K Number
K182098
Device Name
N Latex FLC kappa assay, N Latex FLC lambda assay
Date Cleared
2018-11-01

(90 days)

Product Code
Regulation Number
866.5550
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
In-vitro diagnostic reagents for the quantitative determination of free light chains (FLC), type kappa or type lambda in human serum and EDTA-plasma by means of particle-enhanced immunonephelometry using the BN Systems. FLC measurements are used as an aid in the diagnosis and monitoring of multiple myeloma (MM) and as an aid in the diagnosis of amyloidosis (AL) in conjunction with other laboratory and clinical findings. The response category assignment of Complete Response for the monitoring of MM is reliant upon the combination of clinical history and other tests including protein electrophoresis, immunofixation and bone marrow, imaging and urine assessments.
Device Description
In-vitro diagnostic reagents for the quantitative determination of free light chains (FLC), type kappa or type lambda in human serum and EDTA-plasma by means of particle-enhanced immunonephelometry using the BN Systems. FLC measurements are used as an aid in the diagnosis and monitoring of multiple myeloma (MM) and as an aid in the diagnosis of amyloidosis (AL) in conjunction with other laboratory and clinical findings. The response category assignment of Complete Response for the monitoring of MM is reliant upon the combination of clinical history and other tests including protein electrophoresis, immunofixation and bone marrow, imaging and urine assessments, The FLC test systems are based upon the principles of particle-enhanced immunonephelometry. Polystyrene particles coated with monoclonal antibodies to human free light chains, type kappa or lambda, respectively, are agglutinated with samples containing FLC. 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 devices in this submission have not materially changed since clearance under K171742. The purpose for this submission is to add monitoring of multiple myeloma (MM) to the intended use.
More Information

No
The summary describes a standard in-vitro diagnostic assay based on particle-enhanced immunonephelometry. There is no mention of AI, ML, or any computational methods beyond standard data analysis for calculating concentrations and comparing results. The focus is on the chemical and optical principles of the assay.

No
This device is an in-vitro diagnostic reagent used for measurement, aiding in diagnosis and monitoring, not for treating a condition.

Yes

Explanation: The "Intended Use / Indications for Use" section explicitly states that the FLC measurements are used "as an aid in the diagnosis and monitoring of multiple myeloma (MM) and as an aid in the diagnosis of amyloidosis (AL)". This clearly indicates a diagnostic purpose.

No

The device is described as in-vitro diagnostic reagents and test systems based on particle-enhanced immunonephelometry, which are physical components used in laboratory testing, not software.

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

Here's why:

  • Intended Use/Indications for Use: The description explicitly states "In-vitro diagnostic reagents for the quantitative determination of free light chains (FLC)... in human serum and EDTA-plasma". This clearly indicates the device is intended for testing samples taken from the human body in vitro (outside the body).
  • Device Description: The description reiterates that these are "In-vitro diagnostic reagents". It also describes the mechanism of action (particle-enhanced immunonephelometry) which is a common method used in IVD tests.
  • Performance Studies: The document details performance studies, including clinical sensitivity and specificity, which are standard evaluations for IVD devices to demonstrate their accuracy and reliability for their intended use.
  • Predicate Device(s): The mention of predicate devices (K031016) which are also IVDs further supports that this device falls under the IVD category.
  • Intended User / Care Setting: "Prescription Use" is a common classification for IVD devices that require a healthcare professional's order.

All of these points align with the definition and characteristics of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

In-vitro diagnostic reagents for the quantitative determination of free light chains (FLC), type kappa or type lambda in human serum and EDTA-plasma by means of particle-enhanced immunonephelometry using the BN Systems. FLC measurements are used as an aid in the diagnosis and monitoring of multiple myeloma (MM) and as an aid in the diagnosis of amyloidosis (AL) in conjunction with other laboratory and clinical findings.

The response category assignment of Complete Response for the monitoring of MM is reliant upon the combination of clinical history and other tests including protein electrophoresis, immunofixation and bone marrow, imaging and urine assessments.

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

DFH, DEH

Device Description

In-vitro diagnostic reagents for the quantitative determination of free light chains (FLC), type kappa or type lambda in human serum and EDTA-plasma by means of particle-enhanced immunonephelometry using the BN Systems. FLC measurements are used as an aid in the diagnosis and monitoring of multiple myeloma (MM) and as an aid in the diagnosis of amyloidosis (AL) in conjunction with other laboratory and clinical findings. The response category assignment of Complete Response for the monitoring of MM is reliant upon the combination of clinical history and other tests including protein electrophoresis, immunofixation and bone marrow, imaging and urine assessments,

The FLC test systems are based upon the principles of particle-enhanced immunonephelometry. Polystyrene particles coated with monoclonal antibodies to human free light chains, type kappa or lambda, respectively, are agglutinated with samples containing FLC. 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 devices in this submission have not materially changed since clearance under K171742. The purpose for this submission is to add monitoring of multiple myeloma (MM) to the intended use.

