K Number
K142543
Date Cleared
2015-05-11

(243 days)

Regulation Number
862.2900
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Mission® U120 Ultra Urine Analyzer is intended for use in conjunction with the Mission® Urinalysis Reagent Strips for the semi-quantitative detection of the following analytes in urine: Glucose, Bilirubin, Ketone (Acetoacetic Acid), Specific Gravity, pH, Blood, Protein, Urobilinogen, Leukocytes and Ascorbic Acid as well as the qualitative detection of Nitrite.

The instrument is intended for point-of-care, in vitro diagnostic use only. The measurement can be used in general evaluation of health, and aids in the diagnosis and monitoring of metabolic or systemic diseases that affect kidney function, endocrine disorders and diseases or disorders of the urinary tract. It is intended for professional use only.

The Mission® Liquid Urine Controls Liquid Diptube Urine Controls are assayed urine controls, intended for use in validating the precision of analyzer reading of urinalysis for one or more of the following analytes: Ascorbic acid, Glucose, Bilirubin, Ketone (Acetoacetic acid), Specific Gravity, Blood, pH, Protein, Urobilinogen, Nitrite and Leukocytes. It is intended for professional in vitro diagnostic use only.

Device Description

The Mission® U120 Ultra Urine Analyzer is a reflectance photometer that analyzes the intensity and color of light reflected from the reagent areas of a urinalysis reagent strip. Without a urine analyzer, users must visually compare the reagent areas of the strip to a color chart using the naked eye. Mission® U120 Ultra Urine Analyzer also features data management and report generation capabilities.

AI/ML Overview

Acceptance Criteria and Device Performance Study for Mission® U120 Ultra Urine Analyzer

This report summarizes the acceptance criteria and the study proving the device meets these criteria for the Mission® U120 Ultra Urine Analyzer, as derived from the provided 510(k) summary (K142543).

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria for the Mission® U120 Ultra Urine Analyzer were established through comparison with a predicate device (ACON U120 Urine Analyzer, K070929) and through various performance studies, including sensitivity, precision, interference, and environmental stability. The primary acceptance criteria for clinical performance were based on the agreement levels with the predicate device.

Test / AnalyteAcceptance Criteria (Implied)Reported Device Performance (Exact / Within One Level Agreement with Predicate)
Clinical StudyHigh agreement with predicate device (ACON U120 Urine Analyzer)
LeukocyteN/A (implied high agreement)95.3% / 100%
NitriteN/A (implied high agreement)100% / 100%
Urobilinogen (Uro)N/A (implied high agreement)93.4% / 100%
Protein (Pro)N/A (implied high agreement)92.7% / 100%
pHN/A (implied high agreement)86.8% / 100%
Blood (Blo)N/A (implied high agreement)93.8% / 100%
Specific Gravity (SG)N/A (implied high agreement)85.5% / 100%
KetoneN/A (implied high agreement)96.4% / 100%
Bilirubin (Bil)N/A (implied high agreement)97.4% / 100%
Glucose (Glu)N/A (implied high agreement)95.7% / 100%
Ascorbic Acid (ASC)N/A (implied high agreement)90.0% / 100%
Precision Study100% within +/- one block agreement (across all levels)100% within +/- one block agreement for all analytes and levels
>90% exact agreement (across all levels, where applicable)Range from 92.2% to 100% exact agreement
Sensitivity StudySpecific low and high end sensitivity ranges for each analyteMet the defined low and high end sensitivity ranges (details in source)
Interference StudyIdentification and characterization of interfering substancesIdentified and characterized specific interfering substances and their effects
Temperature Flex StudyOperates satisfactorily within 2°C to 45°CValidated operation within 2°C to 45°C
Humidity Flex StudyStrips remain stable for defined periods at various humiditiesEstablished stability periods at <20%, 30-50%, 60-70%, >80% humidity levels
Voltage Flex StudyOperates properly within 86V to 264VConfirmed proper operation between 86V and 264V
pH Flex StudyCharacterization of pH effects on test resultsDetermined pH ranges for unaffected results and identified pH-related interferences

Note: The exact acceptance criteria were not explicitly stated as numerical thresholds for each analyte in the provided document beyond the general statement of "demonstrated that the intended user can follow the product instruction and obtain comparable instrument read results when using the Mission®U120 Ultra Urine Analyzer and a predicate Analyzer." The reported performance statistics (exact and within one level agreement) implicitly serve as the achieved acceptance. For Sensitivity, the achievement of specific low and high end ranges, as listed in the document, constitutes the acceptance. For Precision, 100% within +/- one block agreement was explicitly stated.

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

The primary clinical test set involved approximately 468 patient urine specimens for each analyte (sample sizes varied slightly for some analytes, e.g., 451 for Nitrite, 450 for Bilirubin, etc.). This number includes both patient-collected specimens and "few contrived urine specimens" to ensure coverage of the measuring range.

The data provenance is prospective, as it involved "patient urine specimens randomly collected from patients at each of 3 clinical sites" and "Additional study was carried out at 2 sites in US," indicating a planned data collection process for the study. The country of origin for the clinical data is the United States (2 sites in US mentioned).

