K Number
K143636
Device Name
IMMULITE 2000 Androstenedione Calibration Verification Material, IMMULITE 2000 Troponin I Calibration Verification Material
Date Cleared
2015-02-25

(65 days)

Product Code
Regulation Number
862.1660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
IMMULITE® 2000 Androstenedione Calibration Verification Material (CVM) is for in vitro diagnostic use in the verification of calibration of the IMMULITE Androstenedione assay on the IMMULITE 2000 systems IMMULITE® 2000 Troponin I Calibration Material (CVM) is for in vitro diagnostic use in the verification of calibration of the IMMULITE Troponin I assay on the IMMULITE 2000 systems
Device Description
The IMMULITE® 2000 Androstenedione Calibration Verification Material (CVM) contains one set of four vials each 2mL in liquid form. CVM1 contains processed human serum with preservatives. CVM2, CVM3 and CVM4 contain androstenedione in processed human serum matrix with preservative. The IMMULITE® 2000 Troponin I Calibration Verification Material (CVM) contains one set of four vials, 2mL each after reconstitution. CVM1 contains equine serum with 0.88% sodium azide and preservative. CVM2, CVM3 and CVM4 contain human Troponin I and rabbit Troponin C in equine serum matrix with 0.88% sodium azide and preservative.
More Information

Not Found

No
The document describes calibration verification materials for laboratory assays, which are chemical reagents used to check the accuracy of the instrument's calibration. There is no mention of AI or ML in the intended use, device description, or performance studies. The performance studies focus on stability, traceability, and value assignment of the chemical materials.

No
This device is an in vitro diagnostic (IVD) calibration verification material, used to verify the calibration of assays on an analytical system, not to treat a condition.

No
This device is a calibration verification material used to verify the calibration of a diagnostic assay (IMMULITE Androstenedione assay on the IMMULITE 2000 systems), not a diagnostic device itself.

No

The device description explicitly states the device is in liquid form and contains processed human/equine serum and other chemical components, indicating it is a physical material, not software.

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

The "Intended Use / Indications for Use" section explicitly states:

  • "IMMULITE® 2000 Androstenedione Calibration Verification Material (CVM) is for in vitro diagnostic use..."
  • "IMMULITE® 2000 Troponin I Calibration Material (CVM) is for in vitro diagnostic use..."

This directly indicates that the device is intended for use in diagnostic procedures performed outside of the living body.

N/A

Intended Use / Indications for Use

IMMULITE® 2000 Androstenedione Calibration Verification Material (CVM) is for in vitro diagnostic use in the verification of calibration of the IMMULITE Androstenedione assay on the IMMULITE 2000 systems.

IMMULITE® 2000 Troponin I Calibration Material (CVM) is for in vitro diagnostic use in the verification of calibration of the IMMULITE Troponin I assay on the IMMULITE 2000 systems.

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

JJX

Device Description

The IMMULITE® 2000 Androstenedione Calibration Verification Material (CVM) contains one set of four vials each 2mL in liquid form. CVM1 contains processed human serum with preservatives. CVM2, CVM3 and CVM4 contain androstenedione in processed human serum matrix with preservative.

The IMMULITE® 2000 Troponin I Calibration Verification Material (CVM) contains one set of four vials, 2mL each after reconstitution. CVM1 contains equine serum with 0.88% sodium azide and preservative. CVM2, CVM3 and CVM4 contain human Troponin I and rabbit Troponin C in equine serum matrix with 0.88% sodium azide and preservative.

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

For prescription use only

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)

IMMULITE® 2000 Androstenedione Calibration Verification Material:
Stability Study:
The stability study was conducted to validate real-time shelf life and open component (in-use or open vial) claim for the IMMULITE 2000 Androstenedione Calibration Material (CVM).
Summary: The Calibration Verification Materials are stable up to 3 years when stored at -20℃ prior to opening. Open Component stability studies presents results that support 8 hours of stability at ambient or room temperature (15-25°C).
Protocol (Real-time): CVM study protocols are run as part of the calibrator stability testing. Stability calibrators/CVMs are run in duplicate (as a minimum) at time points Day 0, 15, 27, 38 months.
Protocol (Open Component): CVM lot 006 was tested at 2-hourly intervals for up to 9 hours at ambient or room temperature (15-25°C) conditions.
Acceptance Criteria: For CVM level 2 and 3, ±10% difference to time 0. For CVM level 4, ±13% difference to time 0. CVM1: ≤ 0.3.

