K Number
K990439
Device Name
CARESIDE CK
Manufacturer
Date Cleared
1999-04-19

(67 days)

Product Code
Regulation Number
862.1215
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For in vitro diagnostic use with the CARESIDE Analyzer™ to quantitatively measure CK from anti-coagulated whole blood, plasma, or serum specimens to aid in the diagnosis and treatment of patients with myocardial infarction and muscle diseases such as progressive, Duchenne-type muscular dystrophy.
Device Description
CARESIDE™ CK cartridges are used with the CARESIDE, Inc. CARESIDE Analyzer™ to measure CK activity in whole blood, serum or plasma specimens. The CARESIDE™ CK cartridge, a single use disposable in vitro diagnostic test cartridge, delivers a measured volume of serum or plasma to a dry film to initiate the measurement of CK activity. The film cartidge (patent pending) contains all reagents necessary to measure CK activity.
More Information

Not Found

No
The summary describes a dry film chemistry assay for measuring CK activity, which is a standard laboratory technique and does not mention any AI or ML components.

No.
The device is an in vitro diagnostic test for measuring CK levels to aid in diagnosis, not for treating patients.

Yes

The "Intended Use / Indications for Use" section explicitly states "For in vitro diagnostic use... to aid in the diagnosis and treatment of patients with myocardial infarction and muscle diseases".

No

The device description explicitly states it is a "single use disposable in vitro diagnostic test cartridge" and a "film cartridge" containing reagents, indicating it is a hardware component used with an analyzer, not a software-only device.

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

Here's why:

  • Intended Use/Indications for Use: Explicitly states "For in vitro diagnostic use".
  • Device Description: Describes a "single use disposable in vitro diagnostic test cartridge".
  • Intended User/Care Setting: While it specifies "professional laboratory use", this is a common setting for IVDs.
  • Performance Studies: The description of performance studies (accuracy, precision, method comparison, etc.) are typical for demonstrating the analytical performance of an IVD.
  • Predicate Device(s): The listed predicate device is also an IVD (Vitros CK DT Slides).

All of these points strongly indicate that this device is intended for in vitro diagnostic use.

N/A

Intended Use / Indications for Use

Intended Use:
The CARESIDE™ CK cartridge is intended for in vitro diagnostic use in conjunction with the CARESIDE Analyzer™ to quantitatively measure CK activity in whole blood, serum or plasma.

Indications for Use:
For in vitro diagnostic use with the CARESIDE Analyzer™ to quantitatively measure CK activity from anti-coagulated whole blood, plasma, or serum specimens to aid in the diagnosis and treatment of patients with myocardial infarction and muscle diseases such as progressive, Duchenne-type muscular dystrophy. It is intended professional laboratory use: not for point of care or physician office laboratory use.

Product codes

75JFX, JHS

Device Description

CARESIDE™ CK cartridges are used with the CARESIDE, Inc. CARESIDE Analyzer™ to measure CK activity in whole blood, serum or plasma specimens. The CARESIDE™ CK cartridge, a single use disposable in vitro diagnostic test cartridge, delivers a measured volume of serum or plasma to a dry film to initiate the measurement of CK activity. The film cartidge (patent pending) contains all reagents necessary to measure CK activity.

Each CARESIDE™ CK cartridge consists of a CK-specific multi-layer reagent film mounted in a plastic base with a hinged lid. The user introduces the specimen into the cartridge sample deposition well, closes the lid and inserts the cartridge into the CARESIDE Analyzer™.

Once loaded, the CARESIDE Analyzer™ scans the cartridge barcode, brings the cartridge and the contained specimen to 37°C, and spins the cartridge to move the sample from the sample deposition well into the cartridge channels and chambers. 8.5 µL microliters of sample remains in the metering passage. Any excess sample flows into an overflow well.

The sample is automatically dispensed onto the multi-layer reagent film. The spreading and substrate layer distributes the specimen which in turn catalyzes the reaction of creatine phosphate with ADP to form creatine and ATP. In the reagent layer, glucose-6phosphate (G-6-P) is formed by the hexokinase catalyzed reaction of glucose with ATP. G-6-P then reduces NAD+ to NADH in a glucose 6-phosphate dehydrogenase (G6PDH) catalyzed reaction. NADH then reduces NTB to diformazan dye in a diaphorase catalyzed reaction. The color intensity of the resulting reddish dye, as measured by the amount of reflected light at 570 nanometers directly relates to the CK activity of the specimen.