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

The ground truth for the clinical test set was established by comparing the results from the Mission® U120 Ultra Urine Analyzer with those from a predicate device, the ACON U120 Urine Analyzer (K070929), rather than human experts.

The testing was performed by 9 intended users in total across 3 clinical sites (3 users at each site). Their qualifications are described as "intended users," implying they are professionals who would typically operate such devices in a point-of-care setting, but specific expert qualifications (e.g., radiologist with 10 years of experience) are not provided.

4. Adjudication Method for the Test Set

The adjudication method used seems to be a direct comparison between the results obtained from the candidate device (Mission® U120 Ultra Urine Analyzer) and the predicate device (ACON U120 Urine Analyzer). The agreement percentages (exact and within one level) are reported, indicating that the predicate device's readings served as the reference for comparison. There is no mention of an independent adjudication panel or a consensus method among multiple experts for the test set's ground truth beyond the comparison to the predicate.

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

An MRMC comparative effectiveness study, in the traditional sense of evaluating human reader performance with and without AI assistance, was not performed. The study compared the new automated analyzer (Mission® U120 Ultra Urine Analyzer) against a predicate automated analyzer (ACON U120 Urine Analyzer), with "intended users" operating the devices. The study objective was to evaluate the performance of the new analyzer compared to the predicate and to observe operational issues. It did not focus on the effect size of how much human readers improve with AI vs. without AI assistance, as the "AI" (automated analyzer) is the primary testing modality being evaluated for its standalone performance relative to a predicate.

6. Standalone (i.e. algorithm only without human-in-the-loop performance) Study

Yes, a standalone study was performed. The core of the clinical study involved comparing the "Mission® U120 Ultra Urine Analyzer" reading "Mission® Urinalysis Reagent Strips" against the "ACON U120 Urine Analyzer" reading "Mission® Urinalysis Reagent Strips." This evaluates the algorithm-driven output of the Mission® U120 Ultra Urine Analyzer as a standalone device against a legally marketed predicate device. The precision, sensitivity, interference, and environmental studies also evaluate the device's performance in a standalone capacity under various conditions.

7. The Type of Ground Truth Used

For the clinical study, the reference standard (ground truth) was the performance of the legally marketed predicate device, the ACON U120 Urine Analyzer (K070929), when reading the same Mission® Urinalysis Reagent Strips. The study directly compared the results from the new device against those of the predicate. Some "contrived urine specimens" were also used, implying that these had pre-defined or known concentrations of analytes, which would also serve as a form of ground truth.

For the precision study, the "target concentration of the analyte in each control solution was confirmed with Siemens reagent strips read by Clinitek Status urine analyzer and Mission® Urinalysis Reagent Strip read by ACON U120 urine analyzer," indicating a combination of predicate devices and validated controls as ground truth.

For the sensitivity study, the "low and high end range of sensitivity" for the reagent strips were determined, which likely relied on precisely prepared samples with known analyte concentrations as the ground truth.

8. The Sample Size for the Training Set

The document does not explicitly state a separate "training set" sample size for the Mission® U120 Ultra Urine Analyzer, as it is primarily a reflectance photometer analyzing color changes rather than a complex machine learning model that typically requires a distinct training phase. The device's operation is based on pre-programmed algorithms for color interpretation.

The clinical study and other performance studies described serve as validation of the device's accuracy and functionality. If any internal calibration or parameter tuning occurred, the data used for that is not detailed in this section.

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

As mentioned above, the document does not describe a distinct training set for a machine learning algorithm. The device is an optical reader with established "tests principles" based on reflectance photometry and CMOS image sensing. The "ground truth" for its development and programming would implicitly derive from the chemical reactions on the reagent strips and the expected colorimetric responses at different analyte concentrations. These foundational principles are well-established in urinalysis technology. The sensitivity study, for instance, establishes the "low and high end range of sensitivity" for the device, which reflects its ability to correctly interpret known concentrations.

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Image /page/0/Picture/1 description: The image is a seal for the Department of Health & Human Services - USA. The seal is circular, with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is an abstract image of an eagle with three heads.

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

ACON LABORATORIES, INC. QIYI XIE SR. STAFF REGULATORY AFFAIRS & CLINICAL AFFAIRS 10125 MESA RIM ROAD SAN DIEGO CA 92121

September 17, 2015

Re: K142543

Trade/Device Name: Mission® Urinalysis Reagent Strips, Mission® Liquid Urine Controls, Mission® Liquid Diptube Urine Controls, Mission® U120 Ultra Urine Analyzer Regulation Number: 21 CFR 862.1340 Regulation Name: Urinary glucose (nonquantitative) test system Regulatory Class: II Product Code: JIL, CDM, CEN, JIN, JIO, JIR, JJB, JMT, JRE, LJX, JMA, JJW, KQO Dated: March 25, 2015 Received: March 26, 2015

Dear Qiyi Xie:

This letter corrects our substantially equivalent letter of May 11, 2015.

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

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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.

