K Number
K192433
Device Name
LZI Methadone II Enzyme Immunoassay
Date Cleared
2019-10-04

(29 days)

Product Code
Regulation Number
862.3620
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The LZI Methadone II Enzyme Immunoassay is an in vitro diagnostic test intended for the qualitative and semi-quantitative determination of methadone in human urine. The cutoff for both the qualitative and semi-quantitative modes of the assay is 300 ng/mL for methadone. The assay is designed for prescription use on automated clinical chemistry analyzers. The semi-quantitative mode is for purposes of (1) enabling laboratories to determine an appropriate dilution of the specimen for confirmation by a confirmatory method such as gas or liquid chromatography/mass spectrometry (GCMS or LC/MS) or (2) permitting laboratories to establish quality control procedures. The assay provides only a preliminary analytical result. A more specific alternative analytical chemistry method must be used in order to obtain a confirmed analytical result. Gas or liquid chromatography/mass spectrometry (GC/MS or LC/MS) is the preferred confirmatory method. Clinical consideration and professional judgment should be exercised with any drug of abuse test result, particularly when the preliminary test result is positive.
Device Description
The LZI Methadone II Enzyme Immunoassay is a homogeneous enzyme immunoassay with ready-to-use liquid reagents. The assay is based on competition between methadone in the sample and methadone labeled with the enzyme glucose-6-phosphate dehydrogenase (G6PDH) for a fixed amount of antibody in the reagent. Enzyme activity decreases upon binding to the antibody, and the methadone concentration in the sample is measured in terms of enzyme activity. In the absence of methadone in the sample, methadone-labeled G6PDH conjugate is bound to antibody, and the enzyme activity is inhibited. On the other hand, when free methadone is present in the sample, antibody would bind to free methadone; the unbound methadone-labeled G6PDH then exhibits its maximal enzyme activity. Active enzyme converts nicotinamide adenine dinucleotide (NAD) to NADH, resulting in an absorbance change that can be measured spectrophotometrically at 340 nm. The LZI Methadone II Enzyme Immunoassay is a kit comprised of two reagents, an R1 and R2 which are bottled separately but sold together within the kit. The Ri solution contains mouse monoclonal anti-methadone antibody, glucose-6-phosphate (G6P) nicotinamide adenine dinucleotide (NAD), stabilizers, and sodium azide (0.09 %) as a preservative. The R2 solution contains glucose-6-phosphate dehydrogenase (G6PDH) labeled with methadone in buffer with sodium azide (0.09 %) as a preservative.
More Information

Not Found

No
The description details a standard enzyme immunoassay based on chemical reactions and spectrophotometric measurement, with no mention of AI or ML algorithms for data analysis or interpretation.

No
This device is an in vitro diagnostic test used for the qualitative and semi-quantitative determination of methadone in human urine. It provides analytical results but does not directly treat or diagnose a disease state in a patient.

Yes
The device is described as an "in vitro diagnostic test" intended for the qualitative and semi-quantitative determination of methadone in human urine, which directly aligns with the definition of a diagnostic device.

No

The device is an in vitro diagnostic test kit comprised of liquid reagents, which are physical components, not software.

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 diagnostic test intended for the qualitative and semi-quantitative determination of methadone in human urine." The term "in vitro diagnostic" is a direct indicator.
  • Device Description: The description details a laboratory test that analyzes a biological sample (human urine) using chemical reagents to detect a substance (methadone). This is the core function of an IVD.
  • Performance Studies: The document describes performance studies conducted to evaluate the accuracy and reliability of the test in a laboratory setting, which is typical for IVD devices.
  • Predicate Device: The mention of a "Predicate Device(s)" with a K number (K023317) and name ("Methadone Enzyme Immunoassay") indicates that this device is being compared to a previously cleared IVD device, further confirming its classification.

N/A

Intended Use / Indications for Use

The LZI Methadone II Enzyme Immunoassay is an in vitro diagnostic test intended for the qualitative and semi-quantitative determination of methadone in human urine. The cutoff for both the qualitative and semi-quantitative modes of the assay is 300 ng/mL for methadone. The assay is designed for prescription use on automated clinical chemistry analyzers.

