica may yield positive test results in 19481 assays. 8. holmesii infection may cause clinical illness similar to B. pertussis, and mixed outbreaks involving both B. pertussis and B. holmesii infection have been reported. Additional testing should be performed if necessary to differentiate B. holmesii and B. pertussis. B. bronchiseptica is a rare cause of infection in humans. When clinical factors suggest that B. pertussis may not be the cause of respiratory infection, other clinically appropriate investigation(s) should be carried out in accordance with published guidelines.

Negative results for the illumigene Pertussis DNA Amplification Assay do not preclude Bordetella pertussis infection and positive results do not rule out co-infection with other respiratory pathogens. Results from the illumigene Pertussis assay should be used in conjunction obtained during the patient's clinical evaluation as an aid in diagnosis of Bordetella pertussis infection and should not be used as for treatment or other patient management decisions.

illumigene Pertussis is intended for use in hospital, reference or state laboratory settings. The device is not intended for point-of-care use.

Similarities
DEVICEillumigene® PertussisPREDICATEFilmArray® Respiratory Panel (RP) SystemPackage Insert: RFIT-PRT-0011-02, May 2012
Intended UseQualitativeQualitative
Indications for UseProfessional UseProfessional Use
Assay TargetBordetella pertussis IS481 Insertional ElementBordetella pertussis DNA, promoter region ofToxin gene
Specimen TypesNasopharyngeal SwabNasopharyngeal Swab
DetectionSelf contained and automatedSelf contained and automated

Predicate Device Comparison:

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Image /page/3/Picture/0 description: The image shows the logo for Meridian Bioscience, Inc. The logo features a stylized globe on the left, followed by the word "Meridian" in a bold, sans-serif font. Below "Meridian" is the text "Bioscience, Inc." and the tagline "Inspired Science. Trusted Solutions."

illumigene® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014
Differences
DEVICEPREDICATE
illumigene® PertussisFilmArray® Respiratory Panel (RP) System
Test FormatDNA Amplification Assay; Loop-MediatedIsothermal Amplification (LAMP)Multiplex PCR Amplification Assay
Reagents/ComponentsThe illumigene Pertussis DNA AmplificationAssay Kit contains illumigene AssayControl/Negative Control, illumigene SampleBuffer, illumigene Pertussis Test Device andMineral Oil.External Positive Control materials areprovided separately in the illumigenePertussis External Control Kit. Theillumigene Assay Control/Negative Controlfunctions as the External Negative Control.The illumipro-10 is provided separately.The FilmArray Respiratory Panel (RP) AssayKit contains FilmArray RP pouch, SampleBuffer, Hydration Solution, transfer pipettesand Sample Loading Syringes (with attachedcannula). The FilmArray Instrument withLoading Station is provided separately.
External ControlsExternal Positive Control for the illumigenePertussis Assay is provided in the illumigenePertussis External Control Kit.The External Positive Control Reagentcontains tris-buffered solution containingnon-infectious Plasmid DNA ( B. pertussistarget DNA inserts) with azide (0.09%) as apreservative.The illumigene Assay Control/NegativeControl provided in the illumigene PertussisDNA Amplification Assay Kit functions as theExternal Negative Control.The Assay Control/Negative Control Reagentcontains tris-buffered solution containingformalin-treated E. coli harboring non-infectious Plasmid DNA ( S. aureus insert) withazide (0.09%) as a preservative.The FilmArray Respiratory Panel (RP) Assaydoes not require external controls. ExternalControls are not providedfor the FilmArrayRespiratory Panel (RP) Assay.
AmplificationTechnology and TargetSequence DetectedAssay performed with the illumipro-10™instrument, utilizes loop-mediated isothermalamplification (LAMP) technology for thedetection of 198 base pair (bp) sequence offound in the IS481 Insertional Element of thethe Bordetella pertussis genomeTheillumipro-10™ detects changes in reactionsolution absorbance by visible lightAssay performed with the FilmArrayInstrument, utilizes freeze-dried reagents toperform nucleic acid purification reversetranscription, and nested multiplex PCR withDNA melt analysis for the detection ofmultiple respiratory pathogens along with aspecific B. pertussis toxin DNA sequence.

