K Number
K142964
Device Name
VALIDATE Anemia Calibration Verification/ Linearity Test Kit
Date Cleared
2015-04-30

(198 days)

Product Code
Regulation Number
862.1660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
VALIDATE® Anemia Calibration Verification/Linearity Test Kit solutions are intended for in vitro diagnostic use in the quantitative determination of linearity, calibration and verification of reportable range for the following analytes: Ferritin Set: ferritin (FERR), Vitamin B12(VITB) and folate (FOL), on automated instrument systems. The product is intended for use with quantitative assays on the indicated analyzers specified in the labeling.
Device Description
Each VALIDATE® Anemia Calibration Verification / Linearity Test Kit contains two analyte sets of purified chemicals in a human serum base. The kit includes a Ferritin set containing five liguid levels, 3.0mL each, and a Vitamin B12/Folate set containing five liquid levels, 4.0 mL each. The sets are provided to establish the relationship between theoretical and actual performance of the included analytes: Ferritin, Vitamin B12 and Folate. Material of human origin used in the manufacture of this test kit was tested at the donor level using FDA approved methods and was found to be non-reactive for HBsAG and to antibodies to HCV and HIV-1/2.
More Information

Not Found

No
The summary describes a calibration and linearity test kit for in vitro diagnostic use, which is a chemical reagent product. There is no mention of software, algorithms, or any technology that would typically incorporate AI/ML. The performance studies focus on linearity and comparison to a predicate device, not on the performance of an AI/ML model.

No.
This device is an in vitro diagnostic (IVD) test kit used for calibrating and verifying the performance of automated instrument systems for measuring specific analytes, not for treating patients.

No

Explanation: This device is a calibration verification and linearity test kit used to verify the performance of automated instrument systems that measure specific analytes (Ferritin, Vitamin B12, and Folate). It is not directly used to diagnose a patient's condition but rather to ensure the accuracy of diagnostic instruments.

No

The device is a physical kit containing liquid solutions for calibrating and verifying laboratory instruments, not a software program.

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

Here's why:

  • Intended Use: The "Intended Use / Indications for Use" section explicitly states that the solutions are "intended for in vitro diagnostic use".
  • Device Description: The device is a "Test Kit" containing solutions used to verify the performance of automated instrument systems that perform quantitative diagnostic assays.
  • Performance Studies: The performance studies compare the device to a "predicate device" which is also a "Calibration Verification / Linearity Test Kit", indicating its use in a diagnostic context.

The device is used to verify the accuracy and linearity of diagnostic tests performed on automated analyzers, which is a key function within the field of in vitro diagnostics.

N/A

Intended Use / Indications for Use

VALIDATE® Anemia Calibration Verification/Linearity Test Kit solutions are intended for in vitro diagnostic use in the quantitative determination of linearity, calibration and verification of reportable range for the following analytes: Ferritin Set: ferritin (FERR), Vitamin B12(VITB) and folate (FOL), on automated instrument systems. The product is intended for use with quantitative assays on the indicated analyzers specified in the labeling.

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

JJY

Device Description

Each VALIDATE® Anemia Calibration Verification / Linearity Test Kit contains two analyte sets of purified chemicals in a human serum base. The kit includes a Ferritin set containing five liguid levels, 3.0mL each, and a Vitamin B12/Folate set containing five liquid levels, 4.0 mL each. The sets are provided to establish the relationship between theoretical and actual performance of the included analytes: Ferritin, Vitamin B12 and Folate. Material of human origin used in the manufacture of this test kit was tested at the donor level using FDA approved methods and was found to be non-reactive for HBsAG and to antibodies to HCV and HIV-1/2.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

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

The performance of the new VALIDATE® Anemia Calibration Verification / Linearity Test Kit was compared to the predicate device K133550, VALIDATE® Ferritin Calibration Verification / Linearity Test Kit.
Value Assignment: VALIDATE® Anemia Calibration Verification / Linearity Test Kits are manufactured such that an equal relationship exists among Levels 1 through 5; Level 1 being the lowest concentration and Level 5 being the highest. Levels 1 and 5 are prepared independently by the addition of Ferritin, Vitamin B12 and Folate to a human serum base. The VALIDATE® Anemia Calibration Verification / Linearity Test Kit was tested on the Roche Cobas and Beckman Access analyzers to confirm adeguate recovery across all levels. Levels 1 through 5 must meet specified Ferritin, Vitamin B12 and Folate targes at all stages of testing. Specific recovery targets for Levels 1 through 5 are determined by the upper and lower detection limits for each analyte. Intermediate 2, 3, and 4 are subsequently prepared from Levels 1 and 5 by equal part dilutions following EP6-A guidelines. Typical value ranges are provided in the package insert. All stated recovery values met internal pre-determined acceptance criteria.
Stability: Stability testing was performed using the Beckman Coulter® Access II and Roche COBAS 6000 instrument systems. The study testing time points included date of manufacture (DOM), followed by testing at specific intervals post manufacture. The last testing event is one month post-expiration. Acceptance criteria are defined as 90 to 110% of DOM value for product levels 2-5. A freeze/thaw stability assessment was also conducted in support of the product package insert four (4) freeze/thaw events claim. All product levels tested within the 90 to 110% of control acceptance criteria limits after 6 freeze/thaw events.
Linearity: Linearity testing was carried out with the candidate device VALIDATE® Anemia Calibration Verification / Linearity Test Kits using a Roche® Cobas 6000 Chemistry Analyzer and Beckman-Coulter® Access II Immunochemistry Analyzer. Product linearity performance was demonstrated for both automated systems. All supporting data for all three analytes is retained on file at Maine Standards Company LLC.