Traceability: The IMMULITE Androstenedione CVMs are traceable to an internal material which has been gravimetrically prepared.

Value Assignment: The IMMULITE Androstenedione CVMs are 4 level materials which are a subset of 7 level Androstenedione calibrators. CVMs are manufactured using qualified materials and measurement procedures. CVMs dose values are generated using curve generated by assigned reference calibrators. CVM values are calculated based on the recovered values for each instrument independently and then averaged across all systems. Quality control is performed by calculating the recovery of patient samples, spiked patient samples and controls using the assigned CVM values.
Testing for Value Assignment: Four levels of commercially available controls and 28 samples (10 normal female serum samples and 18 spiked samples) were used to validate calibrator/CVM value assignments.

Expected Values/Target Values/Reference Range: Each CVM level was tested for a total of 27 replicates; 9 runs and 3 replicates per run, 3 different reagent kit lots and 8 IMMULITE 2000 systems. The Guideline Range (95% confidence interval) for each CVM level was established based on the Target Mean and ± 2 Standard Deviation (SD). The expected assay range is 0.3 to 10 ng/mL.

IMMULITE® 2000 Troponin I Calibration Verification Material:
Stability Study:
The stability study was conducted to validate real-time shelf life and open component (in-use or open vial) claim for the IMMULITE 2000 Troponin I Calibration Material (CVM).
Summary: The Calibration Verification Materials are stable up to 10 months when stored at -20°C prior to opening, and for 2 hours at ambient or room temperature (15-25°C) after reconstitution.
Protocol (Real-time): CVM study protocols are run as part of the calibrator stability testing. Stability CVMs and reference CVMs are run in duplicate (as a minimum) at time points Day 0, 3, 9, 10 months.
Protocol (Open Component): CVM lot 090 was tested at 2-hourly intervals for up to 9 hours at ambient or room temperature (15-25°C) conditions.
Acceptance Criteria: ±10% difference to time 0 for CVM levels 2, 3 and 4. CVM1: ≤0.20.

Traceability: The IMMULITE Troponin I CVMs are traceable to an internal standard which has been gravimetrically prepared.

Value Assignment: The IMMULITE Troponin I CVMs are 4 level materials which are a subset of 10 level Troponin I calibrators. CVMs are manufactured using qualified materials and measurement procedures. CVMs dose values are generated using curve generated by assigned reference calibrators. CVM values are calculated based on the recovered values for each run on each instrument independently and then averaged across all systems. Quality control is performed by calculating the recovery of patient samples and controls using the assigned CVM values.
Testing for Value Assignment: Three levels of commercially available controls and 25 spiked samples were used to validate calibrator/CVM value assignments.

Expected Values/Target Values/Reference Range: The CVMs were tested on 15 replicates in total comprised of 5 runs and 3 replicates per run on 4 IMMULITE 2000 systems and 2 different reagent kit lots. The Guideline Range (95% confidence interval) for each CVM level was established based on the Target Mean and ± 2 Standard Deviation (SD). The expected assay range is up to 180 ng/mL.

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.

K141444, K140818

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.

0

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract image of a stylized caduceus, which is a symbol of medicine and healthcare. The caduceus is composed of three intertwined lines that form the shape of a bird or a wing.

