K Number
K171072
Device Name
N Latex Cystatin C; N Protein Standard UY
Date Cleared
2017-05-12

(32 days)

Product Code
Regulation Number
862.1225
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
N Latex Cystatin C: N Latex Cystatin C is an in vitro diagnostics kit containing reagents for the quantitative determination of cystatin C in human serum and lithium-heparinized plasma by means of particle-enhanced immunonephelometry using the BN Systems. Cystatin C measurements are used in the diagnosis and treatment of renal diseases. N Protein Standard UY: N Protein Standard UY is used for preparing reference curves for the immunonephelometric determination of a1microglobulin and Cystatin C using the BN Systems.
Device Description
The N Latex Cystatin C is an in vitro diagnostics kit containing reagents for the quantitative determination of cystatin C in human serum and lithium heparinized plasma by means of particle-enhanced immunonephelometry using the BN II and BN ProSpec® Systems. Used in conjunction with other clinical and laboratory findings, N Latex Cystatin C measurements are used as an aid in the diagnosis and treatment of renal diseases. Used in conjunction with the assay reagents, N Protein Standard UY is for use in the establishment of reference curves for the determination of cystatin C on the BN II and BN ProSpec Systems. N Cystatin C Control 1 and 2 are included with N Latex Cystatin C kit and are for use as assayed accuracy controls and precision controls in the determination of cystatin C by immunonephelometry with the BN II and BN ProSpec Systems. The N Latex Cystatin C test system is based upon the principles of particle-enhanced immunonephelometry. Polystyrene particles coated with specific antibodies to human cystatin C are aggregated when mixed with samples containing human cystatin C. These aggregates scatter a beam of light passed through the sample. The intensity of the scattered light is proportional to the concentration of the respective protein in the sample. The result is evaluated by comparison with a standard of known concentration.
More Information

No
The description focuses on standard in vitro diagnostic techniques (particle-enhanced immunonephelometry) and does not mention any AI/ML components or methodologies. The performance studies are also standard analytical and clinical validation studies for IVD devices.

No

This device is an in vitro diagnostic kit used to measure cystatin C, which aids in the diagnosis and treatment of renal diseases. It does not directly treat or prevent a disease.

Yes

The device is described as "an in vitro diagnostics kit" and its measurements "are used as an aid in the diagnosis and treatment of renal diseases," which clearly indicates a diagnostic purpose.

No

The device is an in vitro diagnostics kit containing reagents and is used with specific hardware systems (BN II and BN ProSpec® Systems). It is not solely software.

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

Here's why:

  • Intended Use/Indications for Use: The description explicitly states "N Latex Cystatin C is an in vitro diagnostics kit containing reagents for the quantitative determination of cystatin C in human serum and lithium-heparinized plasma..." and "Cystatin C measurements are used in the diagnosis and treatment of renal diseases." This clearly indicates the device is intended for use outside of the body to diagnose or aid in the diagnosis of a disease or condition.
  • Device Description: The description further reinforces this by stating it's an "in vitro diagnostics kit containing reagents for the quantitative determination of cystatin C in human serum and lithium heparinized plasma..." and is used "as an aid in the diagnosis and treatment of renal diseases."
  • Nature of the Test: The test involves analyzing biological samples (serum and plasma) using reagents and a laboratory system (BN Systems) to measure a specific analyte (cystatin C) for clinical purposes. This is a hallmark of an in vitro diagnostic test.

N/A

Intended Use / Indications for Use

N Latex Cystatin C:
N Latex Cystatin C is an in vitro diagnostics kit containing reagents for the quantitative determination of cystatin C in human serum and lithium-heparinized plasma by means of particle-enhanced immunonephelometry using the BN Systems. Cystatin C measurements are used in the diagnosis and treatment of renal diseases.

N Protein Standard UY:
N Protein Standard UY is used for preparing reference curves for the immunonephelometric determination of a1microglobulin and Cystatin C using the BN Systems.

