K Number
K981345
Device Name
CHOLESTRON PRO II CHOLESTEROL TEST
Date Cleared
1998-10-01

(170 days)

Product Code
Regulation Number
862.1175
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Cholestron™ Pro II Cholesterol Test (Cholestron) is a professional-use, point-ofcare in vitro diagnostic device for the measurement of total cholesterol in fingerstick whole blood samples. Total cholesterol measurements aid in the detection of persons who may be at risk for coronary heart disease, and aid in the management of patients undergoing therapy with lipid lowering drugs. The measurement range for the Cholestron is 150 - 300 mg/dL.
Device Description
The Cholestron system consists of a photometer with a display assembly keypad, and single-use, disposable reagent strips. Fingerstick whole blood is applied directly to the device, and cholesterol results are available in approximately three minutes.
More Information

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Not Found

No
The description focuses on a photometer and reagent strips, with no mention of AI/ML terms or capabilities. The performance studies describe standard analytical accuracy and precision evaluations, not AI/ML model training or testing.

No.
The document states that the device is an "in vitro diagnostic device for the measurement of total cholesterol." Its purpose is to aid in the detection of risk and management of patients, not to provide therapy.

Yes
The "Intended Use / Indications for Use" section explicitly states that the device is a "point-of-care in vitro diagnostic device."

No

The device description explicitly states that the system consists of a photometer with a display assembly keypad and single-use, disposable reagent strips, indicating it includes hardware components.

Yes, the Cholestron™ Pro II Cholesterol Test is an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use/Indications for Use: The description explicitly states it is an "in vitro diagnostic device for the measurement of total cholesterol in fingerstick whole blood samples."
  • Device Description: It describes a system that analyzes a biological sample (fingerstick whole blood) outside of the body using reagent strips.
  • Performance Studies: The document details studies evaluating the device's performance in measuring cholesterol in biological samples.

All of these points align with the definition of an In Vitro Diagnostic device, which is used to examine specimens derived from the human body to provide information for diagnostic purposes.

N/A

Intended Use / Indications for Use

INTENDED USE

The Cholestron™ Pro II Cholesterol Test (Cholestron) is a professional-use, point-ofcare in vitro diagnostic device for the measurement of total cholesterol in fingerstick whole blood samples.

INDICATIONS FOR USE

Total cholesterol measurements aid in the detection of persons who may be at risk for coronary heart disease, and aid in the management of patients undergoing therapy with lipid lowering drugs.

The measurement range for the Cholestron is 150 - 300 mg/dL.

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

CHH

Device Description

The Cholestron system consists of a photometer with a display assembly keypad, and single-use, disposable reagent strips. Fingerstick whole blood is applied directly to the device, and cholesterol results are available in approximately three minutes.

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

professional-use, point-of-care

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

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

Studies were performed to evaluate accuracy and precision. Accuracy was evaluated by two studies of 62 subjects each, where results from testing with the Cholestron on fingerstick whole blood samples by each of two operators were compared to venous serum samples assayed by the reference Abell-Kendall (A-K) method. Precision was evaluated in both serum and whole matrices with two levels of cholesterol samples. Serum samples (commercial controls) were assayed in multiple "runs" over several days, and whole blood samples were assayed in single runs on a single day.

Accuracy statistics:

  • Operator #1 vs A-K: n = 57 (5 Cholestron values out of range), r = 0.95, Slope = 0.855, y-intercept = 32, Bias at 200 mg/dL = 203 (1.50%), Bias at 240 mg/dL = 237 (-1.25%).
  • Operator #2 vs A-K: n = 62 (1 Cholestron value out of range), r = 0.94, Slope = 0.840, y-intercept = 37, Bias at 200 mg/dL = 205 (2.50%), Bias at 240 mg/dL = 239 (-0.42%).
  • Operator #3 vs A-K: n = 62, r = 0.94, Slope = 0.858, y-intercept = 32, Bias at 200 mg/dL = 204 (2.00%), Bias at 240 mg/dL = 238 (-0.83%).
  • Operator #4 vs A-K: n = 62, r = 0.93, Slope = 0.882, y-intercept = 28, Bias at 200 mg/dL = 204 (2.00%), Bias at 240 mg/dL = 240 (-zero).
    The data demonstrate all comparative biases were within 3%, as specified by National Cholesterol Education Program (NCEP) guidelines. Each operator obtained Cholestron results that compared closely with the A-K results, and the Cholestron meets NCEP's guidelines for accuracy.