If you desire specific advice for your device on our labeling regulations (21 CFR Parts 801 and 809), please contact the Division of Industry and Consumer Education at its toll-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" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Katherine Serrano -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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Indications for Use

510(k) Number (if known) K142543

Device Name

Mission® Urinalysis Reagent Strips Mission® U120 Ultra Urine Analyzer Mission® Liquid Urine Controls, Mission® Liquid Diptube Urine Controls

Indications for Use (Describe)

The Mission® U120 Ultra Urine Analyzer is intended for use in conjunction with the Mission® Urinalysis Reagent Strips for the semi-quantitative detection of the following analytes in urine: Glucose, Bilirubin, Ketone (Acetoacetic Acid), Specific Gravity, pH, Blood, Protein, Urobilinogen, Leukocytes and Ascorbic Acid as well as the qualitative detection of Nitrite.

The instrument is intended for point-of-care, in vitro diagnostic use only. The measurement can be used in general evaluation of health, and aids in the diagnosis and monitoring of metabolic or systemic diseases that affect kidney function, endocrine disorders and diseases or disorders of the urinary tract. It is intended for professional use only.

The Mission® Liquid Urine Controls Liquid Diptube Urine Controls are assayed urine controls, intended for use in validating the precision of analyzer reading of urinalysis for one or more of the following analytes: Ascorbic acid, Glucose, Bilirubin, Ketone (Acetoacetic acid), Specific Gravity, Blood, pH, Protein, Urobilinogen, Nitrite and Leukocytes. It is intended for professional in vitro diagnostic use only.

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

☑ Prescription Use (Part 21 CFR 801 Subpart D)☐ Over-The-Counter Use (21 CFR 801 Subpart C)
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7. 510(k) SUMMARY

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

The Assigned 510(k) number is K142543

Submitter's Identification:

ACON Laboratories, Inc. 10125 Mesa Rim Road San Diego, California 92121 Tel.: 858-875-8019 Fax: 858-875-8011

Date Prepared: May 11, 2015

Contact Person:

Qiyi Xie Senior Staff, Clinical & Regulatory Affairs Email: qxie@aconlabs.com

Proprietary Name of the Device:

Mission® Urinalysis Reagent Strips Mission® U120 Ultra Urine Analyzer Mission® Liquid Urine Controls Mission® Liquid Diptube Urine Controls

Common Name:

Urine Chemistry Analyzer Urinalysis Controls (Assayed and Unassayed)

Classification Name:

Class II §21 CFR § 862.1340 Urinary Glucose (Non-Quantitative) Test System

Class I §21 CFR 862.2900, Automated Urinalysis System

Class I, reserved §21 CFR 862.1660, Quality control material (assayed and unassayed)

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Predicate Device:

ACON Urinalysis Reagent Strips, ACON U120 Urine Analyzer ACON Laboratories Inc. 10125 Mesa Rim Road San Diego, CA 92121 510(k) Number: K070929

Mission Liquid Urine Control, Mission Liquid Diptube Urine Control ACON Laboratories Inc. 10125 Mesa Rim Road San Diego, CA 92121 510(k) Number: K103387

Device Name: Mission® Urinalysis Reagent Strips, Mission® U120 Ultra Urine Analyzer Mission® Liquid Urine Controls, Mission® Liquid Diptube Urine Controls

Regulation DescriptionProductCodeDeviceClassRegulation
Occult blood testJIOII21 CFR § 864.6550
Urinary glucose (non-quantitative) test systemJILII21 CFR § 862.1340
Urinary protein or albumin (non-quantitative)test systemJIRI21 CFR § 862.1645
Urinary bilirubin and its conjugates (non-quantitative) test systemJJBI21 CFR § 862.1115
Ketones (non-quantitative) test systemJINI21 CFR § 862.1435
Leukocyte peroxidase testLJXI21 CFR § 864.7675
Nitrite (non-quantitative) test systemJMTI21 CFR § 862.1510
Urinary pH (non-quantitative) test systemCENI21 CFR § 862.1550
Refractometer for clinical use (specificgravity)JREI21 CFR § 862.2800
Urinary urobilinogen (non-quantitative) testsystemCDMI21 CFR § 862.1785
Ascorbic acid test systemJMAI21 CFR § 862.1095
Quality control material (assayed andunassayed)JJWI,reserved21 CFR § 862.1660
Automated urinalysis systemKQOI21 CFR § 862.2900

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Device Description:

The Mission® U120 Ultra Urine Analyzer is a reflectance photometer that analyzes the intensity and color of light reflected from the reagent areas of a urinalysis reagent strip. Without a urine analyzer, users must visually compare the reagent areas of the strip to a color chart using the naked eye. Mission® U120 Ultra Urine Analyzer also features data management and report generation capabilities.

Intended Use:

The Mission® U120 Ultra Urine Analyzer is intended for use in conjunction with the Mission® Urinalysis Reagent Strips for the semi-quantitative detection of the following analytes in urine: Glucose, Bilirubin, Ketone (Acetoacetic Acid), Specific Gravity, pH, Blood, Protein, Urobilinogen, Leukocytes and Ascorbic Acid as well as the qualitative detection of Nitrite.

The instrument is intended for point-of-care, in vitro diagnostic use only. The measurement can be used in general evaluation of health, and aids in the diagnosis and monitoring of metabolic or systemic diseases that affect kidney function, endocrine disorders and diseases or disorders of the urinary tract. It is intended for professional use only.

