K Number
K152875
Device Name
QUANTA Flash B2GP1-Domain1, QUANTA Flash B2GP1-Domain1 Controls, HemosIL AcuStar Anti-B2GPI Domain 1, HemosIL AcuStar Anti-B2GPI Domain 1 Controls
Date Cleared
2015-12-21

(82 days)

Product Code
Regulation Number
866.5660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The QUANTA Flash® ß2GP1-Domain1 is an in vitro chemiluminescent immunoassay (CIA) for the semi-quantitative determination of IgG autoantibodies to B2GP1-Domain1 in human serum or citrated plasma. The presence of anti-S2GP1-Domain1 autoantibodies is used in conjunction with clinical and other laboratory findings as an aid in the diagnosis of antiphospholipid syndrome. The QUANTA Flash® ß2GP1-Domain1 is not intended to replace assays for antibodies against the whole B2GP1 molecule. Testing for antibodies to the whole is required according to the classification criteria for antiphospholipid syndrome. The QUANTA Flash® ß2GP1-Domain1 Controls are intended for quality control purposes of the QUANTA Flash® ß2GP1-Domain1 chemiluminescent immunoassay (CIA) kit. The HemosIL® AcuStar Anti-S2GPI Domain 1 is an in vitro chemiluminescent immunoassay (CIA) for the semiquantitative determination of IgG autoantibodies to 82GPI Domain 1 in human serum or citrated plasma. The presence of anti-ß2GPI Domain 1 autoantibodies is used in conjunction with clinical and other laboratory findings as an aid in the diagnosis of antiphospholipid syndrome. The HemosIL® AcuStar Anti-S2GPI Domain 1 is not intended to replace assays for antibodies against the whole 82GPI molecule. Testing for antibodies to the whole 13GPI molecule is required according to the classification criteria for antiphospholipid syndrome. The HemosIL AcuStar Anti-B2GPI Domain 1 Controls are intended for quality control purposes of the HemosIL AcuStar Anti-ß2GPI Domain 1 chemiluminescent immunoassay (CIA) kit.
Device Description
The QUANTA Flash® ß2GP1-Domain1 assay is designed to run on the BIO-FLASH® instrument. This platform is a fully automated closed system with continuous load and random access capabilities that automatically processes the samples, runs the assay and reports the results. It includes liquid handling hardware, luminometer and computer with software-user interface. The QUANTA Flash® ß2GP1-Domain1 assay utilizes a reagent cartridge format, which is compatible with the BIO-FLASH instrument. The assays included in this submission, the QUANTA Flash ®2GP1-Domain1 marketed by Inova Diagnostics Inc. (9900 Old Grove Road, San Diego, CA 92131) and HemoslL "AcuStar Anti-ß2GPI Domain 1 marketed by Instrumentation Laboratory (180 Hartwell Road Bedford, MA 01730), are equivalent assays. Therefore all data stated hereafter and referred to as: QUANTA Flash ß2GP1-Domain1 data is equivalently also valid for HemosIL * AcuStar Anti-ß2GPI Domain 1. Recombinant ß2GP1-Domain1 protein is coated onto paramagnetic beads, which are stored lyophilized in the reagent cartridge. The reagent pack is prepared for use in the BIO-FLASH system by pressing down on the grey lid of the reagent pack to pierce the induction seals on the reagent tubes. Once the seals are broken, the beads are rehydrated by adding the entire contents of the vial of resuspension buffer to the bead reagent tube using the transfer pipette supplied with the kit. Only the hole above the bead reagent tube is accessible at this point. The beads are then mixed with the resuspension buffer by pipetting up and down 30 times. This amount of mixing ensures complete resuspension of the beads. The label covering the remaining three reagent holes is now removed, and the reagent cartridge is then loaded onto the BIO-FLASH instrument. Samples are also loaded onto the instrument in sample racks. A patient serum sample is prediluted 1:10 by the BIO-FLASH with system rinse in a small disposable plastic cuvette. Small amounts of the diluted patient serum, the beads, and assay buffer are all combined into a second cuvette, and mixed. This cuvette is then incubated at 37°C. The beads are magnetized and washed several times. lsoluminol conjugated anti-human IgG antibodies are then added to the cuvette, and again incubated at 37°C. The beads are magnetized and washed repeatedly. The isoluminol conjugate is oxidized when Trigger 1 (Fe(III) coproporphyrin in sodium hydroxide solution) and Trigger 2 (urea-hydrogen peroxide in sodium chloride solution) are added to the cuvette, and the flash of light produced from this reaction is measured as Relative Light Units (RLU) by the BIO-FLASH optical system. The RLU are proportional to the amount of isoluminol conjugate that is bound to the human IgG, which is in turn proportional to the amount of anti- ß2GP1-Domain1 antibodies bound to the corresponding ß2GP1-Domain1 on the beads. The QUANTA Flash® ß2GP1-Domain1 assay utilizes a predefined lot specific Master Curve that is uploaded onto the instrument through the reagent cartridge barcode. Every new lot number of reagent cartridge must be calibrated before first use, with the QUANTA Flash® ß2GP1-Domain1 Calibrators. Based on the results obtained with the two Calibrators included in the reagent kit, an instrument specific Working Curve is created, which is used to calculate chemiluminescent units (CU) from the instrument signal (RLU) obtained for each sample. The QUANTA Flash® ß2GP1-Domain1 kit contains the following materials: One (1) QUANTA Flash ß2GP1-Domain1 Reagent Cartridge, containing the following reagents for 50 determinations: - ß2GP1-Domain1 antigen coated paramagnetic beads in a suspension. a. - b. Assay Buffer – buffer containing protein stabilizers and preservatives. - C. Tracer IgG - Isoluminol labeled anti-human IgG antibodies in buffer, containing protein stabilizers and preservative. - d. Sample Diluent - buffer containing protein stabilizers and preservatives. - d. Resuspension Buffer - buffer containing protein stabilizers and preservatives. - e. QUANTA Flash ß2GP1-Domain1 Calibrator 1: One (1) barcode labeled tube containing 1.0 mL prediluted, ready to use reagent. Calibrators contain human antibodies to ß2GP1-Domain1 in stabilizers and preservatives. - f. QUANTA Flash ß2GP1-Domain1 Calibrator 2: One (1) barcode labeled tube containing 1.0 mL prediluted, ready to use reagent. Calibrators contain human antibodies to ß2GP1-Domain1 in stabilizers and preservatives The QUANTA Flash® ß2GP1-Domain1 Controls kit contains three vials of Low Control and three vials of High Control. - QUANTA Flash ß2GP1-Domain1 Low Control: Three (3) barcode labeled tubes containing 1.0 mL, ready to use reagent. Controls contain human antibodies to ß2GP1-Domain1 in stabilizers and preservatives. - QUANTA Flash ß2GP1-Domain1 High Control: Three (3) barcode labeled tubes containing 1.0 mL, ready to use reagent. Controls contain human antibodies to ß2GP1-Domain1 in stabilizers and preservatives.
More Information

Not Found

No
The description details a standard automated chemiluminescent immunoassay system and its performance characteristics, with no mention of AI or ML in the device description, intended use, or performance studies.