Serum Precision:
A two-level commercial control set was assayed six times a day (three replicates in the morning, and three replicates in the afternoon) over five days for a total of 30 replicates for each level. The controls were label-assigned at mean values of 180 mg/dL ("Low", range 154-207 mg/dL) and 256 mg/dL ("High", range 221-292 mg/dL).

  • Low Control (n=30): Weekly Mean = 184.4, Standard Deviation = 3.17, Percent Coefficient of Variation = 1.72.
  • High Control (n=30): Weekly Mean = 230.9, Standard Deviation = 6.73, Percent Coefficient of Variation = 2.91.
    Cholestron's within-day imprecision ranged from 1.07 %CV to 1.75 %CV with the Low control, and from 1.47 %CV to 273. %CV with the High Control. The between-day (or total) imprecision was 1.72 %CV for the Low Control, and 2.91% CV for the High Control. Testing of the serum controls demonstrated Cholestron meets the NCEP guidelines for precision with %CVs within 3%.

Whole Blood Precision:
Whole blood precision was evaluated by repeat testing of two levels of venous heparinized whole blood; the whole blood samples were targeted at 200 mg/dL and 240 mg/dL.

  • LOW (n=30): Mean = 179.4, Standard Deviation = 2.50, Percent Coefficient of Variation = 1.39.
  • HIGH (n=30): Mean = 228.1, Standard Deviation = 5.43, Percent Coefficient of Variation = 2.38.
    The data demonstrated %CVs of 1.39% ("Low"), and 2.38% ("High"). The whole blood precision testing corroborated the serum precision testing, and confirms Cholestron meets the NCEP guidelines for precision with %CVs within 3%.

Conclusions: Studies were conducted to evaluate Cholestron's accuracy and precision. Accuracy was assessed by paired testing of 62 whole blood/serum samples in two separate evaluations, and precision was assessed by repeated analyses of serum controls and whole blood samples. The data demonstrated Cholestron meets the NCEP guidelines for accuracy and precision, with estimated biases within 3% of the reference method, and with percent coefficients of variation within 3%.

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

Accuracy biases within 3%, precision %CVs within 3%.

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.

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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

§ 862.1175 Cholesterol (total) test system.

(a)
Identification. A cholesterol (total) test system is a device intended to measure cholesterol in plasma and serum. Cholesterol measurements are used in the diagnosis and treatment of disorders involving excess cholesterol in the blood and lipid and lipoprotein metabolism disorders.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 862.9.

0

K9813415

Lifestream Technologies, Inc. Cholesteron™ Pro II Cholesterol Test

OCT 1 1998

SECTION 10

510(K) SUMMARY (REVISED)

1

Image /page/1/Picture/0 description: The image shows the logo for Lifestream Diagnostics Inc. The word "Lifestream" is written in a stylized, cursive font. Below the word "Lifestream" is the word "Diagnostics" written in a sans-serif font. The letters are spaced out.

510(k) SUMMARY

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: K981345.

Submitter Information (21 CFR 807.92(a)(1))

Lifestream Technologies, Inc. 510 Clearwater Loop, Suite 101 Post Falls, ID 83854 phone: (208) 457-9409 (208) 457-9509 fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax: fax:

Contact:

Submitter:

Jackson B. Connolly Director, Product Development Lifestream Diagnostics, Inc. phone: (208) 457-9409

Summary Date: April 13, 1998

Name of Device and Classification (21 CFR 807.92(a)(2)) Name (trade): Cholestron™ Pro II Cholesterol Test

Name (usual): total cholesterol test system

Classification: 21 CFR 862.1175, Class I, CHH

Identification of Legally Marketed Predicate Device(s) (21 CFR 807.92 (a)(3))

Cholesteron TM Pro II Cholesterol Test (Cholestron) is substantially equivalent to the Accu-Chek® InstantPlus™ Cholesterol Test (Boehringer-Mannheim Diagnostics, Indianapolis, IN; also known as Accutrend GC Test). Cholestron and Accu-Chek share the same intended use, methodology and technology, testing matrix, reportable range, and risk to the patient.

age 2 515 Pine Street · Suite 200 · P.O. Box 2130 · Sandpoint, ID 83864 · Phone (208) 263-5433 · Fax (208) 263-6

2

510(k) SUMMARY

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: K981345.

