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510(k) Data Aggregation

    K Number
    K212379
    Date Cleared
    2022-03-02

    (212 days)

    Product Code
    Regulation Number
    866.5550
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    K171742, K182098, K193047, K190879

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    N Latex FLC kappa and lambda are in-vitro diagnostic reagents for the quantitative determination of free light chains (FLC), type kappa or type lambda in human serum and EDTA-plasma. N Latex FLC kappa and lambda assays are used: • as an aid in the diagnosis and monitoring of multiple myeloma (MM) on the BN Systems and Atellica® CH Analyzer. • as an aid in the diagnosis of immunoglobulin light-chain amyloidosis (AL) on the BN Systems and Atellica® CH Analyzer. • as an aid in the monitoring of immunoglobulin light-chain amyloidosis (AL) on the BN Systems. · as an aid in the evaluation of Monoclonal Gammopathy of Undetermined Significance (MGUS) on the BN Systems and Atellica® CH Analyzer. Results of FLC measurements should always be interpreted in conjunction with other laboratory and clinical findings.

    Device Description

    The N Latex FLC (free light chain) assays are in vitro diagnostic reagents for the quantitative determination of free light chains, type kappa or type lambda, in human serum and EDTA plasma by means of particle-enhanced immunoassay determination. Used in conjunction with other clinical and laboratory findings, FLC measurements are used as an aid in the diagnosis and monitoring of multiple myeloma (MM), as an aid in the diagnosis of amyloidosis (AL) on the BN Systems and Atellica® CH Analyzer; as an aid in the monitoring of amyloidosis (AL) on the BN Systems and as an aid in the evaluation of MGUS on the BN Systems. The FLC test systems on the Atellica® CH Analyzer are based upon the principles of particle-enhanced turbidimetry. Polystyrene particles coated with antibodies to human free light chains, type kappa or lambda, respectively, are agglutinated with samples containing FLC. Monitoring the agglutination by measuring the increase in turbidity, a concentration curve is obtained. The actual change in absorbance is proportional to the concentration of the respective protein in the sample. The result is evaluated by comparison with a standard of known concentration.

    AI/ML Overview

    The provided text describes the acceptance criteria and performance study for the Siemens Healthcare Diagnostics Products GmbH N Latex FLC kappa and N Latex FLC lambda assays when applied to the Atellica® CH Analyzer, specifically for the added indication as an aid in the evaluation of Monoclonal Gammopathy of Undetermined Significance (MGUS).

    Here's a breakdown of the requested information:

    1. Table of Acceptance Criteria and Reported Device Performance

    The device performance is assessed through a method comparison study between the N Latex FLC kappa and N Latex FLC lambda assays on the Atellica® CH Analyzer (candidate device) and the N Latex FLC kappa and N Latex FLC lambda assays on the BN ProSpec System (predicate device).

    Acceptance CriteriaN Latex FLC Kappa PerformanceN Latex FLC Lambda PerformanceAcceptance Criteria Met? (Overall)
    Pearson correlation coefficient: r ≥ 0.950.983 (Overall)
    0.977 (MGUS samples only)0.970 (Overall)
    0.970 (MGUS samples only)Yes
    Slope: 0.9 - 1.10.995 (Overall)
    0.966 (MGUS samples only)0.914 (Overall)
    0.841 (MGUS samples only)Yes (Overall), No (Lambda MGUS)
    Predicted bias: ≤ +/- 10%
    Lower limit reference interval0.93% (Overall)
    4.33% (MGUS samples only)-7.60% (Overall)
    -15.7% (MGUS samples only)Yes (Overall), No (Lambda MGUS)
    Upper limit reference interval-0.10% (Overall)
    -1.18% (MGUS samples only)-8.56% (Overall)
    -16.9% (MGUS samples only)Yes (Overall), No (Lambda MGUS)
    Number of samples: n ≥ 160212 (Overall)
    38 (MGUS samples only)202 (Overall)
    35 (MGUS samples only)Yes (Overall), No (MGUS samples only meets criteria for specific MGUS analysis)

    Note on MGUS Specific Results: While the overall study meets the acceptance criteria for slope and predicted bias, the separate analysis for MGUS patients only for N Latex FLC lambda shows predicted biases of -15.7% and -16.9% at the lower and upper limit reference intervals respectively, and a slope of 0.841. These specific MGUS-only results for lambda do not meet the stated acceptance criteria of ≤ +/- 10% bias and a slope of 0.9-1.1. However, the document's general conclusion states "Acceptance criteria fulfilled" based on the overall results (Table 7.3.1-2 and 7.3.1-3). The separate MGUS-only table (7.3.1-4 and 7.3.1-5) is presented as a sub-analysis, and the acceptance criteria for this sub-analysis are not explicitly re-stated or modified from the general criteria. The FDA’s acceptance of this submission implies that the overall performance was considered sufficient.