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Image /page/4/Picture/0 description: The image shows the logo for Meridian Bioscience, Inc. The logo features a globe graphic on the left, followed by the word "Meridian" in a bold, sans-serif font. Below "Meridian" is "Bioscience, Inc." and the tagline "Inspired Science. Trusted Solutions."

illumigene ® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014
Differences (continued)
DEVICEPREDICATE
illumigene® PertussisFilmArray® Respiratory Panel (RP) System
Instrumentationillumipro-10™ Automated IsothermalAmplification and Detection SystemFilmArray® Instrument
Reading MethodVisible Light TransmissionFluorescence Emissions
Interpretation ofResultsResults of the illumigene Pertussis Assay areinterpreted by the illumipro-10 and reportedas INVALID, POSITIVE and NEGATIVE based onchange in light transmission of the reactionmixtures. EMPTY WELL is reported when anillumigene Test Device is not detected by theillumipro-10 or when questionable SignalInitial (Si) transmission is detected.Results of the FilmArray Respiratory Panel(RP) Assay report are interpreted by theFilmArray Instrument for B. pertussis andreported as Detected, Not Detected orInvalid.
PerformanceCharacteristicsProspective and Retrospective, All ComersPositive Percent Agreement (PPA):87.8 % [95% CI: 75.8 - 94.3%]Negative Percent Agreement (NPA):97.8% [95% CI: 96.3 - 98.7%]Retrospective Samples, SelectedPositive Percent Agreement (PPA):90.5 % [95% CI: 71.1 - 97.3%]Negative Percent Agreement (NPA):87.5% [95% CI: 64.0 - 96.5%]Prospective SamplesPPA: 100.0% [95% CI:54.1 - 100%]NPA: 99.9% [95% CI: 99.5 - 100%]Retrospective SamplesPPA: 94.6% [95% CI: 85.1 - 98.9%]NPA: 96.5% [95% CI: 88.1 - 99.6%]

NON-CLINICAL PERFORMANCE DATA

Analytical Performance:

Precision/Reproducibility:

Blind coded panels of 10 samples were supplied to three independent laboratories. Samples were randomly sorted consisting of moderately positive (n=3), low positive (n=3), high negative (n=3) and negative (n=1) samples. Contrived moderately positive, low positive and high negative samples were prepared by inoculating simulated negative matrix (flocked nylon nasopharyngeal swabs inoculated with nasal wash) with Bordetella pertussis strain BAA-589, Tahoma I. A negative specimen containing no Bordetella pertussis was included in the study. Panel specimens were qualified for study use by replicate testing (n=20) for each of three production lots of illumigene Pertussis.

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Image /page/5/Picture/0 description: The image shows the logo for Meridian Bioscience, Inc. The logo features a globe graphic on the left, followed by the word "Meridian" in a bold, sans-serif font. Below "Meridian" is "Bioscience, Inc." and the tagline "Inspired Science. Trusted Solutions."

illumigene® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014

Testing was performed by at least two different operators at each site on the same day (intra-assay variability) for five days (inter-assay variability). Three lots of illumigene Pertussis and six illumipro-10 instruments were used in this study. Positive and Negative Controls were tested with each panel. The results are given in the table below:

Sample TypeClinical Site 1PercentAgreementClinical Site 2PercentAgreementClinical Site 4PercentAgreementTotal
PercentAgreementAverageS₁:S₁SD%CV95% CI
Moderate Positive30/30 100.030/30 100.030/30 100.0090/90 100.057.514.147.20%95.9-100.0
Low Positive.27/30 90.029/30 96.730/30 100.086/90 95.658.1610.0217.23%89.1-98.3
High Negative26/30 86.723/30 76.729/30 96.778/90 86.796.1911.4711.92%78.1-92.2
Negative10/10 100.09/10 90.010/10 100.029/30 96.7100.294.754.73%83.3-99.4
Positive Control10/10 100.010/10 100.010/10 100.030/30 100.056.834.838.50%88.6-100.0
Negative Control10/10 100.010/10 100.010/10 100.030/30 100.0100.703.043.01%88.6-100.0