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

SIEMENS HEALTHCARE DIAGNOSTICS, INC. DONNA VELASQUEZ 5210 PACIFIC CONCOURSE DRIVE LOS ANGELES CA 90045

February 25, 2015

Re: K143636 Trade/Device Name: IMMULITE® 2000 Androstenedione Calibration Verification Material, IMMULITE® 2000 Troponin I Calibration Verification Material Regulation Number: 21 CFR 862.1660 Regulation Name: Quality control material (assayed and unassayed) Regulatory Class: I. Reserved Product Code: JJX Dated: December 19, 2014 Received: December 22, 2014

Dear Ms. Donna Velasquez:

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 -A

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

2

Indications for Use

510(k) Number (if known) K143636

Device Name

IMMULITE® 2000 Androstenedione Calibration Verification Material

Indications for Use (Describe)

IMMULITE® 2000 Androstenedione Calibration Verification Material (CVM) is for in vitro diagnostic use in the verification of calibration of the IMMULITE Androstenedione assay on the IMMULITE 2000 systems

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

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

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

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

3

Indications for Use

510(k) Number (if known) K143636

Device Name

IMMULITE® 2000 Troponin I Calibration Verification Material

Indications for Use (Describe)

IMMULITE® 2000 Troponin I Calibration Material (CVM) is for in vitro diagnostic use in the verification of calibration of the IMMULITE Troponin I assay on the IMMULITE 2000 systems

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

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

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

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

4

510(k) Summary

Introduction: According to the requirements of 21 CFR 807.92, the following information provides sufficient details to understand the basis for determination of substantial equivalence.

The assigned 510(k) Number: K143636

1.Submitter
Mailing Address:Siemens Healthcare Diagnostics Inc.
5210 Pacific Concourse Drive
Los Angeles, CA 90045
Contact Person:Donna Velasquez
Regulatory Technical Specialist
Phone Number:(310)-645-8200 x7403
Fax Number:(310)-645-9999
E-mail Address:donna.velasquez@siemens.com
Date Prepared:January 22, 2015
2. Device Name
Proprietary Name:IMMULITE® 2000 Androstenedione Calibration Verification
Material
Measurand:Quality Control materials for IMMULITE® 2000 Androstenedione
assay
Type of Test:Calibration Verification Material (CVM) for IMMULITE® 2000
Androstenedione assay
Regulation Section:21 CFR 862.1660, Quality Control Material
Classification:Class I Reserved
Products Code:JJX - Single (Specified) Analyte Controls (Assayed and
Unassayed)
Panel:Clinical Chemistry (75)
3. Predicate Device NameIMMULITE® 2000 Cortisol Calibration Verification Material
(CVM)
Predicate 510(k) No:K141444
4. Device Description:The IMMULITE® 2000 Androstenedione Calibration Verification
Material (CVM) contains one set of four vials each 2mL in liquid
form. CVM1 contains processed human serum with preservatives.
CVM2, CVM3 and CVM4 contain androstenedione in processed
human serum matrix with preservative.
5. Intended Use:
Indication for Use:See Indications for Use Statement below
The IMMULITE® 2000 Androstenedione Calibration
Verification Material (CVM) is for in vitro diagnostic use in the
verification of calibration of the IMMULITE Androstenedione
assay on the IMMULITE 2000 systems
Special Conditions for
Use Statement(s):For prescription use only

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Image /page/5/Picture/0 description: The image shows the word "SIEMENS" in a bold, sans-serif font. The color of the text is a bright teal. The letters are evenly spaced and the word is horizontally oriented. The image appears to be a logo or brand name.

Special Instrument Requirements:

IMMULITE® 2000 Systems

6. Technological Characteristics and Substantial Equivalence Comparison with Predicate:

A comparison of the device features, intended use, and other information demonstrates that the IMMULITE® 2000 Androstenedione Calibration Verification Material (CVM) is substantially equivalent to the predicate device as summarized in Table 1.

