K Number
K203270
Device Name
IMMULITE/IMMULITE® 1000 Cortisol
Date Cleared
2021-01-15

(71 days)

Product Code
Regulation Number
862.1205
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For in vitro diagnostic use with the IMMULITE® and IMMULITE 1000 Analyzers - for the quantitative measurement of cortisol (hydrocortisone, Compound F) in serum, as an aid in the clinical assessment of adrenal status.
Device Description
The IMMULITE/IMMULITE® 1000 Cortisol assay is comprised of the following components: Cortisol Test Unit (solid phase) - 1 bead/Test unit, Polyclonal rabbit anti-cortisol antibody. Cortisol Reagent Wedge (liquid phase) - 7.5 mL, Alkaline phosphatase (bovine calf intestine) conjugated to cortisol in buffer, with preservative. Cortisol Adjustors (Low and High) - 3 mL, Cortisol in processed human serum, with preservative.
More Information

Not Found

No
The device description and performance studies focus on standard immunoassay technology and do not mention any AI or ML components or methodologies.

No.
This device is an in vitro diagnostic (IVD) assay designed for quantitative measurement of cortisol in serum, used as an aid in clinical assessment, which does not directly treat or prevent a medical condition.

Yes

The device is for "in vitro diagnostic use" and measures cortisol levels to aid in the "clinical assessment of adrenal status," which directly relates to diagnosing or aiding in the diagnosis of medical conditions.

No

The device description explicitly lists physical components like "Cortisol Test Unit (solid phase)", "Cortisol Reagent Wedge (liquid phase)", and "Cortisol Adjustors". This indicates it is a hardware-based in vitro diagnostic device, not software-only.

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

The "Intended Use / Indications for Use" explicitly states: "For in vitro diagnostic use with the IMMULITE® and IMMULITE 1000 Analyzers - for the quantitative measurement of cortisol (hydrocortisone, Compound F) in serum, as an aid in the clinical assessment of adrenal status."

This statement clearly indicates that the device is intended to be used outside of the body (in vitro) to diagnose or aid in the diagnosis of a medical condition (assessment of adrenal status) by analyzing a biological sample (serum). This aligns directly with the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

For in vitro diagnostic use with the IMMULITE® and IMMULITE 1000 Analyzers — for the quantitative measurement of cortisol (hydrocortisone, Compound F) in serum, as an aid in the clinical assessment of adrenal status.

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

CGR

Device Description

The IMMULITE/IMMULITE® 1000 Cortisol assay is comprised of the following components:

  • Cortisol Test Unit (solid phase): 1 bead/Test unit, Polyclonal rabbit anti-cortisol antibody.
  • Cortisol Reagent Wedge (liquid phase): 7.5 mL, Alkaline phosphatase (bovine calf intestine) conjugated to cortisol in buffer, with preservative.
  • Cortisol Adjustors (Low and High): 3 mL, Cortisol in processed human serum, with 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

For Prescription Use Only

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)

The assay principle, design and reagent formulation has not changed from the original device. Substantial equivalence was demonstrated by testing several performance characteristics including detection limits, linearity, precision, spike recovery, method comparison, interfering and cross-reactive substances. All the studies evaluated produced acceptable results when compared to the Predicate device and were deemed verified.

  1. Detection Limits: LoB, LoD, and LoQ were determined in accordance with Clinical and Laboratory Standards Institute (CLSI) EP17-A2: Evaluation of Detection Capability for Clinical Laboratory Measurement Procedures: Approved Guideline-Second Edition.
  2. Linearity: The Linearity study was conducted in accordance with the principles described in CLSI EP06-A: Evaluation of the Linearity of Quantitative Measurement Procedures: A Statistical Approach: Approved Guideline. Samples spanning the assay range were prepared by combining a high human serum pool with a low human serum pool for a total of 9 levels of dilutions. The modified IMMULITE/IMMULITE 1000 Cortisol assay has been shown to be linear from 0.18 - 50.98 ug/dL.
  3. Repeatability and Within-Lab Precision: The information provided in the Instruction for Use for modified IMMULITE/IMMULITE 1000 Cortisol has not changed and are as per K931409.
  4. Spike Recovery: The information provided in the Instruction for Use for modified IMMULITE/IMMULITE 1000 Cortisol has not changed and are as per K931409.
  5. Method Comparison with predicate device: A method comparison study was performed by comparing the modified device to the currently-marketed predicate device (unmodified IMMULITE 1000 Cortisol Assay) in accordance with CLSI EP09c Measurement Procedure Comparison and Bias Estimation Using Patient Samples, 3rd Edition. A total of 152 native patient samples covering the full range of the assay were assayed in duplicate split across 4 runs, with each run on a different instrument. Regression equation: IMM 1000 = 0.951 (IMMULITE 1000 commercial) - 0.155 µg/dL. r=0.991.
  6. Specificity (Cross-Reactivity): The specificity (cross-reactivity) of the modified IMMULITE/IMMULITE 1000 Cortisol assay to various compounds was evaluated. Cross-reactant solutions were prepared and spiked into a blank sample (charcoal-absorbed human serum).
  7. Interference: Interference with the modified IMMULITE/IMMULITE 1000 Cortisol assay was determined for conjugated and unconjugated bilirubin, hemolysate, hemoglobin, intralipid and biotin. The paired difference approach was employed for this study as per CLSI EP07: Interference Testing in Clinical Chemistry, 3rd Edition. Working stock solutions of the interfering substance were prepared and spiked into 5 patient samples.

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

  • Limit of Blank (LoB): 0.008µg/dL (0.22nmol/L)
  • Limit of Detection (LoD): 0.053µg/dL (1.46nmol/L)
  • Limit of Quantitation (LoQ): 0.2µg/dL (5.52nmol/L)
  • The reportable range of the IMMULITE/IMMULITE 1000 Cortisol assay is 1 to 50 µg/dL (28 to 1380 nmol/L).
  • The modified IMMULITE/IMMULITE 1000 Cortisol assay has been shown to be linear from 0.18 - 50.98 ug/dL.
  • Method comparison regression equation for serum (N=152, Range 2.01 – 48.3 µg/dL): IMM 1000 = 0.951 (IMMULITE 1000 commercial) - 0.155 µg/dL. r=0.991.
  • Specificity (Cross-Reactivity) demonstrated for various compounds with percent cross-reactivity values. For example, Corticosterone showed 0.92%, Cortisone 1.77%, 11-Deoxycortisol 4.05%, Methylprednisolone 1.12%, Prednisolone 16.01%, Allotetrahydrocortisol 2.06%, and 20α-dihydrocortisol 0.28%. Many other compounds showed "ND" (Not Detected).
  • Biotin Interference: At spiking concentration 3500ng/mL, Observed Mean % Recovery was 96.0%.

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.

K931409

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

§ 862.1205 Cortisol (hydrocortisone and hydroxycorticosterone) test system.

(a)
Identification. A cortisol (hydrocortisone and hydroxycorticosterone) test system is a device intended to measure the cortisol hormones secreted by the adrenal gland in plasma and urine. Measurements of cortisol are used in the diagnosis and treatment of disorders of the adrenal gland.(b)
Classification. Class II.

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January 15, 2021

Siemens Healthcare Diagnostics Products Ltd. Malgorzata Robak Regulatory Affairs Supervisor Glyn Rhonwy. Llanberis Caernarfon, Gwynedd LL55 4EL UK

Re: K203270

Trade/Device Name: IMMULITE/IMMULITE® 1000 Cortisol Regulation Number: 21 CFR 862.1205 Regulation Name: Cortisol (Hydrocortisone And Hydroxycorticosterone) Test System Regulatory Class: Class II Product Code: CGR Dated: November 3, 2020 Received: November 5, 2020

Dear Malgorzata Robak:

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

1

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 (OS) 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 mediation-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. 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

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Indications for Use

510(k) Number (if known) K203270

Device Name IMMULITE/IMMULITE® 1000 Cortisol

Indications for Use (Describe)

For in vitro diagnostic use with the IMMULITE® and IMMULITE 1000 Analyzers - for the quantitative measurement of cortisol (hydrocortisone, Compound F) in serum, as an aid in the clinical assessment of adrenal status.

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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510(k) Summary of Safety and Effectiveness for IMMULITE/IMMULITE® 1000 Cortisol

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.

  • A. 510(k) Number:_k203270
  • B. Purpose of the Submission Modified Device - new supplier of the antibody
  • C. Applicant:
Contact:Malgorzata Robak
Regulatory Affairs Supervisor
Address:Siemens Healthcare Diagnostics Products Limited
Glyn Rhonwy
Llanberis, Caernarfon
LL55 4EL
United Kingdom
Phone:+44 7921 882559
E-mail:malgorzata.robak@siemens-healthineers.com
Date:January 8, 2021

D. Proprietary and Established Name:

IMMULITE/IMMULITE® 1000 Cortisol

E. Measurand

Cortisol

F. Regulatory Information

Trade Name:IMMULITE/IMMULITE® 1000 Cortisol
Common Name:Chemiluminescence Immunoassay, for the
determination of Cortisol
Classification Name:Cortisol Test System
FDA Classification:Class II
Review Panel:Clinical Chemistry
Product Code:CRG
Regulation Number:21 CFR 862.1205

G. Predicate Device:

Device Name: IMMULITE/IMMULITE® 1000 Cortisol

510(k) Number: K931409

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Healthine

H. Intended Use:

Same as Indication for Use

-Indications for Use:

For in vitro diagnostic use with the IMMULITE® and IMMULITE 1000 Analyzers - for the quantitative measurement of cortisol (hydrocortisone, Compound F) in serum, as an aid in the clinical assessment of adrenal status.

J. Special Conditions for Use statement(s):

For Prescription Use Only

K. Special Instrument Requirements

For use with IMMULITE/IMMULITE® 1000

L. Device Description

The IMMULITE/IMMULITE® 1000 Cortisol assay is comprised of the following components:

ComponentVolumeIngredients
Cortisol Test Unit
(solid phase)1 bead/Test unitPolyclonal rabbit anti-cortisol antibody.
Cortisol Reagent
Wedge (liquid
phase)7.5 mLAlkaline phosphatase (bovine calf
intestine) conjugated to cortisol in buffer,
with preservative.
Cortisol Adjustors
(Low and High)3 mLCortisol in processed human serum, with
preservative.

M. Substantial Equivalence Information

The following table demonstrates substantial equivalence between the IMMULITE/IMMULITE® 1000 Cortisol (Candidate Device) with an antibody from a new supplier and the currently marketed IMMULITE/IMMULITE® 1000 Cortisol (Predicate Device) that was cleared under 510 (k) K931409.

| Trade name | Candidate Device (Modified)
IMMULITE/IMMULITE®
1000 Cortisol | Predicate device
(Unmodified)
IMMULITE/IMMULITE®
1000 Cortisol |
|--------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Intended Use | For in vitro diagnostic use
with the IMMULITE® and
IMMULITE 1000 Analyzers
— for the quantitative
measurement of cortisol
(hydrocortisone, Compound
F) in serum, as an aid in the
clinical assessment of
adrenal status. | For in vitro diagnostic use
with the IMMULITE® and
IMMULITE 1000 Analyzers
— for the quantitative
measurement of cortisol
(hydrocortisone, Compound
F) in serum, as an aid in the
clinical assessment of
adrenal status. |
| Analyte | Cortisol | Same |

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| Trade name | Candidate Device (Modified)
IMMULITE/IMMULITE®
1000 Cortisol | Predicate device
(Unmodified)
IMMULITE/IMMULITE®
1000 Cortisol |
|----------------------------------|-----------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------|
| Automated | Automated Assay | Same |
| Measurement | Quantitative | Same |
| Sample Type | Human serum | Same |
| Detection
Limit | LoB: 0.008µg/dL
(0.22nmol/L)
LoD: 0.053µg/dL
(1.46nmol/L)
LoQ: 0.2µg/dL
(5.52nmol/L) | Analytical Sensitivity: 0.20 µg/dL (5.5 nmol/L)
Not Applicable
Not Applicable |
| Calibration
Range | 1-50 µg/dL (28 to 1380
nmol/L) | Same |
| Operating
Principle | Competitive | Same |
| Technology | Chemiluminescent enzyme
immunoassay | Same |
| Instrument | IMMULITE/MMULITE 1000 | Same |
| Sample
Volume | 10 μL | 10 μL |
| Calibrator | Two levels (low & high)
cortisol adjustor | Same |
| Controls | Commercial | Commercial |
| Detection
Enzyme
conjugate | Alkaline phosphatase
(bovine calf intestine)
conjugated to cortisol | Same |
| Capture
Antibody | Polyclonal rabbit anti-cortisol | Same |

N. Test Principle

IMMULITE/IMMULITE 1000 Cortisol is a solid-phase, enzyme-labeled chemiluminescent competitive immunoassay. The solid phase (bead) is coated with polyclonal rabbit anti-cortisol antibody. The liquid phase consists of alkaline phosphatase (bovine calf intestine) conjugated to cortisol. The patient sample and the reagent are incubated together with the coated bead for 30 minutes. During this time, cortisol in the sample competes with enzyme-conjugated cortisol in the reagent for a limited number of antibody binding sites on the bead. Unbound patient sample and enzyme conjugate are then removed by centrifugal washes. Finally, chemiluminescent substrate is added to the test unit containing the bead and the signal is generated inversely proportion to the bound enzyme.

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O. Performance Characteristics

The assay principle, design and reagent formulation has not changed from the original device. Substantial equivalence was demonstrated by testing several performance characteristics including detection limits, linearity, precision, spike recovery, method comparison, interfering and cross-reactive substances. All the studies evaluated produced acceptable results when compared to the Predicate device and were deemed verified.

1. Detection Limits

LoB, LoD, and LoQ were determined in accordance with Clinical and Laboratory Standards Institute (CLSI) EP17-A2: Evaluation of Detection Capability for Clinical Laboratory Measurement Procedures: Approved Guideline-Second Edition The LoB/LoD/LoQ estimates are summarized below:

Limit of Blank (LoB)0.008µg/dL (0.22nmol/L)
Limit of Detection (LoD)0.053µg/dL (1.46nmol/L)
Limit of Quantitation (LoQ)0.2µg/dL (5.52nmol/L)

The reportable range of the IMMULITE/IMMULITE 1000 Cortisol assay is 1 to 50 µg/dL (28 to 1380 nmol/L).

2. Linearity

The Linearity study was conducted in accordance with the principles described in CLSI EP06-A: Evaluation of the Linearity of Quantitative Measurement Procedures: A Statistical Approach: Approved Guideline. Samples spanning the assay range were prepared by combining a high human serum pool with a low human serum pool for a total of 9 levels of dilutions prepared by mixing the high and low serum pools. The high serum pool consisted of a human serum pool sample spiked with cortisol to obtain a desired concentration at the upper end of the working range of the assay (observed concentration: 50.98µg/dL). The low serum pool consisted of a low-level human serum pool diluted with charcoal-adsorbed human serum in order to achieve a cortisol concentration at the approximate LoQ (observed concentration: 0.18 µg/dL). The modified IMMULITE/IMMULITE 1000 Cortisol assay has been shown to be linear from 0.18 - 50.98 ug/dL. The Linearity information provided in the Instruction for Use for modified IMMULITE/IMMULITE 1000 Cortisol has not changed and are as per K931409.

3. Repeatability and Within-Lab Precision

The repeatability and within-lab precision information provided in the Instruction for Use for modified IMMULITE/IMMULITE 1000 Cortisol has not changed and are as per K931409.

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4. Spike Recovery

The spike and recovery information provided in the Instruction for Use for modified IMMULITE/IMMULITE 1000 Cortisol has not changed and are as per K931409.

5. Method Comparison with predicate device

A method comparison study was performed by comparing the modified device to the currently-marketed predicate device (unmodified IMMULITE 1000 Cortisol Assay) in accordance with CLSI EP09c Measurement Procedure Comparison and Bias Estimation Using Patient Samples, 3rd Edition. A total of 152 native patient samples covering the full range of the assay were assayed in duplicate split across 4 runs, with each run on a different instrument (41 patients on instrument 1-3, and 30 patients on instrument 4).

| Sample

CategoryNRangeRegression equation
Serum1522.01 – 48.3 µg/dLIMM 1000 = 0.951 (IMMULITE 1000 commercial) - 0.155 µg/dL. r=0.991

6. Specificity (Cross-Reactivity)

Specificity (cross-reactivity) of the modified IMMULITE/IMMULITE 1000 Cortisol assay to the various compounds listed in the Table below were evaluated. Cross-reactant solutions were prepared by dissolving each crossreactant into an appropriate solvent (ethanol, methanol or NaOH). Each cross-reactant was then spiked at a ratio of 1:19 into an aliquot of a blank sample (charcoal-absorbed human serum) such that the final concentration in the sample was equal to that outlined in Table below. Blank samples were also prepared which consisted of charcoal-adsorbed human serum spiked 1:19 with the solvents used to prepare the cross-reactants. In addition to the cross reactants evaluated in K931409 the following cross reactants were evaluated: Allotetrahydrocortisol, α-Cortol, α-Cortolone, β-Cortol' β-Cortolone, Dehydrocorticosterone 20a-Dihydrocortisol, 203-Dihydrocortisol, 20a-Dihydrocortisone, Estradiol, Fludrocortisone. Complete summary of the results are summarized below.

| Compound | Cross-Reactant
added concentration
(µg/dL) | % Cross- Reactivity |
|------------------------------|--------------------------------------------------|---------------------|
| Blank (Methanol) | N/A | N/A |
| Blank (Ethanol) | N/A | N/A |
| Blank (NaOH) | N/A | N/A |
| Aldosterone | 1,000 | ND |
| Androstenedione | 10,000 | ND |
| Compound | Cross-Reactant
added concentration
(µg/dL) | % Cross- Reactivity |
| Betamethasone | 1,000 | ND |
| Corticosterone | 400 | 0.92% |
| Cortisone | 400 | 1.77% |
| 11-
Deoxycorticosterone | 400 | ND |
| 11-Deoxycortisol | 100 | 4.05% |
| 21-Deoxycortisone | 500 | ND |
| Dexamethasone | 400 | ND |
| DHEA-SO4 | 10,000 | ND |
| Estriol | 100 | ND |
| Estrone | 500 | ND |
| Fludrocortisone | 1,000 | ND |
| Fluticasone | 22 | ND |
| 17α-
hydroxyprogesterone | 400 | ND |
| Methotrexate | 100 | ND |
| Methylprednisolone | 200 | 1.12% |
| Prednisolone | 8 | 16.01% |
| Prednisone | 16 | ND |
| Pregnanediol | 2,000 | ND |
| Progesterone | 400 | ND |
| Spironolactone | 1,000 | ND |
| Tetrahydrocortisol | 1,000 | ND |
| Tetrahydrocortisone | 400 | ND |
| Triamcinolone | 5,000 | ND |
| Allotetrahydrocortisol | 100 | 2.06% |
| α-Cortolone | 1,000 | ND |
| α-Cortol | 1,000 | ND |
| β-Cortol | 1,000 | ND |
| β-Cortolone | 1,000 | ND |
| 11-
Dehydrocorticosterone | 1000 | ND |
| 20α-dihydrocortisol | 1,000 | 0.28% |
| 20β-dihydrocortisol | 1000 | ND |
| 20α-dihydrocortisone | 1,000 | ND |
| Estradiol | 1,000 | ND |

Siemens Healthcare Diagnostics Products Ltd., Llanberis UK Traditional 510(k): IMMULITE/IMMULITE® 1000 Cortisol - Modified Device

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7. Interference

Interference with the modified IMMULITE/IMMULITE 1000 Cortisol assay was determined for the following substances: conjugated and unconjugated bilirubin, hemolysate, hemoglobin, intralipid and biotin. The paired difference approach was employed for this study as per CLSI EP07: Interference Testing in Clinical Chemistry, 3rd Edition. Working stock solutions of the interfering substance were prepared and spiked into 5 patient samples such that the final interferent concentration in the sample was equal to that found in Table below. The 5 patient samples ranged from 3.3 - 23.1 µg/dL. The interference information for Bilirubin, Hemolysis and Lipemia provided in the Instruction for Use for modified IMMULITE/IMMULITE 1000 Cortisol has not changed and are as per K931409. Information reqarding Biotin interference are summarized below:

| Interfering
Substance | Interfering
substance
spiking
concentration | Observed
Mean %
Recovery |
|--------------------------|------------------------------------------------------|--------------------------------|
| Biotin | 3500ng/mL | 96.0% |

8. Clinical Evaluation

Not applicable

P. Conclusion

Based on the results of comparative testing, the modified IMMULITE/ IMMULITE 1000 Cortisol is substantially equivalent to the currently marketed predicate device, IMMULITE/IMMULITE 1000 Cortisol.