Detection limit:

Analytical Sensitivity studies were designed to determine, within 95% confidence intervals, the analytical limit of detection (LoD) of Bordetella pertussis. The LoD is the lowest number of colony-forming units (CFUs) per test aliquot that can be distinguished from negative samples with a high degree of probability (95%). Bordetella pertussis strain BAA-589 was evaluated for analytical Limit of Detection. Culture confirmed stock concentrations were standardized and subsequently diluted serially into sterile saline. Dilutions were combined with simulated negative matrix {flocked nylon swabs inoculated with nasal wash screened negative for B. pertussis) prior to test; Meridian utilized a simulated negative matrix for all analytical studies.

Each dilution evaluated in the illumigene Pertussis assay used individually prepared replicates. Not all prepared dilutions were tested in the illumigene Pertussis assay; testing for select dilutions was discontinued when replicate testing did not meet criteria established for limit of detection (e.g. more than 1 negative replicate obtained). The lowest dilution producing positive results in at least 19 of 20 replicates was identified as the preliminary assay limit of detection. Once a preliminary LoD concentration was established, an additional 60 replicates were evaluated by two different technicians to confirm the final LoD concentration for each kit lot.

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Image /page/6/Picture/12 description: The image shows the logo for Meridian Bioscience, Inc. The logo features a globe graphic on the left, followed by the word "Meridian" in a bold, stylized font. Below the word "Meridian" is the text "Bioscience, Inc." in a smaller, bolder font. Underneath that, the text "Inspired Science. Trusted Solutions." is displayed in a smaller font.

illumigene® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014

Testing was performed using three lots of illumigene Pertussis and six illumipro-10 instruments. External Positive and Negative Controls were tested daily. The Limit of Detection for the assay was reported as 1.48 CFU/Test or 3265 CFU/mL).

The following B. pertussis strains were tested and produced positive reactions at the stated assay limit of detect of 1.48 CFU/Test (3265 CFU/mL) with illumigene Pertussis: ATCC 12743, ATCC 8478, ATCC 8467, ATCC 9797, ATCC 53894, ATCC 10380, ATCC 12742, and A639. The following B. pertussis strains were tested and produced positive reactions at 1.59 CFU/Test or 3500 CFU/mL) with illumigene Pertussis: ATCC 51445 and ATCC BAA-1335.

Analytical specificity:

Interference Testing:

Interfering substance testing was performed to assess the potential impact of nonmicrobial contaminants expected to be present in samples collected for Bordetella pertussis testing on illumigene Pertussis test results. Potentially interfering substances were tested with simulated negative and contrived positive (B. pertussis strain BAA-589) nasopharyngeal swab samples. Potentially interfering substances were added to eluted simulated negative and contrived positive swab samples in Tris EDTA at final concentrations of 0.1 mg/mL, 1% v/v, 1% w/v, or greater and tested. Dilution Controls were prepared by adding a sterile saline solution in place of the potentially interfering substance.

The following biological substances, at the saturated solvent/diluents concentrations indicated do not interfere with the illumigene Pertussis test results: Mucin (1% w/v), Human DNA (200 ng/μL), Whole blood (1% w/v).

