K Number
K191296
Device Name
Pointe Scientific Creatinine Kinase (CK) Reagent Set
Manufacturer
Date Cleared
2020-08-11

(455 days)

Product Code
Regulation Number
862.1215
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For the quantitative determination of creatine kinase activity in serum and plasma. Rx only. Measurements of Creatine Kinase are used in the diagnosis and treatment of myocardial infaction and muscle disease, such as progressive Duchenne-type muscular dystrophy.
Device Description
The Pointe Scientific Creatine Kinase (CK) Reagent Set consists of ready-to-use liguid reagents: - . CK R1 (buffer) contains: Imidazole buffer (pH 6.7) 100.0 mmol/L; NADP 2.0 mmol/L: HK (Baker's yeast) 2.5 KU/L: Glucose 20.0 mmol/L: Magnesium Acetate 10.0 mmol/L; EDTA 2.0 mmol/L and N-acetylcysteine (NAC) 20.0 mmol/L. - . CK R2 (enzyme reagent) contains: Imidazole buffer (pH 6.7) 100.0 mmol/L: ADP 2.0 mmol/L: AMP 5.0 mmol/L: Diadensosine pentaphosphate 10.0 mmol/L: Creatine phosphate 30.0 mmol/L; G6PDH (Baker's yeast) 1.5 KU/L and EDTA 2.0 mmol/L. The kinetic procedure presented is a modification of Szasz of the Rosalki technique, which optimizes the reaction by reactivation of CK activity with N-actyl-L-cysteine (NAC). Creatine Kinase specifically catalyzes the transphosphorylation of ADP to ATP. Through a series of coupled enzymatic reactions, NADPH is produced at a rate directly proportional to the CK activity. The method determines the NADPH absorbance increase per min at 340 nm.
More Information

Not Found

No
The summary describes a chemical reagent set and its performance characteristics for measuring creatine kinase activity using a standard enzymatic reaction and spectrophotometry. There is no mention of AI/ML in the device description, intended use, or performance studies. The "Mentions AI, DNN, or ML" field is explicitly marked as "Not Found".

No.
This device is an in vitro diagnostic (IVD) reagent set used for the quantitative determination of creatine kinase activity in serum and plasma, which is used in the diagnosis and treatment of conditions, not for directly treating a disease or condition.

Yes

The "Intended Use / Indications for Use" section explicitly states that "Measurements of Creatine Kinase are used in the diagnosis and treatment of myocardial infaction and muscle disease". This indicates the device provides information for diagnostic purposes.

No

The device description clearly states it is a "Reagent Set" consisting of liquid reagents, which are chemical components, not software. The performance studies also describe testing of these reagents on a chemistry analyzer.

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

Here's why:

  • Intended Use: The intended use explicitly states "For the quantitative determination of creatine kinase activity in serum and plasma." This indicates the device is used to test samples taken from the human body (in vitro) to provide diagnostic information.
  • Indications for Use: The indications for use mention "diagnosis and treatment of myocardial infaction and muscle disease," which are medical conditions. This further supports its use in a diagnostic context.
  • Device Description: The description details reagents used to perform a biochemical test on serum and plasma samples.
  • Intended User / Care Setting: "Intended for use in a clinical laboratory setting" aligns with the typical use environment for IVDs.
  • Performance Studies: The document describes various performance studies (Method Comparison, Precision, Linearity, Detection Capability, Dilution Recovery, Analytical Specificity) which are standard for demonstrating the analytical performance of an IVD.
  • Predicate Device: The mention of a "Predicate Device(s)" with a K number (K043202) indicates that this device is being compared to a previously cleared IVD by a regulatory body like the FDA.

All these elements strongly indicate that this device is an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

For the quantitative determination of creatine kinase activity in serum and plasma. Rx only. Measurements of Creatine Kinase are used in the diagnosis and treatment of myocardial infaction and muscle disease, such as progressive Duchenne-type muscular dystrophy.

