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510(k) Data Aggregation

    K Number
    K141925
    Date Cleared
    2014-12-09

    (146 days)

    Product Code
    Regulation Number
    862.1645
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    In vitro test for the quantitative determination of the total protein concentration in urine and cerebral spinal fluid.

    Protein measurements in urine are used in the diagnosis and treatment of disease conditions such as renal or heart diseases, or thyroid disorders.

    CSF protein measurements are used in the diagnosis and treatment of conditions such as meningitis, brain tumors, and infections of the central nervous systems.

    Device Description

    The Total Protein Urine/CSF assay provides quantitative measurement of total protein that is present in human urine and cerebral spinal fluid (CSF). Measurement is accomplished using a turbidimetric method.
    Reagents for the COBAS Integra 400 plus analyzer are packaged in a cobas c pack with two bottles labeled with their instrument positioning, Reagent R1 in position B and Reagent SR in position C.
    R1 contains Sodium Hydroxide: 677 mmol/L; EDTA-Na: 74 mmol/L
    SR contains Benzethonium chloride: 32 mmol/L

    AI/ML Overview

    Here's an analysis of the acceptance criteria and study findings for the TPUC3 Total Protein Urine/CSF Gen.3 device, based on the provided document:

    1. Table of Acceptance Criteria and Reported Device Performance

    TestAcceptance CriterionReported Device Performance
    Interference by Radiopaque MediaDeviation ≤ ± 10%At 6.4 g/L organically bound Iodine: - Deviation = 5.6% at level 1 (92.5 mg/L total protein) - Deviation = 9.7% at level 2 (961 mg/L total protein) Meets criterion.
    Interference by Homogentisic AcidDeviation ≤ ± 10%At 1.2 mmol/L homogentisic acid: - Deviation = 6.8% at level 1 (107 mg/L total protein) - Deviation = 6.9% at level 2 (1180 mg/L total protein) Meets criterion.
    High Dose Hook EffectNo false result reported up to a protein concentration of 100 g/L. All samples above the measuring range are flagged.No false result reported up to a protein concentration of 100 g/L. All samples above the measuring range are flagged as either being above the measuring range or above the absorbance limit. Meets criterion.

    2. Sample Sizes Used for the Test Set and Data Provenance

    • Interference by Radiopaque Media: The test used pooled human urine samples at two different total protein levels. Each level was spiked with 10 dilution steps of Hexabrix and tested in triplicate. The specific number of distinct pooled samples is not stated, but at least two unique pooled samples were used (referred to as "level 1" and "level 2").
    • Interference by Homogentisic Acid: The test used the same protocol as for radiopaque media, meaning pooled human urine samples at two different total protein levels, spiked with homogentisic acid, and tested in triplicate at 10 dilution steps.
    • High Dose Hook Effect: The test used one pooled human urine sample which was spiked with human Albumin up to 100 g/L, and a dilution series was prepared from this spiked sample. The samples were tested in triplicate.

    Data Provenance: The document explicitly states "pooled human urine samples." While it doesn't specify the country of origin, the FDA submission context usually implies data relevant to the US regulatory environment. The studies appear to be prospective as they were specifically designed and conducted to evaluate the device's performance against the defined acceptance criteria.

    3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications of those Experts

    This document describes performance studies for an in vitro diagnostic (IVD) device that quantifies total protein. The ground truth for such devices is typically established by:

    • Reference methods/materials (e.g., traceable calibrators like NIST SRM-927 mentioned in the similarities section for calibration traceability)
    • Known concentrations of interference substances (e.g., Hexabrix, homogentisic acid)
    • Known concentrations of the analyte itself (e.g., human Albumin for the hook effect).

    Therefore, the ground truth is based on analytical standards and precise spiking of known concentrations, not interpretation by medical experts. No human experts (like radiologists) were involved in establishing the ground truth for these specific performance tests.

    4. Adjudication Method for the Test Set

    Not applicable. The tests involve quantitative measurements against known spiked concentrations or defined analytical limits. There is no subjective interpretation requiring adjudication.