No
This device is an in vitro diagnostic (IVD) immunoassay designed to detect specific autoantibodies as an aid in diagnosing a condition, not to treat it.

Yes

Explanation: The "Intended Use / Indications for Use" section explicitly states that the device is "used in conjunction with clinical and other laboratory findings as an aid in the diagnosis of antiphospholipid syndrome." This indicates its role in the diagnostic process.

No

The device description explicitly states it runs on the BIO-FLASH instrument, which is a fully automated closed system including liquid handling hardware, luminometer, and a computer with software-user interface. It also utilizes reagent cartridges and other physical components for the immunoassay.

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 device is an "in vitro chemiluminescent immunoassay (CIA)" for the determination of autoantibodies in human serum or citrated plasma. This clearly indicates that the test is performed outside of the body using biological samples.
  • Purpose: The intended use also states that the presence of these autoantibodies is used "as an aid in the diagnosis of antiphospholipid syndrome." This is a diagnostic purpose, which is a key characteristic of IVDs.
  • Device Description: The description details a laboratory-based assay process involving reagents, instruments (BIO-FLASH), and the analysis of patient samples (serum or plasma). This further confirms its use in a laboratory setting for diagnostic testing.

N/A

Intended Use / Indications for Use

The QUANTA Flash® ß2GP1-Domain1 is an in vitro chemiluminescent immunoassay (CIA) for the semi-quantitative determination of IgG autoantibodies to B2GP1-Domain1 in human serum or citrated plasma. The presence of anti-S2GP1-Domain1 autoantibodies is used in conjunction with clinical and other laboratory findings as an aid in the diagnosis of antiphospholipid syndrome. The QUANTA Flash® ß2GP1-Domain1 is not intended to replace assays for antibodies against the whole B2GP1 molecule. Testing for antibodies to the whole is required according to the classification criteria for antiphospholipid syndrome.

The QUANTA Flash ß2GP1-Domain1 Controls are intended for quality control purposes of the QUANTA Flash ß2GP1-Domain1 chemiluminescent immunoassay (CIA) kit.

The HemosIL® AcuStar Anti-S2GPI Domain 1 is an in vitro chemiluminescent immunoassay (CIA) for the semiquantitative determination of IgG autoantibodies to 82GPI Domain 1 in human serum or citrated plasma. The presence of anti-ß2GPI Domain 1 autoantibodies is used in conjunction with clinical and other laboratory findings as an aid in the diagnosis of antiphospholipid syndrome. The HemosIL® AcuStar Anti-S2GPI Domain 1 is not intended to replace assays for antibodies against the whole 82GPI molecule. Testing for antibodies to the whole 13GPI molecule is required according to the classification criteria for antiphospholipid syndrome.

The HemosIL AcuStar Anti-B2GPI Domain 1 Controls are intended for quality control purposes of the HemosIL AcuStar Anti-ß2GPI Domain 1 chemiluminescent immunoassay (CIA) kit.

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

MSV, JJX

Device Description

The QUANTA Flash® ß2GP1-Domain1 assay is designed to run on the BIO-FLASH® instrument. This platform is a fully automated closed system with continuous load and random access capabilities that automatically processes the samples, runs the assay and reports the results. It includes liquid handling hardware, luminometer and computer with software-user interface. The QUANTA Flash® ß2GP1-Domain1 assay utilizes a reagent cartridge format, which is compatible with the BIO-FLASH instrument.

The assays included in this submission, the QUANTA Flash ®2GP1-Domain1 marketed by Inova Diagnostics Inc. (9900 Old Grove Road, San Diego, CA 92131) and HemoslL "AcuStar Anti-ß2GPI Domain 1 marketed by Instrumentation Laboratory (180 Hartwell Road Bedford, MA 01730), are equivalent assays. Therefore all data stated hereafter and referred to as: QUANTA Flash ß2GP1-Domain1 data is equivalently also valid for HemosIL * AcuStar Anti-ß2GPI Domain 1.

Recombinant ß2GP1-Domain1 protein is coated onto paramagnetic beads, which are stored lyophilized in the reagent cartridge. The reagent pack is prepared for use in the BIO-FLASH system by pressing down on the grey lid of the reagent pack to pierce the induction seals on the reagent tubes. Once the seals are broken, the beads are rehydrated by adding the entire contents of the vial of resuspension buffer to the bead reagent tube using the transfer pipette supplied with the kit. Only the hole above the bead reagent tube is accessible at this point. The beads are then mixed with the resuspension buffer by pipetting up and down 30 times. This amount of mixing ensures complete resuspension of the beads. The label covering the remaining three reagent holes is now removed, and the reagent cartridge is then loaded onto the BIO-FLASH instrument. Samples are also loaded onto the instrument in sample racks. A patient serum sample is prediluted 1:10 by the BIO-FLASH with system rinse in a small disposable plastic cuvette. Small amounts of the diluted patient serum, the beads, and assay buffer are all combined into a second cuvette, and mixed. This cuvette is then incubated at 37°C. The beads are magnetized and washed several times. lsoluminol conjugated anti-human IgG antibodies are then added to the cuvette, and again incubated at 37°C. The beads are magnetized and washed repeatedly. The isoluminol conjugate is oxidized when Trigger 1 (Fe(III) coproporphyrin in sodium hydroxide solution) and Trigger 2 (urea-hydrogen peroxide in sodium chloride solution) are added to the cuvette, and the flash of light produced from this reaction is measured as Relative Light Units (RLU) by the BIO-FLASH optical system. The RLU are proportional to the amount of isoluminol conjugate that is bound to the human IgG, which is in turn proportional to the amount of anti- ß2GP1-Domain1 antibodies bound to the corresponding ß2GP1-Domain1 on the beads.

The QUANTA Flash® ß2GP1-Domain1 assay utilizes a predefined lot specific Master Curve that is uploaded onto the instrument through the reagent cartridge barcode. Every new lot number of reagent cartridge must be calibrated before first use, with the QUANTA Flash® ß2GP1-Domain1 Calibrators. Based on the results obtained with the two Calibrators included in the reagent kit, an instrument specific Working Curve is created, which is used to calculate chemiluminescent units (CU) from the instrument signal (RLU) obtained for each sample.