Test Reaction Sequence:

Creatine phosphate + ADP - CPK -> Creatine + ATP
Hexokinase > ADP + G-6-P
ATP + Glucose Mg+2
G-6-P + NAD* -- Gepul-> 6-phosphogluconic acid + NADH + H*
NTB + NADH -- Diaphorase > Diformazan dye + NAD*

As the cartridges spin, a photodiode measures reflectance of light emitted by a wavelength-specific light emitting diode (LED) over a fixed time period. The analyzer uses the reflectance measurements and the lot-specific standard curve to calculate CK activity.

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

professional laboratory use: not for point of care or physician office laboratory use.

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)

Comparative Performance Characteristics

  • Detection limit: 20 U/L
  • Reportable range: 20 to 1600 U/L
  • Accuracy: Mean recovery 101%
  • Precision: Total CV, 168 U/L, 10%
  • Reference Method: Kinetic determination with enzymatically coupled spectrophotometric detection of creatine.
  • Method comparison: CARESIDE™ CK = 1.03 (Trace) – 22.4 U/L, r = 0.98
  • Linearity: Linearity yielded slope and correlation coefficient within acceptable limits.
  • Interference: No significant interference observed at tested concentration of interferent: Ascorbic Acid, 10 mg/dL; Bilirubin, 20 mg/dL; Triglycerides 2000 mg/dL

The nonclinical and clinical data provided demonstrate that the CARESIDE™ CK product is as safe, effective, and performs as well as or better than the legally marketed predicate device.

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

Not Found

Predicate Device(s)

K912844/A

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1215 Creatine phosphokinase/creatine kinase or isoenzymes test system.

(a)
Identification. A creatine phosphokinase/creatine kinase or isoenzymes test system is a device intended to measure the activity of the enzyme creatine phosphokinase or its isoenzymes (a group of enzymes with similar biological activity) in plasma and serum. Measurements of creatine phosphokinase and its isoenzymes are used in the diagnosis and treatment of myocardial infarction and muscle diseases such as progressive, Duchenne-type muscular dystrophy.(b)
Classification. Class II.

0

4/19/99

CARESIDE, Inc.

Page 10

510(K) SUMMARY: CARESIDE™ CK SAFETY AND IV. EFFECTIVENESS

I. Applicant Information

  • A. Applicant Name
  • Applicant/Manufacturer Address B.
  • C. Telephone Number
  • D. Contact Person
  • E. FAX Number
  • F. e-Mail Address
  • Date 510(k) Summary prepared G.

II. Device Information

  • A. Device Name (Trade)
  • Device Name (Classification) B.
  • C. Device Classification

CARESIDE, Inc.

6100 Bristol Parkway Culver City, CA 90230 310-338-6767 Kenneth B. Asarch, Pharm.D., Ph.D. 310-338-6789 AsarchK@CARESIDE.com January 29, 1999

CARESIDE™ CK

Creatine phosphokinase/creatine kinase or isoenzymes test system Clinical chemistry panel CK test system Regulation Number: 21 CFR 862.1215 Regulatory Class II Classification Number: 75JFX None applicable

  • D. Special controls and performance standards

III. Substantial Equivalence Claim

  • General equivalency claim A.
    The ability to monitor analyte-specific biochemical reactions in dry film and other formats is widely recognized and has gained widespread acceptance for use in chemistry assays.

CK in vitro diagnostic products, in both dry film and other formats, are already on the U.S. market, including CK products that utilize enzymatic coupling to convert the reaction product, ATP, to a colored dye.

B. Specific equivalency claim

This CARESIDE™ CK test is substantially equivalent in principle, intended use, and clinical performance to the currently marketed Vitros slides for the quantitative measurement of CK for use on the Vitros DTSC module of the Vitros DT II system.

| Name of Predicate Device: | Johnson and Johnson's (formerly Eastman Kodak, Inc.) Vitros CK DT Slides for use on the
Vitros DTSC module of the Virtos DT II system
(formerly Eastman Kodak's DT 60 II). |
|-------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Predicate Device 510K number: | K912844/A |
| Product Code: | 75JFX |

1

IV. Device Description

CARESIDE™ CK cartridges are used with the CARESIDE, Inc. CARESIDE Analyzer™ to The CARESIDE™ CK measure CK activity in whole blood, serum or plasma specimens. cartridge, a single use disposable in vitro diagnostic test cartridge, delivers a measured volume of serum or plasma to a dry film to initiate the measurement of CK activity. The film cartidge (patent pending) contains all reagents necessary to measure CK activity.