The following chemical substances, at the saturated solvent/diluents concentrations indicated do not interfere with test results: Acetaminophen (10 mg/ml), Advil® [Ibuprofen (10 mg/mL)], Afrin® Decongestant Nasal Spray [Oxymetazoline hydrochloride (0.0005% w/v)], Albuterol Sulfate [Salbutamol sulfate (1% w/v)], Aspirin (5 Coricidin® HBP Cold/Flu tablets [Acetominophen (3.26 mg/mL), mg/mL), Chlorpheniramine maleate (0.02 mg/mL)], Diphenhydramine HCl (0.25 mg/mL) , Erythromycin (2% w/v), Mupirocin (2% w/v), Petroleum Jelly |White Petrolatum (1% w/v)], Robitussin® Cough+Chest Congestion DM Cough Syrup [Dextromethorphan HBr (0.1 mg/mL), Guaifenesin (1.0 mg/mL)}, Suphedrine PE {Phenylephrine HCl (0.3 mg/mL)], Saline Nasal Spray [Sodium chloride (0.0065% w/v)], Smokeless Tobacco (snuff) (1% w/v), Tobramycin (0.6 mg/mL), Vicks® VaporRub® [Camphor (0.48% w/v), Eucalyptus oil (0.12% w/v), Menthol (0.26% w/v)].

Ibuprofen (10 mg/mL) produced invalid results (3/6 replicates) during original testing of contrived B. pertussis specimens. All repeat testing produced positive results (10/10

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Image /page/7/Picture/0 description: The image contains the logo for Meridian Bioscience, Inc. The logo features a stylized globe graphic to the left of the word "Meridian" in a bold, sans-serif font. Below "Meridian" is the text "Bioscience, Inc." in a smaller, also bolded, sans-serif font. Underneath that, the text "Inspired Science. Trusted Solutions." is displayed in an even smaller font size.

illumigene® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014

replicates). As the original results were not confirmed, Ibuprofen (10 mg/ml.) is not considered an interfering substance.

Aspirin was found to interfere with illumigene Pertussis testing at concentrations above 5 mg/mL.

Cross-Reactivity Study:

Potentially cross-reacting microorganisms expected to be present in nasopharyngeal swab specimens were added to negative and contrived positive samples. Negative samples were prepared with flocked nylon nasopharyngeal swabs inoculated with confirmed negative nasal wash. The contrived positive sample was prepared by spiking confirmed negative sample matrix (flocked nylon nasopharyngeal swabs inoculated with nasal wash) with Bordetella pertussis strain BAA-589, at concentrations at or around the determined limit of detection. Dilution Controls were prepared by adding a sterile saline solution in place of the potentially cross-reactive organisms. Each inoculated sample was tested in triplicate.

Potentially cross-reactive microorganisms were at minimum concentrations of 1.0 x 10 CFU/mL for bacteria/fungi or concentrations greater than 1.0 x 10° TCIDs//mL for viruses.

None of the following organisms reacted with illumigene Pertussis:

baumannii, Acinetobacter calcoaceticus, Acinetobacter lwoffii. Acinetobacter odontolyticus, Arcanobacterium haemolyticum, Bacillus subtilis. Actinomyces Bacteroides fragilis, Bordetella avium, Bordetella hinzii, Bordetella parapertussis, Bordetella petrii, Bordetella trematum, Burkholderia cepacia, Candida albicans, Candida glabrata, Chlamydia pneumoniae, Chlamydia trachomatis, Citrobacter freundii, difficile, Corynebacterium diphtheriae, Corynebacterium Clostridium pseudodiphtheriticum, Enterobacter cloacae, Enterococcus faecalis, Escherichia coli, Escherichia coli (ESBL), Fusobacterium nucleatum, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella oxytoca, Klebsiella pneumoniae (KPC), Lactobacillus acidophilus, Lactobacillus plantarum, Legionella jordanis, Legionella longbeachae, Leaionella micdadei. Leaionella pneumophila, Listeria monocytogenes, Moraxella catarrhalis, Mycobacterium tuberculosis, Mycoplasma genitalium, Mycoplasma hominis, Mycoplasma pneumoniae, Neisseria cinerea, Neisseria elongata, Neisseria gonorrhoeae, Neisseria meningitidis, Nocardia asteroides, Peptostreptococcus anaerobius, Proteus mirabilis, Proteus vulgaris, Pseudomonas aeruginosa, Pseudomonas fluorescens, Serratia liquefaciens, Staphylococcus aureus, Staphylococcus epidermidis, Stenotrophomonas maltophilia, Streptococcus anginosus (Group F), Streptococcus bovis (Group D), Streptococcus canis (Group G), Streptococcus dysgalactiae ssp. dysgalactiae, Streptococcus dysgalactiae ssp. equisimilis Streptoccus intermedius, Streptococcus mitis, Streptococcus mutans, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus salivarius, Streptoccus suis, Ureaplasma urealyticum, Adenovirus,

