GEM Premier ChemSTAT

{0} FDA U.S. FOOD & DRUG ADMINISTRATION # SPECIAL 510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY ## I Background Information: A 510(k) Number K223090 B Applicant Instrumentation Laboratory Co. C Proprietary and Established Names GEM Premier ChemSTAT D Regulatory Information | Product Code(s) | Classification | Regulation Section | Panel | | --- | --- | --- | --- | | CGA | Class II | 21 CFR 862.1345 - Glucose test system | CH - Clinical Chemistry | | JGS | Class II | 21 CFR 862.1665 - Sodium test system | CH - Clinical Chemistry | | CEM | Class II | 21 CFR 862.1600 - Potassium test system | CH - Clinical Chemistry | | CGZ | Class II | 21 CFR 862.1170 - Chloride test system | CH - Clinical Chemistry | | JFP | Class II | 21 CFR 862.1145 - Calcium test system | CH - Clinical Chemistry | | CHL | Class II | 21 CFR 862.1120 - Electrode Measurement, Blood-Gases (Pco2, Po2) And Blood Ph system | CH - Clinical Chemistry | | KHP | Class I | 21 CFR 862.1450 - Lactic acid test system | CH - Clinical Chemistry | | GKF | Class II | 21 CFR 864.5600 - Automated hematocrit instrument | HE - Hematology | Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993-0002 www.fda.gov {1} | JFY | Class II | 21 CFR 862.1225 - Creatinine test system | CH - Clinical Chemistry | | --- | --- | --- | --- | | CDQ | Class II | 21 CFR 862.1770 - Urea nitrogen test system | CH - Clinical Chemistry | | KHS | Class II | 21 CFR 862.1160 - Bicarbonate/carbon dioxide test system | CH - Clinical Chemistry | ## II Review Summary: This 510(k) submission contains information/data on modifications made to the submitter's own Class II device requiring 510(k). The following items are present and acceptable. The name and 510(k) number of the SUBMITTER'S previously cleared device. GEM Premier ChemSTAT, K183549, K183546 and K183555 1. Submitter's statement that the INDICATIONS FOR USE/INTENDED USE of the modified device as described in its labeling HAS NOT CHANGED along with the proposed labeling which includes instructions for use, package labeling, and, if available, advertisements or promotional materials (labeling changes are permitted as long as they do not affect the intended use). 2. A description of the device MODIFICATION(S), including clearly labeled diagrams, engineering drawings, photographs, user's and/or service manuals in sufficient detail to demonstrate that the FUNDAMENTAL SCIENTIFIC TECHNOLOGY of the modified device has not changed. The device modification is an upgrade to the operating system of the instrument from Fedora 17 Linux to WindRiver LTS 18 Linux. 3. Comparison Information (i.e., similarities and differences) to the submitter's legally marketed predicate device including, labeling, intended use, and physical characteristics. 4. A Design Control Activities Summary which includes: a) Identification of Risk Analysis method(s) used to assess the impact of the modification on the device and its components, and the results of the analysis. b) Based on the Risk Analysis, an identification of the verification and/or validation activities required, including methods or tests used and acceptance criteria to be applied. The labeling for this modified subject device has been reviewed to verify that the indication/intended use for the device is unaffected by the modification. In addition, the submitter's description of the particular modification(s) and the comparative information between the modified and unmodified devices demonstrate that the fundamental scientific technology has not changed. The submitter has provided the design control information as specified in The New 510(k) Paradigm and on this basis, I recommend the device be determined substantially equivalent to the previously cleared (or their preamendment) device. K223090 - Page 2 of 2