PROPARAFLU+ ASSAY

K132238 · Gen-Probe Prodesse, Inc. · OOU · Aug 26, 2013 · Microbiology

Device Facts

• Record ID: K132238
• Device Name: PROPARAFLU+ ASSAY
• Applicant: Gen-Probe Prodesse, Inc.
• Product Code: OOU · Microbiology
• Decision Date: Aug 26, 2013
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 866.3980
• Device Class: Class 2

Indications for Use

The Prodesse® ProParaflu®+ Assay is a multiplex Real-Time PCR (RT-PCR) in vitro diagnostic test for the qualitative detection and discrimination of Parainfluenza 1 Virus, Parainfluenza 2 Virus and Parainfluenza 3 Virus (HPIV-1. HPIV-2 and HPIV-3) nucleic acids isolated and purified from nasopharvngeal (NP) swab specimens obtained from individuals exhibiting signs and symptoms of respiratory tract infections. This Assay targets the conserved regions of the Hemagglutinin-Neuraminidase (HN) gene of HPIV-1, HPIV-3, respectively. The detection and discrimination of HPIV-1, HPIV-2 and HPIV-3 nucleic acids from symptomatic patients aid in the diagnosis of human respiratory tract parainfluenza infections if used in conjunction with other clinical and laboratory findings. This test is not intended to detect Parainfluenza 4a or Parainfluenza 4b Viruses. Negative test results are presumptive and should be confirmed by cell culture. Negative results do not preclude Parainfluenza 1, 2 or 3 virus infections and should not be used as the sole basis for treatment or other management decisions.

Device Story

Prodesse ProParaflu+ Assay is a multiplex nucleic acid amplification test for HPIV-1, HPIV-2, and HPIV-3. Input: nasopharyngeal swab specimens. Process: nucleic acid extraction (via bioMérieux NucliSENS easyMAG or Roche MagNA Pure) followed by RT-PCR on Cepheid SmartCycler II. Output: qualitative detection of viral RNA. Modifications include a Universal Internal Control (UIC-A) containing RNA IVT and DNA plasmid, and a pre-diluted Positive Control. Used in high-complexity clinical laboratories by trained technicians. Results assist clinicians in diagnosing respiratory viral infections. Benefits include standardized internal control across multiple Pro+ assays and simplified positive control handling.

Clinical Evidence

Retrospective clinical comparison study demonstrated that the modified ProParaflu+ Assay with Universal Internal Control (UIC) maintains performance claims equivalent to the original device. Analytical studies confirmed UIC does not affect limit of detection or target organism detection.

Technological Characteristics

Multiplex RT-PCR assay; Taqman chemistry; dual-labeled oligonucleotide probes (FAM, CAL Fluor Orange 560, CAL Fluor Red 610, Quasar 670). Instrumentation: Cepheid SmartCycler II. Nucleic acid isolation: MagNA Pure LC or NucliSENS easyMAG. Connectivity: standalone instrument. Software: embedded firmware in SmartCycler II for real-time fluorescence monitoring.

Indications for Use

Indicated for the qualitative detection of HPIV-1, HPIV-2, and HPIV-3 RNA in nasopharyngeal swab specimens from patients suspected of respiratory viral infection. For use by high-complexity laboratories.

Regulatory Classification

Identification

A respiratory viral panel multiplex nucleic acid assay is a qualitative in vitro diagnostic device intended to simultaneously detect and identify multiple viral nucleic acids extracted from human respiratory specimens or viral culture. The detection and identification of a specific viral nucleic acid from individuals exhibiting signs and symptoms of respiratory infection aids in the diagnosis of respiratory viral infection when used in conjunction with other clinical and laboratory findings. The device is intended for detection and identification of a combination of the following viruses:(1) Influenza A and Influenza B; (2) Influenza A subtype H1 and Influenza A subtype H3; (3) Respiratory Syncytial Virus subtype A and Respiratory Syncytial Virus subtype B; (4) Parainfluenza 1, Parainfluenza 2, and Parainfluenza 3 virus; (5) Human Metapneumovirus; (6) Rhinovirus; and (7) Adenovirus.