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MeridianBioscience, Inc.Inspired Science. Trusted Solutions."illumigene® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014

Coronavirus, Coxsackievirus, Cytomegalovirus, Epstein Barr Virus, Herpes Simplex Virus 1, Herpes Simplex Virus 2, Human Metapneumovirus, Influenza A, Influenza B, Measles virus, Mumps virus, Parainfluenza virus 1, Parainfluenza virus 2, Parainfluenza virus 3, Respiratory syncytial virus A, Respiratory syncytial virus B, Rhinovirus.

Bordetella holmesii and Bordetella bronchiseptica also contain the IS481 insertional element. Bordetella bronchiseptica ATCC® Strain 4617 and Bordetella holmesii were tested at 1.0 x 108 CFU/mL and found to react with the illumigene Pertussis assay.

Unexpected results were observed during original testing of specimens containing B. hinzii, H. parainfluenzae and M. genitalium. One of three negative sample replicates containing B. hinzii produced a false-positive result that was not confirmed with further testing (20/20 replicates). Three of three negative sample replicates containing H. parainfluenzae produced false-positive results that were not confirmed with further testing (20/20 replicates). Three of three B. pertussis positive sample replicates produced invalid results that were not confirmed with further testing (10/10 replicates). Three of three negative sample replicates containing M. genitolium produced invalid results that were not confirmed with further testing (10/10 replicates). As repeat testing using a heightened number of replicates did not confirm original results, B. hinzii, H. parainfluenzae and M. genitalium are not considered cross-reactive or interferents in illumigene Pertussis testing.

Assay cut-off:

The illumigene Pertussis assay is manufactured with fixed cut-off values. The product is designed around a pre-selected cut-off value and amplification reagent concentrations are optimized to ensure appropriate reactions are obtained. Development optimization includes evaluation of characterized positive and negative clinical specimens. Amplification reagent concentrations are adjusted during design as needed to ensure illumigene results are aligned with clinical specimen reported results.

Cut-off values applied in the following manner:

  • . The illumipro-10™ calculates the ratio of the Run End (Signal final or S;) reads with the Run Start (Signal Initial or S;) reads and compares the ratio to an established cut-off value. The illumipro-10 performs this ratio calculation to both the TEST chamber and the CONTROL chamber.
    • . Fixed cut-off values for the CONTROL chamber are used to determine validity. CONTROL chamber S;:S; ratios less than 90% are considered valid and allow for reporting of TEST chamber results (POSITIVE, NEGATIVE). CONTROL chamber S :S, ratios greater than or equal to 90% are considered invalid. Results are reported as 'INVALID'; Test chamber results are not reported. More stringent cut-off criteria are applied to the Control chamber reaction to ensure amplification is not inhibited, reagents are performing as intended and that sample processing was performed appropriately.

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Image /page/9/Picture/0 description: The image is a logo for Meridian Bioscience, Inc. The logo features a globe graphic on the left, followed by the word "Meridian" in a bold, italicized font. Below that is "Bioscience, Inc." and the tagline "Inspired Science. Trusted Solutions."

illumigene® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014

Fixed cut-off values for the TEST chamber are used to report sample results. TEST chamber S;:S; ratios less than 82% are reported as 'POSITIVE'; TEST chamber S;:S; ratios greater than or equal to 82% are reported as 'NEGATIVE'. Numerical values are not reported.

CLINICAL PERFORMANCE DATA:

Clinical Studies:

Clinical Performance:

Clinical trials for the illumigene Pertussis DNA Amplification Assay, including the illumipro-10 Automated Isothermal amplification and detection system, were conducted from December 2012 to July 2013. A total of 729 qualified nasopharyngeal (NP) swab specimens collected from patients suspected of having Bordetella pertussis infection were evaluated with the test. All specimens were leftover and de-identified.

