K Number
K991371
Device Name
CARESIDE AMMONIA
Manufacturer
Date Cleared
1999-08-03

(105 days)

Product Code
Regulation Number
862.1065
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For in vitro diagnostic use with the CARESIDE Analyzer™ to measure ammonia from anti-coagulated whole blood or plasma specimens to aid in the diagnosis and treatment of patients with severe liver disorders such as cirrhosis, hepatitis, and Reye's syndrome.
Device Description
CARESIDE™ Ammonia cartridges are used with the CARESIDE Analyzer™ to measure ammonia in anti-coagulated whole blood or plasma specimens. The CARESIDE™ Ammonia cartridge, a single use disposable in vitro diagnostic test cartridge, delivers a measured volume of plasma to a dry film to initiate the measurement of ammonia The film cartridge (patent pending) contains all reagents necessary to measure ammonia. Each CARESIDE™ Ammonia cartridge consists of an ammonia-specific multi-layer reagent film mounted in a plastic base with a hinged lid. The user introduces the specimen into the cartridge Sample 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 Well into the cartridge channels and chambers. 8.5 microliters of sample remains in the metering passage. Any excess sample flows into the Overflow Well. The 8.5 microliters of sample is automatically dispensed onto the multi-layer reagent film. The spreading layer distributes the sample evenly on the film before the sample moves through the reaction, porous, and detection layers where a blue-green dye forms in the presence of ammonia. The color intensity of the resulting blue-green dye, as measured by the amount of reflected light at 590 nanometers, directly relates to the ammonia concentration of the specimen. 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 ammonia concentration.
More Information

Not Found

No
The description details a chemical reaction and optical measurement system with calculations based on a standard curve, with no mention of AI or ML.

No
The device is an in vitro diagnostic (IVD) device used to measure ammonia levels, which aids in diagnosis and treatment, but it does not directly treat or provide therapy to a patient.

Yes

Explanation: The "Intended Use / Indications for Use" section explicitly states "For in vitro diagnostic use... to aid in the diagnosis and treatment of patients with severe liver disorders". The "Device Description" also refers to the cartridge as a "single use disposable in vitro diagnostic test cartridge".

No

The device description clearly details a physical cartridge and an analyzer that performs physical actions (heating, spinning, dispensing) and optical measurements. This is a hardware-based in vitro diagnostic system, 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".
  • Function: The device measures ammonia from biological specimens (whole blood or plasma) to aid in the diagnosis and treatment of medical conditions. This is a core function of an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The CARESIDE™ Ammonia cartridge is intended for in vitro diagnostic use in conjunction with the CARESIDE Analyzer™ to quantitatively measure ammonia in anticoagulated whole blood or plasma. This product is indicated for use in the diagnosis and treatment of patients with severe liver disorders such as cirrhosis, hepatitis, and Reye's syndrome.

Product codes

75JID

Device Description

CARESIDE™ Ammonia cartridges are used with the CARESIDE Analyzer™ to measure ammonia in anti-coagulated whole blood or plasma specimens. The CARESIDE™ Ammonia cartridge, a single use disposable in vitro diagnostic test cartridge, delivers a measured volume of plasma to a dry film to initiate the measurement of ammonia The film cartridge (patent pending) contains all reagents necessary to measure ammonia. Each CARESIDE™ Ammonia cartridge consists of an ammonia-specific multi-layer reagent film mounted in a plastic base with a hinged lid. The user introduces the specimen into the cartridge Sample 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 Well into the cartridge channels and chambers. 8.5 microliters of sample remains in the metering passage. Any excess sample flows into the Overflow Well. The 8.5 microliters of sample is automatically dispensed onto the multi-layer reagent film. The spreading layer distributes the sample evenly on the film before the sample moves through the reaction, porous, and detection layers where a blue-green dye forms in the presence of ammonia. The color intensity of the resulting blue-green dye, as measured by the amount of reflected light at 590 nanometers, directly relates to the ammonia concentration of the specimen. 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 ammonia concentration.