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

CGS

Device Description

The Pointe Scientific Creatine Kinase (CK) Reagent Set consists of ready-to-use liguid reagents:

  • . CK R1 (buffer) contains: Imidazole buffer (pH 6.7) 100.0 mmol/L; NADP 2.0 mmol/L: HK (Baker's yeast) 2.5 KU/L: Glucose 20.0 mmol/L: Magnesium Acetate 10.0 mmol/L; EDTA 2.0 mmol/L and N-acetylcysteine (NAC) 20.0 mmol/L.
  • . CK R2 (enzyme reagent) contains: Imidazole buffer (pH 6.7) 100.0 mmol/L: ADP 2.0 mmol/L: AMP 5.0 mmol/L: Diadensosine pentaphosphate 10.0 mmol/L: Creatine phosphate 30.0 mmol/L; G6PDH (Baker's yeast) 1.5 KU/L and EDTA 2.0 mmol/L.
    The kinetic procedure presented is a modification of Szasz of the Rosalki technique, which optimizes the reaction by reactivation of CK activity with N-actyl-L-cysteine (NAC).
    Creatine Kinase specifically catalyzes the transphosphorylation of ADP to ATP. Through a series of coupled enzymatic reactions, NADPH is produced at a rate directly proportional to the CK activity. The method determines the NADPH absorbance increase per min at 340 nm.

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

Adult population (from 200 blood donors in North Texas)

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)

Performance Data: All analytical performance studies presented below were performed on the Shenzhen Mindrav BA-800M Chemistry Analyzer. All studies were performed using either serum samples collected in serum separator tubes (SST) or plasma collected in lithium heparin tubes.

Method Comparison Study: Two separate split-sample method comparison studies between the Pointe Scientific Creatine Kinase (CK) Reagent Set on the Shenzhen Mindray BA-800M Chemistry Analyzer versus the predicate Beckman Coulter Creatine Kinase (CK-Nac) on the Beckman Coulter Olympus AU400 Clinical Chemistry Analyzer were performed on either serum or plasma samples following CLSI EP09-A2 guidelines using one lot of each of the manufacturer's reagents and a single BA-800M Chemistry analyzer and a single AU400 Clinical Chemistry Analyzer.
a. Method Comparison with serum:
N=120, Range (U/L)=9-1188, Standard Deviation=249.5, Regression Analysis=y = 1.041x - 5.2, Correlation Coefficient=0.9991. Samples were deidentified remnant serum samples obtained from a commercial repository.
b. Method Comparison with plasma:
N=123, Range (U/L)=9-1119, Standard Deviation=255.4, Regression Analysis=y = 1.032x - 0.4, Correlation Coefficient=0.9946. Samples were deidentified remnant Plasma samples obtained from a commercial repository.

Precision Studies: Precision studies were conducted in accordance with CLSI EP05-A3. Samples consisted of two commercial quality controls, three serum pools and three plasma pools. Analyte levels of the tested pools approximated Westgard medical decision points for normal and elevated creatine kinase levels. A third level for each matrix was included above the mid-point of the measurable range for each matrix. Testing was performed utilizing two lots of the Pointe Scientific Creatine Kinase (CK) Reagent Set on the same Shenzhen Mindray BA-800M Chemistry Analyzer. Pools were tested in duplicate twice per day for a total of 20 days (final n per sample = 80).

Linearity/Assay Range Study: A linearity study was conducted according to CLSI EP06-A. A set of 12 serum samples ranging from 9 to 1700 U/L or 12 plasma samples ranging from 8 to 1595 U/L were prepared by admixture of high-level and low-level sample pools. Each admixture was analyzed in duplicate using two lots of reagent on the same Shenzhen Mindray BA-800M Chemistry Analyzer. The linearity study data supports the claimed range of 9 to 1200 U/L.

Detection Capability: The limit of blank (LoB), limit of detection (LoD), and limit of quantitation (LoQ) were determined for both serum and plasma in accordance to CLSI EP17-A2 suggested guidelines on two lots of Pointe Creatine Kinase (CK) Reagent Sets and a single BA-800M Chemistry Analyzer.

  • LoB: Saline used as blank. Sixty measurements (1 sample X 20 repetitions x 3 days each) analyzed across two lots of reagent. Determined to be 2 U/L.
  • LoD: Twenty low-level depleted serum samples and twenty depleted plasma samples analyzed in duplicate across two lots of reagent within a single day.
  • LoQ: Series of 5 low activity samples each run in 8 duplicates over 5 days. Derived from lowest sample results exhibiting a precision CV of less than 20%.