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

Not Found

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

K133550

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

Not Found

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

Not Found

§ 862.1660 Quality control material (assayed and unassayed).

(a)
Identification. A quality control material (assayed and unassayed) for clinical chemistry is a device intended for medical purposes for use in a test system to estimate test precision and to detect systematic analytical deviations that may arise from reagent or analytical instrument variation. A quality control material (assayed and unassayed) may be used for proficiency testing in interlaboratory surveys. This generic type of device includes controls (assayed and unassayed) for blood gases, electrolytes, enzymes, multianalytes (all kinds), single (specified) analytes, or urinalysis controls.(b)
Classification. Class I (general controls). Except when intended for use in donor screening tests, quality control materials (assayed and unassayed) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.

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Image /page/0/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features the department's name arranged in a circular fashion around a symbol. The symbol consists of a stylized caduceus-like design, with three human profiles facing right, representing health and human services.

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

MAINE STANDARDS COMPANY LLC JAMES CHAMPLIN MANAGER, QA & RA 221 US ROUTE 1 CUMBERLAND FORESIDE, ME 04110

April 30, 2015

Re: K142964

Trade/Device Name: VALIDATE® Anemia Calibration Verification/ Linearity Test Kit Regulation Number: 21 CFR 862.1660 Regulation Name: Quality control material (assayed and unassayed) Regulatory Class: I. Reserved Product Code: JJY Dated: April 1, 2015 Received: April 2, 2015

Dear James Champlin:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food. Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Parts 801 and 809); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

1

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/Resourcesfor You/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) K142964

Device Name

VALIDATE® Anemia Calibration Verification/Linearity Test Kit

Indications for Use (Describe)

VALIDATE® Anemia Calibration Verification/Linearity Test Kit solutions are intended for in vitro diagnostic use in the quantitative determination of linearity, calibration and verification of reportable range for the following analytes: Ferritin Set: ferritin (FERR), Vitamin B12(VITB) and folate (FOL), on automated instrument systems. The product is intended for use with quantitative assays on the indicated analyzers specified in the labeling.

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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"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: K142964

A. Submitter:

Maine Standards Company LLC 221 US Route 1 Cumberland Foreside, ME 04110 Telephone: 207-892-1300 Fax: 207-892-2266

Contact Person: James Champlin Manager, Quality Assurance & Requlatory Affairs ichamplin@mainestandards.com 207-892-1300 Ext. 29 Telephone:

Date of Summary Preparation: April 24, 2015

B. Device Classification:

Device classification name:Quality control material (assayed and un-assayed)*
Common name:Calibration Verification / Linearity Test Kit
Proprietary Name:VALIDATE® Anemia Calibration Verification / Linearity Test Kit
Review Panel:Clinical Chemistry 75
Regulation Number:21 CFR 862.1660
Product Code:JJY
Regulatory Class:Class I Reserved

C. Predicate Device Identification:

VALIDATE® Ferritin Calibration Verification / Linearity Test Kit Maine Standards Company LLC, Cumberland Foreside, ME 04110. 510(k) Number: K133550

D. Candidate Device description: Each VALIDATE® Anemia Calibration Verification / Linearity Test Kit contains two analyte sets of purified chemicals in a human serum base. The kit includes a Ferritin set containing five liguid levels, 3.0mL each, and a Vitamin B12/Folate set containing five liquid levels, 4.0 mL each. The sets are provided to establish the relationship between theoretical and actual performance of the included analytes: Ferritin, Vitamin B12 and Folate. Material of human origin used in the manufacture of this test kit was tested at the donor level using FDA approved methods and was found to be non-reactive for HBsAG and to antibodies to HCV and HIV-1/2.

E. Intended use: VALIDATE® Anemia Calibration Verification / Linearity Test Kit solutions are intended for in vitro diagnostic use in the quantitative determination of linearity, calibration verification and verification of reportable range for the following analytes: Ferritin Set: Ferritin (FERR), Vitamin B12 / Folate Set: Vitamin B12 (VIT B) and Folate (FOL), on automated instrument systems. The product is intended for use with quantitative assays on the indicated analyzers specified in the labeling.