The QUANTA Flash® ß2GP1-Domain1 kit contains the following materials:
One (1) QUANTA Flash ß2GP1-Domain1 Reagent Cartridge, containing the following reagents for 50 determinations:

  • ß2GP1-Domain1 antigen coated paramagnetic beads in a suspension. a.
  • b. Assay Buffer – buffer containing protein stabilizers and preservatives.
  • C. Tracer IgG - Isoluminol labeled anti-human IgG antibodies in buffer, containing protein stabilizers and preservative.
  • d. Sample Diluent - buffer containing protein stabilizers and preservatives.
  • d. Resuspension Buffer - buffer containing protein stabilizers and preservatives.
  • e. QUANTA Flash ß2GP1-Domain1 Calibrator 1: One (1) barcode labeled tube containing 1.0 mL prediluted, ready to use reagent. Calibrators contain human antibodies to ß2GP1-Domain1 in stabilizers and preservatives.
  • f. QUANTA Flash ß2GP1-Domain1 Calibrator 2: One (1) barcode labeled tube containing 1.0 mL prediluted, ready to use reagent. Calibrators contain human antibodies to ß2GP1-Domain1 in stabilizers and preservatives

The QUANTA Flash® ß2GP1-Domain1 Controls kit contains three vials of Low Control and three vials of High Control.

  • QUANTA Flash ß2GP1-Domain1 Low Control: Three (3) barcode labeled tubes containing 1.0 mL, ready to use reagent. Controls contain human antibodies to ß2GP1-Domain1 in stabilizers and preservatives.
  • QUANTA Flash ß2GP1-Domain1 High Control: Three (3) barcode labeled tubes containing 1.0 mL, ready to use reagent. Controls contain human antibodies to ß2GP1-Domain1 in stabilizers and preservatives.

Mentions image processing

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Mentions AI, DNN, or ML

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Input Imaging Modality

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Anatomical Site

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Indicated Patient Age Range

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Intended User / Care Setting

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

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

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

Sample Matrix Comparison
Seventy-nine matched serum and citrated plasma samples (with different reactivity levels, 13.9% of samples around the cut-off) were tested side-by-side in singleton on QUANTA Flash® ß2GP1-Domain1 and analyzed according to CLSI Guideline EP09/A3.
All paired samples fulfill the acceptance criteria, where 53/60 positive samples showed ≤10% difference, being 12.8% the maximum difference obtained. Therefore, the assay is claimed to be used with serum and citrated plasma.

Precision
The precision of the QUANTA Flash ß2GP1-Domain1 assay was evaluated on 8 serum samples containing various concentrations of anti-Domain1 antibodies in accordance with CLSI EPO5-A2, Evaluation of Precision Performance of Quantitative Measurement Methods; Approved Guideline. Samples were run in duplicates, twice a day, for 20 days. Data were analyzed with the Analyse-it for Excel method evaluation software, and within run, between run, between day and total precision were calculated.
Total %CV: 5.6-10.6%.

Plasma Precision Verification
The precision of the QUANTA Flash B2GP1-Domain1 assay using plasma samples was verified using 3 plasma samples containing various concentrations of antibodies in accordance with CLSI EP15-A3, User Verification of Precision and Estimation of Bias; Approved Guideline - Third Edition. Samples were run in replicates of 5, once a day, for 5 days. Data were analyzed with the Analyse-it for Excel method evaluation software, and within run, between day and total precision were calculated.
Total %CV: 2.5-7.8%.

Auto-rerun function and reportable results
Three high positive specimens with results above the analytical measuring range were selected. The samples were run with the Auto-rerun function enabled on the BIO-FLASH. Then the specimens were manually diluted the same way as it happens in the Auto-rerun function (10 fold), and tested on the BIO-FLASH. The results were within the analytical measuring range after autorerun or manual dilution for all specimens. The % recovery values for results obtained with the auto-rerun results compared to the results obtained by manual dilution were between 91.9% and 99% (average 94.9%).

High concentration hook effect
To assess hook effect, measurement signal (RLU) was examined by performing serial dilutions of two high positive samples (with results above the AMR when tested as neat samples). RLU values showed increase with increasing antibody concentrations above the AMR, thereby confirming that high positive specimens above the analytical measuring range do not show hook effect up to 16,060.8 CU (theoretical value calculated using the highest value in the AMR and its dilution factor) in the ß2GP1-Domain1 assay.

Linearity
The linearity of the AMR was evaluated by a study according to CLSI EPG-A, Evaluation of the Linearity of Quantitative Measurement Procedures: A Statistical Approved Guideline. Five serum samples and three plasma samples with various ß2GP1-Domain1 antibody concentrations were diluted with negative serum or plasma in 10% increments (from 0% to 90% negative serum) to obtain values that cover the AMR. The dilutions were assayed in duplicates. Percent recovery of obtained mean results was calculated compared to the expected mean results (based on the dilution factor). Moreover, obtained values of individual replicates were plotted against expected values, and linear regression analysis was performed.
All five serum specimens showed dilution linearity individually and combined. Serum % Recovery Range: 83.9%-113.9%.
All three plasma specimens showed dilution linearity individually and combined. Plasma % Recovery Range: 86.6%-111.9%.

Interference
The interference study was performed according to CLSI EPO7-A2, Interference Testing in Clinical Chemistry; Approved Guideline - Second Edition. Five specimens were tested, three serum samples (negative: 10.7 CU; low positive: 55.9 CU; high positive: 456.6 CU) and two plasma samples (negative: 6.6 CU; high positive: 132.4 CU). Interfering substances (bilirubin, hemoglobin, triglycerides and cholesterol) were spiked into every specimen at three different concentrations in 10% of total specimen volume, and the resulting samples were assessed in triplicates with the ß2GP1-Domain1 assay. For Rheumatoid Factor lgM, the samples are diluted to varying extent depending on the desired concentrations of RF as an interferent, and the resulting samples were assessed in triplicates with the ß2GP1-Domain1 assay.
No interference was detected with bilirubin up to 100 mg/dL (recovery: 92.9% to 109.4%), hemoglobin up to 200 mg/dL (recovery: 95.6% to 106.3% or 1.7 CU), triglycerides up to 1000 mg/dL (recovery: 92.5% to 107.7%), cholesterol up to 224.3 mg/dL (recovery: 92.5% to 107.7%), and RF IgM up to 500 IU/mL (recovery: 86.2% to 109.9% or 0.9 CU).

Cross-reactivity
A potential cross-reactivity of the QUANTA Flash ß2GP1 Domain1 CIA with other autoantibodies was evaluated with 613 control samples that were included in the clinical validation study. The anti-ß2GP1 Domain1 positivity rate from total controls was 0.5%.
Based on the results, the QUANTA Flash ß2GP1 Domain1 assay does not show cross-reactivity with autoantibodies that are present in various autoimmune diseases or with antibodies against infectious agents.

