K Number
K974694
Device Name
IS-DSDNA TEST SYSTEM
Manufacturer
Date Cleared
1998-03-03

(77 days)

Product Code
Regulation Number
866.5100
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
lndications for Use :The Diamedix Is-dsDNA an Enzyme Immunoassay (ElA) for the detection and quantitative determination of IgG antibodies in human serum to DNA antigen as an aid in the diagnosis of systemic lupus erythematosus in patients with clinical signs of the disease. These reagents can be used either manually or in conjunction with the MAGO® Automated EIA Processor.
Device Description
The Is-dsDNA Test Kit System is an enzyme-linked immunosorbent assay (ELISA) for the detection and quantitation of IgG to DNA in human serum
More Information

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Not Found

No
The summary describes a standard ELISA assay and an automated processor, neither of which are described as using AI or ML.

No
The device is an in vitro diagnostic (IVD) test used to detect antibodies for diagnosis, not to treat a condition.

Yes.
The device is used "as an aid in the diagnosis of systemic lupus erythematosus."

No

The device is described as a "Test Kit System" and an "enzyme-linked immunosorbent assay (ELISA)" which are inherently hardware-based laboratory components used for performing a chemical reaction to detect antibodies. While it can be used with an automated processor (MAGO), the core device itself is a physical kit.

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

Here's why:

  • Intended Use: The "Indications for Use" explicitly states that the device is an "Enzyme Immunoassay (ElA) for the detection and quantitative determination of IgG antibodies in human serum to DNA antigen as an aid in the diagnosis of systemic lupus erythematosus in patients with clinical signs of the disease." This describes a test performed in vitro (outside the body) on a biological sample (human serum) to provide information for diagnostic purposes.
  • Device Description: The "Device Description" confirms it is an "enzyme-linked immunosorbent assay (ELISA) for the detection and quantitation of IgG to DNA in human serum," further supporting its nature as an in vitro test.
  • Performance Studies: The performance studies describe testing of "sera" (plural of serum), which is a biological sample.

All of these points align with the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The assay is intended for use in detecting IgG antibodies to dsDNA in a single human serum sample. The results of the assay are to be used as an aid in the diagnosis of SLE.

lndications for Use :The Diamedix Is-dsDNA an Enzyme Immunoassay (ElA) for the detection and quantitative determination of IgG antibodies in human serum to DNA antigen as an aid in the diagnosis of systemic lupus erythematosus in patients with clinical signs of the disease. These reagents can be used either manually or in conjunction with the MAGO® Automated EIA Processor.

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

LRM

Device Description

The Is-dsDNA Test Kit System is an enzyme-linked immunosorbent assay (ELISA) for the detection and quantitation of IgG to DNA in human serum

The Is-dsDNA Test System is an enzyme-linked immunosorbent assay to detect IgG toDNA in human serum. Purified DNA is attached to a solid phase microtiter well. Diluted test sera are added to each well. If antibodies which recognize the DNA antigen are present in the patient sample they will bind to the antigen in the well. After incubation, the wells are washed to remove unbound antibody. An enzyme labeled anti-human immunoglobulin (conjugate) is added to each test well. If antibody is present the enzyme-linked antibody will bind to it. After incubation, the wells are washed to remove unbound conjugate. A substrate solution is then added to each well. If enzyme is present from prior step, the reaction is stopped and the color intensity is measured photometrically producing an indirect measure of the specific antibody present in the patient sample.

Mentions image processing

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Mentions AI, DNN, or ML

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Input Imaging Modality

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Anatomical Site

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Indicated Patient Age Range

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Intended User / Care Setting

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Description of the training set, sample size, data source, and annotation protocol

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Description of the test set, sample size, data source, and annotation protocol

Description of the test set: Two hundred sera from normal blood donors and 50 sera from SLE patients.
Sample size: 250 (200 normal, 50 SLE patients)
Data source: Two hundred sera from normal blood donors and 50 sera from SLE patients were tested by the Is-dsDNA test kit and the comparative method.
Annotation protocol: Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Study Type: Comparison Testing, Linearity, Precision, Crossreactivity, Expected Values, Correlation of Manual and MAGO Results.
Sample Size:
Comparison Testing: 200 normal blood donors and 50 SLE patients sera (total 250).
Precision: Six different sera and the kit calibrator and controls, tested in triplicate in two runs on three different days.
Crossreactivity: 11 samples containing other autoantibodies, 49 samples containing single-stranded DNA.
Expected Values: 200 normal donor sera, 50 sera from SLE patients.
Correlation of Manual and MAGO Results: 249 samples.