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

    No. This document describes the performance of an IVD analyzer for quantitative protein measurement. MRMC studies are typically performed for diagnostic imaging devices where human readers interpret medical images. This is a standalone device performance study.

    6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

    Yes. The entire study described focuses on the standalone performance of the TPUC3 Total Protein Urine/CSF Gen.3 assay on the Roche COBAS Integra 400 plus analyzer. It evaluates the device's accuracy in the presence of specific interferents and its response to high analyte concentrations, without any human interpretation of the results being part of the performance evaluation.

    7. The Type of Ground Truth Used

    The ground truth used for these studies is based on:

    • Known (spiked) concentrations of interferents (organically bound iodine from Radiopaque media, homogentisic acid) in pooled human urine.
    • Known (spiked) concentrations of the analyte (human Albumin) to assess the high dose hook effect.
    • The concentrations of these substances were precisely controlled and quantified.

    8. The Sample Size for the Training Set

    The document does not provide information on the training set size. This submission is for modifications to an existing device (TPUC3 Total Protein Urine/CSF Gen.3). The described studies are validation/verification tests for these specific modifications related to interference claims and hook effect, not for initial model development or training. IVD devices like this are typically developed through iterative analytical and clinical studies, but information about the "training set" for the underlying chemistry/method is not detailed here.

    9. How the Ground Truth for the Training Set Was Established

    As no training set information is provided, there is no information on how its ground truth was established. For IVD devices, the initial ground truth for method development (analogous to a training set) would generally involve:

    • Certified reference materials.
    • Patient samples characterized by established reference methods.
    • Spiking studies with known concentrations of analytes and interferents.
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    K Number
    K071239
    Manufacturer
    Date Cleared
    2007-09-14

    (134 days)

    Product Code
    Regulation Number
    862.1635
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    In vitro test for the quantitative determination of the total protein in urine and cerebrospinal fluid on the COABS INTEGRA systems.

    Measurements obtained by this device are used in the diagnosis and treatment of a variety of diseases involving the liver, kidnev or bone marrow as well as metabolic or nutritional disorders.

    Protein measurements in urine are used in the diagnosis and treatment of disease conditions such as renal or heart diseases, or thyroid disorders, which are characterized by proteinuria or albuminuria.

    CSF protein measurements are used in diagnosis and treatment of disease conditions such as meningitis, brain tumors and infections of the central nervous systems.

    C.f.a.s. (Calibrator for automated systems) TPUC 200 is for use in the calibration of quantitative determination of protein in urine (U) and cerebrospinal fluid (CSF) on COBAS INTEGRA analyzers and Roche/Hitachi cobas c systems.

    Device Description

    The COBAS INTEGRA Total Protein Urine/SCG Gen. 3 reagent is intended for use on the COBAS INTEGRA systems for the quantitative determination of protein in urine and cerebrospinal fluid.

    AI/ML Overview

    Here's a breakdown of the acceptance criteria and study information for the Total Protein Urine/CSF Gen. 3 device, based on the provided text:

    1. Acceptance Criteria and Reported Device Performance

    The document doesn't explicitly state quantitative acceptance criteria in a dedicated table format. Instead, it compares the performance of the modified device (Total Protein Urine/CSF Gen. 3 on COBAS INTEGRA and Roche/Hitachi platforms) against its predicate device (Roche/Hitachi Total Protein Urine/CSF K913615) for various features. The implicit acceptance criterion is "Substantial Equivalence" to the predicate device, meaning the new device performs as well as or better than the predicate for key parameters.

    Here's a table summarizing the reported device performance, with the understanding that for most parameters, the 'acceptance' is that the modified device's performance aligns with or improves upon the predicate.