Dilution Recovery Studies: Studies were performed to provide evidence that values of highly concentrated samples of creatine kinase outside of the claimed measurement range (9-1200 U/L) can be accurately determined through a 10-fold dilution of the sample. A dilution recovery study was undertaken utilizing suggested methods from CLSI EP34-E1. Three contrived high-level samples greater than the Pointe Creatine Kinase (CK) Reagent Set's measurement range for both serum and plasma were diluted in physiological saline at dilutions of 1:2; 1:4; 1;10 and 1:12 then subsequently analyzed using two lots of the Pointe Creatine Kinase (CK) Reagent set on the same Shenzhen Mindray BA-800M Chemistry.

Analytical Specificity (Endogenous Substances): Interference studies were performed following the recommendation of CLSI EP07-A3. Interference testing was conducted using one lot of reagent and one Mindray BA-800M analyzer. All interferents were evaluated in randomly selected serum and plasma samples ranging from 43 U/L to 268 U/L. Interferents were tested across an evenly spaced range of concentrations. Significant interference defined as percent difference greater than 10% from control. Highest concentration at which no significant interference was observed: Bilirubin (Conjugated and Unconjugated) 60 mg/dL, Ascorbic Acid 500 mg/dL, Hemoglobin 500 mg/dL, Intralipid 1382 mg/dL.

Traceability: The Pointe Scientific Creatine Kinase (CK) Assay is traceable to the IFCC reference method.

Stability: Reagent shelf life stability claim is 24 months at 2-8°C. Reagent onboard (in use and refrigerated) stability claim is 29 days.

Expected Values: 30-223 U/L creatine kinase in an adult population (from 200 blood donors in North Texas).

Conclusion: Based on the results of the testing conducted, the Pointe Scientific Creatine Kinase (CK) Reagent Set is substantially equivalent to the predicate device, the Olympus Creatine Kinase Reagent (K043202).

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

Correlation Coefficient for method comparison: 0.9991 (serum), 0.9946 (plasma).
Precision: %CV values for repeatability and total precision provided in tables, ranging from 0.5% to 3.8%.
Linearity: % Recovery for different dilutions, generally between 92% and 105%.
Limit of Blank: 2 U/L (Plasma and Serum).
Limit of Detection: Not explicitly stated as a number, but noted for Plasma and Serum.
Limit of Quantitation: Not explicitly stated as a number, but noted for Plasma and Serum.

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.

K043202

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

Not Found

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

Not Found

§ 862.1215 Creatine phosphokinase/creatine kinase or isoenzymes test system.

(a)
Identification. A creatine phosphokinase/creatine kinase or isoenzymes test system is a device intended to measure the activity of the enzyme creatine phosphokinase or its isoenzymes (a group of enzymes with similar biological activity) in plasma and serum. Measurements of creatine phosphokinase and its isoenzymes are used in the diagnosis and treatment of myocardial infarction and muscle diseases such as progressive, Duchenne-type muscular dystrophy.(b)
Classification. Class II.

0

August 11, 2020

MedTest Dx William Cripps Director, R&D, QA/RA 5449 Research Drive Canton, MI 48188

Re: K191296

Trade/Device Name: Pointe Scientific Creatine Kinase (CK) Reagent Set Regulation Number: 21 CFR 862.1215 Regulation Name: Creatine phosphokinase/creatine kinase or isoenzymes test system Regulatory Class: Class II Product Code: CGS Dated: July 8, 2020 Received: July 10, 2020

Dear William Cripps:

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/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Marianela Perez-Torres, Ph.D. Acting Deputy Director Division of Chemistry and Toxicology Devices OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: 06/30/2020 See PRA Statement below.

510(k) Number (if known) K191296

Device Name

Pointe Scientific Creatine Kinase (CK) Reagent Set

Indications for Use (Describe)

For the quantitative determination of creatine kinase activity in serum and plasma. Rx only.

Measurements of Creatine Kinase are used in the diagnosis and treatment of myocardial infaction and muscle disease, such as progressive Duchenne-type muscular dystrophy.