SIMILARITIES
Candidate Device
IMMULITE 2000 Androstenedione
CVMPredicate Device
IMMULITE 2000 Cortisol CVM
Intended
UseThe IMMULITE® 2000
Androstenedione Calibration
Verification Material
(CVM) is for in vitro diagnostic use
in the verification of calibration of the
IMMULITE Androstenedione assay
on the IMMUL-DPC2000 systems.The IMMULITE® Cortisol
Calibration Verification Material
(CVM) is for in vitro diagnostic use in
the verification of calibration of the
IMMULITE Cortisol assay on the
IMMULITE 2000 systems
StorageSame
FormLiquidSame
StabilityStable unopened until the
expiration dateSame
Levels4Same
MatrixHuman Serum with preservativesSame
UseSingle Use OnlySame
DIFFERENCES
Candidate Device
IMMULITE 2000 Androstenedione
CVMPredicate Device
IMMULITE 2000 Cortisol CVM
AnalyteAndrostenedioneCortisol

Table 1: Substantial Equivalence Comparison

7. Non-Clinical Performance Testing

Performance testing has been carried out to demonstrate that this device meets the performance Specifications for its intend use. The following tests were performed on the candidate device.

Stability Summary:

The stability study was conducted to validate real-time shelf life and open component (in-use or open vial) claim for the IMMULITE 2000 Androstenedione Calibration Material (CVM) to ensure that it maintains optimal product performance on IMMULITE 2000 platforms throughout the established shelf life of the CVM. The Calibration Verification Materials are stable up to 3 years when stored at -20℃ prior to opening.

6

Open Component stability studies presents results that support 8 hours of stability at ambient or room temperature (15-25°C).

Stability Protocol Summary:

The CVM study protocols are run as part of the calibrator stability testing. The stability calibrators/CVMs are run in duplicate (as a minimum) at the time points shown in Table 2, and the dose value is determined from the reference calibrator curve.

CVM LevelTime-Points (Months)
LAOCVM1Day 0152738
LAOCVM2Day 0152738
LAOCVM3Day 0152738
LAOCVM4Day 0152738

Table 2: Stability Protocol Summary - LAOCVM Lot 006

For Open Component testing, the results were determined from a 2-point adjustment. Using IMMULITE 2000 Androstenedione (L2KAO) kit lot 336, CVM lot 006 was tested at 2-hourly intervals for up to 9 hours at ambient or room temperature (15-25°C) conditions.

Stability Acceptance Criteria Summary:

The Acceptance Criteria for the IMMULITE Androstenedione Calibration Verification Material (CVM) real time and open component stability testing is applied to dose compared to dose at time point zero. The result is required to fall between ±10% for CVM level 2 and 3 and ±13% for CVM level 4 as shown in Table 3.

Table 3: Acceptance criteria for stability of IMMULITE 2000 Androstenedione CVM Lot 006

| CVM Level | Dose at
time 0
(ng/mL) | Guideline
Criteria
% difference
to time 0 | Acceptable
dose range
(ng/mL) |
|-----------|------------------------------|----------------------------------------------------|-------------------------------------|
| LAOCVM1 | 0.00 | N/A | ≤ 0.3 |
| LAOCVM2 | 1.93 | ±10% | 1.74 - 2.12 |
| LAOCVM3 | 6.68 | ±10% | 6.01 - 7.35 |
| LAOCVM4 | 15.4 | ±13% | 13.4 - 17.4 |

Traceability:

The IMMULITE Androstenedione CVMs are traceable to an internal material which has been gravimetrically prepared. The CVMs are manufactured using qualified materials and measurement procedures.

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Value Assignment:

The IMMULITE Androstenedione CVMs are 4 level materials which are a subset of 7 level Androstenedione calibrators. Calibrators are not commercialized but are used internally during manufacture and release testing of Androstenedione reagents and two point adjustors. The IMMULITE calibrators and therefore CVMs are value assigned reference calibrators. The CVMs are manufactured using qualified materials and measurement procedures. The CVMs dose values are generated using curve generated by assigned reference calibrators. The CVM values are calculated based on the recovered values for each instrument independently. CVM values are then averaged across all systems. Quality control is performed by calculating the recovery of patient samples, spiked patient samples and controls using the assigned CVM values. Four levels of commercially available controls and 28 samples (10 normal female serum samples and 18 spiked samples) were used to validate calibrator/CVM value assignments.