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F. Summary of Performance Data:

The performance of the new VALIDATE® Anemia Calibration Verification / Linearity Test Kit was compared to the predicate device K133550, VALIDATE® Ferritin Calibration Verification / Linearity Test Kit. Table 1 compares the technical characteristics of the new VALIDATE® Anemia Calibration Verification / Linearity Test Kit with those of the predicate VALIDATE® Ferritin Calibration Verification / Linearity Test Kit.

Table 1 - Technical Comparison to Predicate
New DevicePredicate (K133550)
VALIDATE® Anemia Calibration
Verification / Linearity Test KitVALIDATE® Ferritin Calibration
Verification / Linearity Test Kit
Similarities
Test KitCalibration Verification Test KitSame
Intended UseFor in vitro diagnostic use in the
quantitative determination of
linearity, calibration verification
and verification of reportable
range in automated instrument
systemsSame
PreparationLiquid, ready to useSame
StabilityUntil expiration dateSame
Storage-10 to -25°CSame
MatrixHuman serum baseSame
Number of Levels5 levelsSame
Differences
AnalytesFerritin, Vitamin B12 and FolateFerritin
Packaging3.0 mL each level Ferritin Set
4.0 mL each level Vitamin B12/
Folate Set3.0 mL each level

Table 1 - Technical Comparison to Predicate

Value Assignment

VALIDATE® Anemia Calibration Verification / Linearity Test Kits are manufactured such that an equal relationship exists among Levels 1 through 5; Level 1 being the lowest concentration and Level 5 being the highest. Levels 1 and 5 are prepared independently by the addition of Ferritin, Vitamin B12 and Folate to a human serum base. The VALIDATE® Anemia Calibration Verification / Linearity Test Kit was tested on the Roche Cobas and Beckman Access analyzers to confirm adeguate recovery across all levels. Levels 1 through 5 must meet specified Ferritin, Vitamin B12 and Folate targes at all stages of testing.

Specific recovery targets for Levels 1 through 5 are determined by the upper and lower detection limits for each analyte. Intermediate 2, 3, and 4 are subsequently prepared from Levels 1 and 5 by equal part dilutions following EP6-A guidelines. Typical value ranges are provided in the package insert. All stated recovery values met internal pre-determined acceptance criteria.

Typical recovery values for Low Levels and High Levels, established via an internal protocol, are presented in Table 1. Typical values for Mid-Levels are calculated based on an equal distance (delta) between levels. Any level result showing no value is above the method's reportable range. Due to the analytical differences of immunoassays on different instrument systems, these ranges are to be used as a guide only. Expected target values may change depending on instrumentation and methodology.

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| Table
1

I
-------------------
Ferritin Set
Levels
InstrumentAnalyteUnits12345
Beckman
Access/DxlFERRng/mL1.93486941,0401,386
Roche
Cobas/ElecsysFERRng/mL3.04659261,3881,850
Vitamin B12 / Folate Set
Levels
InstrumentAnalyteUnits12345
Beckman
Access/DxIVIT B12pg/mL684628551,248N/A
Roche
Cobas/ElecsysVIT B12pg/mL835159471,3801,812
Beckman
Access/DxlFOLng/mL1.1471013

The quantitative determination of linearity, calibration, and verification of reportable range relies on the known relationship between each of the levels of the product (in this case equal deltas as outlined in the CLSI EP6A referenced standard) not on an expected value.

Traceability

This product is traceable to a reference standard based on the automated instrument platform it is used on. The traceability of our product will be established per the respective end user automated instrument calibrator traceability reference statement.

Stability

Stability testing was performed using the Beckman Coulter® Access II and Roche COBAS 6000 instrument systems. The study testing time points included date of manufacture (DOM), followed by testing at specific intervals post manufacture. The last testing event is one month post-expiration. Acceptance criteria are defined as 90 to 110% of DOM value for product levels 2-5.

A freeze/thaw stability assessment was also conducted in support of the product package insert four (4) freeze/thaw events claim. All product levels tested within the 90 to 110% of control acceptance criteria limits after 6 freeze/thaw events.

Shelf Life Claim: Stability of the VALIDATE® Anemia Calibration Verification / Linearity Test Kit was set at 12 months based on real-time open vial studies as a worst case scenario. The recommended storage temperature is -10 to -25°C. All supporting data is retained on file at Maine Standards Company LLC.

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Linearity:

Linearity testing was carried out with the candidate device VALIDATE® Anemia Calibration Verification / Linearity Test Kits using a Roche® Cobas 6000 Chemistry Analyzer and Beckman-Coulter® Access II Immunochemistry Analyzer. Product linearity performance was demonstrated for both automated systems. All supporting data for all three analytes is retained on file at Maine Standards Company LLC.

G. Conclusion:

Based upon the purpose of the device, the descriptions and labeling of the predicate device, the VALIDATE® Anemia Calibration Verification / Linearity Test Kit behaves substantially equivalent to the predicate for the evaluation of calibration verification, verification of reportable range. The product is substantially equivalent to the predicate device K133550.