Submitter Information (21 CFR 807.92(a)(1))

Submitter: Lifestream Technologies, Inc. 510 Clearwater Loop, Suite 101 Post Falls, ID 83854 phone: (208) 457-9409 fax: (208) 457-9509

Contact:

Jackson B. Connolly Director, Product Development Lifestream Diagnostics, Inc. phone: (208) 457-9409

Summary Date: April 13, 1998

Name of Device and Classification (21 CFR 807.92(a)(2)) Name (trade): Cholestron™ Pro II Cholesterol Test

Name (usual): total cholesterol test system

Classification: 21 CFR 862.1175, Class I, CHH

Identification of Legally Marketed Predicate Device(s) (21 CFR 807.92 (a)(3))

Cholesteron TM Pro II Cholesterol Test (Cholestron) is substantially equivalent to the Accu-Chek® InstantPlus™ Cholesterol Test (Boehringer-Mannheim Diagnostics, Indianapolis, IN; also known as Accutrend GC Test). Cholestron and Accu-Chek share the same intended use, methodology and technology, testing matrix, reportable range, and risk to the patient.

3

Description of Device (21 CFR 807.92 (a)(4))

The Cholestron system consists of a photometer with a display assembly keypad, and single-use, disposable reagent strips. Fingerstick whole blood is applied directly to the device, and cholesterol results are available in approximately three minutes.

Intended Use (21 CFR 807.92 (a)(5))

The Cholestron™ Pro II Cholesterol Test is a professional-use, point-of-care in vitro diagnostic device for the measurement of total cholesterol in fingerstick whole blood samples. Total cholesterol measurements aid in the detection of persons who may be at risk for coronary heart disease, and aid in the management of patients undergoing therapy with lipid lowering drugs.

Similarities to the Predicate(s) (21 CFR 807.92 (a)(6))

A summary table of the similarities and differences between Cholestron and the predicate device (Accu-Chek) follows.

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CHARACTERISTICCHOLESTRONAccu-Chek
Intended Usetotal cholesterol
measurement to aid in the
diagnosis and management of
coronary heart diseasetotal cholesterol
measurement to aid in the
diagnosis and management of
coronary heart disease
Analyte Measuredtotal cholesteroltotal cholesterol
Methodology/TechnologyEnzymatic: cholesterol
esterase and cholesterol
oxidase (Trinder Reaction)
Cholesterol esterase reacts
with lipoproteins in the
sample to split the
cholesterol ester into
cholesterol and fatty acid.
Cholesterol is oxidized to 4-
cholesten-3-one and H2O2 in
the presence of cholesterol
oxidase. Hydrogen peroxidase
reacts with a reducing agent
to produce a blue color that is
measured photometrically.Enzymatic: cholesterol
esterase and cholesterol
oxidase (Trinder Reaction)
Cholesterol esterase reacts
with lipoproteins in the
sample to split the
cholesterol ester into
cholesterol and fatty acid.
Cholesterol is oxidized to 4-
cholesten-3-one and H2O2 in
the presence of cholesterol
oxidase. Hydrogen peroxidase
reacts with a reducing agent
to produce a blue color that is
measured photometrically.
Testing Matrixfingerstick whole bloodfingerstick whole blood
Reportable Range150-300 mg/dL150-300 mg/dL
Risk to Patientminimal, not a sole
discriminate; total
cholesterol results are
interpreted along with
medical histories and other
biochemical markersminimal, not a sole
discriminate; total
cholesterol results are
interpreted along with
medical histories and other
biochemical markers
CHARACTERISTICCHOLESTRONACCUTREND
K944458
(cholesterol portion)
Safety Feature for Correct
Reagent Strip Usageincludes external keypad that
requires correct entry of
reagent strip lot informationno such feature
User Interface16-key4-key
Battery Power1 9-volt3 AAA
ElectronicsDiagnostic + Memory +
Display Conversion + Code #
Correlation to Lot # (safety)
  • Cardiac Risk Assessment | Diagnostic + Memory |