The Mission® Liquid Urine Controls and Mission® Liquid Diptube Urine Controls are assayed urine controls, intended for use in validating the precision of analyzer reading of urinalysis for one or more of the following analytes: Ascorbic acid, Glucose, Bilirubin, Ketone (Acetoacetic acid), Specific Gravity, Blood, pH, Protein, Urobilinogen, Nitrite and Leukocytes. It is intended for professional in vitro diagnostic use only.

Tests Principles:

The Mission® U120 Ultra Urine Analyzer is a reflectance photometer that analyzes the intensity and color of light reflected from the reagent areas of a urinalysis reagent strip. Using a light emitting diode (LED) as the light source and a CMOS image sensor as a light sensor, the optical system reads the color change in the urine test strips after a sample is applied.

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Urine Controls: The Mission® Liquid Urine Controls and Mission® Liquid Diptube Urine Controls are assayed urine controls, intended for use in validating the precision of analyzer reading of urinalysis for the following analytes: Ascorbic acid, Glucose, Bilirubin, Ketone (Acetoacetic acid), Specific Gravity, Blood, pH, Protein, Urobilinogen, Nitrite and Leukocytes.

FeatureMission® U120 Ultra Urine Analyzer
MethodologyReflectance Photometer
DetectionCMOS Image Sensor
ChemistryMission® Urinalysis Reagent Strips
ThroughputSingle Test Mode: 55 tests/hourContinuous Test Mode: 120 tests/hour
MemoryLast 2000 results
Strip Incubation Time1 minute
PC PortUSB (data communications);(Not connect to PC)
Bluetooth Wireless
Standard RS232C Port
CapabilitiesInternal thermal printer
Barcode reader Connector
External printer (optional)
Barcode reader (optional)
RJ45 Ethernet; (optional)
Available Languages on ScreenEnglish and Spanish
Analyzer Operating Conditions0-40°C (32-104°F); ≤85% RelativeHumidity (non-condensing)
Strip Operating Conditions15-30°C (59-86°F); 20-80% RelativeHumidity (non-condensing)
Power Source6 AA batteries with 100 tests/6 newbatteries: 100- 240 VAC(adapter). (50-60Hz)

Technological Characteristics:

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Hz± 1HZ)
Weight≤1.66 kg (3.65 lb) without batteries or power supply
Dimensions (L X W X H)26.0 (L) x 15.0 (W) x 17.5 (H) cm(10.2"x 5.9"x 6.9")
Display Dimensions (L X W)Large touch screen Color LCDTFT 640x480, 11.7 (W) x 8.8 (H) cm

Substantial Equivalence:

The Mission® U120 Urinalysis Reagent Strips and the Ultra Urine Analyzer is substantially equivalent to the ACON Urinalysis Reagent Strips and the ACON U120 Urine Analyzer (K070929):

ItemMission® Urinalysis Reagent Strips,Mission® U120 Ultra Urine Analyzer,Candidate DeviceACON Urinalysis Reagent Strips,ACON U120 Urine Analyzer,Predicate
Similarities
MethodologyReflectance PhotometerReflectance Photometer
PrincipleThe U120 Urine Analyzermeasures the intensity of the lightreflected from the reagent areasof a urinalysis reagent strip.The U120 Ultra UrineAnalyzer measures theintensity of the light reflectedfrom the reagent areas of aurinalysis reagent strip.
ChemistryMission® Urinalysis ReagentStripsMission® Urinalysis ReagentStrips
Analytes DetectedLeukocytes, Nitrite, blood(Occult), Glucose, Protein,Ketone, Specific Gravity, pH,Bilirubin, Urobilinogen andAscorbic AcidLeukocytes, Nitrite, blood(Occult), Glucose, Protein,Ketone, Specific Gravity, pH,Bilirubin, Urobilinogen andAscorbic Acid
Strip IncubationTime1 minute1 minute
AvailableLanguages onScreenEnglish and SpanishEnglish and Spanish
AnalyzerOperatingConditions0-40°C (32-104°F); ≤85%Relative Humidity (non-condensing)0-40°C (32-104°F); ≤85%Relative Humidity (non-condensing)
Line LeakageCurrent<0.5mA<0.5mA
Differences
DetectionThe ACON U120 Urine Analyzerutilizes a photodiode to measurethe intensity of light.The Mission® U120 UltraUrine Analyzer utilizes aCMOS image sensor tomeasure the intensity of light.
ThroughputSingle Test Mode: 60 tests/hourContinuous Test Mode: 120tests/hourSingle Test Mode: 55tests/hourContinuous Test Mode: 120tests/hour
MemoryLast 500 resultsLast 2000 results
PC PortStandard RS232C Port (cable notincluded)Standard RS232C Port (cablenot included),USB Port (cable not included);(Not connect to PC)Bluetooth Wireless
CapabilitiesInternal heat sensitive printer(included)25 Pin Parallel External PrinterPort (not included)External printer (optional)Internal thermal printerBarcode reader ConnectorExternal printer (optional)Barcode reader (optional)RJ45 Ethernet; (optional)
Power Source220 Volts AC (±10%), 50 Hz(±1),110 Volts AC (±10%), 60 Hz(±1),110-230 Volts AC, 50/60 Hz6 AA batteries with 100 tests/6new batteries; 100- 240VAC(adapter), (50-60 Hz±1HZ)
OptimumOperatingConditions15-30°C (59-86°F); ≤75%Relative Humidity (non-condensing)15-30°C (59-86°F); 20-80%Relative Humidity (non-condensing)
User InterfaceMKB Key based UITouch Screen based UI
Weight2.6 Kg (5.73 lbs.)≤1.66 kg (3.65 lbs.) withoutbatteries or power supply
Dimensions (L XW X H)27.1 (L) x 26.5 (W) x 14.6 (H)cm26.0 (L) x 15.0 (W) x 17.5 (H)cm
DisplayDimensions (L XW)240x128 blue and white,10.6 (W) x 2.8 (H) cmLarge touch screen Color LCDTFT 640x480,11.7 (W) x 8.8 (H) cm
AppearanceImage: Mission U120Image: Mission U120 Ultra