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

    • Sample Size (Overall):
      • N Latex FLC kappa: 212 samples
      • N Latex FLC lambda: 202 samples
    • Sample Size (MGUS-specific analysis):
      • N Latex FLC kappa: 38 MGUS samples
      • N Latex FLC lambda: 35 MGUS samples
    • Data Provenance: The method comparison study was conducted internally at the Siemens Healthcare Diagnostics Products GmbH site in Marburg, Germany. It incorporated "samples derived from MGUS patients." The text for the clinical performance study for MGUS evaluation mentions "121 MGUS samples (89 Non-IgM, 21 IqM and 11 LC MGUS) and 102 polyclonal immunostimulation samples," but it's important to differentiate these from the test set numbers used in the method comparison study (212/202 and 38/35). The specific type (retrospective/prospective) is not explicitly stated for the source of these samples, but the mention of "derived from MGUS patients" suggests pre-existing samples, which would typically be retrospective.

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

    This information is not provided in the given text. The device is an in-vitro diagnostic reagent for quantitative determination of free light chains, and the "ground truth" for the method comparison study is established by comparison to a legally marketed predicate device (N Latex FLC assays on the BN ProSpec System).

    4. Adjudication Method for the Test Set

    This information is not applicable as the ground truth is established by a predicate diagnostic device, not by expert consensus or adjudication. The study is a method comparison, not a reader study.

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

    No, an MRMC comparative effectiveness study was not done. This device is an in-vitro diagnostic assay, not an imaging AI device that relies on human reader interpretation. The study evaluates the analytical performance of the assay compared to a predicate, not how human readers improve with AI assistance.

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

    Yes, in essence. This is a standalone performance study of the diagnostic assay on a new instrument platform (Atellica® CH Analyzer) compared to its performance on a predicate instrument (BN ProSpec System). The "algorithm" here refers to the analytical process of the in-vitro diagnostic test.

    7. The Type of Ground Truth Used

    The ground truth for the method comparison study is the performance of the predicate device (N Latex FLC kappa and N Latex FLC lambda assays on the BN ProSpec System). This is a comparative study aiming to show equivalence to an already legally marketed and accepted diagnostic method.

    8. The Sample Size for the Training Set

    This information is not provided in the text. The document describes a study to support a 510(k) submission for a diagnostic assay, which typically involves validation studies rather than "training sets" in the context of machine learning (unless the underlying technology uses machine learning, which is not indicated here). If there was any internal development or calibration process that could be considered "training," the sample size used for that is not disclosed.

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

    This information is not applicable/not provided as there is no mention of a "training set" in the context of machine learning. If the question refers to how the "predicate device" performance (which acts as the reference for this study) was originally established, that information is outside the scope of this particular 510(k) submission document. The predicate device itself has been cleared under previous 510(k)s (K171742, K182098, K193047, K201496).

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    K Number
    K201496
    Date Cleared
    2021-10-29

    (511 days)

    Product Code
    Regulation Number
    866.5550
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    K171742, K182098, K193047

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    N Latex FLC kappa and lambda are in-vitro diagnostic reagents for the quantitative determination of free light chains (FLC), type kappa or type lambda in human serum and EDTA plasma. N Latex FLC kappa and lambda assays are used:
    • as an aid in the diagnosis and monitoring of multiple myeloma (MM) on the BN Systems and Atellica® CH Analyzer.
    • as an aid in the diagnosis of immunoglobulin light-chain amyloidosis (AL) on the BN Systems and Atellica® CH Analyzer.
    · as an aid in the monitoring of immunoglobulin light-chain amyloidosis (AL) on the BN Systems.
    · as an aid in the evaluation of Monoclonal Gammopathy of Undetermined Significance (MGUS) on the BN Systems.
    Results of FLC measurements should always be interpreted in conjunction with other laboratory and clinical findings.

    Device Description

    N Latex FLC kappa and lambda are in-vitro diagnostic reagents for the quantitative determination of free light chains (FLC), type kappa or type lambda in human serum and EDTAplasma. N Latex FLC kappa and lambda assays are used as an aid in the diagnosis and monitoring of multiple myeloma (MM) and immunoglobulin light-chain amyloidosis (AL) and as an aid in the evaluation of Monoclonal Gammopathy of Undetermined Significance (MGUS). Monitoring of immunoglobulin light-chain amyloidosis (AL) and evaluation of MGUS are cleared for use only on the BN Systems.
    The N Latex FLC test systems are based upon the principles of particle-enhanced immunonephelometry. Polystyrene particles coated with monoclonal antibodies to human free light chains, type kappa or lambda, respectively, are agglutinated when mixed with samples containing free light chains. These aggregates scatter a beam of light passed through the sample. The intensity of the scattered light is proportional to the concentration of the respective protein in the sample. The result is evaluated by comparison with a standard of known concentration.