Performance characteristics of the assay were determined by comparison to a Composite Comparator Reference Method that included two manufacturer validated, real-time PCR Assays (PCR1 and PCR2) followed by bi-directional sequencing. Both comparator PCR assays targeted unique sequences within the IS481 insertional element; neither of the comparator target sequences overlaps with the illumigene Pertussis assay target sequence. Specimens producing positive Bordetella pertussis results from either comparator PCR assay were sent for bi-directional sequencing. Only samples that matched sequences within the Bordetella pertussis genome with pre-defined quality scores (PHRED20 and E-values) were considered true positives. Samples were considered negative when neither comparator PCR assay returned positive Bordetella pertussis results.

The clinical study population included retrospective and prospective specimens. A total of 508 (69.7%) prospective and 221 (30.3%) retrospective specimens were tested and included in final performance calculations. The retrospective sample population included non-selected specimens (all comers) and selected specimens. Overall performance characteristics of illumigene Pertussis Assay are summarized in Table 1.

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Image /page/10/Picture/0 description: The image shows the logo for Meridian Bioscience, Inc. The logo features a globe graphic on the left, followed by the word "Meridian" in a bold, stylized font. Below "Meridian" is the text "Bioscience, Inc." and the tagline "Inspired Science. Trusted Solutions."

illumigene® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014

Table 1. illumigene Assay Performance

Positive SpecimensNegative Specimens
SpecimenDescriptionillumigenevs.ComparatorPPAa95% CIillumigenevs.ComparatorNPA95% CIInvalidResultsb
Composite Method Comparator, All Comers
Prospective39/4586.7%73.8 - 93.7%447/45997.4%95.5 – 98.5%2 (13)
Retrospective4/4100.0%51.0 - 100.0%176/17898.9%96.0 - 99.7%0
Total:43/4987.8%75.8 - 94.3%623/63797.8%96.3 - 98.7%2 (13)
Composite Method Comparator, Selected Specimens
Retrospective19/2190.5%71.1 - 97.3%14/1687.5%64.0 - 96.5%0

° Eight specimens produced false-negative illumigene results when composite Comparator Method. Six of the eight specimens produced detectable levels of DNA between 35 and 40 comparator assay amplification cycles and were confirmed positive by bi-directional sequencing. Three of these six specimens gave positive results in only one of the two comparator PCR/Sequencing assays.

b 11/13 initial invalid specimens produced valid results upon repeat testing.

False-negative illumigene results were individually evaluated at the conclusion of clinical testing. The Cycle threshold (Ct) values produced during comparator assay testing were above 35 for one or both PCR/Bi-directional sequencing assays for six of the eight specimens evaluated. High Ct values in PCR assays may indicate that low levels of DNA are present. False-negative illumigene results and corresponding Composite Comparator data are shown in Table 2.

Table 2. False-Negative illumigene Specimens, Comparator Assay Results

SpecimenDesignationSpecimenStatusPCR1PCR2
Ct ValueBi-DirectionalSequencingResultCt ValueBi-DirectionalSequencingResult
1-19Prospective34.90+33.85+
1-29ProspectiveNegativeN/A37.69+
1-259Prospective34.07+35.09+
1-269Prospective35.72+NegativeN/A
1-275ProspectiveNegativeN/A39.13+
3-33Prospective39.28+35.80+
4-710Retrospective36.87+36.06+
4-712Retrospective37.44+38.41+

Four independent clinical test sites located in the Midwestern, Northern, and Eastern regions of the United States participated in the device evaluation All samples included in the study were submitted to the testing laboratory by an ordering physician

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Image: Globe logoMeridian
Bioscience, Inc.Inspired Science. Trusted Solutions.
illumigene® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014

for Bordetella pertussis testing and were presumed from symptomatic patients. No restrictions were placed on age, gender, medications or known pharmaceutical therapies.