Explanation of Device Function A.

Fach CARESIDE™ CK cartridge consists of a CK-specific multi-layer reagent film mounted in a plastic base with a hinged lid. The user introduces the specimen into the cartridge sample deposition well, closes the lid and inserts the cartridge into the CARESIDE Analyzer™.

Once loaded, the CARESIDE Analyzer™ scans the cartridge barcode, brings the cartridge and the contained specimen to 37°C, and spins the cartridge to move the sample from the sample deposition well into the cartridge channels and chambers. 8.5 µL microliters of sample remains in the metering passage. Any excess sample flows into an overflow well.

The sample is automatically dispensed onto the multi-layer reagent film. The spreading and substrate layer distributes the specimen which in turn catalyzes the reaction of creatine phosphate with ADP to form creatine and ATP. In the reagent layer, glucose-6phosphate (G-6-P) is formed by the hexokinase catalyzed reaction of glucose with ATP. G-6-P then reduces NAD+ to NADH in a glucose 6-phosphate dehydrogenase (G6PDH) catalyzed reaction. NADH then reduces NTB to diformazan dye in a diaphorase catalyzed reaction. The color intensity of the resulting reddish dye, as measured by the amount of reflected light at 570 nanometers directly relates to the CK activity of the specimen.

Test Reaction Sequence:

Creatine phosphate + ADP - CPK -> Creatine + ATP Hexokinase > ADP + G-6-P ATP + Glucose Mg+2 G-6-P + NAD* -- Gepul-> 6-phosphogluconic acid + NADH + H* NTB + NADH -- Diaphorase > Diformazan dye + NAD*

As the cartridges spin, a photodiode measures reflectance of light emitted by a wavelength-specific light emitting diode (LED) over a fixed time period. The analyzer uses the reflectance measurements and the lot-specific standard curve to calculate CK activity.

2

B. Test Summary

Creatine kinase (CK), also known as creatine phosphokinase, is an enzyme consisting of two sub-units (termed B and M) that catalyzes the reversible phosphorylation of creatine by adenosine-triphosphate (ATP) to creatine phosphate and adenosine-diphosphate (ADP). Only the CK dimer has enzymatic activity. Thus, total active CK is the combination of CKBB, CKMB and CKMM isoenzymes. These are also referred to as CK-1, CK-2 and CK-3 respectively, according to their differential mobility on an electrophoretic gel. CK is distributed in various organs; the highest activities are found in skeletal muscle, heart, and brain. Considerably lower activities are present in the urinary bladder, stomach, ileum, colon, and uterus. The CK content of liver, erythrocytes, and kidney is less that 1% of the amount found in skeletal muscle.

Measurement of total CK activity is important in the diagnosis of cardiac and skeletomuscular disorders, and is increased after muscle trauma, intramuscular injections, exercise, and in other conditions. CK level is also increased after acute alcohol intoxication, surgery-induced muscle injury, drug overdoses and poisoning, trauma to muscle or brain, hypothermia, hyperthermia, Reye's syndrome, infectious diseases, and hypothyroidism. Abnormal CK activities have been described in all forms of muscular dystrophy as well as polymyositis, dermatomyositis, and other myopathies. Many non-affected carriers of muscular dystrophy have abnormal CK activity in the blood. which provides a method for identifying such carriers.

V. Intended Use

  • A. Intended Use
    The CARESIDE™ CK cartridge is intended for in vitro diagnostic use in conjunction with the CARESIDE Analyzer™ to quantitatively measure CK activity in whole blood, serum or plasma.

B. Indications for Use

For in vitro diagnostic use with the CARESIDE Analyzer™ to quantitatively measure CK activity from anti-coagulated whole blood, plasma, or serum specimens to aid in the diagnosis and treatment of patients with myocardial infarction and muscle diseases such as progressive, Duchenne-type muscular dystrophy. It is intended professional laboratory use: not for point of care or physician office laboratory use.