Lot to lot comparison
Twenty-six samples with various reactivity levels were tested with three different reagent lots: RP0003 (RP3), RP011 (RP11) and 131001P1 (PP1). The samples covered the total analytical measuring range of the assay. Results were processed by linear regression analysis and bias calculation according to CLSI EPO9-A3, Measurement Procedure Comparison and Bias Estimation Using Patient Samples; Approved Guideline.
All results were within the acceptance limits.

Shelf life stability
Accelerated stability studies were performed for 4 weeks at 37 °C, where one week is equal to six months at 5 ± 3°C. All components tested fulfilled the acceptance criteria, so one year expiration dating was assigned to each component.

Onboard stability - Calibrators
A total of 5 successful calibrations were performed over a 8.5 hour period. Calibrator RLU values remained within the 90-110% range. Moreover, all Controls and patient panel samples ran within their expected range. This supports the claim that calibrators can be used for up to 4 calibrations over an 8 hour period.

Onboard stability - Controls
All controls ran within their respective acceptable ranges for all runs. Moreover, the regression line remained between 85% and 115% at run 15 for both Controls. These results support the claim that controls can be used for up to 15 times, at 10 minutes per use.

Onboard stability - Reagent Cartridge
The in-use (onboard) stability of Domain1 reagent cartridge was set at 60 days.

Real time stability
Results available up to 12 months for reagent cartridge, up to 15 months on Calibrators and Controls. All results to date were within the acceptance limit, therefore one year expiration dating has been verified through real-time studies.

Sample stability
This study has been performed using serum and citrated plasma samples and all results fulfilled the acceptance criteria.
-Samples can be stored at room temperature for up to 48 hours.
-Samples can be stored at 2-8°C for up to 14 days.
-Samples can be frozen and thawed up to 3 times.

Clinical sensitivity, specificity
A cohort of 1090 characterized samples, none of which were used for establishing the reference range, was used to validate the clinical performance of the QUANTA Flash ß2GP1-Domain1 CIA.
Clinical sensitivity for APS (n=270): 51.1% (45.0-57.2%)
Clinical specificity for APS (n=820): 99.6% (98.9-99.9%)
ROC AUC for QUANTA Flash B2GP1-Domain1 (CU): 0.84 (0.81 to 0.86)

Comparison with predicate device
Samples for method comparison analysis included all samples that fell within the reportable range from the clinical validation study, along with 8 additional samples, for a total of 238 samples.
Positive Agreement = 91.0% (84.1-95.6%)
Negative Agreement = 78.0% (69.7-84.8%)
Total Agreement = 84.0% (78.7-88.4%)
For samples around the cut-off (n=22):
Positive Agreement = 80.0% (28.4-99.5%)
Negative Agreement = 82.4% (56.6-96.2%)
Total Agreement = 81.8% (59.7-94.8%)

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

Clinical sensitivity for APS: 51.1% (95% confidence interval: 45.0-57.2%)
Clinical specificity for APS: 99.6% (95% confidence interval: 98.9-99.9%)
ROC AUC: 0.84 (95% CI: 0.81 to 0.86)
Agreement with Predicate Device (All samples):
Positive Agreement = 91.0% (84.1-95.6%)
Negative Agreement = 78.0% (69.7-84.8%)
Total Agreement = 84.0% (78.7-88.4%)
Agreement with Predicate Device (Samples around cut-off):
Positive Agreement = 80.0% (28.4-99.5%)
Negative Agreement = 82.4% (56.6-96.2%)
Total Agreement = 81.8% (59.7-94.8%)

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.

K970551

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

§ 866.5660 Multiple autoantibodies immunological test system.

(a)
Identification. A multiple autoantibodies immunological test system is a device that consists of the reagents used to measure by immunochemical techniques the autoantibodies (antibodies produced against the body's own tissues) in serum and other body fluids. Measurement of multiple autoantibodies aids in the diagnosis of autoimmune disorders (disease produced when the body's own tissues are injured by autoantibodies).(b)
Classification. Class II (performance standards).

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of three human profiles facing to the right, with a design that suggests a bird or wing-like shape above the profiles.

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

February 4, 2016

INOVA DIAGNOSTICS, INC. DR. GABRIELLA LAKOS DIRECTOR OF RESEARCH AND DEVELOPMENT 9900 OLD GROVE ROAD SAN DIEGO, CA, 92131

Re: K152875 Trade/Device Name: QUANTA Flash® ß2GP1-Domain1 OUANTA Flash® ß2GP1-Domain1 Controls HemosIL® Acustar Anti-ß2GPI-Domain 1 HemosIL® Acustar Anti-ß2GPI-Domain 1 Controls Regulation Number: 21 CFR § 866.5660 Regulation Name: Multiple autoantibodies immunological test system Regulatory Class: II Product Code: MSV, JJX Dated: September 29, 2015 Received: October 5, 2015

Dear Dr. Lakos:

This letter corrects our substantially equivalent letter of December 21, 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

1

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.

Kelly Oliner -S

FOR

Leonthena R. Carrington, MS, MBA, MT(ASCP) Director Division of Immunology and Hematology Devices Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health

Enclosure

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510(k) Number (if known) K152875

Device Name QUANTA Flash® ß2GP1-Domain1

Indications for Use (Describe)

The QUANTA Flash® ß2GP1-Domain1 is an in vitro chemiluminescent immunoassay (CIA) for the semi-quantitative determination of IgG autoantibodies to B2GP1-Domain1 in human serum or citrated plasma. The presence of anti-S2GP1-Domain1 autoantibodies is used in conjunction with clinical and other laboratory findings as an aid in the diagnosis of antiphospholipid syndrome. The QUANTA Flash® ß2GP1-Domain1 is not intended to replace assays for antibodies against the whole B2GP1 molecule. Testing for antibodies to the whole is required according to the classification criteria for antiphospholipid syndrome.

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

3

510(k) Number (if known) K152875

Device Name QUANTA Flash® ß2GP1-Domain1 Controls

Indications for Use (Describe)

The QUANTA Flash ß2GP1-Domain1 Controls are intended for quality control purposes of the QUANTA Flash ß2GP1-Domain1 chemiluminescent immunoassay (CIA) kit.

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:

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4

510(k) Number (if known) K152875

Device Name HemosIL® AcuStar Anti-ß2GPI Domain 1

Indications for Use (Describe)

The HemosIL® AcuStar Anti-S2GPI Domain 1 is an in vitro chemiluminescent immunoassay (CIA) for the semiquantitative determination of IgG autoantibodies to 82GPI Domain 1 in human serum or citrated plasma. The presence of anti-ß2GPI Domain 1 autoantibodies is used in conjunction with clinical and other laboratory findings as an aid in the diagnosis of antiphospholipid syndrome. The HemosIL® AcuStar Anti-S2GPI Domain 1 is not intended to replace assays for antibodies against the whole 82GPI molecule. Testing for antibodies to the whole 13GPI molecule is required according to the classification criteria for antiphospholipid syndrome.