Similarities Between Cholestron and Accu-Chek

5

Differences Between Cholestron and Accutrend

Brief Discussion of Nonclinical Data (21 CFR 807.92(b)(1))

Laboratory tests were conducted to assess the effects of potential interferents on the cholesterol results; both biological and therapeutic were evaluated. The results appear below.

Potential InterferentLevel of Interference
Bilirubinno interference in samples containing up to
10 mg/dL
Hemoglobinhemolyzed samples (as would be seen in
cases of excessive squeezing at the puncture
site) should be avoided
High Hematocritcholesterol values were not affected when
hematocrit levels ranged from 30% to 55%
Triglyceridesno interference in samples containing up to
400 mg/dL
Uric Acidno interference in samples containing up to
9 mg/dL
Excessive Squeezing of Puncture Siteexcessive squeezing and milking of the
puncture site may produce erroneous
results

INTERFERENCE TESTING WITH BIOLOGICAL COMPOUNDS

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Therapeutic Compounds

Specificity testing was performed with common therapeutic compounds. The following compounds, when present in pathological concentrations, were found to possibly alter cholesterol results.

Acetaminophen Ascorbic Acid Dopamine Gentisic Acid Methyldopa

Brief Discussion of Clinical Data (21 CFR 807.92 (b)(2)

Studies were performed to evaluate accuracy and precision. Accuracy was evaluated by two studies of 62 subjects each, where results from testing with the Cholestron on fingerstick whole blood samples by each of two operators were compared to venous serum samples assayed by the reference Abell-Kendall (A-K) method. Precision was evaluated in both serum and whole matrices with two levels of cholesterol samples. Serum samples (commercial controls) were assayed in multiple "runs" over several days, and whole blood samples were assayed in single runs on a single day.

| Comparison | n = | r = | Slope | y-intercept | Bias at
200 mg/dL
(% bias) | Bias at
240 mg/dL
(% bias) |
|--------------------|------|------|-------|-------------|----------------------------------|----------------------------------|
| Operator #1 vs A-K | 57* | 0.95 | 0.855 | 32 | 203
(1.50%) | 237
(-1.25%) |
| Operator #2 vs A-K | 62** | 0.94 | 0.840 | 37 | 205
(2.50%) | 239
(-0.42%) |
| Operator #3 vs A-K | 62 | 0.94 | 0.858 | 32 | 204
(2.00%) | 238
(-0.83%) |
| Operator #4 vs A-K | 62 | 0.93 | 0.882 | 28 | 204
(2.00%) | 240
(-zero) |

CHOLESTRON ACCURACY STATISTICS

  • 5 Cholestron values out of range ** 1 Cholestron value out of range

The data demonstrate all comparative biases were within 3%, as specified by National Cholesterol Education Program (NCEP) guidelines. Each operator obtained Cholestron results that compared closely with the A-K results, and the Cholestron meets NCEP's guidelines for accuracy.

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SERUM PRECISION

A two-level commercial control set was assayed six times a day (three replicates in the morning, and three replicates in the afternoon) over five days for a total of 30 replicates for each level. The controls were label-assigned at mean values of 180 mg/dL ("Low", range 154-207 mg/dL) and 256 mg/dL ("High", range 221-292 mg/dL), and testing was performed via the pipetting of 25μL of sample onto each of two Cholestron devices.

| DAY | N = | MEAN | STANDARD
DEVIATION | PERCENT
COEFFICIENT
OF VARIATION |
|--------|-----|-------|-----------------------|----------------------------------------|
| 1 | 6 | 184.7 | 2.58 | 1.40 |
| 2 | 6 | 186.3 | 3.27 | 1.75 |
| 3 | 6 | 183.7 | 2.94 | 1.60 |
| 4 | 6 | 186.3 | 2.50 | 1.34 |
| 5 | 6 | 181.2 | 1.94 | 1.07 |
| Weekly | 30 | 184.4 | 3.17 | 1.72 |