    AI/ML Overview

    This document describes the N Latex FLC kappa and N Latex FLC lambda assays, in vitro diagnostic reagents used for the quantitative determination of free light chains (FLC), type kappa or type lambda, in human serum and EDTA plasma. This submission seeks to add "monitoring of immunoglobulin light-chain amyloidosis (AL) on the BN Systems" to the device's indications for use.

    1. Acceptance Criteria and Reported Device Performance

    The acceptance criteria are implicitly derived from the comparative studies presented, aiming to demonstrate substantial equivalence to the predicate device and acceptable concordance with clinical status. The reported performance is summarized in the tables below, using Evaluation Mode 2 as favored by Siemens.

    Comparison of N Latex FLC versus Freelite (Predicate Device) - Evaluation Mode 2

    Response CriteriaAcceptance Criteria (Implicit)Reported Performance (Agreement Rate)95% CI Bootstrap
    Complete ResponseHigh agreement68.1%53.6 – 86.3%
    VGPRHigh agreement81.8%67.4 – 91.1%
    Partial ResponseHigh agreement45.5%15.0 – 60.0%
    Stable DiseaseHigh agreement84.4%76.5 – 95.4%
    Progressive DiseaseHigh agreement88.2%70.0 – 100.0%
    PPA (Progressive Disease)High agreement88.2% (15/17)70.0 – 100.0%
    NPA (Progressive Disease)High agreement97.8% (219/224)95.9 - 99.6%

    Concordance of N Latex FLC versus Clinical Status - Evaluation Mode 2

    Response CriteriaAcceptance Criteria (Implicit)Reported Performance (Concordance Rate)95% CI Bootstrap
    Complete ResponseHigh concordance52.9%25.0 – 74.3%
    VGPRHigh concordance71.4%56.6 – 88.9%
    Partial ResponseHigh concordance26.8%8.0 – 30.3%
    Stable DiseaseHigh concordance57.6%38.2 – 72.9%
    Progressive DiseaseHigh concordance70.6%47.1 – 88.2%
    Sensitivity (Progressive Disease)High sensitivity70.6% (12/17)47.1 – 88.2%
    Specificity (Progressive Disease)High specificity96.1% (197/205)94.8 - 99.0%

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

    The test set for the comparative effectiveness study included data from a multi-center study on immunoglobulin light-chain amyloidosis (AL) patients.

    • Sample Size: The N Latex FLC versus Freelite comparison involves a total of 241 observations based on initial and consecutive blood draws. The comparison to clinical status involves 222 observations.
    • Data Provenance: The document does not explicitly state the country of origin. The study is retrospective, comparing changes between an initial sample draw and each consecutive blood draw, and then comparing these results to both a predicate device and clinical response.

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

    The "clinical response" used as ground truth was "provided by the physician taking into account all available clinical and laboratory information."

    • Number of Experts: Not explicitly stated, but it implies individual physicians for each patient.
    • Qualifications: "Physician" is the qualification mentioned. No specific experience levels (e.g., years of experience or specialization in oncology/hematology) are provided for these physicians.

    4. Adjudication Method for the Test Set

    The document mentions that clinical response was "provided by the physician taking into account all available clinical and laboratory information." There is no mention of a formal adjudication panel or process (e.g., 2+1, 3+1). The response evaluation criteria are derived from NCCN Response Criteria for serum M protein/IFE and FLC levels/ratios.

    5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

    No MRMC study was conducted. This device is an in-vitro diagnostic assay, not an imaging AI device that would typically involve human readers. The comparative effectiveness assessment focuses on the agreement between the new device and a predicate device, and the concordance of both devices with physician-determined clinical status.

    6. Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study

    Yes, the studies presented are standalone performance assessments of the N Latex FLC kappa and lambda assays. The device itself is an automated assay, and its performance is evaluated directly (algorithm only). The comparison to clinical status is essentially an evaluation of the algorithm's output versus an established clinical truth.

    7. Type of Ground Truth Used

    The ground truth for the clinical comparison was based on clinical status/physician assessment, which encompasses "all available clinical and laboratory information" including NCCN Response Criteria. This is closer to an "outcomes data" or "expert consensus" type of ground truth in a clinical context.

    8. Sample Size for the Training Set

    The document does not provide information on the training set size. This submission focuses on performance data for an extended indication for monitoring AL. It refers to previous submissions (K171742, K182098, K193047) for established analytical and clinical studies, implying that the device was already developed and validated. The current submission's study used a distinct set of AL patients for evaluating the new monitoring claim.

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

    Not applicable/provided. As this submission is for an extended indication and refers to previous clearances for the device, details on the ground truth establishment for the initial training set (if any for algorithm development) are not included in this document. The focus of the provided text is on demonstrating performance for the new monitoring claim.

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