Clinical studies were conducted with multiple nasopharyngeal swab and sample elution buffer types. Sample buffers tested during clinical studies included 0.85 % Saline (n=30 or 4.1%), Tris EDTA (n=8 or 1.1%) and Molecular Grade Water (n=687 or 94.2%). All sample buffers were used in 0.5 mL volumes. Analytical studies were performed with 0.85% Saline, Tris EDTA, Phosphate Buffered Saline (PBS) and Molecular Grade Water. Analytical studies established equivalence between all sample elution buffer types.

Clinical performance data was evaluated by patient age and gender. Age information was known for 723 (99.2%) of the patients from whom samples were tested. Patient age ranged from 1 month to 88 years. Thirty-eight (5.2%) patients were less than 1 year of age; 13 (1.8%) were between 1 and 2 years old; 296 (40.6%) were between 2 and up . to 12 years, 157 (21.5%) were between 12 and up to 21 years, 190 (26.0%) were above 21 but below 65 years, and the remaining 29 (4.0%) patients were above 65 years of age. The study population included 413 (56.7%) female and 308 (42.2%) male patients. Gender was unknown for 8 (1/1%) patients included in the study. There is no expectation that the illumigene Pertussis assay performance characteristics are influenced by patient gender.

Performance data by Clinical Test Site, analyzed based on the Composite Reference Method, is shown in Table 3. Statistical analysis of Site performance data was performed with no significant difference among Sites identified.

Positive SpecimensNegative Specimens
Specimen Descriptionillumigenevs.ComparatorPPA95% CIillumigenevs.ComparatorNPA95% CIInvalidResults
Composite Method Comparator, All Comers
Site 135/4087.5%73.9 - 94.5%440/45097.8%96.0 - 98.8%2 (13)
Site 24/4100.0%51.0 - 100.0%67/6997.1%90.0 - 99.2%0 (2)
Site 30/10.0%0.0 - 79.3%7/7100.0%64.6 - 100.0%0 (0)
Site 44/4100.051.0 - 100.0%109/11198.2%93.7 - 99.5%0 (0)
Composite Method Comparator, Selected Specimens
Site 115/15100.0%79.6 - 100.0%6/875.0%40.9 - 92.9%0 (0)
Site 44/666.7%30.0 - 90.3%8/8100.0%67.6 - 100.0%0 (0)

Table 3. illumigene Pertussis Assay Performance by Clinical Test Site, Composite Reference Method (CRM)

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Image /page/12/Picture/0 description: The image shows the logo for Meridian Bioscience, Inc. The logo features a globe graphic on the left, followed by the company name in bold, black font. Below the name is the tagline "Inspired Science. Trusted Solutions."

illumigene® Pertussis DNA Amplification Assay
Application Reference:K133673
Attachment Description:Additional Information Request (January 13, 2014)510(k) Summary
Application Date:March 19, 2014

Expected values/Reference Range:

Overall incidence of B. pertussis as detected by the illumigene Pertussis Assay in prospectively and retrospectively collected, non-selected specimens (all comers) during the period of this study was 8.2% (57/692).

CONCLUSIONS

The illumigene® Pertussis DNA amplification assay, performed on the illumipro-10™, can be used to detect Bordetello pertussis in human nasopharyngeal swabs obtained from patients suspected of having respiratory infection attributable to Bordetella pertussis.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WObb-Cition Silver Spring, MD 20993-00012

March 25, 2014

MERIDIAN BIOSCIENCE, INC. MICHELLE SMITH SR. DIRECTOR REGULATORY AFFAIRS AND DESIGN ASSURANCE 3471 RIVER HILLS DRIVE CINCINNATI, OH 45244

Re: K133673

్రా

Trade/Device Name: illumigene Pertussis DNA Amplification Assay Regulation Number: 21 CFR 866.3980 Regulation Name: Respiratory Viral Panel Multiplex Nucleic Acid Assay Regulatory Class: II Product Code: OZZ Dated: March 13, 2014 Received: March 19, 2014

Dear Ms. Smith:

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 clectronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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Page 2-Ms. Smith

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/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/Resourcesfor You/Industry/default.htm.

