K Number
K973100
Device Name
PROSTATE SPECIFIC ANTIGEN (PSA) CALIBRATOR
Date Cleared
1997-09-29

(41 days)

Product Code
Regulation Number
862.1150
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The PSA Calibrator is an in vitro diagnostic product intended to be used to calibrate the Prostate Specific Antigen (PSA) method for the Dimension® RxL clinical chemistry system with the heterogeneous immunoassy module. This product was designed to meet the needs of users to assure accurate results over the assay range of this method.
Device Description
Prostate Specific Antigen (PSA) Calibrator for the Dimension® RxL clinical chemistry system with the heterogeneous immunoassay module is a frozen product. The Level 1 calibrator is horse serum based with no detectable PSA. Levels 2 through 5 contain human PSA-ACT in a bovine serum albumin base. The kit consists of ten vials; two at each of five levels, containing 1 mL each.
More Information

aca® plus Prostate Specific Antigen Calibrator

Not Found

No
The summary describes a calibrator for a clinical chemistry system, which is a standard laboratory reagent, and makes no mention of AI or ML.

No
The device is described as an in vitro diagnostic product intended to calibrate a PSA method, not to treat or cure a disease.

Yes

Explanation: The "Intended Use / Indications for Use" section explicitly states, "The PSA Calibrator is an in vitro diagnostic product intended to be used to calibrate the Prostate Specific Antigen (PSA) method..." This clearly indicates its diagnostic purpose.

No

The device description explicitly states it is a "frozen product" and consists of "vials" containing "serum based" material, indicating it is a physical reagent, not software.

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

The "Intended Use / Indications for Use" section explicitly states: "The PSA Calibrator is an in vitro diagnostic product intended to be used to calibrate the Prostate Specific Antigen (PSA) method..."

This statement clearly identifies the device as an in vitro diagnostic product.

N/A

Intended Use / Indications for Use

The PSA Calibrator is an in vitro diagnostic product intended to be used to calibrate the Prostate Specific Antigen (PSA) method for the Dimension® RxL clinical chemistry system with the heterogeneous immunoassy module. This product was designed to meet the needs of users to assure accurate results over the assay range of this method.

Product codes

JIT

Device Description

Prostate Specific Antigen (PSA) Calibrator for the Dimension® RxL clinical chemistry system with the heterogeneous immunoassay module is a frozen product. The Level 1 calibrator is horse serum based with no detectable PSA. Levels 2 through 5 contain human PSA-ACT in a bovine serum albumin base. The kit consists of ten vials; two at each of five levels, containing 1 mL each.

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

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

aca® plus Prostate Specific Antigen Calibrator

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1150 Calibrator.

(a)
Identification. A calibrator is a device intended for medical purposes for use in a test system to establish points of reference that are used in the determination of values in the measurement of substances in human specimens. (See also § 862.2 in this part.)(b)
Classification. Class II (special controls). 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.

0

Image /page/0/Picture/0 description: The image shows the word "DADE" in a bold, sans-serif font. The letters are large and black, contrasting with the white background. The letters are evenly spaced and aligned horizontally.

KA73100

SEP 2 9 1997

DADE INTERNATIONAL

Chemistry Systems P.O. Box 6101

Newark, DE 19714

Summary of Safety and Effectiveness Information

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.

| Submitter's Name: | Rebecca S. Ayash
Dade International Inc.
Building 500, Mailbox 514
P.O. Box 6101
Newark, DE 19714-6101 |
|----------------------|--------------------------------------------------------------------------------------------------------------------|
| Date of Preparation: | 8/15/97 |
| Device Name: | Prostate Specific Antigen (PSA) Calibrator |
| Classification Name: | Calibrator, Secondary |
| Predicate Device: | aca® plus Prostate Specific Antigen Calibrator |

Device Description: Prostate Specific Antigen (PSA) Calibrator for the Dimension® RxL clinical chemistry system with the heterogeneous immunoassay module is a frozen product. The Level 1 calibrator is horse serum based with no detectable PSA. Levels 2 through 5 contain human PSA-ACT in a bovine serum albumin base. The kit consists of ten vials; two at each of five levels, containing 1 mL each.

Intended Use: PSA Calibrator is intended to be used to calibrate the PSA method for the Dimension® RxL clinical chemistry system with the heterogeneous immunoassay module.

Comparison to Predicate Device:

Dimension® RxL PSA Calibratoraca® plus PSA Calibrator
Intended UseCalibratorCalibrator
AnalytePSA-ACTPSA-ACT
MatrixL-1 horse serum
L-2-5 BSAL-1 horse serum
L-2-3 BSA
Formfrozenliquid
Volume1.0 mL per vial3.0 mL per vial
Levels5 levels3 levels

1

Comments on Substantial

Equivalence: Both the PSA Calibrator for the Dimension® RxL system and the aca® plus PSA Calibrator are manufactured using the same matrices and contain PSA-ACT as the analyte source. Both products are intended to be used as calibrators for prostate specific antigen assays.

Conclusion: PSA Calibrator for the Dimension® RxL system is substantially equivalent to the aca® plus PSA Calibrator based on the comparison summarized above.

Rebecca Slayden

Rebecca S. Ayash Regulatory Affairs and Compliance Manager Date: 8/15/97

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle or other bird-like figure with three tail feathers.

Public Health Service

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

Rebecca S. Ayash Requlatory Affairs and Compliance Manager Dade International Inc. Building 500, mailbox 514 P.O. Box 6101 Newark, DE 19714-6101

SEP 2 9 1997

Re: K973100 Trade Name: Prostate Specific Antigen (PSA) Calibrator Requlatory Class: II Product Code: JIT Dated: August 15, 1997 Received: August 19, 1997

Dear Ms. Ayash:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). You may, therefore, market the device, subject to the general controls provisions of the Act. 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.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirement, as set forth in the Quality System Requlation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. this response to your premarket notification Please note: submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

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Page 2

Under the Clinical Laboratory Improvement Amendments of 1988 (CLIA-88), this device may require a CLIA complexity categorization. To determine if it does, you should contact the Centers for Disease Control and Prevention (CDC) at (770)488-7655.

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4588. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll free number (800) 638-2041 or at (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html"

Sincerely yours,

Steven Putman

Steven I. Gutman, M.D., M.B.A. Director Division of Clinical Laboratory Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications Statement

Device Name: Prostate Specific Antigen (PSA) Calibrator

Indications for Use: The PSA Calibrator is an in vitro diagnostic product intended to be used to calibrate the Prostate Specific Antigen (PSA) method for the Dimension® RxL clinical chemistry system with the heterogeneous immunoassy module. This product was designed to meet the needs of users to assure accurate results over the assay range of this method.

Rebecca Scapph

Rebecca S. Ayas Regulatory Affairs and Compliance Manager Date: 9/25/97

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

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K 973100
(510(k) Number

Victor E. Macher

Division Sign-Off Office of Device Evaluation

Prescription Use ✓