    FeaturePredicate Device Performance (Roche/Hitachi Total Protein Urine/CSF K913615)Modified Device Performance (Total Protein Urine/CSF Gen. 3)
    Intended Use/Indications for UseIn vitro test for quantitative determination of protein in urine (U) and CSFSame
    SpecimenUrine and CSFSame
    ApplicationEndpoint assaySame
    Test PrincipleTurbidimetricSame
    Reagent CompositionR1: Sodium hydroxide 530 mmol/L, EDTA sodium, 74 mmol/L; R2=SR: Benzethonium chloride 32 mmol/LSame
    Stability (Shelf-life)20-25 °C until expiration dateRoche/Hitachi: 15-25 °C until expiration date
    Stability (On-board)R1: 3 weeks on board at 2-12 °C; R2: 3 weeks on board at 2-12 °CRoche/Hitachi: R1: 21 days on board and refrigerated; R2: 21 days on board and refrigerated COBAS INTEGRA 400/400 plus: 12 weeks on board at 10 to 15°C COBAS INTEGRA 700/800 plus: 6 weeks on board at 10 to 15°C
    Quality ControlCommercially available urine and CSF protein controlsRoche/Hitachi: Same COBAS INTEGRA: Same
    TraceabilityStandardized against National Bureau of Standards Reference Material SRM 927 using the biuret method.Same
    Precision (Urine - Within Run)2.25% @ 17.9 mg/dL; 0.5% @ 102.2 mg/dLRoche/Hitachi: 1.9% @ 21 mg/dL; 1.0% @ 67.3 mg/dL COBAS INTEGRA: 2.8%@ 89 mg/L; 1.4% @ 227 mg/L; 0.4% @ 616 mg/L
    Precision (Urine - Total/Between day)3.05% @ 17.9 mg/dL; 0.8% @ 102.2 mg/dLRoche/Hitachi: 1.7% @ 34.5 mg/dL; 1.1% @ 114.37 mg/dL COBAS INTEGRA: 1.3% @ 91 mg/L; 1.0% @ 229 mg/L; 0.6% @ 613 mg/L
    Precision (CSF - Within Run)3.05% @ 17.9 mg/dL; 0.8% @ 102.2 mg/dL * (Listed as Urine, likely a typo)Roche/Hitachi: 0.9% @ 23.1 mg/dL; 0.7% @ 53.6 mg/dL COBAS INTEGRA: 0.5% @ 345 mg/L; 0.3% @ 867 mg/L
    Precision (CSF - Total/Between day)1.9% @ 18.1 mg/dL; 1.03% @ 102.4 mg/dLRoche/Hitachi: 1.0% @ 29.3 mg/dL; 0.6% @ 90.2 mg/dL COBAS INTEGRA: 0.9% @ 346 mg/L; 0.6% @ 867 mg/L
    Measuring Range (Linearity)Analyzer specific linearity claims: 2-200 mg/dL (Hitachi 717)Roche/Hitachi: 2-200 mg/dl (20-2000 mg/l) with dilution capability COBAS INTEGRA: 40-2000 mg/L (Extended to 40-6000 mg/L with post dilution factor of 3)
    Lower Detection LimitNot specifiedRoche/Hitachi: 20 mg/L COBAS INTEGRA: 40 mg/L
    Expected ValuesUrine 24h: < 150 mg/24 h; CSF: < 150-450 mg/LRoche/Hitachi: Same COBAS INTEGRA: Same
    Endogenous InterferencesReference to Young et al and Friedman et alRoche/Hitachi: Icterus: No significant interference up to I index of 45 (45 mg/dL bilirubin); Hemolysis: Hemoglobin interferes COBAS INTEGRA Urine: Icterus: No significant interference up to I index of 35 (35 mg/dL bilirubin); Hemolysis: Hemoglobin interferes COBAS INTEGRA CSF: Hemolysis: hemoglobin interferences
    Exogenous Interferences15 drugs test - no interferencesHitachi/Roche: No significant interference from Ascorbic Acid, Creatinine, Glucose, Phosphorus, Urea, Magnesium, Sodium Citrate, Caffeine, Cefazolin Sodium, Chlorpromazine, Calcium L-Dopa, Gentamicin Sulfate, Sodium Oxalate and Uric Acid.COBAS INTEGRA: Levodopa, Methyldopa and Cefoxitin sodium cause interference at therapeutic concentrations. Rare cases of gammopathy (IgM) may cause unreliable results.
    Method Comparison (Urine)Hitachi 717 vs. Dupont ACA: y = 1.051x + 2.78, r = 0.996, n = 34COBAS INTEGRA 800 vs. Roche/Hitachi 917: Passing/Bablok: y = 1.003x + 2.0 mg/L, τ = 0.951, n = 54 Linear regression: y = 1.007x + 4.2 mg/L, r = 0.999 (Concentrations 40-1989 mg/L)
    Method Comparison (CSF)Hitachi 717 vs. Dupont ACA: y = 0.982x - 0.957, r = 0.982, n = 59COBAS INTEGRA 800 vs. Roche/Hitachi 917: Passing/Bablok: y = 1.018x + 1.9 mg/L, τ = 0.991, n = 68 Linear regression: y = 1.019x + 2.3 mg/L, r = 1.000 (Concentrations 59-1996 mg/L)
    Instrument PlatformsRoche/Hitachi analyzersRoche/Hitachi family of analyzers and COBAS INTEGRA family of analyzers
    CalibratorPreciset U/CSFRoche/Hitachi: Same COBAS INTEGRA: C.f.a.s. TPUC 200
    Calibrator Levels5 levels: 100, 200, 400, 800, 2000 mg/L1 level - 2000 mg/L