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

5

510(k) Number (if known) K152875

Device Name

HemosIL® AcuStar Anti-ß2GPI Domain 1 Controls

Indications for Use (Describe)

The HemosIL AcuStar Anti-B2GPI Domain 1 Controls are intended for quality control purposes of the HemosIL AcuStar Anti-ß2GPI Domain 1 chemiluminescent immunoassay (CIA) kit.

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

X 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

6

Image /page/6/Picture/0 description: The image shows the logo for Inova Diagnostics, a Werfen Company. The logo consists of a stylized "W" formed by two overlapping triangles, one red and one blue. To the right of the "W" is the text "Inova Diagnostics" in a gray sans-serif font, and below that is the text "A Werfen Company" in a smaller font.

510(k) Summary

QUANTA Flash® β2GP1-Domain1
QUANTA Flash® β2GP1-Domain1 Controls
HemosIL® AcuStar Anti- β₂GPI Domain 1
HemosIL® AcuStar Anti- β₂GPI Domain 1 Controls
Page 1 of 19

Table of Contents

Administrative data……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
Predicate device……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
Device description
Intended use(s)
Indications for use……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
Substantial equivalence
Comparison to predicate device
Analytical performance characteristics
Value assignment and traceability of Calibrators and Controls
Sample Matrix Comparison
Precision
Plasma Precision Verification
Limit of Blank (LoB) and Limit of Detection (LoD)
Analytical Measuring Range (AMR)
Auto-rerun function and reportable results
High concentration hook effect
Linearity
Interference
Cross-reactivity
Lot to lot comparison
Stability
Cut-off, reference range
Clinical performance characteristics
Clinical sensitivity, specificity
Expected values
Comparison with predicate device

7

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

Administrative data

| Submitter: | Inova Diagnostics, Inc
9900 Old Grove Road,
San Diego, CA, 92131 | |
|------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------|
| Purpose of submission: | New device(s) | |
| Devices in the submission: | QUANTA Flash® β2GP1-Domain1
QUANTA Flash® β2GP1-Domain1 Controls
HemosIL® AcuStar Anti-β2GPI Domain 1
HemosIL® AcuStar Anti-β2GPI Domain 1 Controls | |
| Scientific contact: | Gabriella Lakos, Director of Research, Rheumatology
Inova Diagnostics, Inc.
9900 Old Grove Road, San Diego, CA, 92131
Phone: 858-586-9900/1393
Fax: 858-863-0025
email: glakos@inovadx.com | |
| Quality Systems contact: | Ronda Elliott, VP, Quality Systems and RA
Inova Diagnostics, Inc
9900 Old Grove Road, San Diego, CA, 92131
Phone: 858-586-9900/1381
Fax: 858-863-0025
email: relliot@inovadx.com | |
| Device name (assay kit): | Proprietary name: | QUANTA Flash® β2GP1-Domain1
HemosIL® AcuStar Anti-β₂GPI Domain 1 |
| | Common name: | Anti-β2GPI Domain 1 Chemiluminescent immunoassay |
| | Classification name: | Anti-β2GPI Domain 1 antibody, antigen and control |
| Regulation Description | | Multiple autoantibodies immunological test system |
| Regulation Medical Specialty | | Immunology |
| Review Panel | | Immunology |

8

510(k) Summary QUANTA Flash® ß2GP1-Domain1

Product CodeSystem, Test, Antibodies,B2-Glycoprotein I (B2-GPI) (MSV)
Regulation Number866.5660
Device Class2
Device name (Controls):Proprietary name:QUANTA Flash® β2GP1-Domain1 Controls
HemosIL® AcuStar Anti-β2GPI Domain 1 Controls
Common name:Domain1 Controls
Classification name:single (specified) analyte controls (assayed and
unassayed)
Regulation DescriptionQuality control material (assayed and unassayed)
Regulation Medical SpecialtyClinical Chemistry
Product CodeJJX
Regulation Number862.1660
Device Class1 (reserved)

Predicate device

QUANTA Lite® ß2GPI IgG ELISA, 510(k) number: K970551

Device description

The QUANTA Flash® ß2GP1-Domain1 assay is designed to run on the BIO-FLASH® instrument. This platform is a fully automated closed system with continuous load and random access capabilities that automatically processes the samples, runs the assay and reports the results. It includes liquid handling hardware, luminometer and computer with software-user interface. The QUANTA Flash® ß2GP1-Domain1 assay utilizes a reagent cartridge format, which is compatible with the BIO-FLASH instrument.

The assays included in this submission, the QUANTA Flash ®2GP1-Domain1 marketed by Inova Diagnostics Inc. (9900 Old Grove Road, San Diego, CA 92131) and HemoslL "AcuStar Anti-ß2GPI Domain 1 marketed by Instrumentation Laboratory (180 Hartwell Road Bedford, MA 01730), are equivalent assays. Therefore all data stated hereafter and referred to as: QUANTA Flash ß2GP1-Domain1 data is equivalently also valid for HemosIL * AcuStar Anti-ß2GPI Domain 1.

Recombinant ß2GP1-Domain1 protein is coated onto paramagnetic beads, which are stored lyophilized in the reagent cartridge. The reagent pack is prepared for use in the BIO-FLASH system by pressing down on the grey lid of the reagent pack to pierce the induction seals on the reagent tubes. Once the seals are broken, the beads are rehydrated by adding the entire contents of the vial of resuspension buffer to the bead reagent tube using the transfer pipette supplied with the kit. Only the hole above the bead reagent

9

tube is accessible at this point. The beads are then mixed with the resuspension buffer by pipetting up and down 30 times. This amount of mixing ensures complete resuspension of the beads. The label covering the remaining three reagent holes is now removed, and the reagent cartridge is then loaded onto the BIO-FLASH instrument. Samples are also loaded onto the instrument in sample racks. A patient serum sample is prediluted 1:10 by the BIO-FLASH with system rinse in a small disposable plastic cuvette. Small amounts of the diluted patient serum, the beads, and assay buffer are all combined into a second cuvette, and mixed. This cuvette is then incubated at 37°C. The beads are magnetized and washed several times. lsoluminol conjugated anti-human IgG antibodies are then added to the cuvette, and again incubated at 37°C. The beads are magnetized and washed repeatedly. The isoluminol conjugate is oxidized when Trigger 1 (Fe(III) coproporphyrin in sodium hydroxide solution) and Trigger 2 (urea-hydrogen peroxide in sodium chloride solution) are added to the cuvette, and the flash of light produced from this reaction is measured as Relative Light Units (RLU) by the BIO-FLASH optical system. The RLU are proportional to the amount of isoluminol conjugate that is bound to the human IgG, which is in turn proportional to the amount of anti- ß2GP1-Domain1 antibodies bound to the corresponding ß2GP1-Domain1 on the beads.