3

VI. Technological Characteristics

  • A. Similarities
CARESIDE™ CKVitros CK DT Slides
Intended UsePrimarily to aid in the diagnosisDiagnosis of skeletal muscle
and treatment of patients withdisease, myocardial infarction,
with myocardial infarctionand cerebrovascular accidents.
and muscle diseases such as
progressive, Duchenne-type
muscular dystrophy.
IndicationsFor in vitro diagnostic use.For in vitro diagnostic use
For professional laboratory:
for point of care or
not
physician office laboratory use.
MeasurementQuantitativeSame
Method PrincipleReflectometry of enzymatically
coupled production of dye fromSame
CK reaction product.
Specimen dilutionNot requiredSame
MaterialsCreatine phosphate,Glycerophosphate oxidase,
peroxidase, gycerol kinase,
nitrotetrazorium blue, ADP,creatine phosphate,
glucose, hexokinase, glucose-N-acetylsysteine, magnesium
6-phosphate dehydrogenaseacetate, glycerol, ADP.
(G6PDH), NAD*, diaphorase
Reflectance (570 nm)
DetectorReflectance (680 nm)
Test timeApproximately
4-minute
warm-up (on-board)
plus15 minutes slide warm-up
4 minute test time.(off-line) plus 5 minutes test
time.
Sample TypeAnti-coagulated
whole blood,Plasma or serum
plasma, or serum
Specimen volume8.5 ul test volume10 µl
(85 ± 15 ul applied volume)
CalibrationCalibration
informationRun Vitros DT II calibrators
bar-coded on each cartridge.whenever a new slide lot is
Calibration information
mayused or when necessary.
change with each lot.
Quality Control2 levelsSame
Reporting UnitsU/LSame
Reaction Temp.37°CSame

B. Differences

CARESIDE™ CKVitros CK DT Slides
Accurate
pipettingNot requiredRequired
Reagent
pre-warmingNot requiredRequired

4


: ・・・

C. Comparative Performance Characteristics

CARESIDE™ CKVitros CK DT Slides
Detection limit20 U/L20 U/L
Reportable range20 to 1600 U/L20 to 1600 U/L
AccuracyMean recovery 101%Not provided
PrecisionTotal CV, 168 U/L, 10%Total CV, 175 U/L, 3%
Reference MethodKinetic determination with
enzymatically coupled
spectrophotometric detection of
creatine.Not provided
Method
comparisonCARESIDE™ CK = 1.03 (Trace) – 22.4 U/L, r = 0.98
LinearityLinearity yielded slope and
correlation coefficient within
acceptable limits.Not provided
InterferenceNo significant interference
observed at tested
concentration of interferent:
Ascorbic Acid, 10 mg/dL
Bilirubin, 20 mg/dL
Triglycerides 2000 mg/dLElevated carbon dioxide
(> 40mmol/L) may decrease
CK results.

D. Conclusion

The nonclinical and clinical data provided demonstrate that the CARESIDE™ CK product is as safe, effective, and performs as well as or better than the legally marketed predicate device.

5

Image /page/5/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with three lines forming its body and wings. The eagle is enclosed within a circle, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged around the upper half of the circle.

Public Health Service

APR 1 9 1995

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Kenneth B. Asarch, Pharm. D., Ph.D. Vice President, Quality Systems/ Regulatory Affairs Careside Inc. 6100 Bristol Parkway Culver City, California 90230

K990439 Re: Trade Name: CARESIDE™ CK Regulatory Class: II Product Code: JHS Dated: January 29, 1999 Received: February 11, 1999

Dear Dr. Asarch:

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 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). 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 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 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 regulations.

6

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/cdrl/dsma/dsmamain.html".

Sincerely yours,

Steven Dutman

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

7

CARESIDE, Inc. Page 16

INDICATIONS FOR USE VI.

510(k) Number:

Device Name:

K 990439

CARESIDE™ CK

Indications for use:

For in vitro diagnostic use with the CARESIDE Analyzer™ to quantitatively measure CK from anti-coagulated whole blood, plasma, or serum specimens to aid in the diagnosis and treatment of patients with myocardial infarction and muscle diseases such as progressive, Duchenne-type muscular dystrophy.

Sean Cooper
(Division Sign-Off)
Division of Clinical Laboratory Devices
K99 0439

510(k) Number

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use
(Per 21 CFR 801.109)

OR

Over-The-Counter Use (Optional Format 1-2-96)