Expected Values/Target Values/Reference Range:

Each CVM level was tested for a total of 27 replicates; 9 runs and 3 replicates per run, 3 different reagent kit lots and 8 IMMULITE 2000 systems. The Guideline Range (95% confidence interval) for each CVM level was established based on the Target Mean and ± 2 Standard Deviation (SD). The target values are provided in the IMMULITE® 2000 CVM Calibration Material lotspecific value card. The expected assay range is 0.3 to 10 ng/mL. The target values in Table 4 can be considered as guidelines.

| Analyte target
levels | CVM Level | Target
Mean
(ng/mL) | Standard
Deviation
(SD) | Guideline ±2SD Range
(ng/mL) | | |
|--------------------------|-----------------|---------------------------|-------------------------------|---------------------------------|--|--|
| | LAOCVM1 | 0.00 | - | 0.00 ≤0.30 | | |
| | LAOCVM2 | 1.31 | 0.10 | 1.11 1.51 | | |
| | LAOCVM3 | 5.00 | 0.25 | 4.50 5.50 | | |
| | LAOCVM4 | 10.0 | 0.65 | 8.70 11.3 | | |
| Assay Range | 0.3 to 10 ng/mL | | | | | |

Table 4: Analyte Target Range Values
-------------------------------------------------

Each laboratory should establish their limits for acceptability based on methodology, clinical significance and medical decision levels of the test analyte. The representative, total precision tabulated in the respective assay instructions for use may be considered as one factor when establishing local, acceptable ranges. The values provided above may be considered as guidelines. Value assignment is lot specific.

Standard/Guidance Documents Referenced:

  • CEN 13640 Stability Testing of In Vitro Diagnostic Reagents
  • Guidance for Industry Abbreviated 510(k) Submissions for In Vitro Diagnostic Calibrators ●
  • Guidance for Industry and FDA Staff Assayed and Unassayed Quality Control Material ●

Proposed Labeling:

The labeling is sufficient and it satisfies the requirements of 21 CFR Part 809.10

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Conclusion: 8.

The IMMULITE® 2000 Androstenedione Calibration Verification Material is substantially equivalent to the predicate device intended for similar use. The substantial equivalence of the device is supported by the non-clinical testing and was found to be comparable and supports the claims of substantial equivalence, product safety and effectiveness. Based on the testing completed and the comparisons with predicate device, the IMMULITE® 2000 Androstenedione Calibration Verification Material does not raise any new questions on safety and effectiveness and the results support a determination of substantial equivalence.

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510(k) Summary

Introduction: According to the requirements of 21 CFR 807.92, the following information provides sufficient details to understand the basis for determination of substantial equivalence.

The assigned 510(k) Number: K143636

| 1. Submitter
Mailing Address: | Siemens Healthcare Diagnostics Inc.
5210 Pacific Concourse Drive
Los Angeles, CA 90045 |
|------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person:
Phone Number:
Fax Number:
E-mail Address:
Date Prepared: | Donna Velasquez
Regulatory Technical Specialist
(310) 645-8200 x7403
(310) 645-9999
donna.velasquez@siemens.com
January 22, 2015 |
| 2. Device Name
Proprietary Name:
Measurand:
Type of Test:
Regulation Section:
Classification:
Products Code:
Panel: | IMMULITE® 2000 Troponin I Calibration Verification Material
Quality Control materials for IMMULITE® 2000 Troponin I assay
Calibration Verification Material (CVM) for IMMULITE® 2000
Troponin I assay
21 CFR 862.1660, Quality Control Material
Class I Reserved
JJX - Single (Specified) Analyte Controls (Assayed and
Unassayed)
Clinical Chemistry (75) |
| 3. Predicate Device Name
Predicate 510(k) No: | IMMULITE 2000 Prolactin Calibration Verification Material
(CVM)
K140818 |
| 4. Device Description: | The IMMULITE® 2000 Troponin I Calibration Verification
Material (CVM) contains one set of four vials, 2mL each after
reconstitution. CVM1 contains equine serum with 0.88% sodium
azide and preservative. CVM2, CVM3 and CVM4 contain human
Troponin I and rabbit Troponin C in equine serum matrix with
0.88% sodium azide and preservative. |
| 5. Intended Use:
Indication for Use: | See Indications for Use Statement below
The IMMULITE® 2000 Troponin I Calibration Verification
Material (CVM) is for in vitro diagnostic use in the verification
of calibration of the IMMULITE Troponin I assay on the
IMMULITE 2000 systems |
| Special Conditions for
Use Statement(s): | For prescription use only |