The QUANTA Flash® ß2GP1-Domain1 assay utilizes a predefined lot specific Master Curve that is uploaded onto the instrument through the reagent cartridge barcode. Every new lot number of reagent cartridge must be calibrated before first use, with the QUANTA Flash® ß2GP1-Domain1 Calibrators. Based on the results obtained with the two Calibrators included in the reagent kit, an instrument specific Working Curve is created, which is used to calculate chemiluminescent units (CU) from the instrument signal (RLU) obtained for each sample.

The QUANTA Flash® ß2GP1-Domain1 kit contains the following materials:

One (1) QUANTA Flash ß2GP1-Domain1 Reagent Cartridge, containing the following reagents for 50 determinations:

  • ß2GP1-Domain1 antigen coated paramagnetic beads in a suspension. a.
  • b. Assay Buffer – buffer containing protein stabilizers and preservatives.
  • C. Tracer IgG - Isoluminol labeled anti-human IgG antibodies in buffer, containing protein stabilizers and preservative.
  • d. Sample Diluent - buffer containing protein stabilizers and preservatives.
  • d. Resuspension Buffer - buffer containing protein stabilizers and preservatives.
  • e. QUANTA Flash ß2GP1-Domain1 Calibrator 1: One (1) barcode labeled tube containing 1.0 mL prediluted, ready to use reagent. Calibrators contain human antibodies to ß2GP1-Domain1 in stabilizers and preservatives.
  • f. QUANTA Flash ß2GP1-Domain1 Calibrator 2: One (1) barcode labeled tube containing 1.0 mL prediluted, ready to use reagent. Calibrators contain human antibodies to ß2GP1-Domain1 in stabilizers and preservatives

The QUANTA Flash® ß2GP1-Domain1 Controls kit contains three vials of Low Control and three vials of High Control.

10

  • QUANTA Flash ß2GP1-Domain1 Low Control: Three (3) barcode labeled tubes containing 1.0 mL, ready to use reagent. Controls contain human antibodies to ß2GP1-Domain1 in stabilizers and preservatives.
  • QUANTA Flash ß2GP1-Domain1 High Control: Three (3) barcode labeled tubes containing 1.0 mL, ready to use reagent. Controls contain human antibodies to ß2GP1-Domain1 in stabilizers and preservatives.

Intended use(s)

QUANTA Flash ß2GP1-Domain1

The QUANTA Flash ß2GP1-Domain1 is an in vitro chemiluminescent immunoassay (CIA) for the semiquantitative determination of IgG autoantibodies to ß2GP1-Domain1 in human serum or citrated plasma. The presence of anti-ß2GP1-Domain1 autoantibodies is used in conjunction with clinical and other laboratory findings as an aid in the diagnosis of antiphospholipid syndrome. The QUANTA Flash 182GP1-Domain1 is not intended to replace assays for antibodies against the whole ß2GP1 molecule. Testing for antibodies to the whole ß2GP1 molecule is required according to the classification criteria for antiphospholipid syndrome.

QUANTA Flash ß2GP1-Domain1 Controls

The QUANTA Flash ß2GP1-Domain1 Controls are intended for quality control purposes of the QUANTA Flash ß2GP1-Domain1 chemiluminescent immunoassay (CIA) kit.

HemosIL AcuStar Anti-ß₂GPI Domain 1

The HemosIL AcuStar Anti-R2GPI Domain 1 is an in vitro chemiluminescent immunoassay (CIA) for the semi-quantitative determination of IgG autoantibodies to ßGPI Domain 1 in human serum or citrated plasma. The presence of anti-ß2GPI Domain 1 autoantibodies is used in conjunction with clinical and other laboratory findings as an aid in the diagnosis of antiphospholipid syndrome. The HemoslL® AcuStar Antiß,GPI Domain 1 is not intended to replace assays for antibodies against the whole ß₂GPI molecule. Testing for antibodies to the whole ß2GPI molecule is required according to the classification criteria for antiphospholipid syndrome.

HemosIL AcuStar Anti-ß2GPI Domain 1 Controls

The HemosIL AcuStar Anti-ß2GPI Domain 1 Controls are intended for quality control purposes of the HemosIL Anti-ß2GPI Domain 1 chemiluminescent immunoassay (CIA) kit.

Indications for use

Same as Intended use.

Substantial equivalence

The QUANTA Flash ß2GP1-Domain1 and the QUANTA Flash ß2GP1-Domain1 Controls have a similar intended use and assay principle as the predicate device.

11

Comparison to predicate device

QUANTA Flash® ß2GP1-Domain1 reagent kit

Similarities
ItemApplicantPredicate Device
QUANTA Flash® ß2GP1-Domain1QUANTA Lite® ß₂GPI IgG ELISA
Intended useThe QUANTA Flash® ß2GP1-Domain1 is
an in vitro chemiluminescent
immunoassay (CIA) for the semi-
quantitative determination of IgG
autoantibodies to ß2GP1-Domain1 in
human serum or citrated plasma. The
presence of anti-ß2GP1-Domain1
autoantibodies is used in conjunction
with clinical and other laboratory
findings as an aid in the diagnosis of
antiphospholipid syndrome. The
QUANTA Flash® ß2GP1-Domain1 is not
intended to replace assays for
antibodies against the whole ß2GP1
molecule. Testing for antibodies to the
whole ß2GP1 molecule is required
according to the classification criteria
for antiphospholipid syndrome.QUANTA Lite® ß2 GPI IgG is an enzyme
linked immunoassay (ELISA) for the
semi-quantitative detection of ß2 GPI
IgG antibodies in human serum. The
presence of ß₂ GPI IgG antibodies can
be used in conjunction with clinical
findings and other laboratory tests to
aid in the diagnosis of certain
autoimmune disease thrombotic
disorders such as those secondary to
systemic lupus erythematosus (SLE) or
other lupus-like thrombotic diseases.
Assay methodologySolid phase (heterogeneous)
immunoassaySolid phase (heterogeneous)
immunoassay
Shelf lifeOne yearOne year
Differences
ItemQUANTA Flash β2GP1-Domain1Predicate Device
Detection/
Operating principleChemiluminescent immunoassayEnzyme-linked immunosorbent assay
Solid phaseParamagnetic microparticles (beads)96-well plate
AntigenRecombinant domain1 of β2-
Glycoprotein1purified β2-Glycoprotein1
ConjugateIsoluminol conjugated anti-human IgGHRP conjugated anti-human IgG
CalibrationLot specific Master Curve + two
Calibrators (included in kit)Five lot specific calibrators
(Included in the kit)
Units1380.4 CU by further diluting it by a factor specified in the assay definition file (10 fold), thereby bringing the measured value within the AMR. The final result will be calculated by the software by taking into account the additional dilution factor. As the highest value that can be measured is 1380.4 CU, the highest value that can be reported is 13804 CU.