The semi-quantitative mode is for purposes of (1) enabling laboratories to determine an appropriate dilution of the specimen for confirmation by a confirmatory method such as gas or liquid chromatography/mass spectrometry (GC/MS or LC/MS) or (2) permitting laboratories to establish quality control procedures.

The assay provides only a preliminary analytical result. A more specific alternative analytical chemistry method must be used in order to obtain a confirmed analytical result. Gas or liquid chromatography/mass spectrometry (GC/MS or LC/MS) is the preferred confirmatory method. Clinical consideration and professional judgment should be exercised with any drug of abuse test result, particularly when the preliminary test result is positive.

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

DJR

Device Description

The LZI Methadone II Enzyme Immunoassay is a homogeneous enzyme immunoassay with ready-to-use liquid reagents. The assay is based on competition between methadone in the sample and methadone labeled with the enzyme glucose-6-phosphate dehydrogenase (G6PDH) for a fixed amount of antibody in the reagent. Enzyme activity decreases upon binding to the antibody, and the methadone concentration in the sample is measured in terms of enzyme activity. In the absence of methadone in the sample, methadone-labeled G6PDH conjugate is bound to antibody, and the enzyme activity is inhibited. On the other hand, when free methadone is present in the sample, antibody would bind to free methadone; the unbound methadone-labeled G6PDH then exhibits its maximal enzyme activity. Active enzyme converts nicotinamide adenine dinucleotide (NAD) to NADH, resulting in an absorbance change that can be measured spectrophotometrically at 340 nm.

The LZI Methadone II Enzyme Immunoassay is a kit comprised of two reagents, an R1 and R2 which are bottled separately but sold together within the kit.

The Ri solution contains mouse monoclonal anti-methadone antibody, glucose-6-phosphate (G6P) nicotinamide adenine dinucleotide (NAD), stabilizers, and sodium azide (0.09 %) as a preservative. The R2 solution contains glucose-6-phosphate dehydrogenase (G6PDH) labeled with methadone in buffer with sodium azide (0.09 %) as a preservative.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

prescription use on automated clinical chemistry analyzers.
laboratories

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)

Precision: The assay was tested in qualitative and semi-quantitative modes using a modified NCCLS-EP5 protocol. Methadone sample concentrations were prepared by spiking a methadone standard into a pool of negative human urine at concentrations ±25%, ±50%, ±75%, and ±100% of cutoff concentration. Results were obtained by testing all samples in replicate of two, two runs a day for 22 days on one AU680 automatic clinical analyzer for a total of 88 runs. One single lot of reagents, calibrators, and controls were used.
Qualitative Results:
At 0, 75, 150, 225 ng/mL methadone concentration, all 88 samples were negative.
At 300 ng/mL, 66 samples were negative and 22 were positive out of 88 total.
At 375, 450, 525, 600 ng/mL methadone concentration, all 88 samples were positive.

Linearity: To demonstrate linearity of the entire assay range, a drug free-urine pool spiked with methadone at 1000 ng/mL was serially diluted. Each sample was run in 10 replicates and the average was used to determine percent recovery compared to the expected target value. Recovery values (Expected Value divided by the Observed Value) were considered acceptable between 85 - 115%. Samples from the linear range of the assay (100 ng/mL to 1000 ng/mL) were tested with recovery ranging from 93.7% to 104.9%.

Method Comparison - Clinical Samples: A total of ninety-four (94) unaltered clinical samples were tested with the LZI Methadone II Enzyme Immunoassay on the Beckman Coulter® AU680 automated clinical analyzer. All samples were tested in singlet. All samples were confirmed with LC/MS for both methadone and methadone metabolite concentrations. Samples were collected by Lin-Zhi International, Inc. (LZI) and from the University of California, San Francisco (UCSF).

Semi-Quantitative Accuracy Study:
Agreement for positive results: 97.8% (45 positive out of 46 samples with LC/MS values > cutoff). One discrepant sample (Sample #48) with LC/MS 274 ng/mL (negative) was positive by EIA.
Agreement for negative results: 97.9% (47 negative out of 48 samples with LC/MS values

§ 862.3620 Methadone test system.

(a)
Identification. A methadone test system is a device intended to measure methadone, an addictive narcotic pain-relieving drug, in serum and urine. Measurements obtained by this device are used in the diagnosis and treatment of methadone use or overdose and to determine compliance with regulations in methadone maintenance treatment.(b)
Classification. Class II (special controls). A methadone test system is not exempt if it is intended for any use other than employment or insurance testing or is intended for Federal drug testing programs. The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9, provided the test system is intended for employment and insurance testing and includes a statement in the labeling that the device is intended solely for use in employment and insurance testing, and does not include devices intended for Federal drug testing programs (e.g., programs run by the Substance Abuse and Mental Health Services Administration (SAMHSA), the Department of Transportation (DOT), and the U.S. military).

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Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health and Human Services logo on the left and the FDA logo on the right. The FDA logo is a blue square with the letters "FDA" in white, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue.

October 4, 2019

Lin-Zhi International, Inc Bernice Lin VP Operations 2945 Oakmead Village Court Santa Clara, CA 95051

Re: K192433

Trade/Device Name: LZI Methadone II Enzyme Immunoassay Regulation Number: 21 CFR 862.3620 Regulation Name: Methadone test system Regulatory Class: Class II Product Code: DJR Dated: August 30, 2019 Received: September 5, 2019

Dear Bernice Lin:

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

1

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) 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,

Kellie B. Kelm, Ph.D. Acting 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

Indications for Use

510(k) Number (if known) K192433

Device Name LZI Methadone II Enzyme Immunoassay

Indications for Use (Describe)

The LZI Methadone II Enzyme Immunoassay is an in vitro diagnostic test intended for the qualitative and semi-quantitative determination of methadone in human urine. The cutoff for both the qualitative and semi-quantitative modes of the assay is 300 ng/mL for methadone. The assay is designed for prescription use on automated clinical chemistry analyzers.

The semi-quantitative mode is for purposes of (1) enabling laboratories to determine an appropriate dilution of the specimen for confirmation by a confirmatory method such as gas or liquid chromatography/mass spectrometry (GCMS or LC/MS) or (2) permitting laboratories to establish quality control procedures.

The assay provides only a preliminary analytical result. A more specific alternative analytical chemistry method must be used in order to obtain a confirmed analytical result. Gas or liquid chromatography/mass spectrometry (GC/MS or LC/MS) is the preferred confirmatory method. Clinical consideration and professional judgment should be exercised with any drug of abuse test result, particularly when the preliminary test result is positive.

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 of Safety and Effectiveness

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

Submitted On

August 30, 2019

Last Updated On

October 3, 2019

Introduction

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

Submitter Name, Address, and Contact:

Lin-Zhi International, Inc. 2945 Oakmead Village Court Santa Clara, CA 95051 Phone: (408) 970-8811 Fax: (408) 970-9030 e-mail: bclin@lin-zhi.com

Contact:Bernice Lin, Ph.D.
VP Operations

Device Name and Classification

| Classification Name: | Enzyme Immunoassay, Methadone
Class II, DJR (91 Toxicology),
21 CFR 862.3620 |
|----------------------|------------------------------------------------------------------------------------|
| Common Name: | Homogeneous Methadone Enzyme Immunoassay |
| Proprietary Name: | LZI Methadone II Enzyme Immunoassay |

4

Legally Marketed Predicate Device(s)

The LZI Methadone II Enzyme Immunoassay (EIA) is substantially equivalent to the Methadone Enzyme Immunoassay (K023317) manufactured by Lin-Zhi International, Inc. The LZI Methadone II Enzyme Immunoassay is identical or similar to its predicate in terms of intended use, method principle, device components, and clinical performance.

Device Description

The LZI Methadone II Enzyme Immunoassay is a homogeneous enzyme immunoassay with ready-to-use liquid reagents. The assay is based on competition between methadone in the sample and methadone labeled with the enzyme glucose-6-phosphate dehydrogenase (G6PDH) for a fixed amount of antibody in the reagent. Enzyme activity decreases upon binding to the antibody, and the methadone concentration in the sample is measured in terms of enzyme activity. In the absence of methadone in the sample, methadone-labeled G6PDH conjugate is bound to antibody, and the enzyme activity is inhibited. On the other hand, when free methadone is present in the sample, antibody would bind to free methadone; the unbound methadone-labeled G6PDH then exhibits its maximal enzyme activity. Active enzyme converts nicotinamide adenine dinucleotide (NAD) to NADH, resulting in an absorbance change that can be measured spectrophotometrically at 340 nm.

The LZI Methadone II Enzyme Immunoassay is a kit comprised of two reagents, an R1 and R2 which are bottled separately but sold together within the kit.

The Ri solution contains mouse monoclonal anti-methadone antibody, glucose-6-phosphate (G6P) nicotinamide adenine dinucleotide (NAD), stabilizers, and sodium azide (0.09 %) as a preservative. The R2 solution contains glucose-6-phosphate dehydrogenase (G6PDH) labeled with methadone in buffer with sodium azide (0.09 %) as a preservative.

5

Intended Use

The LZI Methadone II Enzyme Immunoassay is an in vitro diagnostic test intended for the qualitative and semi-quantitative determination of methadone in human urine. The cutoff for both the qualitative and semi-quantitative modes of the assay is 300 ng/mL for methadone. The assay is designed for prescription use on automated clinical chemistry analyzers.

The semi-quantitative mode is for purposes of (1) enabling laboratories to determine an appropriate dilution of the specimen for confirmation by a confirmatory method such as gas or liquid chromatography/mass spectrometry (GC/MS or LC/MS) or (2) permitting laboratories to establish quality control procedures.

The assay provides only a preliminary analytical result. A more specific alternative analytical chemistry method must be used in order to obtain a confirmed analytical result. Gas or liguid chromatography/mass spectrometry (GC/MS or LC/MS) is the preferred confirmatory method. Clinical consideration and professional judgment should be exercised with any drug of abuse test result, particularly when the preliminary test result is positive.

6

Comparison to Predicate Device

The LZI Methadone II Enzyme Immunoassay is substantially equivalent to the Lin-Zhi International, Inc. Methadone Enzyme Immunoassay, Calibrators, and Controls for Hitachi systems cleared by the FDA under the premarket notification K023317 for their stated intended use.

The following table compares the LZI Methadone II Enzyme Immunoassay with the predicate device.

| Device

CharacteristicsSubject DevicePredicate Device (K023317)
Intended UseThe LZI Methadone II Enzyme Immunoassay
The LZI Methadone II Enzyme
Immunoassay is an in vitro diagnostic test
intended for the qualitative and
semi-quantitative determination of
methadone in human urine. The cutoff for
the qualitative and semi-quantitative
modes of the assay is 300 ng/mL for
methadone. The assay is designed for
prescription use on automated clinical
chemistry analyzers.
The semi-quantitative mode is for
purposes of (1) enabling laboratories to
determine an appropriate dilution of the
specimen for confirmation by a
confirmatory method such as gas or liquid
chromatography/mass spectrometry
(GC/MS or LC/MS) or (2) permitting
laboratories to establish quality control
procedures.
The assay provides only a preliminary analytical
result. A more specific alternative analytical
chemistry method must be used in order to obtain a
confirmed analytical result. Gas or liquid
chromatography/mass spectrometry (GC/MS or
LC/MS) is the preferred confirmatory method.
Clinical consideration and professional judgment
should be exercised with any drug of abuse test
result, particularly when the preliminary test result
is positive.Methadone Enzyme Immunoassay
The Lin-Zhi International, Inc. (LZI)
Methadone Enzyme Immunoassay is
intended for the qualitative and
semi-quantitative determination of
methadone in human urine at a cutoff value
of 300 ng/mL. The assay is designed for
professional use with a number of
automated clinical chemistry analyzers.
This assay provides a rapid screening procedure
for determining the presence of methadone
metabolite in urine. The assay provides only a
preliminary analytical result. A more specific
alternative chemical method must be used in order
to obtain a confirmed analytical result. Gas or
liquid chromatography/mass spectrometry (GC/MS
or LC/MS) is the preferred confirmatory method.
Clinical consideration and professional judgment
should be exercised with any drug of abuse test
result, particularly when the preliminary test result
is positive.
Analytemethadonemethadone
Cutoff300 ng/mL300 ng/mL
Matrixurineurine
Calibrators Level0, 150, 300, 600, and 1000 ng/mL0, 150, 300, 600, and 1000 ng/mL
Controls Level225 ng/mL and 375 ng/mL225 ng/mL and 375 ng/mL
Storage2-8°C until expiration date2-8°C until expiration date

7

Performance Characteristics Summary: Beckman Coulter® AU680 Analyzer

Precision

The assay tested in qualitative (△OD, mAU) and semi-quantitative (ng/mL) mode using a modified NCCLS-EP5 protocol. Methadone sample concentrations were prepared by spiking a methadone standard into a pool of negative human urine at concentrations ±25%, ±50%, ±75%, and ±100% of cutoff concentration.

Results shown below were obtained by testing all samples in replicate of two, two runs a day (one in the morning and one in the afternoon) for 22 days on one AU680 automatic clinical analyzer for a total of 88 runs. Samples were evaluated against the assay's calibration curve in both qualitative and semi-quantitative modes. One single lot of reagents, calibrators, and controls were used and stored at 2-8℃ when not in use.

| Methadone
Concentration | Within Run (N=22)
Qualitative
Response | Total Precision (N=88)
Qualitative Response |
|----------------------------|----------------------------------------------|------------------------------------------------|
| 0 ng/mL | - | - |
| 75 ng/mL | - | - |
| 150 ng/mL | - | - |
| 225 ng/mL | - | - |
| 300 ng/mL | - | - |
| 375 ng/mL | + | + |
| 450 ng/mL | + | + |
| 525 ng/mL | + | + |
| 600 ng/mL | + | + |

Semi-Quantitative Precision Analysis Summary: Qualitative Results

Semi-Quantitative Positive/Negative Results:
300 ng/mL Cutoff Result:Within Run (N=22)Total Precision (N=88)
Methadone
Concentration% of Cutoff# of SamplesEIA Result# of SamplesEIA Result
0 ng/mL0.0%2222 Negative8888 Negative
75 ng/mL25.0%2222 Negative8888 Negative
150 ng/mL50.0%2222 Negative8888 Negative
225 ng/mL75.0%2222 Negative8888 Negative
300 ng/mL100.0%2218 Neg/4 Pos8866 Neg/22 Pos
375 ng/mL125.0%2222 Positive8888 Positive
450 ng/mL150.0%2222 Positive8888 Positive
525 ng/mL175.0%2222 Positive8888 Positive
600 ng/mL200.0%2222 Positive8888 Positive

8

Performance Characteristics Summary, continued:

Beckman Coulter® AU680 Analyzer

300 ng/mL Cutoff Result:Within Run (N=22)Total Precision (N=88)
Methadone
Concentration% of Cutoff# of SamplesEIA Result# of SamplesEIA Result
0 ng/mL0.0 %2222 Negative8888 Negative
75 ng/mL25.0 %2222 Negative8888 Negative
150 ng/mL50.0 %2222 Negative8888 Negative
225 ng/mL75.0 %2222 Negative8888 Negative
300 ng/mL100.0 %2217 Neg/ 5 Pos8859 Neg/29 Pos
375 ng/mL125.0 %2222 Positive8888 Positive
450 ng/mL150.0 %2222 Positive8888 Positive
525 ng/mL175.0 %2222 Positive8888 Positive
600 ng/mL200.0 %2222 Positive8888 Positive

Qualitative Positive/Negative Results:

Linearity

To demonstrate linearity of the entire assay range, a drug free-urine pool spiked with methadone at 1000 ng/mL was serially diluted. Each sample was run in 10 replicates and the average was used to determine percent recovery compared to the expected target value.

Observed values were obtained and acceptable if measurements were ±15% of the expected values. Recovery values (Expected Value divided by the Observed Value) were considered acceptable between 85 - 115%.

Samples from the linear range of the assay (100 ng/mL to 1000 ng/mL) were tested with recovery ranging from 93.7% to 104.9%.

| Expected Value
(ng/mL) | Observed Value
(ng/mL) | % Recovery |
|---------------------------|---------------------------|------------|
| 1000 | 950.5 | 95.0% |
| 900 | 848.6 | 94.3% |
| 800 | 767.9 | 96.0% |
| 700 | 668.0 | 95.4% |
| 600 | 572.2 | 95.4% |
| 500 | 463.0 | 92.6% |
| 400 | 393.4 | 98.4% |
| 300 | 287.8 | 95.9% |
| 200 | 187.4 | 93.7% |
| 100 | 104.9 | 104.9% |
| 20 | 15.8 | 78.9% |
| 0 | -7.1 | N/A |

9

Method Comparison - Clinical Samples

A total of ninety-four (94) unaltered clinical samples were tested with the LZI Methadone II Enzyme Immunoassay on the Beckman Coulter® AU680 automated clinical analyzer. Samples were evaluated against the assay's calibration curve in both qualitative and semi-quantitative modes. All samples were tested in singlet.

All samples were confirmed with LC/MS for both methadone and methadone metabolite concentrations. Samples were collected by Lin-Zhi International, Inc. (LZI) and from the University of California, San Francisco (UCSF).

Semi-Quantitative Accuracy Study

Discrepant samples determined as compared to methadone concentration from LC/MS.

| Candidate
Device
Results | Negative | 50 %
above
cutoff) | %
Agreement |
|--------------------------------|----------|-----------------------|--------------------------------------------------------------------------|-----------------------------------------------------------------------|------------------------------------------------|----------------|
| Positive | 0 | 0 | 1* | 4 | 41 | 97.8 % |
| Negative | 20 | 23 | 4 | 1** | 0 | 97.9 % |

| Sample

| LC/MS

Methadone
(ng/mL) | Pos/Neg
Result | AU680 EIA
Pos/Neg
Result |
|-------------|-------------------------------|-------------------|--------------------------------|
| 48* | 274 | - | + |
| 50** | 317 | + | - |

  • Discrepant between 50% below cutoff and cutoff concentration (150 – 299,9 ng/mL)

** Discrepant between cutoff and 50% above cutoff concentration (300 - 449.9 ng/mL)

Qualitative Accuracy Study

| Candidate
Device
Results | Negative | 50 %
above
cutoff) | %
Agreement |
|--------------------------------|----------|-----------------------|--------------------------------------------------------------------------|-----------------------------------------------------------------------|------------------------------------------------|----------------|
| Positive | 0 | 0 | 1* | 4 | 44 | 97.8 % |
| Negative | 20 | 23 | 4 | 1** | 0 | 97.9 % |

| Sample

| LC/MS

Methadone
(ng/mL) | Pos/Neg
Result | AU680 EIA
Qualitative
Result (mAU) | Pos/
Neg
Result | Qualitative
Cutoff Rate
(mAU) |
|-------------|-------------------------------|-------------------|------------------------------------------|-----------------------|-------------------------------------|
| 48* | 274 | - | 176.5 | + | 133.5 |
| 50** | 317 | + | 95.4 | - | 165.0 |

  • Discrepant between 50% below cutoff and cutoff concentration (150 - 299.9 ng/mL)

** Discrepant between cutoff and 50% above cutoff concentration (300 - 449.9 ng/mL)

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Cross-reactivity

The Cross-reactivity of various potentially interfering drugs were tested by spiking various concentrations of each substance into a pool of negative human urine and then evaluated against the assay's calibration curve in both qualitative and semi-quantitative modes. All samples were tested in replicates.

The table below lists the concentration of each test compound that gave a response approximately equivalent to that of the cutoff calibrator (as positive) or the maximal concentration of the compound tested that gave a response below the response of the cutoff calibrator (as negative). Compounds tested at high concentration with results below the cutoff value were listed as Not Detected (ND).

| Compound | Target
Concentration
(ng/mL) | % Cross-
reactivity |
|-------------------------------------------|------------------------------------|------------------------|
| Methadone | 300 | 100.00% |
| EDDP | 100,000 |