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Image /page/10/Picture/0 description: The image shows the word "SIEMENS" in a bold, sans-serif font. The color of the text is a bright teal. The letters are evenly spaced and the word is horizontally oriented.

Special Instrument Requirements:

IMMULITE® 2000 Systems

    1. Technological Characteristics and Substantial Equivalence Comparison with Predicate:
      A comparison of the device features, intended use, and other information demonstrates that the IMMULITE® 2000 Troponin I Calibration Verification Material (CVM) is substantially equivalent to the predicate device as summarized in Table 1.
SIMILARITIES
Candidate DevicePredicate Device
IMMULITE 2000 Troponin I CVMIMMULITE 2000 Prolactin CVM
Intended
UseThe IMMULITE® 2000 Troponin I
Calibration Verification Material (CVM)
is for in vitro diagnostic use in the
verification of calibration of the
IMMULITE Troponin I assay on the
IMMULITE 2000 systemsThe IMMULITE® Prolactin
Calibration Verification Material
(CVM) is for in vitro diagnostic use
in the verification of calibration of
the IMMULITE Prolactin assay on
the IMMULITE 2000 systems
FormLyophilizedSame
MatrixEquine serum with preservativesSame
Levels4Same
StabilityStable unopened until the expiration dateSame
UseSingle Use OnlySame
DIFFERENCES
Candidate Device
IMMULITE 2000 Troponin I CVMPredicate Device
IMMULITE 2000 Prolactin CVM
Storage≤-20°C2-8°C
AnalyteTroponin IProlactin

7. Non-Clinical Performance Testing

Performance testing has been carried out to demonstrate that this device meets the performance specifications for its intend use. The following tests were performed on the candidate device.

Stability Summary:

The stability study was conducted to validate real-time shelf life and open component (in-use or open vial) claim for the IMMULITE 2000 Troponin I Calibration Material (CVM) to ensure that it maintains optimal product performance on IMMULITE 2000 platforms throughout the established shelf life of the CVM. The Calibration Verification Materials are stable up to 10 months when stored at -20°C prior to opening, and for 2 hours at ambient or room temperature (15-25°C) after reconstitution.

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Stability Protocol Summary:

The CVM study protocols are run as part of the calibrator stability testing. The stability CVMs and reference CVMs are run in duplicate (as a minimum) at the time points shown in Table 2 and the dose value determined from the reference calibrator curve.

CVM LevelTime-Points (Months)
LTICVM1Day 03910
LTICVM2Day 03910
LTICVM3Day 03910
LTICVM4Day 03910
Table 2: Stability Protocol Summary - LTICVM Lot 010

For Open Component testing, the results were determined from a 2-point adjustment. Using IMMULITE 2000 Troponin I (L2KT12) kit lot 270, CVM lot 090 was tested at 2-hourly intervals for up to 9 hours at ambient or room temperature (15-25°C) conditions.

Stability Acceptance Criteria Summary:

The Acceptance Criteria for the IMMULITE 2000 Troponin I CVM for real time stability and Open-Component testing is applied to dose compared to dose at time point zero. The result is required to fall between ±10% difference for CVM levels 2, 3 and 4 as shown in Table 3.