To validate the Auto-rerun function, three high positive specimens with results above the analytical measuring range were selected. The samples were run with the Auto-rerun function enabled on the BIO-FLASH. Then the specimens were manually diluted the same way as it happens in the Auto-rerun function (10 fold), and tested on the BIO-FLASH. The results were within the analytical measuring range after autorerun or manual dilution for all specimens. The % recovery values for results obtained with the auto-rerun results compared to the results obtained by manual dilution were between 91.9% and 99% (average 94.9%).

High concentration hook effect

To assess hook effect, measurement signal (RLU) was examined by performing serial dilutions of two high positive samples (with results above the AMR when tested as neat samples). RLU values showed increase with increasing antibody concentrations above the AMR, thereby confirming that high positive specimens above the analytical measuring range do not show hook effect up to 16,060.8 CU (theoretical value calculated using the highest value in the AMR and its dilution factor) in the ß2GP1-Domain1 assay.

Linearity

The linearity of the AMR was evaluated by a study according to CLSI EPG-A, Evaluation of the Linearity of Quantitative Measurement Procedures: A Statistical Approved Guideline. Five serum samples and three plasma samples with various ß2GP1-Domain1 antibody concentrations were diluted with negative serum or plasma in 10% increments (from 0% to 90% negative serum) to obtain values that cover the AMR. The dilutions were assayed in duplicates. Percent recovery of obtained mean results was

17

510(k) Summary QUANTA Flash® ß2GP1-Domain1

calculated compared to the expected mean results (based on the dilution factor). Moreover, obtained values of individual replicates were plotted against expected values, and linear regression analysis was performed.

  • Recovery is between 80-120%, or ± 4 CU, whichever is greater. Acceptance criteria:

  • For linear regression analysis, slope is between 0.9-1.1, and R2 is ≥ 0.95.

All five serum specimens showed dilution linearity individually and combined.

SampleTest Range (CU)Slope (95% CI)R2% Recovery Range
11640.7 to 164.11.04 (0.98 - 1.09)0.9995.1%-106.2%
2454.7 to 45.50.99 (0.96 - 1.03)0.9995.5%-104.1%
3124.9 to 12.51.03 (1.00 - 1.05)1.0094.3%-103.3%
481.1 to 8.11.01 (0.95 - 1.08)0.9883.9%-106.7%
510.3 to 1.00.96 (0.91 - 1.01)0.9990.9%-113.9%
Combined1640.7 to 1.01.01 (0.99 to 1.02)1.0083.9%-113.9%

All three plasma specimens showed dilution linearity individually and combined.

PlasmaTest Range (CU)Slope (95% CI)% Recovery Range
11,357.6 to 135.81.02 (0.96 - 1.07)0.9986.6%- 102.6%
2182.2 to 18.20.97 (0.93 - 1.01)0.9990.1%- 100.0%
317.7 to 3.50.96 (0.93 - 0.99)1.0098.2%- 111.9%
Combined1,357.6 to 3.50.96 (0.94 - 0.98)0.9986.6%- 111.9%

These data demonstrate the linearity of the analytical measuring range (3.6 CU - 1380.4 CU) of the QUANTA Flash ß2GP1-Domain1 assay using serum or plasma samples.

Interference

The interference study was performed according to CLSI EPO7-A2, Interference Testing in Clinical Chemistry; Approved Guideline - Second Edition. Five specimens were tested, three serum samples (negative: 10.7 CU; low positive: 55.9 CU; high positive: 456.6 CU) and two plasma samples (negative: 6.6 CU; high positive: 132.4 CU). Interfering substances (bilirubin, hemoglobin, triglycerides and cholesterol) were spiked into every specimen at three different concentrations in 10% of total specimen volume, and the resulting samples were assessed in triplicates with the ß2GP1-Domain1 assay. For Rheumatoid Factor lgM, the samples are diluted to varying extent depending on the desired concentrations of RF as an interferent, and the resulting samples were assessed in triplicates with the ß2GP1-Domain1 assay. Recovery of the unit values was calculated compared to control samples. Acceptance criteria for the interference studies were 85%-115% recovery, or ±4 CU difference, whichever is greater.

No interference was detected with bilirubin up to 100 mg/dL (recovery: 92.9% to 109.4%), hemoglobin up to 200 mg/dL (recovery: 95.6% to 106.3% or 1.7 CU), triglycerides up to 1000 mg/dL (recovery: 92.5% to 107.7%), cholesterol up to 224.3 mg/dL (recovery: 92.5% to 107.7%), and RF IgM up to 500 IU/mL (recovery: 86.2% to 109.9% or 0.9 CU).

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Cross-reactivity

A potential cross-reactivity of the QUANTA Flash ß2GP1 Domain1 CIA with other autoantibodies was evaluated with 613 control samples that were included in the clinical validation study. These samples were from patients with autoimmune diseases that are characterized with disease specific autoantibodies, or from patients with infection. The composition of the cohort and the anti-ß2GP1 Domain1 positivity rate is shown in the Table below:

DiagnosisNumber of samples# pos% pos
Crohn's Disease10411.0%
Ulcerative Colitis9400.0%
Rheumatoid Arthritis16800.0%
Osteoarthritis4900.0%
Scleroderma12721.6%
Hepatitis B virus2100.0%
Hepatitis C virus1000.0%
Syphilis4000.0%
Total controls61330.5%

Based on the results, the QUANTA Flash ß2GP1 Domain1 assay does not show cross-reactivity with autoantibodies that are present in various autoimmune diseases or with antibodies against infectious agents.

Lot to lot comparison

Twenty-six samples with various reactivity levels were tested with three different reagent lots: RP0003 (RP3), RP011 (RP11) and 131001P1 (PP1). The samples covered the total analytical measuring range of the assay. Results were processed by linear regression analysis and bias calculation according to CLSI EPO9-A3, Measurement Procedure Comparison and Bias Estimation Using Patient Samples; Approved Guideline. Pair-wise comparisons were performed between lot RP3 vs RP11 and lot RP11 vs PP1.

Acceptance criteria and results are in the Table below. All results were within the acceptance limits.