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. However, the predicate device indicates "For professional laboratory: 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

Comparative Performance Characteristics:

  • Detection limit: 7 micromol/L
  • Reportable range: 7 to 350 micromol/L
  • Accuracy: Mean recovery 99%
  • Precision: Total CV, 109 micromol/L, 11%
  • Method comparison: CARESIDE™ = 0.98 (RAICHEM) + 3.9 micromol/L, r = 0.99
  • Linearity: Linearity yielded slope and correlation coefficient within acceptable limits.
  • Interference: No significant interference observed at tested concentration of interferent: Ascorbic Acid, 20 mg/dL; Total Protein, 12 g/dL; Hemoglobin 500 mg/dL; Triglycerides 3000 mg/dL; Urea (BUN) 40 mg/dL.

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

Key Metrics

  • Accuracy: Mean recovery 99%
  • Precision: Total CV, 109 µmol/L, 11%
  • Correlation coefficient (r) = 0.99 for method comparison

Predicate Device(s)

K912844/A

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1065 Ammonia test system.

(a)
Identification. An ammonia test system is a device intended to measure ammonia levels in blood, serum, and plasma, Ammonia measurements are used in the diagnosis and treatment of severe liver disorders, such as cirrhosis, hepatitis, and Reye's syndrome.(b)
Classification. Class I.

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CARESIDE, Inc. Page 10

510(K) SUMMARY: CARESIDE™ AMMONIA SAFETY V. AND EFFECTIVENESS

I. Applicant Information

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

II. Device Information

  • A. Device Name (Trade)
  • B. Device Name (Classification)
  • 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 April 16, 1999

CARESIDE™ Ammonia

Ammonia test system Clinical chemistry panel Ammonia test system Regulation Number: 21 CFR 862.1065 Regulatory Class 1 Classification Number: 75JID None applicable

  • D. Special controls and performance standards

III. Substantial Equivalence Claim

  • A. General equivalency claim
    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.

Ammonia in vitro diagnostic products, in both dry film and other formats, are already on the U.S. market. Ammonia products include those that use bromophenol blue as an ammonia indicator.

B. Specific equivalency claim

This CARESIDE™ Ammonia test is substantially equivalent in intended use and clinical performance to the currently marketed Vitros slides for the quantitative measurement of ammonia on the Vitros DT 60 II system. Both are based on the principle of dry film, both use the bromphenol blue ammonia indicator, and both are read by reflectance photometry.

Name of Predicate Device: Johnson and Johnson's (formerly Eastman Kodak, Inc.) Vitros NH3 Slides for Johnson and Johnson's Vitros DT 60 II system (formerly Eastman Kodak's DT 60 II). Predicate Device 510K number: K912844/A Product Code: 75JID

1

IV. Device Description

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

Explanation of Device Function A. .

Each CARESIDE™ Ammonia cartridge consists of an ammonia-specific multi-layer reagent film mounted in a plastic base with a hinged lid. The user introduces the specimen into the cartridge Sample 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 Well into the cartridge channels and chambers. 8.5 microliters of sample remains in the metering passage. Any excess sample flows into the Overflow Well.

The 8.5 microliters of sample is automatically dispensed onto the multi-layer reagent film. The spreading layer distributes the sample evenly on the film before the sample moves through the reaction, porous, and detection layers where a blue-green dye forms in the presence of ammonia. The color intensity of the resulting blue-green dye, as measured by the amount of reflected light at 590 nanometers, directly relates to the ammonia concentration of the specimen.

Test Reaction Sequence:

Bromophenol blue (yellow) + NH3 -- > Blue-green dye

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 ammonia concentration.

  • B. Test Summary
    The majority of ammonia in the body is generated in the gastrointestinal tract through the action of bacterial enzymes on dietary protein in the colon and from the catabolism of amino acids. Ammonia is detoxified in the liver by conversion to urea. Elevated ammonia levels are caused by liver dysfunction from such causes as viral hepatitis, cirrhosis, or Reye's syndrome, and inherited deficiencies of enzymes involved in the conversion of ammonia to urea. Excess ammonia exerts toxic effects on the central nervous system,

V. Intended Use

11 23

  • A. Intended Use
    The CARESIDE™ Ammonia cartridge is intended for in vitro diagnostic use in conjunction with the CARESIDE Analyzer™ to quantitatively measure ammonia in anticoagulated whole blood or plasma.