SUMMARIZED SERUM PRECISION DATA-LOW CONTROI

SUMMARIZED SERUM PRECISION DATA-HIGH CONTROL

| DAY | N = | MEAN | STANDARD
DEVIATION | PERCENT
COEFFICIENT
OF VARIATION |
|--------|-----|-------|-----------------------|----------------------------------------|
| 1 | 6 | 228.5 | 6.38 | 2.79 |
| 2 | 6 | 233.2 | 4.26 | 1.83 |
| 3 | 6 | 233.0 | 7.38 | 3.17 |
| 4 | 6 | 234.2 | 8.73 | 3.73 |
| 5 | 6 | 225.8 | 3.31 | 1.47 |
| Weekly | 30 | 230.9 | 6.73 | 2.91 |

Cholestron's within-day imprecision ranged from 1.07 %CV to 1.75 %CV with the Low control, and from 1.47 %CV to 273. %CV with the High Control. The between-day (or total) imprecision was 1.72 %CV for the Low Control, and 2.91% CV for the High Control. Testing of the serum controls demonstrated Cholestron meets the NCEP guidelines for precision with %CVs within 3%.

8

WHOLE BLOOD PRECISION

Whole blood precision was evaluated by repeat testing of two levels of venous heparinized whole blood; the whole blood samples were targeted at 200 mg/dL and 240 mg/dL. Whole blood precision was included in the clinical trial as this is the relevant matrix for the Cholestron. Testing was performed via the pipetting of 25uL of sample onto the devices.

| LEVEL ID | N = | MEAN | STANDARD
DEVIATION | PERCENT
COEFFICIENT
OF VARIATION |
|----------|-----|-------|-----------------------|----------------------------------------|
| LOW | 30 | 179.4 | 2.50 | 1.39 |
| HIGH | 30 | 228.1 | 5.43 | 2.38 |

SUMMARIZED WHOLE BLOOD PRECISION DATA

The data demonstrated %CVs of 1.39% ("Low"), and 2.38% ("High"). The whole blood precision testing corroborated the serum precision testing, and confirms Cholestron meets the NCEP guidelines for precision with %CVs within 3%.

Performance Data - Conclusions (21 CFR 807.92 (b)(3))

Studies were conducted to evaluate Cholestron's accuracy and precision. Accuracy was assessed by paired testing of 62 whole blood/serum samples in two separate evaluations, and precision was assessed by repeated analyses of serum controls and whole blood samples.

The data demonstrated Cholestron meets the NCEP guidelines for accuracy and precision, with estimated biases within 3% of the reference method, and with percent coefficients of variation within 3%.

9

Image /page/9/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 text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" around the perimeter. Inside the circle is an abstract symbol that resembles an eagle or a bird in flight, composed of three stylized human profiles facing to the right.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

1 1998 OCT

Lifestream Technologies, Inc. · C/O Erika B. Ammirati, R.A.C. MT(ASCP) Ammirati Requlatory Consulting 575 Shirlynn Court Los Altos, California 94022

Re : K981345 Cholestron™ Pro II Cholesterol Test Requlatory Class: I Product Code: СНН Dated: August 26, 1998 Received: Auqust 28, 1998

Dear Ms. Ammirati:

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 Requlations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (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 In addition, FDA may publish further announcements action. 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.

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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 (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,
Steven Bitman

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

11

SECTION 3 INTENDED USE/INDICATIONS FOR USE

INTENDED USE

The Cholestron™ Pro II Cholesterol Test (Cholestron) is a professional-use, point-ofcare in vitro diagnostic device for the measurement of total cholesterol in fingerstick whole blood samples.

INDICATIONS FOR USE

Total cholesterol measurements aid in the detection of persons who may be at risk for coronary heart disease, and aid in the management of patients undergoing therapy with lipid lowering drugs.

The measurement range for the Cholestron is 150 - 300 mg/dL.

(Division Sign-Off)
Division of Clinical Laboratory Devices
510(k) Number K981345