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

Prescription Use (Part 21 CFR 801 Subpart D)

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)

Performance Data: Extended indication for monitoring of MM. The Latex FLC assays were evaluated on BN II Systems in a multi-center study to evaluate performance in monitoring multiple myeloma (MM) patients.

Study Type: Comparison to Clinical Status
Sample Size: Not explicitly stated, but tables show totals: 391
Key Results: Therapy response was evaluated according to IMWG FLC criteria considering IFE and serum FLC measurements. The response levels obtained by the two different test systems (N Latex FLC and predicate Freelite) were compared to the clinical response level provided by the physician.
Clinical Sensitivity: 26% (12/47) (95% CI: 13.9% – 40.3%)
Clinical Specificity: 97% (335/344) (95% CI: 95.1%– 98.8%)
Agreement between N Latex FLC and IFE results compared to clinical assessment:
Good Response: 62%
Moderate Response: 79%
Stable Disease: 70%
Progressive Disease: 26%
Overall Agreement: 67%

Study Type: Comparison to Predicates
Sample Size: Not explicitly stated, but tables show totals: 391
Key Results: The performance of N Latex FLC kappa and FLC lambda assays were compared to the predicate devices based on disease response categories. In this retrospective clinical study, all samples were tested with the N Latex FLC kappa and lambda assays and with the predicate device.
Agreement between N Latex FLC results and Freelite results across response categories:
Good Response: 100%
Moderate Response: 81%
Stable Disease: 92%
Progressive Disease: 67%
Overall Agreement: 89%

Study Type: Comparison to Predicates using Follow-up Graphs
Sample Size: 102 patients
Key Results: Patients were monitored and tested using N Latex FLC kappa and lambda and Freelite Kappa and Lambda after initiation of the first therapy phase and at intervals of ≥ three weeks with a total of at least four collections. Two graphs each were established for the 102 patients included in the study, one using lin/lin and one using log/log scaling.
"While N Latex FLC assays and Freelite Kappa and Lambda assays react in the same manner and follow a parallel response, they do not always agree in the magnitude of concentration. For this reason, different FLC assays cannot be used interchangeably (as stated in the sponsor's package insert)."

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

Clinical Sensitivity: 26% (12/47) (95% CI: 13.9% – 40.3%)
Clinical Specificity: 97% (335/344) (95% CI: 95.1%– 98.8%)

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.

K031016

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

§ 866.5550 Immunoglobulin (light chain specific) immunological test system.

(a)
Identification. An immunoglobulin (light chain specific) immunological test system is a device that consists of the reagents used to measure by immunochemical techniques both kappa and lambda types of light chain portions of immunoglobulin molecules in serum, other body fluids, and tissues. In some disease states, an excess of light chains are produced by the antibody-forming cells. These free light chains, unassociated with gamma globulin molecules, can be found in a patient's body fluids and tissues. Measurement of the various amounts of the different types of light chains aids in the diagnosis of multiple myeloma (cancer of antibody-forming cells), lymphocytic neoplasms (cancer of lymphoid tissue), Waldenstrom's macroglobulinemia (increased production of large immunoglobulins), and connective tissue diseases such as rheumatoid arthritis or systemic lupus erythematosus.(b)
Classification. Class II (performance standards).

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November 1, 2018

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

Re: K182098

Trade/Device Name: N Latex FLC kappa assay, N Latex FLC lambda assay Regulation Number: 21 CFR 866.5550 Regulation Name: Immunoglobulin (light chain specific) immunological test system Regulatory Class: Class II Product Code: DFH, DEH Dated: August 2, 2018 Received: August 3, 2018

Dear Christine Perkins:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

1

801 and Part 809); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.htm); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice

(https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Leonthena R. Carrington -S

Lea Carrington 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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Indications for Use

510(k) Number (if known) K182098

Device Name

N Latex FLC kappa and N Latex FLC lambda

Indications for Use (Describe)

In-vitro diagnostic reagents for the quantitative determination of free light chains (FLC), type kappa or type lambda in human serum and EDTA-plasma by means of particle-enhanced immunonephelometry using the BN Systems. FLC measurements are used as an aid in the diagnosis and monitoring of multiple myeloma (MM) and as an aid in the diagnosis of amyloidosis (AL) in conjunction with other laboratory and clinical findings.