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

NDY, JIX

Device Description

The N Latex Cystatin C is an in vitro diagnostics kit containing reagents for the quantitative determination of cystatin C in human serum and lithium heparinized plasma by means of particle-enhanced immunonephelometry using the BN II and BN ProSpec® Systems. Used in conjunction with other clinical and laboratory findings, N Latex Cystatin C measurements are used as an aid in the diagnosis and treatment of renal diseases.

Used in conjunction with the assay reagents, N Protein Standard UY is for use in the establishment of reference curves for the determination of cystatin C on the BN II and BN ProSpec Systems. N Cystatin C Control 1 and 2 are included with N Latex Cystatin C kit and are for use as assayed accuracy controls and precision controls in the determination of cystatin C by immunonephelometry with the BN II and BN ProSpec Systems.

The N Latex Cystatin C test system is based upon the principles of particle-enhanced immunonephelometry. Polystyrene particles coated with specific antibodies to human cystatin C are aggregated when mixed with samples containing human cystatin C. These aggregates scatter a beam of light passed through the sample. The intensity of the scattered light is proportional to the concentration of the respective protein in the sample. The result is evaluated by comparison with a standard of known concentration.

The N Latex Cystatin C subject of this 510(k) is materially the same as the assay cleared in K041878. The reason for the submission is for a new standardization to ERM-DA471/IFCC. This is being accomplished solely by changing the calibrator value assignment process.

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

The reference interval study included serum samples from a US population of apparently healthy adults or patients with diseases not linked to renal disease or failure, between the ages of 21 and 72.

Intended User / Care Setting

Not Found

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

Not Found

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

Not Found

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

5.7.1 Analytical Performance
5.7.1.1 Precision
Confirmation of precision studies was performed internally on one BN II and one BN ProSpec instrument for twenty days following the scheme of two runs per day, with two replicates per run according to CLSI EP05-A2, Evaluation of Precision Performance of Quantitative Measurement Methods; Approved Guideline-Second Edition.
Precision samples included serum and plasma pools and N Cystatin C Control 1 and 2, spanning the measuring range with sample pools close to the medical decision point (MDP) of 1.1 mg/L.

5.7.1.2 Measuring Range (Linearity and LoQ)
A linearity study was performed according to CLSI EP06-A, Evaluation of the Linearity of Quantitative Measurement Procedures: A Statistical Approach. One N Latex Cystatin C reagent lot, one BN II and one BN ProSpec instrument were used.
A concentrated Cystatin C stock solution was used to spike pooled human serum to a Cystatin C concentration between 10 ± 0.5 mg/L which is just above the upper limit of the measuring interval of 9.4 mg/L. This high pool was serially diluted with human serum containing undetectable levels of Cystatin C down to the minimum measuring range. Each dilution was tested in replicates of five using an individual aliquot. The N Latex Cystatin C assay demonstrates acceptable linearity over the range of 0.27 to 10.3 mg/L.
Limit of Quantitation (LoQ) testing was performed according to CLSI Guideline EP17-A2: Evaluation of Detection Capability for Clinical Laboratory Measurement Procedures. LoQ was demonstrated to be 0.08 mg/L at

§ 862.1225 Creatinine test system.

(a)
Identification. A creatinine test system is a device intended to measure creatinine levels in plasma and urine. Creatinine measurements are used in the diagnosis and treatment of renal diseases, in monitoring renal dialysis, and as a calculation basis for measuring other urine analytes.(b)
Classification. Class II.

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November 7, 2017

Image /page/0/Picture/1 description: The image shows the logos of the Department of Health and Human Services and the Food and Drug Administration (FDA). The Department of Health and Human Services logo is on the left, and the FDA logo is on the right. The FDA logo includes the letters "FDA" in a blue square, followed by the words "U.S. Food & Drug Administration" in blue text.