Key Results:
Comparison Testing:
Manual Testing: Relative Sensitivity 94.9% (37/39), Relative Specificity 100.0% (199/199), Overall Agreement 99.2% (236/238).
MAGO Testing: Relative Sensitivity 90.6% (29/32), Relative Specificity 100.0% (201/201), Overall Agreement 98.7% (230/233).
Linearity: High degree of linearity throughout the reportable range. R-squared value for manual linearity is 0.9821, for MAGO linearity is 0.9961.
Precision: Intra-assay and interassay precision data provided for both manual and MAGO testing, showing acceptable variability.
Crossreactivity: No cross-reactivity with samples containing other autoantibodies. Of 49 samples with ssDNA, 37 were negative, 1 borderline, and 11 positive (which were also positive by at least two other dsDNA tests, indicating presence of both ssDNA and dsDNA).
Correlation of Manual and MAGO Results: R-squared value of 0.9334, indicating a strong positive correlation.

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

Relative Sensitivity
Manual: 94.9% (95% CI: 82.7-99.4)
MAGO: 90.6% (95% CI: 75.0-98.0)

Relative Specificity
Manual: 100.0% (95% CI: 98.2-100)
MAGO: 100.0% (95% CI: 98.2-100.0)

Overall Agreement
Manual: 99.2% (95% CI: 97.0-99.9)
MAGO: 98.7% (95% CI: 96.3-99.7)

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.

Not Found

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

§ 866.5100 Antinuclear antibody immunological test system.

(a)
Identification. An antinuclear antibody immunological test system is a device that consists of the reagents used to measure by immunochemical techniques the autoimmune antibodies in serum, other body fluids, and tissues that react with cellular nuclear constituents (molecules present in the nucleus of a cell, such as ribonucleic acid, deoxyribonucleic acid, or nuclear proteins). The measurements aid in the diagnosis of systemic lupus erythematosus (a multisystem autoimmune disease in which antibodies attack the victim's own tissues), hepatitis (a liver disease), rheumatoid arthritis, Sjögren's syndrome (arthritis with inflammation of the eye, eyelid, and salivary glands), and systemic sclerosis (chronic hardening and shrinking of many body tissues).(b)
Classification. Class II (performance standards).

0

K974694

MAR - 3 1998

Appendix E. 510(k) Summary of Safety and Effectiveness

The following section is included as required by the Safe Medical Device Act (SMDA) of 1990.

Name: Address:

ﺔ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤ

Diamedix Corporation 2140 N. Miami Avenue Miami, FL 33127

ﻣﻌﻤﻮﺩ

Contact Person: Phone Number: Fax Number:

"

Dr. Lynne Stirling 305-324-2354 305-324-2585

1

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.

The assigned 510(k) number is: _ K974694

Applicant Information:

Date Prepared:December 15, 1997
Name:Diamedix Corporation
Address:2140 N. Miami Avenue
Miami, FL 33127
Contact Person:Dr. Lynne Stirling
Phone Number:305-324-2354
Fax Number:305-324-2585

Device Information:

Trade Name:Is-dsDNA Test System
Common Name:Anti-DNA EIA Test
Classification Name:Anti-DNA Antibody

Equivalent Device:

varelisa dsDNA Antibodies

Device Description: The Is-dsDNA Test Kit System is an enzyme-linked immunosorbent assay (ELISA) for the detection and quantitation of IgG to DNA in human serum

Intended Use: The assay is intended for use in detecting IgG antibodies to dsDNA in a single human serum sample. The results of the assay are to be used as an aid in the diagnosis of SLE.

Principle of the Procedure:

The Is-dsDNA Test System is an enzyme-linked immunosorbent assay to detect IgG toDNA in human serum. Purified DNA is attached to a solid phase microtiter well. Diluted test sera are added to each well. If antibodies which recognize the DNA antigen are present in the patient sample they will bind to the antigen in the well. After incubation, the wells are washed to remove unbound antibody. An enzyme labeled anti-human immunoglobulin (conjugate) is added to each test well. If antibody is present the enzyme-linked antibody will bind to it. After incubation, the wells are washed to remove unbound conjugate. A substrate solution is then added to each well. If enzyme is present from prior step, the reaction is stopped and the color intensity is measured photometrically producing an indirect measure of the specific antibody present in the patient sample.