Acceptance criteriaRP3 vs RP11RP11 vs PP1PP1 vs RP3
Weighted R for linear regression$\geq 0.975$0.9960.9980.986
Intercept of the regression line (constant bias)$\pm 3$ CU1.90.06-1.3
Slope of the regression line (proportional bias)0.9 - 1.11.031.041.00
Weighted S y/x (Standard error estimate)$\leq 0.5$0.070.050.13
Predicted bias (difference) at cut-off$\pm 3$ CU2.50.8-1.2
95% CI of the bias$\leq 20%$ or $\pm 4$ CU1.1 to 3.8-0.3 to 1.8-3.9 to 1.6

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Stability

Shelf life

To establish the initial claim for shelf life, accelerated stability studies were performed for 4 weeks at 37 °C, where one week is equal to six months at 5 ± 3°C.

Accelerated stability testing was performed on each of the following sealed components of the QUANTA Flash® ß2GP1-Domain1 to establish initial stability claim:

• QUANTA Flash® β2GP1-Domain1 Reagent Kit(1 Lot)
• β2GP1-Domain1 beads(3 Lots)
• Resuspension Buffer(3 Lots)
• Calibrators 1 and 2(3 Lots)
• Low and High controls(3 Lots)

Each week a new sealed component was placed in the incubator, and all components were tested at the end of the experiment together with the one that was stored at 5 ± 3℃. The recovery of the measured values was calculated for each time point (compared to those obtained with 5 ± 3°C stored reagent). All calculations were performed by comparing results of sealed components stored at 5 ± 3℃ (control) to those stored at 37 ± 3℃ (test) for 1, 2, 3, and 4 weeks, where one week is equal to six months at 5 ± 3℃. Linear regression analysis was performed between recovery values and the number of days.

Acceptance criteria for one year preliminary expiration dating:

  • Beads, Resuspension Buffer, and Reagent Kit:

With regression analysis, the lower and upper 95% Cl interval of the regression line is between 85% and 115% recovery at day 14, and no individual data point has ≤75% or ≥125% recovery at day 14.

- Controls and Calibrators:

With regression analysis, the lower and upper 95% Cl interval of the regression line is between 90% and 110% recovery at day 14, and no individual data point has ≤80% or ≥120% recovery at day 14.

All components tested fulfilled the acceptance criteria above, so one year expiration dating was assigned to each component

In-use (onboard) stability

Calibrators

Onboard stability claim: 4 calibrations, or 8 hours onboard

During assessment of on-board stability, Calibrators were placed uncapped, onboard the instrument, and calibration was performed altogether five times over 8.5 hours. Controls and a panel of characterized patient specimens were run on each calibration curve.

Calibrators are considered stable if all five calibrations performed in the 8.5 hour period are successful, and average Calibrator RLU recovery values are between 90% and 110% compared to the first use.

20

A total of 5 successful calibrations were performed over a 8.5 hour period. Calibrator RLU values remained within the 90-110% range. Moreover, all Controls and patient panel samples ran within their expected range. This supports the claim that calibrators can be used for up to 4 calibrations over an 8 hour period.

Controls

Onboard stability claim: up to 15 uses, at 10 minutes onboard per use

During assessing on-board stability, 2 vials of each Control were assayed twice a day for a total of 20 runs. The first run was used to establish baseline value, by running each vial in duplicate, and then additional 19 runs were performed, by running each vial in singleton. During runs, the Controls were left uncapped, onboard the instrument for 15 minutes per run. When not in use, the controls were capped, and stored at 5 ± 3°C. Percent recovery of each value was calculated compared to the baseline value. Controls are considered stable when all values run within their established range, and the linear regression line obtained by plotting %recovery values against the number of runs stays between 85% and 15. All controls ran within their respective acceptable ranges for all runs. Moreover, the regression line remained between 85% and 115% at run 15 for both Controls. These results support the claim that controls can be used for up to 15 times, at 10 minutes per use.

Reagent Cartridge

To establish the in-use (onboard) stability of the QUANTA Flash ß2GP1-Domain1 reagent cartridge, three lots of reagent cartridge were tested with up to 4 serum specimens (with different reactivity levels) along with the Low and High Controls. The specimens were tested periodically up to 64 days. Percent recoveries were calculated compared to the day zero average values, and linear regression analysis was performed by plotting %recovery against the number of days. The claim was established using the following criteria (using the one that is fulfilled first):

  • The stability claim is established at the actual measurement day preceding the day when the 95% confidence interval of the regression line reaches 85% or 115% recovery, or

  • At the actual measurement day preceding the day when 2 data points or ≥2% of the recovery data (whichever is greater) is ≤ 75% or ≥ 125% recovery.

As none of these endpoints were reached during the duration of the in-use (onboard) stability of Domain1 reagent cartridge was set at 60 days.

Real time stability

Real time stability testing has been scheduled to be performed approximately every three months on the reagent cartridge, Calibrators and Controls, to verify the one year expiration that was assigned based on accelerated stability studies. At the of the submission, results were available up to 12 months for reagent cartridge, up to 15 months on Calibrators and Controls.

For reagent cartridge, QC panel samples were tested in singleton at each time point. The QC panel is a group of characterized patient samples with target values, used by the QC Department for reagent release and QC.

21

  • Acceptance criteria: results should fall within their respective QC ranges.

Calibrators were used to calibrate a cartridge at each time point. After calibration, the QC panel samples were tested in singleton at each time point.

  • Acceptance criteria: results should fall within their respective QC ranges.

Controls were tested in singleton on a calibrated cartridge at each time point. Individual values were compared to the values that were assigned to the Controls at release.

  • Acceptance criteria: results should fall within their acceptable ranges as were established at the release of the Controls.

All results to date were within the acceptance limit, therefore one year expiration dating has been verified through real-time studies.

Sample stability

Sample stability claim: -Samples can be stored at room temperature for up to 48 hours.

-Samples can be stored at 2-8°C for up to 14 days.

-Samples can be frozen and thawed up to 3 times.

During the sample stability study, eight (four serum and four plasma samples) samples with varying anti-Domain1 levels have been tested along with Low and High Controls at different time points after being stored at each temperature condition. For the room temperature claim, samples were tested at 0, 8, 24 and 48 hours. For the 2-8°C claim, samples were tested at 0, 1, 2, 3, 7 and 14 days. For the freeze and thaw claim, samples were tested after 0, 1, 2 and 3 cycles. Samples were tested in duplicates at each time point. Percent recoveries were calculated at each time point compared to the time zero average values. Samples are considered stable if the recovery is between 85%-115% for positive samples. Samples are considered stable if the recovery is between 80-120%, or 20% of the cutoff in units (4 CU) for negative samples.

This study has been performed using serum and citrated plasma samples and all results fulfilled the acceptance criteria above, so the following claims have been established for both serum and citrated plasma:

-Samples can be stored at room temperature for up to 48 hours.

-Samples can be stored at 2-8°C for up to 14 days.

-Samples can be frozen and thawed up to 3 times.

Cut-off, reference range

| QUANTA Flash ß2GP1-Domain1: | Negative |