Table 3: Acceptance criteria for stability of IMMULITE 2000 Troponin I CVM Lot 010

| CVM level | Dose at
Time 0
(ng/mL) | Guideline
Criteria
% difference to
Time 0 | Acceptable
dose range
(ng/mL) |
|-----------|------------------------------|----------------------------------------------------|-------------------------------------|
| LTICVM1 | 0.00 | N/A | ≤0.20 |
| LTICVM2 | 0.56 | ±10% | 0.50 - 0.62 |
| LTICVM3 | 13.8 | ±10% | 12.4 - 15.2 |
| LTICVM4 | 159 | ±10% | 143 - 175 |

Traceability:

The IMMULITE Troponin I CVMs are traceable to an internal standard which has been gravimetrically prepared. The CVMs are manufactured using qualified materials and measurement procedures.

Value Assignment:

The IMMULITE Troponin I CVMs are 4 level materials which are a subset of 10 level Troponin I calibrators. Calibrators are not commercialized but are used internally during manufacture and release testing of Troponin I reagents and two point adjustors. The IMMULITE calibrators and therefore CVMs are value assigned using assigned reference calibrators. The CVMs dose values are generated using curve generated by assigned reference calibrators. The CVM values are calculated based on the recovered values for each run on each instrument independently. The CVM values are then averaged

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across all systems. Quality control is performed by calculating the recovery of patient samples and controls using the assigned CVM values. The controls must fall within their target ranges. Three levels of commercially available controls and 25 spiked samples were used to validate calibrator/CVM value assignments.

Expected Values/Target Values/Reference Range:

The CVMs are manufactured using qualified materials and measurement procedures. The Troponin I CVMs were tested on 15 replicates in total comprised of 5 runs and 3 replicates per run on 4 IMMULITE 2000 systems and 2 different reagent kit lots. The CVMs dose values are generated using curve generated by assigned reference calibrators. The CVM values are calculated based on the recovered values for each run on each instrument independently. The CVM values are then averaged across all systems. Quality control is performed by calculating the recovery of patient samples and controls using the assigned CVM values. The Guideline Range (95% confidence interval) for each CVM level was established based on the Target Mean and ± 2 Standard Deviation (SD). The expected assay range is up to 180 ng/mL. The target values in Table 4 can be considered as guidelines.

| Analyte target
levels | CVM Level | Target
Mean
(ng/mL) | Standard
Deviation
(SD) | Guideline ±2SD Range
(ng/mL) | |
|--------------------------|-----------------|---------------------------|-------------------------------|---------------------------------|-------|
| | LTICVM1 | 0.00 | - | 0.00 $\leq$ 0.20 | |
| | LTICVM2 | 0.575 | 0.092 | 0.391 | 0.759 |
| | LTICVM3 | 14.2 | 0.90 | 12.4 | 16.0 |
| | LTICVM4 | 159 | 15.0 | 129 | 189 |
| Assay Range | Up to 180 ng/mL | | | | |

Table 4: Analyte Target Range Levels

Each laboratory should establish their limits for acceptability based on methodology, clinical significance and medical decision levels of the test analyte. The representative, total precision tabulated in the respective assay instructions for use may be considered as one factor when establishing local, acceptable ranges. The values provided above may be considered as guidelines. Value assignment is lot specific.

Standard/Guidance Documents Referenced:

  • CEN 13640 Stability Testing of In Vitro Diagnostic Reagents ●
  • Guidance for Industry Abbreviated 510(k) Submissions for In Vitro Diagnostic Calibrators ●
  • Guidance for Industry and FDA Staff Assayed and Unassayed Quality Control Material ●

Proposed Labeling:

The labeling is sufficient and it satisfies the requirements of 21 CFR Part 809.10

8. Conclusion:

The IMMULITE® 2000 Troponin I Calibration Verification Material is substantially equivalent to the predicate device intended for similar use. The substantial equivalence of the device is supported by the non-clinical testing and was found to be comparable and supports the claims of substantial equivalence, product safety and effectiveness. Based on the testing completed and the comparisons with predicate device, the IMMULITE® 2000 Troponin I Calibration Verification Material does not

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raise any new questions on safety and effectiveness and the results support a determination of substantial equivalence.