Siemens Healthcare Diagnostics Products GmbH Christine Perkins Regulatory Specialist Emil-von-Behring-Str. 76 Marburg, 35041 De

Re: K171072

Trade/Device Name: N Latex Cystatin C; N Protein Standard UY Regulation Number: 21 CFR 862.1225 Regulation Name: Creatinine test system Regulatory Class: Class II Product Code: NDY, JIX Dated: April 6, 2017 Received: April 10, 2017

Dear Christine Perkins:

This letter corrects our substantially equivalent letter of May 12, 2017.

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 Part 801 and Part 809); medical device 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

1

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 regulation (21 CFR Part 801 and Part 809), please contact the Division of Industry and Consumer Education (DICE) at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevicesforYou/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 (DICE) 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,

Kellie B. Kelm -S

for Courtney H. Lias, Ph.D. Director Division of Chemistry and Toxicology Devices Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K171072

Device Name

N Latex Cystatin C; N Protein Standard UY

Indications for Use (Describe)

N Latex Cystatin C:

N Latex Cystatin C is an in vitro diagnostics kit containing reagents for the quantitative determination of cystatin C in human serum and lithium-heparinized plasma by means of particle-enhanced immunonephelometry using the BN Systems. Cystatin C measurements are used in the diagnosis and treatment of renal diseases.

N Protein Standard UY:

N Protein Standard UY is used for preparing reference curves for the immunonephelometric determination of a1microglobulin and Cystatin C using the BN 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)

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3

510(k) Summary per 21 CFR 807.92

This summary of 510(k) safety and effectiveness information is submitted in accordance with the requirements of 21 CFR 807.92 and follows the FDA guidance "The 510(k) Program: Evaluating Substantial Equivalence in Premarket Notifications [510(k)]", issued July 28, 2014.

The assigned 510(k) number is: K171072

5.1 Submitter

Siemens Healthcare Diagnostics Products GmbH Emil-von-Behring-Str. 76 35041 Marburg, Germany

Contact Person:Christine Perkins
Email:christine.perkins@siemens.com
Phone:302-631-8811
Fax:302-631-6299
Date of Preparation:May 11, 2017

5.2 Device Information

Trade Name:N Latex Cystatin C
Common or Usual Name:Test, Cystatin C Creatinine test system
Classification Name:Creatinine test system (21CFR 862.1225)
Regulatory Class:Class II
Product Code:NDY
510(k) Review Panel:Clinical Chemistry
Trade Name:N Protein Standard UY
Common or Usual Name:Calibrator, Multi-Analyte Calibrator
Classification Name:Calibrator (21 CFR 862.1150)

sification Name: Class II Regulatory Class: Product Code: الا 510(k) Review Panel: Clinical Chemistry

Calibrator (21 CFR 862.1150)

5.3 Predicate Device:

The predicate device is the Tina-quant Cystatin C Gen.2 Test System, for use on Roche/Hitachi cobas c systems cleared by the FDA under K141143.

4

Assay:Tina-quant Cystatin C Gen.2
Calibrator:C.f.a.s. (Calibrator for automated systems) Cystatin C

5.4 Device Description / Test Principle

The N Latex Cystatin C is an in vitro diagnostics kit containing reagents for the quantitative determination of cystatin C in human serum and lithium heparinized plasma by means of particle-enhanced immunonephelometry using the BN II and BN ProSpec® Systems. Used in conjunction with other clinical and laboratory findings, N Latex Cystatin C measurements are used as an aid in the diagnosis and treatment of renal diseases.

Used in conjunction with the assay reagents, N Protein Standard UY is for use in the establishment of reference curves for the determination of cystatin C on the BN II and BN ProSpec Systems. N Cystatin C Control 1 and 2 are included with N Latex Cystatin C kit and are for use as assayed accuracy controls and precision controls in the determination of cystatin C by immunonephelometry with the BN II and BN ProSpec Systems.

The N Latex Cystatin C test system is based upon the principles of particle-enhanced immunonephelometry. Polystyrene particles coated with specific antibodies to human cystatin C are aggregated when mixed with samples containing human cystatin C. These aggregates scatter a beam of light passed through the sample. The intensity of the scattered light is proportional to the concentration of the respective protein in the sample. The result is evaluated by comparison with a standard of known concentration.

The N Latex Cystatin C subject of this 510(k) is materially the same as the assay cleared in K041878. The reason for the submission is for a new standardization to ERM-DA471/IFCC. This is being accomplished solely by changing the calibrator value assignment process.

5.5 Intended Use / Indications for Use

N Latex Cystatin C assay

N Latex Cystatin C is an in vitro diagnostics kit containing reagents for the quantitative determination of cystatin C in human serum and lithium-heparinized plasma by means of particle-enhanced immunonephelometry using the BN Systems. Cystatin C measurements are used in the diagnosis and treatment of renal diseases.

N Protein Standard UY

N Protein Standard UY is used for preparing reference curves for the immunonephelometric determination of α1-microglobulin and Cystatin C using the BN Systems.

5

Comparison of Technological Characteristics

Predicate Device:
AttributesProposed Device:Roche Tina-quant Cystatin
N Latex Cystatin C assayC Gen.2
(K141143)
Intended Use / Indications
for UseN Latex Cystatin C is an in
vitro diagnostics kit containing
reagents for the quantitative
determination of cystatin C in
human serum and lithium-
heparinized plasma by meansTina-quant Cystatin C Gen. 2
is an in vitro test for the
quantitative determination of
cystatin C in human serum
and plasma on Roche/Hitachi
cobas c systems.
of particle-enhanced
immunonephelometry using
the BN Systems.
Cystatin C measurements are
used in the diagnosis andCystatin C measurements are
used as an aid in the
diagnosis and treatment of
renal diseases.
treatment of renal diseases.
Analytecystatin CSame
Assay type/ TechnologyImmunonephelometryTurbidimetry
Sample TypeHuman serum and plasmaHuman serum and plasma
PermissibleLi-HeparinLi-Heparin,
anticoagulantsK2-EDTA, K3-EDTA
CompositionN Latex Cystatin C consists of
a suspension of polystyrene
particles coated with
approximately 0.016 g/L anti-
human cystatin C from rabbitsReagent 2 is latex particles in
qlycine buffer coated with anti-
Cystatin C antibodies (rabbit);
preservatives and stabilizers.
Ancillary ReagentsN Cystatin C Supplementary
Reagent A contains rabbit
immunoglobulin (14 g/L) in
buffered solution.
N Cystatin C Supplementary
Reagent B consists of an
aqueous solution of
polyethylene glycol sorbitan
monolaureate (85 g/L) and
polyethylene glycol ether (27
g/L).R1 contains solution of
polymers in MOPS-buffered
saline; preservative,
stabilizers.
Unitsmg/LSame
Analytical measuring0.27 - 9.4 mg/L0.40 - 6.80 mg/L
range0.40 - 13.6 mg/L (1:2 dilution)
(Calibrator lot dependent)
Reference Interval0.49 - 1.19 mg/L
Age 21-72Age 21 - 77 0.61 - 0.95 mg/L

6

| | Proposed Device:
N Protein Standard UY | Predicate Device:
C.f.a.s. Cystatin C
(K141143) |
|------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Intended Use | N Protein Standard UY is
used for preparing reference
curves for the
immunonephelometric
determination of α1-
microglobulin and Cystatin C
using the BN Systems. | Calibrator for automated
systems Cystatin C is for use
in the calibration of
quantitative Roche methods
on Roche clinical chemistry
analyzers. |
| Matrix | N Protein Standard UY
consists of lyophilized
polygeline with urinary
proteins of human origin.
Contains sodium azide (