2

SUMMARY OF SAFETY AND EFFECTIVENESS

Performance Charactistics

A. Comparison Testing

The Diamedix Is-dsDNA Test Kit was evaluated relative to another commercially available anti-dsDNA test kit that is also standardized against the Wo/80 WHO Standard. Two hundred sera from normal blood donors and 50 sera from SLE patients were tested by the Is-dsDNA test kit and the comparative method. Testing was performed both manually and using the MAGO Automated Processor. Results are shown in Table 1.

TABLE 1ManualMAGO
# of Sera%95% CI# of Sera%95% CI
Relative Sensitivity37/3994.982.7-99.429/3290.675.0-98.0
Relative Specificiity199/199100.098.2-100201/201100.098.2-100.0
Overall Agreement236/238*99.297.0-99.9230/233**98.796.3-99.7
  • 12 equivocal/borderline results excluded from calculations

ﺎﺕ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟ

** 16 equivocal/borderline results excluded from calculations; I sample QNS

For manual testing there were three samples negative by the Is-dsDNA and positive by the comparative method. When these samples were tested by a referee method two were positive and one was negative. For MAGO testing there were two samples that were negative in the Is-dsDNA and positive in the comparative method. When these samples were tested by a referee method one was negative and one was positive.

B. Linearity

Figures 1 and 2 show typical examples of the Is-dsDNA linearity. These figures depict the inhouse reference standard (which has been standardized against the Wo/80 Standard) tested by the Is-dsDNA after serial two-fold manual dilution in Sample Diluent. Separate dilutions were tested both manually and with MAGO. The results demonstrate a high degree of linearity for the Is-dsDNA Test Kit throughout the reportable range of the assay.

Image /page/2/Figure/10 description: The image contains two scatter plots comparing manual linearity and MAGO linearity. Both plots show the relationship between dilution and absorbance. The R-squared value for manual linearity is 0.9821, while the R-squared value for MAGO linearity is 0.9961, indicating a slightly better fit for the MAGO linearity data.

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C. Precision

The precision of the Is-dsDNA test kit was determined by testing six different sera and the kit calibrator and controls in triplicate in two runs on three different days. Precision was evaluated both manually and using the MAGO. The intra-and interassay precision is shown in Tables 2 and 3.

(AD)BL1C
----------------

Is-dsDNA Precision (Manual)

Intra-assay *Interassay **
Day 1Day 2Day 3
SERUMMean SD %CVMean SD %CVMean SD %CVMean SD %CV
A (Neg)7.8 1.6 N/A6.7 0.7 N/A7.4 0.9 N/A7.3 1.2 N/A
B (Neg)6.0 0.9 N/A4.9 0.2 N/A5.5 0.3 N/A5.5 0.7 N/A
C (Pos)78.2 10.1 12.971.1 5.0 7.075.0 2.7 3.674.8 7.0 9.3
D (Pos)114.4 10.3 9.0107.9 9.8 9.0122.9 11.2 9.1115.1 11.7 10.2
E (Pos)202.8 16.2 8.0199.0 27.7 13.9232.3 27.3 11.7211.4 27.5 13.0
F (Pos)364.2 26.0 7.1336.3 10.5 3.1376.6 17.0 4.5359.1 24.9 6.9
Cal.372.9 26.1 7.0346.0 37.4 10.8384.1 20.4 5.3367.7 31.7 8.6
Pos.79.0 4.1 5.275.2 5.7 7.682.9 4.4 5.479.1 5.6 7.0
Neg.7.1 2.1 N/A5.6 1.3 N/A5.7 1.4 N/A6.1 1.7 N/A
ls-dsDNA Precision (MAGO)
Is-dsDNA Precision (MAGO)
Intra-assay *Interassay **
Day 1Day 2Day 3
SERUMMeanSD%CVMeanSD%CVMeanSD%CVMeanSD%CV
A (Neg)8.93.7N/A5.54.1N/A18.58.0N/A11.07.7N/A
B (Neg)9.01.9N/A6.64.4N/A9.42.1N/A8.33.1N/A
C (Pos)81.78.510.478.811.714.985.312.314.481.910.713.1
D (Pos)114.713.511.8102.613.413.0112.818.716.6110.015.514.1
E (Pos)249.934.713.9280.142.415.1285.740.014.0271.940.214.8
F (Pos)360.312.63.5366.515.04.1398.020.85.2374.923.06.1
Cal.373.420.95.6390.626.56.8391.728.57.3385.225.46.6
Pos.100.115.615.6102.310.410.1104.27.87.5102.211.211.0
Neg.17.57.2N/A13.25.5N/A23.412.5N/A18.09.4N/A
* n = 6** n = 18

D. Crossreactivity

The absence of cross-reactivity in the Is-dsDNA was established by testing several sera (samples 1 to 11) containing some type of autoantibody by other methods, but with no antibody to ds DNA by other methods. These results are shown in Table 4.