The response category assignment of Complete Response for the monitoring of MM is reliant upon the combination of clinical history and other tests including protein electrophoresis, immunofixation and bone marrow, imaging and urine assessments.

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)

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Image /page/3/Picture/0 description: The image shows the Siemens Healthineers logo. The word "SIEMENS" is in teal, and the word "Healthineers" is in orange. To the right of the word "Healthineers" is a graphic of orange dots arranged in a circular pattern.

510(k) Summary per 21 CFR 807.92

This 510(k) Summary of Safety and Effectiveness is being submitted in accordance with the requirements of the Safe Medical Device Act of 1990 and 21 CFR 807.92.

The assigned 510(k) number is: K182098_

1. Submitter

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

Contact:Christine Perkins
Email:christine.perkins@siemens-healthineers.com
Phone:302-631-8811
Fax:302-631-6299
Date of Preparation:August 29, 2018

2. Device Information

| Trade Name: | N Latex FLC kappa assay
N Latex FLC lambda assay |
|-----------------------|---------------------------------------------------------------------------------------|
| Common or Usual Name: | Light Chain immunological test system |
| Classification Name: | Immunoglobulin (light chain specific) immunological
test system per 21CFR 866.5550 |
| Product Code: | DFH (kappa)
DEH (lambda) |
| Regulatory Class: | |
| 510(k) Review Panel: | Clinical Immunology (82) |

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3. Predicate Devices

The Binding Site Freelite® Human Kappa Free Kit for use on the Siemens BN™ II - K031016

The Binding Site Freelite® Human Lambda Free Kit for use on the Siemens BN™ II - K031016

4. Device Description / Test Principle

In-vitro diagnostic reagents for the quantitative determination of free light chains (FLC), type kappa or type lambda in human serum and EDTA-plasma by means of particle-enhanced immunonephelometry using the BN Systems. FLC measurements are used as an aid in the diagnosis and monitoring of multiple myeloma (MM) and as an aid in the diagnosis of amyloidosis (AL) in conjunction with other laboratory and clinical findings. The response category assignment of Complete Response for the monitoring of MM is reliant upon the combination of clinical history and other tests including protein electrophoresis, immunofixation and bone marrow, imaging and urine assessments,

The FLC test systems are based upon the principles of particle-enhanced immunonephelometry. Polystyrene particles coated with monoclonal antibodies to human free light chains, type kappa or lambda, respectively, are agglutinated with samples containing FLC. 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 devices in this submission have not materially changed since clearance under K171742. The purpose for this submission is to add monitoring of multiple myeloma (MM) to the intended use.

5. Intended Use / Indications for Use

N Latex FLC kappa and N Latex FLC lambda assays

In-vitro diagnostic reagents for the quantitative determination of free light chains (FLC), type kappa or type lambda in human serum and EDTA-plasma by means of particle-enhanced immunonephelometry using the BN Systems. FLC measurements are used as an aid in the diagnosis and monitoring of multiple myeloma (MM) and as an aid in the diagnosis of amvloidosis (AL) in coniunction with other laboratory and clinical findings. The response category assignment of Complete Response for the monitoring of MM is reliant upon the combination of clinical history and other tests including protein electrophoresis, immunofixation and bone marrow, imaging and urine assessments.

N FLC Supplementary Reagent

Supplementary reagent for the immunonephelometric determination of free light chains (FLC), type kappa and type lambda on BN Systems. A mixture of both supplementary reagents is used to suppress interference by rheumatoid factors and human anti-mouse antibodies (HAMA).

Special Conditions for Use:

For prescription use only.

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Special instrument requirements:

BN II (K943997) and BN ProSpec Systems (K001647)

6. Technical Characteristics

Similarities and Differences to the Predicate

A comparison of the similarities and differences between the proposed Siemens Healthcare N Latex FLC kappa and N Latex FLC lambda assays versus The Binding Site (TBS) Freelite Human Kappa Free and Lambda Free assays (predicates) is provided in the table below.