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Mission® Liquid Urine Controls and Mission® Liquid Diptube Urine Controls are substantially equivalent to ACON's 510k cleared - Mission® Liquid Urine Controls and Mission® Liquid Diptube Urine Controls (K103387)

FeatureMission® Liquid Urine Controls,Mission® Liquid Diptube UrineControlsMission® Liquid UrineControls, Mission® LiquidDiptube Urine Controls(K103387)
Intended/Indicationsfor UseFor use as an assayed qualitycontrol urine to monitor theprecision of urinalysis testprocedures for the analytes listedin the package insert.The Mission® Liquid UrineControl and Mission® LiquidDiptube Urine Control are foruse with the Mission® UrinalysisReagent Strips and Mission U120Ultra Urine AnalyzerFor use as an assayed qualitycontrol urine to monitor theprecision of urinalysis testprocedures for the analyteslisted in the package insert.The Mission® Liquid UrineControl and Mission® LiquidDiptube Urine Control are foruse with the Mission®Urinalysis Reagent Strips andMission U120 Urine Analyzer(K070929)
Levels2Same
FormLiquidSame

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AnalytesGlucose, Bilirubin, Ketone(Acetoacetic acid), SpecificGravity, Blood, pH, Protein,Urobilinogen, Nitrite,Leukocytes, and Ascorbic AcidSame
Storage2 to 8°CSame
MatrixLiquid Matrix SolutionSame
Open Vial24 months at 2-8°C30 Days at 15-30°CSame
PackagingConfigurationDropper, diptubeSame
Shelf Life24 months at 2-8°CSame

Discussion of Clinical Tests Performed:

Clinical studies were conducted using the Mission® U120 Ultra Urine Analyzer and Mission® Urinalysis Reagent strips. The purpose of the study was to evaluate the performance of Mission® Urinalysis Reagent strip read by Mission® U120 Ultra Urine Analyzer compared to the predicate: Mission® Urinalysis Reagent strip read by ACON U120 Urine Analyzer (K070929); and to observe if there is any problem/issue with operation of the Mission® Urinalysis Reagent strip / Mission® U120 Ultra Urine Analyzer when they are placed in the hands of the intended user.

Approximately 120 patient urine specimens were randomly collected from patients at each of 3 clinical sites, and tested by 3 intended users at each site (total of 9 users for all 3 sites) Each specimen was tested by Mission® Urinalysis Reagent strip read with Mission® U120 Ultra Urine Analyzers and Mission® Urinalysis Reagent strip read with Mission® U120 Urine Analyzers. Each intended user tested approximately the same number of specimens at each site. The study period at each site last over 3 months. In order to evaluate the performance with the analyte covering the measuring range, few contrived urine specimens were tested at each site following the study protocol.

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Additional study was carried out at 2 sites in US; a POC site and a specialty care office for inclusion of positive samples for the Nitrite, Urobilinogen, Ketone and Bilirubin analytes. Below is the summary of the specimens tested at all sites combined:

TestComparativeMethodN (includingcontrivedsamples)% ExactAgreement% Withinone levelAgreement
LeukocyteU120 Ultra vs U120Urine Analyzer46895.3%(446/468)100%(468/468)
NitriteU120 Ultra vs U120Urine Analyzer451100%(451/451)100%(451/451)
UroU120 Ultra vs U120Urine Analyzer42693.4%(398/426)100%(426/426)
ProU120 Ultra vs U120Urine Analyzer46892.7%(434/468)100%(468/468)
pHU120 Ultra vs U120Urine Analyzer46886.8%(406/468)100%(468/468)
BloU120 Ultra vs U120Urine Analyzer46893.8%(439/468)100%(468/468)
SGU120 Ultra vs U120Urine Analyzer46885.5%(400/468)100%(468/468)
KetoneU120 Ultra vs U120Urine Analyzer45896.4%(446/458)100%(458/458)
BilU120 Ultra vs U120Urine Analyzer45097.4%(444/450)100%(450/450)
GluU120 Ultra vs U120Urine Analyzer46895.7%(448/468)100%(468/468)
ASCU120 Ultra vs U120Urine Analyzer46890.0%(421/468)100%(468/468)

These clinical study and statistical data demonstrated that the intended user can follow the product instruction and obtain comparable instrument read results when using the Mission®U120 Ultra Urine Analyzer and a predicate Analyzer. The clinical study results indicate that the Mission®U120 Ultra Urine Analyzer is substantially equivalent to the legally marketed device ACON U120 Urine Analyzer.

Discussion of Performance Tests Performed:

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The performance characteristics of the Mission® U120 Ultra Urine Analyzer to read Mission® Urinalysis Reagent Strips were verified by Precision study, Interference study, Temperature flex study, voltage flex study, SG flex study, pH flex study, Humidity flex study, sensitivity study, stability study, electrical safety testing and EMC testing. Laboratory testing results indicate that the Mission® U120 Ultra Urine Analyzer is robust and can perform satisfactorily when used according to the "Indication for Use" statement specified in the Instruction Manual and Package Insert of the device.

Sensitivity Study:

The sensitivity of the Mission® Urinalysis Reagent Strips was determined in combination of the Mission® U120 Ultra Urine Analyzer. The low and high end range of sensitivity for Mission® Urinalysis Reagent Strips tested by Mission® U120 Ultra is listed in table below.

AnalyteColor blockLow end sensitivityHigh endsensitivity
Ascorbic Acid40 mg/dL30 mg/dL>40 mg/dL
Ascorbic Acid20 mg/dL15 mg/dL27.5 mg/dL
Ascorbic Acid10 mg/dL5 mg/dL13.5 mg/dL
Ascorbic Acid0 mg/dL0 mg/dL4.5 mg/dL
Glucose1000 mg/dL750 mg/dL>1000 mg/dL
Glucose500 mg/dL375 mg/dL675 mg/dL
Glucose250 mg/dL192.5 mg/dL337.5mg/dL
Glucose100 mg/dL50 mg/dL175 mg/dL
Glucose0 mg/dL0 mg/dL45mg/dL
Bilirubin4 mg/dL3 mg/dL>4 mg/dL
Bilirubin2 mg/dL1.5 mg/dL2.7 mg/dL
Bilirubin1 mg/dL0.4 mg/dL1.35 mg/dL
Bilirubin0 mg/dL0 mg/dL0.35 mg/dL
Ketone80 mg/dL60 mg/dL> 80 mg/dL
Ketone40 mg/dL27.5 mg/dL54 mg/dL
Ketone15 mg/dL11 mg/dL24.75 mg/dL

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5 mg/dL2.5 mg/dL10 mg/dL
0 mg/dL0 mg/dL2.25 mg/dL
Specific Gravity1.000~1.0301.0001.030
Blood200Ery/µL140 Ery/µL>200 Ery/µL
80 Ery/µL52.5 Ery/µL126 Ery/µL
25 Ery/µL12.5 Ery/µL47.25 Ery/µL
10 Ery/µL5 Ery/µL15.75 Ery/µL
0 Ery/µL0 Ery/µL4.5 Ery/µL
pH5.0~9.05.09.0
Protein300 mg/dL200 mg/dL>300 mg/dL
100 mg/dL65 mg/dL180 mg/dL
30 mg/dL22.5 mg/dL58.5 mg/dL
15 mg/dL7.5 mg/dL20.25 mg/dL
0 mg/dL0 mg/dL6.75 mg/dL
Urobilinogen8 mg/dL6 mg/dL>8 mg/dL
4 mg/dL3 mg/dL5.4 mg/dL
2 mg/dL1.5 mg/dL2.7 mg/dL
1 mg/dL0.6 mg/dL1.35 mg/dL
0.2mg/dL0 mg/dL0.54mg/dL
Nitrite0.1 mg/dL0.05mg/dL>0.1 mg/dL
0 mg/dL0 mg/dL0.045 mg/dL
Leukocyte500 Leu/µL312.5 Leu/µL>500 Leu/µL
125 Leu/µL97.5 Leu/µL281.25 Leu/µL
70 Leu/µL42.5 Leu/µL87.75 Leu/µL
15 Leu/µL9 Leu/µL38.25 Leu/µL
0 Leu/µL0 Leu/µL8.25 Leu/µL

Precision Study:

The reproducibility of the Mission® U120 Ultra Urine Analyzer was evaluated using 3 levels of Control Solutions. The target concentration of the analyte in each control solution was

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confirmed with Siemens reagent strips read by Clinitek Status urine analyzer and Mission® Urinalysis Reagent Strip read by ACON U120 urine analyzer. Each control solution was tested with one lot of strip in duplicates per run, 2 runs each day by one operator for 20 days. Second operator performed the test following the same protocol with second lot and second analyzer. A total of160 strips were used for each concentration tested (2 strips x 2 run x 20 days x 2 operators= 160 strips). The precision for each device was 100% exact agreement. The results are summarized as below.

ControlAnalyteAgreement at same blockAgreement within +/- one block
Level 1Ascorbic acid100% (160/160)100% (160/160)
Glucose100% (160/160)100% (160/160)
Bilirubin100% (160/160)100% (160/160)
Ketone100% (160/160)100% (160/160)
S.G.95.0% (152/160)100% (160/160)
Blood100% (160/160)100% (160/160)
pH97.5% (156/160)100% (160/160)
Protein100% (160/160)100% (160/160)
Urobilinogen100% (160/160)100% (160/160)
Nitrite100% (160/160)100% (160/160)
Level 2Leukocyte100% (160/160)
Ascorbic acid96.9% (155/160)100% (160/160)
Glucose98.1% (157/160)100% (160/160)
Bilirubin97.5% (156/160)100% (160/160)
Ketone98.1% (157/160)100% (160/160)
S.G.95.6% (153/160)100% (160/160)
Blood98.8% (158/160)100% (160/160)
pH96.9% (155/160)100% (160/160)
Protein96.9% (155/160)100% (160/160)
Urobilinogen97.5% (156/160)100% (160/160)
Nitrite100% (160/160)100% (160/160)
Leukocyte99.4% (159/160)100% (160/160)
Level 3Ascorbic acid100% (160/160)100% (160/160)
Glucose98.8% (158/160)100% (160/160)
Bilirubin98.1% (157/160)100% (160/160)
Ketone96.3% (154/160)100% (160/160)
S.G.94.4% (151/160)100% (160/160)
Blood99.4% (159/160)100% (160/160)
pH98.1% (157/160)100% (160/160)
Protein100% (160/160)100% (160/160)
Urobilinogen98.1% (157/160)100% (160/160)
Nitrite100% (160/160)100% (160/160)
Leukocyte98.1% (157/160)100% (160/160)

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Precision Studies were also performed by testing each level of control solution by a single operator in 20 replicates per run per day with each lot on U120 Ultra. Operator 3 followed the same procedure with different lots of strips on different Mission® U120 Ultra Analyzers. A total of 180 strips were used for each concentration tested (20 strips x 3 lots x 3 analyzers (3 operators) x 1day = 180 strips. The precision for each device was 100% exact agreement. The results are summarized as below.

Control LevelAnalyteAgreement at same blockAgreement within +/- one block
Ascorbic acid100% (180/180)100% (180/180)
Glucose100% (180/180)100% (180/180)
Bilirubin100% (180/180)100% (180/180)
Ketone100% (180/180)100% (180/180)
S.G.95.6% (172/180)100% (180/180)
Level 1Blood100% (180/180)100% (180/180)
pH97.2% (175/180)100% (180/180)
Protein100% (180/180)100% (180/180)
Urobilinogen100% (180/180)100% (180/180)
Nitrite100% (180/180)100% (180/180)
Leukocyte100% (180/180)100% (180/180)

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Ascorbic acid97.8% (176/180)100% (180/180)
Glucose96.7% (174/180)100% (180/180)
Bilirubin97.2% (175/180)100% (180/180)
Ketone97.2% (175/180)100% (180/180)
S.G.92.2% (166/180)100% (180/180)
Level 2Blood95.6% (172/180)100% (180/180)
pH93.9% (169/180)100% (180/180)
Protein97.2% (175/180)100% (180/180)
Urobilinogen95.5% (172/180)100% (180/180)
Nitrite100% (180/180)100% (180/180)
Leukocyte98.3% (177/180)100% (180/180)
Ascorbic acid98.9% (178/180)100% (180/180)
Glucose93.3% (168/180)100% (180/180)
Bilirubin97.2% (175/180)100% (180/180)
Ketone97.8% (176/180)100% (180/180)
S.G.97.8% (176/180)100% (180/180)
Level 3Blood96.7% (174/180)100% (180/180)
pH93.9% (169/180)100% (180/180)
Protein98.9% (178/180)100% (180/180)
Urobilinogen97.8% (176/180)100% (180/180)
Nitrite100% (180/180)100% (180/180)
Leukocyte97.8% (176/180)100% (180/180)

Interference Substances:

The effect of interfering substances commonly found in urine on Mission® Urinalysis Reagent Strips when read by Mission® U120 Ultra Urine Analyzers was studied by preparing 3 levels of controls for each analyte present in the urine and tested with one urine strip on one analyzer following the product insert. Total 3 lots of urine test strips and 3 urine analyzers were used for the study. The following substances were found to interfere with the testing results.

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Reagent padInterferencesubstancesConc.U120 Ultra analyzer
GlucoseAscorbic acid≥25 mg/dLFalse decreased results
GlucoseKetone (Acetoacetate)≥100 mg/dLFalse decreased results
BilirubinAscorbic acid≥50 mg/dLFalse decreased results
BilirubinBlood≥5%False increased results
KetoneBlood≥5%False increased results
Specific gravityProtein (Albumin)≥300 mg/dLFalse increased results
BloodAscorbic acid≥50 mg/dLFalse decreased results
UrobilinogenNitrite≥10 mg/dLFalse decreased results
ProteinHemoglobin≥20 mg/dLFalse increased results
ProteinBlood≥0.05%False increased results
UrobilinogenBlood≥5%False increased results
NitriteAscorbic acid≥30 mg/dLFalse decreased results
NitriteBlood≥1%False increased results
LeukocyteGlucose≥2000 mg/dLFalse decreased results
LeukocyteBlood≥0.05%False increased results

Temperature Flex Study:

The optimal temperature range for performing the test of Mission® Urinalysis Reagent Strip by Mission® U120 Ultra Urine Analyzer was validated at temperature 2°C to 45°C by performing the test at different temperatures in 5 replicates for each sample.