Sample #Is-dsDNAInterpSpecificity
IU/ml
17.7NEGSSA, SSB
29.3NEGSSA, SSB, Sm/RNP
314.1NEGSm/RNP
44.1NEGJo-1
59.1NEGJo-1
612.3NEGScl-70
722.2NEGScl-70
84.1NEGSSA, Sm/RNP
915.3NEGSSA, SSB
1011.7NEGSm, Sm/RNP
1118.9NEGSm, Sm/RNP

TABLE 4

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4

In addition to the samples listed in Table 4, 49 samples containing varying levels of single-stranded DNA were also tested in the Is-dsDNA test Kit. Thirty seven samples were negative, one sample was borderline and eleven samples were positive. All eleven positive samples were also positive by at least two other commercially available tests for detecting dsDNA antibodies which would indicate that these samples indeed contain both ssDNA and dsDNA.

E. Expected Values

Antibodies to dsDNA are found in 60-70% of patients with SLE and are rarely present in normal populations. The expected values in the normal population were evaluated by assaying 200 normal donor sera collected in South Florida. Figures 3 and 5 show the distribution of dsDNA results in the normal population performed manually and on MAGO respectively. The distribution of IU/ml values for 50 sera from SLE patients is shown in Figures 4 and 6 performed manually and on MAGO respectively.

Image /page/4/Figure/3 description: The image contains four figures, each displaying a graph. Figures 3 and 4 are labeled "MANUAL," while Figures 5 and 6 are labeled "MAGO." Figures 3 and 5 are titled "Normals," and Figures 4 and 6 are titled "SLE patients." Each graph plots data points with "Number of Sera" on the x-axis and "IU/ml" on the y-axis, showing different distributions for normals and SLE patients under both MANUAL and MAGO conditions.

5

F. Correlation of Manual and Mago Results

. .

  • V OCT Cateles of the MAGO IU/ml values for 249 samples tested in the Is-dsDNA Test Kit is shown in Figure 7.

Image /page/5/Figure/2 description: This image is a scatter plot showing the relationship between two variables. The y-axis is labeled "MAGO (IU/ml)" and ranges from 0 to 600. The data points are clustered near the origin and then spread out along a positive trend line. The R-squared value is 0.9334, indicating a strong positive correlation.

Image /page/5/Figure/6 description: The image shows the words "FIGURE 7" in bold, black font. The text is arranged on a single line, with "FIGURE" preceding the number "7". The image appears to be a label or title for a figure in a document.

Manual (IUml)

6

Image /page/6/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized depiction of an eagle with its wings spread, positioned to the right of the department's name. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the eagle symbol.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

Lynne Stirling, Ph.D. Vice President, Regulatory Affairs MAR - 3 1998 Diamedix Corporation 2140 N. Miami Avenue Miami, Florida 33127

Re : K974694 Is-dsDNA Test System Trade Name: Regulatory Class: II Product Code: LRM Dated: December 15, 1997 December 16, 1997 Received:

Dear Dr. Stirling:

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, labelinq, and prohibitions aqainst misbranding and adulteration.

If your device is classified (see above) into either class II (Smecial Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major requlations 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 Regulation (QS) for Medical Devices: General requlation (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. Please note: this response to your premarket notification 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 Requlations.

7

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 Butman

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

8

Page__________________________________________________________________________________________________________________________________________________________________________

510(k) Number (if known):_K97 4694

Device Name:

Indications For Use:

lndications for Use :The Diamedix Is-dsDNA an Enzyme Immunoassay (ElA) for the detection and quantitative determination of IgG antibodies in human serum to DNA antigen as an aid in the diagnosis of systemic lupus erythematosus in patients with clinical signs of the disease. These reagents can be used either manually or in conjunction with the MAGO® Automated EIA Processor.

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

Concurrence of CDRH, Office of Defice Evaluation (ODE)

_
(Division Sign-Off)

Division of Clinical Laboratory Devices
510(k) Number K674694

Prescription Use
(Per 21 CFR 801.109)

OR

Over-The-Counter Use__________________________________________________________________________________________________________________________________________________________

(Optional Format 1-2-96)