    2. Sample Sizes Used for the Test Set and Data Provenance

    The document describes method comparison studies for the COBAS INTEGRA platform against the Roche/Hitachi 917 analyzer.

    • Urine Test Set: Sample size (n) = 54
    • CSF Test Set: Sample size (n) = 68
    • Data Provenance: The text does not explicitly state the country of origin or if the data was retrospective or prospective. It refers to "human urine and CSF samples," suggesting clinical samples were used.

    3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications

    This information is not provided in the document. The method comparison relies on comparing the device's measurements against a predicate device's measurements, which are assumed to be "ground truth" for the purpose of demonstrating substantial equivalence. There is no mention of independent experts assessing the "accuracy" of the total protein levels.

    4. Adjudication Method for the Test Set

    This information is not applicable as the ground truth was established by comparison to a predicate device's quantitative measurements, not through subjective expert review and adjudication.

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done

    No. An MRMC comparative effectiveness study is not relevant for this type of quantitative biochemical assay. This study is about the performance of an automated diagnostic test, not about human readers interpreting images or data.

    6. If a Standalone (i.e. algorithm only without human-in-the-loop performance) was done

    Yes. The entire study describes the standalone performance of the Total Protein Urine/CSF Gen. 3 reagent on automated COBAS INTEGRA systems. This is a fully automated test system, and its performance characteristics (precision, linearity, detection limit, interference) are assessed in a standalone manner without human intervention in the interpretive process. The "human-in-the-loop" aspect would be a laboratory technician operating the instrument and reporting results, but the analytical performance itself is standalone.

    7. The Type of Ground Truth Used

    The ground truth for the method comparison studies (the primary study described for the modified device) was established by the measurements from the predicate device (Roche/Hitachi 917 analyzer) using the same reagent. The predicate device itself was "Standardized against National Bureau of Standards Reference Material SRM 927 using the biuret method for the quantitation of protein." This suggests a chain of traceability to a recognized standard.

    8. The Sample Size for the Training Set

    The document does not specify a separate "training set" sample size. For an IVD reagent modification submission like this, the focus is typically on validation testing of the final product. Any internal development or training of algorithms (if applicable for such a device, though unlikely for a turbidimetric assay) would be part of the manufacturer's internal design control process and not usually detailed in a 510(k) summary unless explicitly part of the new functionality being validated.

    9. How the Ground Truth for the Training Set Was Established

    As no training set is explicitly mentioned or detailed, the method for establishing its ground truth is not provided.

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