Humidity Flex Study:

50 strips were stored in different humidity environments and tested with Mission® U120 Ultra Urine Analyzer at different time points. The time that the strips was stable after exposed to the different storage condition is listed in the following table:

Reagent stripsHumidity of the storage conditionsThe time that the strips was stable afterexposed to the different storagecondition
Ascorbic acid<20%>24h
30-50%>24h
60-70%>24h
>80%>24h
Glucose<20%>24h
30-50%>24h
60-70%8h
>80%4h
Bilirubin<20%>24h
30-50%>24h
60-70%>24h
>80%>24h
Ketone<20%>24h
30-50%16h
60-70%2h
>80%2h
Specific Gravity<20%>24h
30-50%>24h
60-70%>24h
>80%>24h
Blood<20%>24h
30-50%>24h
60-70%16h
>80%4h
pH<20%>24h
30-50%>24h
60-70%>24h
>80%>24h
Protein<20%>24h
30-50%>24h
60-70%>24h
>80%>24h
Urobilinogen<20%>24h
30-50%>24h
60-70%>24h
>80%>24h
Nitrite<20%>24h
30-50%16h
60-70%1h
>80%0.5h
Leukocyte<20%>24h
30-50%>24h
60-70%>24h
>80%8h

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Voltage Flex Study:

The voltage flex study was performed using Mission® Liquid urine control, Level 1(normal) and Level 2 (abnormal) on analyzers supplied with the following voltages: 86V, 100V and 264V. 220V was also tested as the baseline control condition. Three analyzers were turned on using each of the voltage, and tested to see if the analyzer works properly. The analyzers were tested three times under each voltage. Mission® U120 Ultra urine analyzer can operate properly under 86V, 100V and 264V, and the test results are comparable to those of the 220V baseline control results. In conclusion, the range from 86V to 264V is suitable for operation of the Mission® U120 Ultra urine analyzer.

pH Flex Study:

5 normal fresh urines were collected and mixed. The mixed urine was tested with Siemens Clinitek Status and ACON U120 urine analyzer to determine the concentrations in the pooled urine. The Leu, Nit, Uro, Pro, Blo, Ket, Bil, Glu and Asc in the pooled urine were negative with pH at 6.5 and SG at 1.010. The mixed urine samples were split into five aliquots (150 ml / each glass container). Adjust these five aliquots urine pH to 5, 6, 7, 8, 9 with 1M Hydrochloric acid aqueous and 1M Sodium hydroxide aqueous. Then spiked analytes to different concentration as control Level 1, Level 2 and Level 3 listed in the table. The concentrations of each analyte in the control at pH 6 were confirmed with 510(k) cleared Siemens Clinitek Status and U120 urine analyzer, the results were used as expected values. Test these control solutions

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with Mission® Urinalysis Reagent strips by Mission U120 Ultra analyzer following the product inserts. 5 replicates were tested for each sample.

Sample pH from 5.0 to 9.0 does not affect the results of Urobilinogen, Ketone, Bilirubin, and Glucose tests. Sample pH>8 would generate false high results on Protein test. Sample pH>9 would generate false high results on Leukocyte and Specific Gravity test, and false low results on Nitrite, Blood, Ascorbic acid test.

Urine Controls Validation:

Value Assignment

Control value assignment for the Mission Liquid Urine Control and Mission Liquid Diptube Urine Control was done by testing Level 1 and Level 2 using the Mission Urinalysis Reagent Strips tested on the Mission U120 Ultra Urine analyzer. Three lots of strips and three analyzers were tested for three consecutive days by three operators. All results for level 1 were negative except for SG and pH which should be +/- 2 color blocks of target results and all results for level 2 showed positive results except for ascorbic acid.

Stability Studies

Accelerated, Real Time and Open Stability studies were performed to test the shelf life of Mission Liquid Urine Control and Mission Liquid Diptube Urine Control under different conditions. Accelerated stability study confirmed that the product is stable at 2-8℃ for 24 months when stored properly in unopened bottles. Real Time Stability study confirmed the shelf life of the controls is 24 month. Open Canister Stability study confirmed that the controls remain stable for up to 30 days at 15-30°C and 24months at 2-8°C after being opened.

Conclusion:

The laboratory testing results and clinical studies demonstrate that the Mission® U120 Ultra Urine Analyzer is safe, effective and easy-to-use and such is substantially equivalent to the ACON U120 Urine Analyzer (K070929), currently sold on the U.S. market for professional (point-of-care) testing.

§ 862.2900 Automated urinalysis system.

(a)
Identification. An automated urinalysis system is a device intended to measure certain of the physical properties and chemical constituents of urine by procedures that duplicate manual urinalysis systems. This device is used in conjunction with certain materials to measure a variety of urinary analytes.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 862.9.