  • B. Indications for Use
    This product is indicated for use in the diagnosis and treatment of patients with severe liver disorders such as cirrhosis, hepatitis, and Reye's syndrome.

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t

VI. Technological Characteristics

  • Similarities A.
CARESIDE™ AmmoniaVitros NH3 DT Slides
Intended UsePrimarily to aid in the
diagnosis and treatment of
patients with severe liver
disorders such as cirrhosis,
hepatitis, and Reye's
syndrome.Primarily to aid in the
diagnosis of hepatic coma and
Reye's syndrome, as an
indicator during the final
stages of terminal cirrhosis.
IndicationsFor in vitro diagnostic use.

For professional laboratory:
not for point of care or
physician office laboratory
use. | For in vitro diagnostic use. |
| Measurement | Quantitative | Same |
| Method Principle | Dry film, bromophenol blue
dye. | Dry film, bromophenol blue
dye. |
| Materials | Bromophenol blue | Bromophenol blue |
| Detector | Reflectance (590 nm) | Reflectance (605 nm) |
| Test time | 4 minute warm-up (on-board)
plus 3 minute test time. | 15 minute warm-up (off-line)
plus 5 minutes test time. |
| Reference Method | Glutamate dehydrogenase | Glutamate dehydrogenase |
| Sample Type | Anti-coagulated whole blood
or plasma. | Heparinized plasma |
| Specimen volume | 8.5 µl test volume
(85 ± 15 µl applied volume) | 10 µl |
| Calibration | Calibration information bar-
coded on each cartridge.
Calibration information may
change with each lot. | Run Vitros DT II calibrators
whenever a new slide lot is
used or when necessary. |
| Quality Control | 2 levels | Same |
| Reporting Units | µmol/L NH3 | Same |
| Reaction Temp. | 37 °C | Same |

B. Differences

Qaran

CARESIDE™ AmmoniaVitros NH3 DT Slides
Specimen
ProcessingNot requiredRequired
Accurate
pipettingNot requiredRequired
Reagent pre-
warmingNot requiredRequired

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C. Comparative Performance Characteristics

CARESIDE™ AmmoniaVitros NH3 DT Slides
Detection limit7 µmol/L1 µmol/L
Reportable range7 to 350 µmol/L1 to 500 µmol/L
AccuracyMean recovery 99%Not provided
PrecisionTotal CV, 109 µmol/L, 11%Total CV, 100 µmol/L, 10%
Method
comparisonCARESIDE™ = 0.98 (RAICHEM) + 3.9 µmol/L, r = 0.99
LinearityLinearity yielded slope and
correlation coefficient within
acceptable limits.Not provided
InterferenceNo significant interference
observed at tested
concentration of interferent:
Ascorbic Acid, ........20 mg/dL
Total Protein, ........12 g/dL
Hemoglobin ........500 mg/dL
Triglycerides ........3000 mg/dL
Urea (BUN).........40 mg/dLNo reported interference

D. Conclusion

·

..............................................................................................................................................................................

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

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Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" around the perimeter. Inside the circle is an abstract image of an eagle or bird-like figure, composed of three curved lines that suggest the head and wings.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

AUG - 3 1999

Kenneth B. Asarch, Ph.D. VP Quality Systems and Regulatory Affairs CARESIDE, Inc. 6100 Bristol Parkway Culver City, California 90230

Re: K991371

Trade Name: CARESIDE™ AMMONIA Regulatory Class: I reserved Product Code: JID Dated: June 15, 1999 Received: June 16, 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 (OS) 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.

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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/dsma/dsmamain.html".

Sincerely yours,

Steven Gutman

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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CARESIDE, Inc. Page 15

VII. INDICATIONS FOR USE

510(k) Number:

Device Name:

CARESIDE™ Ammonia

Indications for use:

For in vitro diagnostic use with the CARESIDE Analyzer™ to measure ammonia from anti-coagulated whole blood or plasma specimens to aid in the diagnosis and treatment of patients with severe liver disorders such as cirrhosis, hepatitis, and Reye's syndrome.

Dean Cooper
(Division Sign-Off)

Division of Clinical Laboratory Devices 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)