Sincerely yours,

John Hobson -S for

Sally Hojvat, M.Sc., Ph.D Director Division of Microbiology Devices Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Indications for Use

510(k) Number (if known)

K133673 Device Name

illumigene® Pertussis DNA Amplification Assay

Indications for Use (Describe)

The illumigene® Pertussis DNA Amplification Assay, performed on the illumipro-10™, is a qualitative in vitro diagnostic test for the direction of Bordetella pertussis in human nasopharyngeal swab samples taken from patients suspected of having respiratory tract infection attributable to Bordetello pertussis.

The illumigene Pertussis assay utilizes loop-mediated isothermal DNA amplification (LAMP) technology to detect Bordetella pertussis by targeting the IS481 insertional element of the Bordetella pertussis genome. The IS481 insertional element can also be found in Bordetella holmesii and Bordetella bronchiseptica strains. Respiratory infection with Bordetella pertussis Bardetella bronchiseptica may yield positive test results in IS481 assays. B. holmesii infection may cause clinical illness similar to B. pertussis, and mixed outbreaks involving both 8. pertussis and B. holmesii infection have been reported. Additional testing should be performed if necessary to differentiate B. holmesii and B. pertussis. B. bronchiseptica is a rare cause of infection in humans. When clinical factors suggest that B. pertussis may not be the cause of respiratory infection, other clinically appropriate investigation(s) should be carried out in accordance with published guidelines.

Negative results for the illumigene Pertussis DNA Amplification Assay do not preclude Bordetello pertussis infection and positive results do not rule out co-infection with other respiratory pathogens. Results from the illumigene Pertussis assay should be used in conjunction with information obtained during the patient's clinical evaluation as an aid in diagnosis of Bordetella pertussis infection and should not be used as the sole basis for treatment or other patient management decisions.

illumigene Pertussis is intended for use in hospital, reference or state laboratory settings. The intended for point-of-care use.

Type of Use (Select one or both, as applicable) Over-The-Counter Use (21 CFR 801 Subpart C) X Prescription Use (Part 21 CFR 801 Subpart D)

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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§ 866.3980 Respiratory viral panel multiplex nucleic acid assay.

(a)
Identification. A respiratory viral panel multiplex nucleic acid assay is a qualitative in vitro diagnostic device intended to simultaneously detect and identify multiple viral nucleic acids extracted from human respiratory specimens or viral culture. The detection and identification of a specific viral nucleic acid from individuals exhibiting signs and symptoms of respiratory infection aids in the diagnosis of respiratory viral infection when used in conjunction with other clinical and laboratory findings. The device is intended for detection and identification of a combination of the following viruses:(1) Influenza A and Influenza B;
(2) Influenza A subtype H1 and Influenza A subtype H3;
(3) Respiratory Syncytial Virus subtype A and Respiratory Syncytial Virus subtype B;
(4) Parainfluenza 1, Parainfluenza 2, and Parainfluenza 3 virus;
(5) Human Metapneumovirus;
(6) Rhinovirus; and
(7) Adenovirus.
(b)
Classification. Class II (special controls). The special controls are:(1) FDA's guidance document entitled “Class II Special Controls Guidance Document: Respiratory Viral Panel Multiplex Nucleic Acid Assay;”
(2) For a device that detects and identifies Human Metapneumovirus, FDA's guidance document entitled “Class II Special Controls Guidance Document: Testing for Human Metapneumovirus (hMPV) Using Nucleic Acid Assays;” and
(3) For a device that detects and differentiates Influenza A subtype H1 and subtype H3, FDA's guidance document entitled “Class II Special Controls Guidance Document: Testing for Detection and Differentiation of Influenza A Virus Subtypes Using Multiplex Nucleic Acid Assays.” See § 866.1(e) for the availability of these guidance documents.