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

Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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

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

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

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

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

FORM FDA 3881 (7/17)

Page 1 of 1

PSC Paklishing Survices (301) 443-6740 EF

3

5. 510(k) SUMMARY (K191296)

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

a. Device Information

CategoryComments
SponsorMedTest Dx
5449 Research Drive
Canton, MI 48188
Phone: 734-487-8300
Fax: 734-483-1592
Correspondent
Contact InformationWilliam Cripps
Director, R&D/RA/QA
Email: wcripps@medtestdx.com
Phone: 734-487-8300 ext. 120
Fax: 734-483-1592
Device Common
NameCreatine Kinase (CK)
Trade or Proprietary
NamePointe Scientific Creatine Kinase (CK) Reagent Set
Candidate Device
Product Code,
Classification,
Classification Name
& PanelCGS, Class II, 21 CFR 862.1215 - Nad Reduction/Nadh
Oxidation, Cpk Or Isoenzymes, 75 – Clinical Chemistry

Predicate Device Information

| Predicate Device | Olympus Creatine Kinase
Reagent |
|--------------------------------------------------|------------------------------------|
| Predicate Device
Manufacturer | Beckman Coulter, Inc. |
| Predicate Device
Premarket
Notification #: | K043202 |

b. Date Summary Prepared

May 10, 2019 Updated on: October 4, 2019 Updated on: November 8, 2019 Updated on: July 8, 2020 Updated on: August 4, 2020

4

c. Description of Device

The Pointe Scientific Creatine Kinase (CK) Reagent Set consists of ready-to-use liguid reagents:

  • . CK R1 (buffer) contains: Imidazole buffer (pH 6.7) 100.0 mmol/L; NADP 2.0 mmol/L: HK (Baker's yeast) 2.5 KU/L: Glucose 20.0 mmol/L: Magnesium Acetate 10.0 mmol/L; EDTA 2.0 mmol/L and N-acetylcysteine (NAC) 20.0 mmol/L.
  • . CK R2 (enzyme reagent) contains: Imidazole buffer (pH 6.7) 100.0 mmol/L: ADP 2.0 mmol/L: AMP 5.0 mmol/L: Diadensosine pentaphosphate 10.0 mmol/L: Creatine phosphate 30.0 mmol/L; G6PDH (Baker's yeast) 1.5 KU/L and EDTA 2.0 mmol/L.

The kinetic procedure presented is a modification of Szasz of the Rosalki technique, which optimizes the reaction by reactivation of CK activity with N-actyl-L-cysteine (NAC).

Creatine Kinase specifically catalyzes the transphosphorylation of ADP to ATP. Through a series of coupled enzymatic reactions, NADPH is produced at a rate directly proportional to the CK activity. The method determines the NADPH absorbance increase per min at 340 nm.

d. Intended Use

For the quantitative determination of creatine kinase activity in serum and plasma. Rx Only.

Measurements of Creatine Kinase are used in the diagnosis and treatment of myocardial infarction and muscle disease, such as progressive Duchenne-type muscular dystrophy.

5

e. Comparison to Predicate Device

The chart below illustrates the similarities between the Pointe Scientific Creatine Kinase (CK) Reagent Set and the predicate, Beckman Coulter Creatine Kinase.