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Proposed DevicesPredicate Devices
Siemens Healthcare
BN SystemsThe Binding Site
N Latex FLC kappa
N Latex FLC lambdaFreelite® Human Kappa Free and
Freelite® Human Lambda Free
kits on the Siemens BN™II
K031016
Indications for
UseIn-vitro diagnostic reagents for the
quantitative determination of free
light chains (FLC), type kappa or
type lambda in human serum and
EDTA-plasma by means of particle-
enhanced immunonephelometry
using the BN Systems. FLC
measurements are used as an aid in
the diagnosis and monitoring of
multiple myeloma (MM) and as an
aid in the diagnosis of amyloidosis
(AL) in conjunction with other
laboratory and clinical findings.
The response category assignment
of Complete Response for the
monitoring of MM is reliant upon the
combination of clinical history and
other tests including protein
electrophoresis, immunofixation
and bone marrow, imaging and
urine assessments.Kappa: This kit is intended for the
quantitation of kappa free light chains
in serum and urine on the Siemens
BN™ II. Measurement of free light
chains aids in the diagnosis and
monitoring of multiple myeloma,
lymphocytic neoplasms,
Waldenstrom's macroglobulinemia,
AL amyloidosis, light chain
deposition disease and connective
tissue diseases such as systemic
lupus erythematosus in conjunction
with other laboratory and clinical
findings.
Lambda: This kit is intended for the
quantitation of lambda free light
chains in serum and urine on the
Siemens BN™ II. Measurement of
free light chains aids in the diagnosis
and monitoring of multiple myeloma,
lymphocytic neoplasms,
Waldenstrom's macroglobulinemia,
AL amyloidosis, light chain
deposition disease and connective
tissue diseases such as systemic
lupus erythematosus in conjunction
with other laboratory and clinical
findings.
Sample TypeHuman serum and EDTA plasmaHuman serum and urine
Unitsmg/LSame
TechnologyNephelometryNephelometry
Polystyrene particles coated with
monoclonal antibodiesPolystyrene particles coated with
polyclonal monospecific antibodies
TraceabilityInternal Reference Plasma PoolInternal reference preparation
CalibratorsOne levelSame
Instrument
SystemSiemens BN II and BN ProSpec
SystemsSiemens BN II
Proposed DevicesPredicate Devices
Siemens Healthcare
BN SystemsThe Binding Site
N Latex FLC kappa
N Latex FLC lambdaFreelite® Human Kappa Free and
Freelite® Human Lambda Free
kits on the Siemens BN™II
K031016
Analytical
Measuring Range
(Calibrator lot
dependent)kappa: 3.4 to 110 mg/L
lambda: 1.9 to 60 mg/LKappa: 5.9 to 190 mg/L
Lambda: 5.0 to 160 mg/L
Reference
Intervalkappa: 8.24 – 28.90 mg/L
lambda: 9.10 - 32.60 mg/L
Ratio: 0.53 to 1.51Kappa: 3.30 to 19.40 mg/L
Lambda: 5.71 to 26.30 mg/L
Ratio: 0.26 to 1.65

Comparison of Technological Characteristics

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The differences between the predicate devices and proposed reagents do not result in a change to the intended use, the indications for use, or the safety and efficacy when used according to the product labeling.

7. Performance Data

Performance Data: Extended indication for monitoring of MM. See original submission (K171742) for previously documented analytical and clinical studies:

  • Precision and Reproducibility ●
  • Linearity / Assay Measuring Range ●
  • Antigen Excess ●
  • Stability
  • . Detection Capabilities
  • Analytical Specificity / Interferences ●
  • Expected Values
  • Clinical Specificity and Sensitivity ●
  • Method comparison to Predicate Devices ●

7.1 Performance data for monitoring of MM patients

The Latex FLC assays were evaluated on BN II Systems in a multi-center study to evaluate performance in monitoring multiple myeloma (MM) patients. The following studies were performed in support of an MM monitoring claim:

Comparison to Clinical Status

Therapy response was evaluated according to IMWG FLC criteria considering IFE and serum FLC measurements. Response categories were determined for FLC testing by N Latex FLC and Freelite, respectively. The response levels obtained by the two different test systems were compared to the clinical response level provided by the physician in charge within the Case Report Form (CRF). Relative agreement between the clinical responses (including further

8

information in addition to serum testing) and the response level applying the IMWG FLC response scheme by either using N Latex FLC or the predicate device were calculated and compared.

Clinical Status
ProgressionNo ProgressionTotal
Change in N
Latex FLCPositive*12921
Negative**35335370
Total47344391
Clinical Sensitivity: 26%*** (12/47) (95% CI: 13.9% – 40.3%)
Clinical Specificity: 97% (335/344) (95% CI: 95.1%– 98.8%)

*Positive: ≥25% rd dFLC and d dFLC ≥100 mg/L

**Negative: