K Number
K221658
Device Name
Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set
Date Cleared
2022-06-10

(2 days)

Product Code
Regulation Number
866.3315
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set is intended for the in vitro qualitative presumptive detection of non-variola Orthopoxvirus DNA extracted from human pustular rash specimens and viral cell culture lysates submitted to a Laboratory Response Network (LRN) reference laboratory. The assay detects non-variola Orthopoxvirus DNA, including Vaccinia, Cowpox, Monkeypox and Ectromelia viruses at varying concentrations. This assay does not differentiate Vaccinia virus or Monkeypox virus from other Orthopoxviruses detected by this assay and does not detect Variola virus. Refer to the CDC algorithm, Acute, Generalized Vesicular or Pustular Rash Illness Testing Protocol in the United States for recommended testing and evaluation algorithms for patients presenting with acute, generalized pustular or vesicular rash illness. Results of this assay are for the identification of non-variola Orthopoxvirus DNA. These results must be used in conjunction with other diagnostic assays and clinical observations to diagnose Orthopoxvirus infection. The assay should only be used to test specimens with low/moderate risk of smallpox exists, viral culture should not be attempted. Negative results obtained with this device do not prection and should not be used as the sole basis for treatment or other patient management decisions. Use is limited to Laboratory Response Network (LRN) designated laboratories.
Device Description
The Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set uses a fluorogenic probe, consisting of an oliqonucleotide with a reporter dye (FAM) attached to the 5′ end and a quencher dye (BHQ1) attached at or near the 3′ end. The probe anneals to a specific target sequence located between the forward and reverse primers. During the extension phase of the PCR cycle, the 5' nuclease activity of the Taq polymerase degrades the probe causing the reporter dye to separate from the quencher dye, thereby generating a fluorescent signal. With each cycle, additional reporter dye molecules are cleaved from their respective probes and the fluorescence intensity is monitored during the PCR in real-time. The Taq polymerase used in this assay is inactive at room temperature and is activated by incubation at 95°C, thus minimizing the production of nonspecific amplification products. Each extracted DNA sample is tested using the Non-variola Orthopoxvirus Real-time PCR Primer and Probe set alonq with an internal control primer and probe set(s) to demonstrate adequate DNA extraction, proper function of common reagents and equipment, and the absence of inhibitory substances.
More Information

Not Found

No
The device description details a standard real-time PCR assay based on primer and probe binding and fluorescence detection. There is no mention of AI or ML in the intended use, device description, or performance studies.

No
Explanation: This device is an in vitro diagnostic (IVD) test intended for the qualitative detection of specific DNA, not for treating or preventing disease. The 'Intended Use' section explicitly states that the results are for identification and must be used in conjunction with other diagnostic assays and clinical observations, and negative results should not be used as the sole basis for treatment or other patient management decisions.

Yes

The device is intended for the in vitro qualitative presumptive detection of non-variola Orthopoxvirus DNA from human specimens. The results are used in conjunction with other diagnostic assays and clinical observations to diagnose Orthopoxvirus infection, indicating its role in the diagnostic process.

No

The device description clearly outlines a physical primer and probe set used in a real-time PCR assay, which is a laboratory-based diagnostic method involving chemical reagents and equipment. It is not a software-only device.

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 "intended for the in vitro qualitative presumptive detection of non-variola Orthopoxvirus DNA extracted from human pustular rash specimens and viral cell culture lysates". The term "in vitro" is a key indicator of an IVD.
  • Specimen Type: The device is designed to test biological specimens (human pustular rash specimens and viral cell culture lysates) outside of the human body.
  • Purpose: The purpose is to provide information about the presence of non-variola Orthopoxvirus DNA, which is used in conjunction with other diagnostic assays and clinical observations to diagnose Orthopoxvirus infection. This aligns with the definition of an IVD, which is used to examine specimens derived from the human body to provide information for diagnostic purposes.
  • Device Description: The description details a laboratory-based assay (Real-time PCR) that analyzes DNA extracted from specimens. This is typical of IVD devices used in clinical laboratories.
  • Use Setting: The device is limited to use in Laboratory Response Network (LRN) designated laboratories, which are clinical or public health laboratories.

Therefore, based on the provided information, the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set clearly fits the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set is intended for the in vitro qualitative presumptive detection of non-variola Orthopoxvirus DNA extracted from human pustular rash specimens and viral cell culture lysates submitted to a Laboratory Response Network (LRN) reference laboratory. The assay detects non-variola Orthopoxvirus DNA, including Vaccinia, Cowpox, Monkeypox and Ectromelia viruses at varying concentrations. This assay does not differentiate Vaccinia virus or Monkeypox virus from other Orthopoxviruses detected by this assay and does not detect Variola virus. Refer to the CDC algorithm, Acute, Generalized Vesicular or Pustular Rash Illness Testing Protocol in the United States for recommended testing and evaluation algorithms for patients presenting with acute, generalized pustular or vesicular rash illness.

Results of this assay are for the identification of non-variola Orthopoxvirus DNA. These results must be used in conjunction with other diagnostic assays and clinical observations to diagnose Orthopoxvirus infection. The assay should only be used to test specimens with low/moderate risk of smallpox exists, viral culture should not be attempted. Negative results obtained with this device do not prection and should not be used as the sole basis for treatment or other patient management decisions.

Use is limited to Laboratory Response Network (LRN) designated laboratories.

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

PBK

Device Description

With the exception of some reagents and instrumentation, the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set device description remains unchanged from the 2018 submission (K181205).

The Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set uses a fluorogenic probe, consisting of an oliqonucleotide with a reporter dye (FAM) attached to the 5′ end and a quencher dye (BHQ1) attached at or near the 3′ end. The probe anneals to a specific target sequence located between the forward and reverse primers. During the extension phase of the PCR cycle, the 5' nuclease activity of the Taq polymerase degrades the probe causing the reporter dye to separate from the quencher dye, thereby generating a fluorescent signal. With each cycle, additional reporter dye molecules are cleaved from their respective probes and the fluorescence intensity is monitored during the PCR in real-time. The Taq polymerase used in this assay is inactive at room temperature and is activated by incubation at 95°C, thus minimizing the production of nonspecific amplification products.

Each extracted DNA sample is tested using the Non-variola Orthopoxvirus Real-time PCR Primer and Probe set alonq with an internal control primer and probe set(s) to demonstrate adequate DNA extraction, proper function of common reagents and equipment, and the absence of inhibitory substances.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

human pustular rash specimens

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Laboratory Response Network (LRN) designated 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)

Analytical Limit of Detection (LoD): The limit of detection for the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set was determined through an analytical sensitivity study. Inquiries regarding performance characteristics for the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set should be directed to the Centers for Disease Control and Prevention.

Analytical Sensitivity and Specificity: Inquiries regarding performance characteristics for the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set should be directed to the Centers for Disease Control and Prevention.

Clinical Performance: Inquiries regarding clinical performance characteristics for the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set should be directed to the Centers for Disease Control and Prevention.

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

Not Found

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.

K181205

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

N/A

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Centers for Disease Control and Prevention Julie Villanueva Laboratory Preparedness and Response Branch Chief 1600 Clifton Road NE, MS: H24-11 Atlanta, Georgia 30329

June 10, 2022

Re: K221658

Trade/Device Name: Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set Regulation Number: 21 CFR 866.3315 Regulation Name: Nucleic Acid Based Reagents For Detection Of Non-Variola Orthopoxviruses Regulatory Class: Class II Product Code: PBK Dated: June 7, 2022 Received: June 8, 2022

Dear Julie Villanueva:

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

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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 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,

Noel J. Gerald, Ph.D. Branch Chief Bacterial Respiratory and Medical Countermeasures Branch Division of Microbiology Devices OHT7: Office of In Vitro Diagnostics 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) K221658

Device Name

Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set

Indications for Use (Describe)

The Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set is intended for the in vitro qualitative presumptive detection of non-variola Orthopoxvirus DNA extracted from human pustular rash specimens and viral cell culture lysates submitted to a Laboratory Response Network (LRN) reference laboratory. The assay detects non-variola Orthopoxvirus DNA, including Vaccinia, Cowpox, Monkeypox and Ectromelia viruses at varying concentrations. This assay does not differentiate Vaccinia virus or Monkeypox virus from other Orthopoxviruses detected by this assay and does not detect Variola virus. Refer to the CDC algorithm, Acute, Generalized Vesicular or Pustular Rash Illness Testing Protocol in the United States for recommended testing and evaluation algorithms for patients presenting with acute, generalized pustular or vesicular rash illness.

Results of this assay are for the identification of non-variola Orthopoxvirus DNA. These results must be used in conjunction with other diagnostic assays and clinical observations to diagnose Orthopoxvirus infection. The assay should only be used to test specimens with low/moderate risk of smallpox exists, viral culture should not be attempted. Negative results obtained with this device do not prection and should not be used as the sole basis for treatment or other patient management decisions.

Use is limited to Laboratory Response Network (LRN) designated laboratories.

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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Centers for Disease Control and Prevention Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set 510(k) Premarket Notification

510(k) Summary 10.

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

| Assigned 510(k)

number:TBD
Submitted by:Centers for Disease Control and Prevention
1600 Clifton Road NE
Atlanta, GA 30329
Contact Person:Julie Villanueva, PhD
Laboratory Preparedness and Response Branch Chief
Division of Preparedness and Emerging Infections
National Center for Emerging and Zoonotic Infectious
Diseases
Centers for Disease Control and Prevention
(Registration number: 1050190)
1600 Clifton Road, NE, MS H24-11
Atlanta, GA 30329
(404) 639-3851 (office)
Jfv3@cdc.gov
Date prepared:June 7, 2022
Device trade name:Non-variola Orthopoxvirus Real-time PCR
Primer and Probe Set
Classification name and
regulation (if applicable):21 CFR 866.3315
Predicate device(s):Non-variola Orthopoxvirus Real-time PCR
Primer and Probe Set (K181205)

Background

Variola virus, a member of the Orthopoxvirus genus, is the causative agent of smallpox and was certified eradicated in 1980 by the World Health Organization. At that time, smallpox vaccinations were ceased worldwide as a result. However, in recent years, concerns over the potential use of Variola virus as a biological weapon led the United States to resume smallpox vaccinations on a limited basis. Since the smallpox vaccine contains live Vaccinia virus, it is possible for vaccine recipients and/or their close contacts to develop adverse reactions to the vaccine including the emergence of pustules on the skin.

The Laboratory Response Network (LRN) is part of a national bioterrorism preparedness initiative created to ensure an effective laboratory response to biological threats by helping to improve the nation's public health laboratory infrastructure. Member laboratories must meet specific membership requirements and pass rigorous proficiency tests demonstrating their ability to accurately identify agents of concern. One of the major goals is the development and validation of rapid and specific assays for detection of

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biothreat agents and emerging infectious diseases. Accordingly, scientists at the Centers for Disease Control and Prevention have developed several realtime PCR based assays to detect non-variola Orthopoxvirus and other potential biothreat agents in an effort to meet the need for rapid detection.

The Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set was developed for use in conjunction with clinical observations and other tests as described in the CDC algorithm, Acute, Generalized Vesicular or Pustular Rash Illness Testing Protocol in the United States. The assay is designed to aid in the identification of the causative aqent of a pustular or vesicular rash illness and to help rule out the presence of Variola virus in patients presenting with pustular rash illness.

This assay detects most commonly known human pathogenic Orthopoxyiruses (e.q., Vaccinia, Cowpox, and Monkeypox viruses) but does not detect Variola virus, the causative agent of smallpox. Vaccinia virus infection in the United States usually occurs in conjunction with smallpox vaccination or contact with a smallpox vaccine recipient. Monkeypox and Cowpox viruses are endemic to locations outside the United States, with the exception of the 2003 monkeypox outbreak associated with prairie dogs, which became infected due to imported African rodents.

On May 17, 2022, skin lesions that had several characteristics similar to monkevpox on a U.S. resident prompted specialized LRN testing of swab specimens collected from the resident; preliminary testing confirmed the presence of DNA consistent with an orthopoxvirus using the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set. This group of viruses includes monkeypox virus (the causative agent of monkeypox). Testing at CDC on May 18 confirmed the patient was infected with a strain from the West African clade of monkeypox virus. Additional cases of orthopoxvirus infection were subsequently detected using the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set.

Device Description

With the exception of some reagents and instrumentation, the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set device description remains unchanged from the 2018 submission (K181205).

The Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set uses a fluorogenic probe, consisting of an oliqonucleotide with a reporter dye (FAM) attached to the 5′ end and a quencher dye (BHQ1) attached at or near the 3′ end. The probe anneals to a specific target sequence located between the forward and reverse primers. During the extension phase of the PCR cycle, the 5' nuclease activity of the Taq polymerase degrades the probe causing the reporter dye to separate from the quencher dye, thereby generating a fluorescent signal. With each cycle, additional reporter dye molecules are cleaved from their respective probes and the fluorescence intensity is monitored during the PCR in real-time. The Taq polymerase used in this assay is inactive at room temperature and is activated by incubation at 95°C, thus minimizing the production of nonspecific amplification products.

Each extracted DNA sample is tested using the Non-variola Orthopoxvirus Real-time PCR Primer and Probe set alonq with an internal control primer and

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probe set(s) to demonstrate adequate DNA extraction, proper function of common reagents and equipment, and the absence of inhibitory substances.

Intended Use

The Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set is intended for the in vitro qualitative presumptive detection of non-variola Orthopoxvirus DNA extracted from human pustular or vesicular rash specimens and viral cell culture lysates submitted to a Laboratory Response Network (LRN) reference laboratory. The assay detects non-variola Orthopoxvirus DNA, including Vaccinia, Cowpox, Monkeypox and Ectromelia viruses at varying concentrations. This assay does not differentiate Vaccinia virus or Monkeypox virus from other Orthopoxviruses detected by this assay and does not detect Variola virus. Refer to the CDC algorithm, Acute, Generalized Vesicular or Pustular Rash Illness Testing Protocol in the United States for recommended testing and evaluation algorithms for patients presenting with acute, generalized pustular or vesicular rash illness.

Results of this assay are for the presumptive identification of non-variola Orthopoxvirus DNA. These results must be used in conjunction with other diagnostic assays and clinical observations to diagnose Orthopoxvirus infection. The assay should only be used to test specimens with low/moderate risk of smallpox. If a high risk of smallpox exists, viral culture should not be attempted. Negative results obtained with this device do not preclude Variola virus infection and should not be used as the sole basis for treatment or other patient management decisions.

Use is limited to Laboratory Response Network (LRN) designated laboratories.

Device Comparison

The following table summarizes the similarities and differences between the cleared assay and the new submission for this device.

New SubmissionOriginal Submission
DeviceNon-variola Orthopoxvirus
Real-time PCR Primer and
Probe SetNon-variola Orthopoxvirus
Real-time PCR Primer and
Probe Set (K181205)
Intended UseUnchangedThe Non-variola
Orthopoxvirus Real-time
PCR Primer and Probe Set
is intended for the in vitro
qualitative presumptive
detection of non-variola
Orthopoxvirus DNA
extracted from human
pustular or vesicular rash
specimens and viral cell
culture lysates submitted
to a Laboratory Response
Network (LRN) reference
laboratory. The assay
detects non-variola
Orthopoxvirus DNA,
including vaccinia,
cowpox, monkeypox and
ectromelia viruses at
varying concentrations.
This assay does not
differentiate vaccinia virus
or monkeypox virus from
other orthopoxviruses
detected by this assay
and does not detect
variola virus. Refer to the
CDC algorithm, Acute,
Generalized Vesicular or
Pustular Rash Illness
Testing Protocol in the
United States for
recommended testing and
evaluation algorithms for
patients presenting with
acute, generalized
pustular or vesicular rash
illness.
Results of this assay are
for the presumptive
identification of non-
variola Orthopoxvirus
DNA. These results must
be used in conjunction
with other diagnostic
assays and clinical
observations to diagnose
Orthopoxvirus
infection. The assay
should only be used to
test specimens with
low/moderate risk of
smallpox. If a high risk of
smallpox exists, viral
culture should not be
attempted. Negative
results obtained with this
device do not preclude
Variola virus infection and
should not be used as the
sole basis for treatment
or other patient
management decisions.
Use is limited to
Laboratory Response
Network (LRN)
designated
laboratories.
Principle of
OperationUnchangedNucleic acid amplification
and fluorescent probe
detection
Sample TypesUnchanged• Vesicle fluid, skin,
crust, "roof"
• Dry or wet swab of
lesion (dry swab is
preferred)
• Touch prep (slide) of
lesion
• Fresh biopsy of pustule
or vesicle (no formalin)
• Viral cell culture lysates
Instrumentation
and SoftwareUnchangedReal-time PCR
instrumentation and
software

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Establishment of Performance Characteristics

Inquiries regarding performance characteristics for the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set should be directed to the Centers for Disease Control and Prevention.

Analytical Limit of Detection (LoD)

The limit of detection for the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set was determined through an analytical sensitivity study.

Analytical Sensitivity and Specificity

Inquiries regarding performance characteristics for the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set should be directed to the Centers for Disease Control and Prevention.

Clinical Performance

Inquiries regarding clinical performance characteristics for the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set should be directed to the Centers for Disease Control and Prevention.