| Characteristics | Pointe Scientific Creatine
Kinase (CK) Reagent Set
(Proposed Device) | Beckman Coulter K043202
(Predicate Device) |
|----------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Intended Use | For the quantitative
determination of creatine kinase
activity in serum and plasma. Rx
Only.
Measurements of Creatine
Kinase are used in the diagnosis
and treatment of myocardial
infarction and muscle disease,
such as progressive Duchenne-
type muscular dystrophy. | For use in the Olympus
automated clinical chemistry
analyzers for the quantitative
determination of creatine
kinase activity in human
serum and plasma
Measurements of Creatine
Kinase are used in the
diagnosis and treatment of
myocardial infarction and
muscle disease, such as
progressive Duchenne-type
muscular dystrophy. |
| Contents | • CK R1 (buffer) contains:
Imidazole buffer (pH 6.7) 100.0
mmol/L; NADP 2.0 mmol/L; HK
(Baker's yeast) 2.5 KU/L;
Glucose 20.0 mmol/L;
Magnesium Acetate 10.0
mmol/L; EDTA 2.0 mmol/L and
N-acetylcysteine (NAC) 20.0
mmol/L.
• CK R2 (enzyme reagent)
contains: Imidazole buffer (pH
6.7) 100.0 mmol/L; ADP 2.0
mmol/L; AMP 5.0 mmol/L;
Diadensosine pentaphosphate
10.0 mmol/L;
Creatine
phosphate 30.0 mmol/L;
G6PDH (Baker's yeast) 1.5
KU/L and EDTA 2.0 mmol/L. | • Final concentration of
reactive ingredients:
• Imidazole (pH 6.5) 100
mmol/L
• HK (Yeast) ≥ 4.0 kU/L (66.7
µkat/L)
• NADP 2 mmol/L
• G6P-DH (Leuconostoc
mesenteroides) ≥ 2.8 kU/L
(46.7 µkat/L)
• ADP 2 mmol/L
• Mg2+ 20 mmol/L
• AMP 5 mmol/L
• Diadenosine
pentaphosphate 10 µmol/L
• EDTA 2 mmol/L
• Glucose 20 mmol/L
• Creatine Phosphate 30
mmol/L
• N-Acetylcysteine 0.2 mmol/L
• Stabilizers
• Also contains preservatives |
| | | |
| Principle | The kinetic procedure presented
is a modification of Szasz of the
Rosalki technique, which
optimizes the reaction by
reactivation of CK activity with
N-actyl-L-cysteine (NAC).

CK specifically catalyzes the
transphosphorylation of ADP to
ATP. Through a series of
coupled enzymatic reactions,
NADPH is produced at a rate
directly proportional to the CK
activity. The method determines
the NADPH absorbance
increase per min at 340 nm. | This CK procedure is a
modification of the IFCC
method. CK reversibly
catalyzes the transfer of a
phosphate group from
creatine phosphate to
adenosine diphosphate (ADP)
to give creatine and
adenosine triphosphate (ATP)
as products. The ATP formed
is used to produce glucose-6-
phosphate and ADP from
glucose. This reaction is
catalyzed by hexokinase (HK)
which requires magnesium
ions for maximum activity.
The glucose6-phosphate is
oxidized by the action of the
enzyme glucose-6-phosphate
dehydrogenase (G6P-DH)
with simultaneous reduction
of the coenzyme
nicotinamide adenine
dinucleotide (NADP) to give
NADPH and 6-
phosphogluconate. The rate
of increase of absorbance at
340/660 nm due to the
formation of NADPH is
directly proportional to the
activity of CK in the sample |
| Sample Type | Serum and lithium heparin
plasma | Serum and heparinized
plasma |
| Measurement
Range | 9-1200 U/L | 10-2000 U/L |

6

7

Performance Data

All analytical performance studies presented below were performed on the Shenzhen Mindrav BA-800M Chemistry Analyzer. All studies were performed using either serum samples collected in serum separator tubes (SST) or plasma collected in lithium heparin tubes.

Method Comparison Study

Two separate split-sample method comparison studies between the Pointe Scientific Creatine Kinase (CK) Reagent Set on the Shenzhen Mindray BA-800M Chemistry Analyzer versus the predicate Beckman Coulter Creatine Kinase (CK-Nac) on the Beckman Coulter Olympus AU400 Clinical Chemistry Analyzer were performed on either serum or plasma samples following CLSI EP09-A2 guidelines using one lot of each of the manufacturer's reagents and a single BA-800M Chemistry analyzer and a single AU400 Clinical Chemistry Analyzer.

a. Method Comparison with serum:

A total of 120 deidentified remnant serum samples were obtained from a commercial repository and tested in duplicate across the assay range of 9-1188 U/L. Of these samples, 4 were altered by mixing of two samples together to obtain an analyte level within the measurement range. Samples were analyzed in singlicate. Results using a Deming regression were obtained with EP Evaluator Software. Results from single representative data set are summarized below:

Serum-Serum
MethodCreatine Kinase
N120
Range (U/L)9-1188
Standard Deviation249.5
Regression Analysisy = 1.041x - 5.2
Correlation Coefficient0.9991

b. Method Comparison with plasma:

A total of 123 deidentified remnant Plasma samples were obtained from a commercial repository and tested in duplicate across the assay range of 9-1119 U/L. Of these samples, 2 were altered by mixing of two samples together to obtain an analyte level within the measurement range. Samples were analyzed in singlicate. Results using a Deming regression were obtained with EP Evaluator Software. Results from single representative data set are summarized below:

Plasma-Plasma
MethodCreatine Kinase
N123
Range (U/L)9-1119
Standard Deviation255.4
Regression Analysis$y = 1.032x - 0.4$
Correlation Coefficient0.9946

Plasma-Plasma

8

Precision Studies

Precision studies were conducted in accordance with CLSI EP05-A3. Samples consisted of two commercial quality controls, three serum pools and three plasma pools. Analyte levels of the tested pools approximated Westgard medical decision points for normal and elevated creatine kinase levels. A third level for each matrix was included above the mid-point of the measurable range for each matrix.

Testing was performed utilizing two lots of the Pointe Scientific Creatine Kinase (CK) Reagent Set on the same Shenzhen Mindray BA-800M Chemistry Analyzer. Pools were tested in duplicate twice per day for a total of 20 days (final n per sample = 80). Results from a single representative lot are summarized below.

MatrixSampleNMean CKRepeatabilityTotal
(U/L)SD%CVSD%CV
ControlsControl 180134.371.220.91.971.5
ControlsControl 280265.181.350.54.391.7
SerumLevel 18088.191.501.73.163.6
SerumLevel 280288.021.790.88.713.8
SerumLevel 380691.633.200.510.401.5
PlasmaLevel 180109.181.121.03.833.5
PlasmaLevel 280219.331.360.65.052.3
PlasmaLevel 380686.115.790.813.862.0

Linearity/Assay Range Study

A linearity study was conducted according to CLSI EP06-A. A set of 12 serum samples ranging from 9 to 1700 U/L or 12 plasma samples ranging from 8 to 1595 U/L were prepared by admixture of high-level and low-level sample pools. Each admixture was analyzed in duplicate using two lots of reagent on the same Shenzhen Mindray BA-800M Chemistry Analyzer.

The results from one representative lot run are summarized below. Acceptable deviation from expected value was set at less than or equal to 10%. The linearity study data supports the claimed range of 9 to 1200 U/L.

Matrix: SerumMatrix: Plasma
SampleMean
ResultExpected
Result%
RecoverySampleMean
ResultExpected
Result%
Recovery
Low99100%Low88100%
Dil 19694102%Dil 18887102%
Dil 2145145100%Dil 213313599%
Dil 3222221100%Dil 319620695%
Dil 425226396%Dil 422724693%
Dil 542343298%Dil 537240492%
Dil 6645643100%Dil 659560399%
Dil 7855855100%Dil 7801801100%
Dil 81060106699%Dil 81024999102%
Dil 91254127798%Dil 912061198101%
Dil 101448148997%Dil 1014551396104%
High1637170096%High16691595105%

9

Detection Capability

The limit of blank (LoB), limit of detection (LoD), and limit of quantitation (LoQ) were determined for both serum and plasma in accordance to CLSI EP17-A2 suggested quidelines on two lots of Pointe Creatine Kinase (CK) Reagent Sets and a single BA-800M Chemistry Analyzer.

Saline was used as the blank sample for the determination of LoB. Sixty measurements (1 sample X 20 repetitions x 3 days each) were analyzed across two lots of reagent to determine the LoB of the system. Using a non-parametric distribution calculation of LoB, as detailed in CLSI EP17-A2, the limit of blank was determined to be 2 U/L.

For LoD determination, twenty low-level depleted serum samples and twenty depleted plasma samples were analyzed in duplicate across two lots of reagent within a single day. Results were used in conjunction with Limit of Blank results to determine LoD using the equation LoD=LoB +1.625(SDLow Level Samples), per CLSI 17-A2 quidance. Results from one representative lot are presented below.

The LoQ is the lowest amount of creatine kinase that can be determined quantitatively within a defined precision (