Special Controls

*Classification.* Class II (special controls). The special controls are:(1) FDA's guidance document entitled “Class II Special Controls Guidance Document: Respiratory Viral Panel Multiplex Nucleic Acid Assay;” (2) For a device that detects and identifies Human Metapneumovirus, FDA's guidance document entitled “Class II Special Controls Guidance Document: Testing for Human Metapneumovirus (hMPV) Using Nucleic Acid Assays;” and (3) For a device that detects and differentiates Influenza A subtype H1 and subtype H3, FDA's guidance document entitled “Class II Special Controls Guidance Document: Testing for Detection and Differentiation of Influenza A Virus Subtypes Using Multiplex Nucleic Acid Assays.” See § 866.1(e) for the availability of these guidance documents.

Predicate Devices

• Prodesse® ProParaflu™+ Assay (K091053)

Submission Summary (Full Text)

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SPECIAL 510(k): Device Modification Review Memorandum

To: Hologic, Inc. (Gen-Probe Prodesse, Inc.)

RE: K132238

This 510(k) submission contains information/data on modifications made to the SUBMITTER'S own Class II devices requiring 510(k). The following items are present and acceptable:

1. The name and 510(k) number of the SUBMITTER'S previously cleared device:

Prodesse® ProParaflu™+ Assay

510(k) number: K091053

2. Submitter's statement that the INDICATION/INTENDED USE of the modified device as described in its labeling HAS NOT CHANGED along with the proposed labeling which includes instructions for use and package labeling.

3. A description of the device MODIFICATION(S) to demonstrate that the FUNDAMENTAL SCIENTIFIC TECHNOLOGY of the modified device has not changed.

The 510k submission contained modifications to the Internal Control and Positive Control. The modifications are summarized as follows:

a. Outsourcing of the manufacturing of the Internal Control and subsequent minor changes to 5' and 3' ends of the internal control sequence.

The current Internal Control (RIC) in ProParaflu+ Assay contains a RNA in vitro transcript (IVT). The new Universal Internal Control (UIC-A) will contain a RNA in vitro transcript (IVT) and a DNA plasmid to allow users to perform one nucleic acid extraction and test with any combination of the Pro+ Series Assays including ProFlu+, ProhMPV+, ProParaflu+, ProFAST+, and ProAdeno+. Due to the different vector being used in the Universal Internal Control (UIC-A), minor changes were made to the 5' and 3' ends of the UIC-A sequence.

The concentration of the RNA IVT in the Universal Internal Control (UIC-A) is the same as in the current Internal RNA Control (RIC). Handling of Universal Internal Control is identical to that of the current Internal RNA Control (RIC) included in the ProParaflu+ Assay.

b. The handling of the Positive Control for the ProParaflu+ Assay will be changed to eliminate the customer dilution that occurs immediately prior to RT-PCR setup, effectively raising the testing concentration one log.

4. Comparison Information (similarities and differences) to applicant's legally marketed predicate device including, labeling, intended use, and physical characteristics.

| Element | Similarities | |
| --- | --- | --- |
| | Modified Prodesse ProParaflu+ Assay | Current Prodesse ProParaflu+ Assay (K091053) |
| Organisms Detected | Same | HPIV-1, HPIV-2, and HPIV-3 |
| Analyte | Same | RNA |
| Technological Principles | Same | Multiplex nucleic acid amplification |

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| Specimen | Same | Nasopharyngeal Swab |
| --- | --- | --- |
| Types | | |
| User Complexity | Same | High |
| Sample Preparation | Same | Up front sample processing is required to extract nucleic acid. |
| Method | | |
| Instrumentation | Same | bioMérieux NucliSENS easyMAG or Roche MagNA Pure and Cepheid SmartCycler II Instrument |
| Time to result | Same | Approximately 4 hours |
| Controls | Same | Internal control in each sample. External control processed with each batch of samples. (see below for differences) |
| Differences | | | |
| --- | --- | --- | --- |
| Element | | Modified ProParaflu+ Assay | Current Prodesse ProParaflu+ Assay |
| Controls | Internal | • Universal Internal Control
- Contains DNA plasmid in addition to RNA IVT
• Control Stocks outsourced
- Change in manufacturer leading to change in control vectors and minor sequence changes at the 5' and 3' ends of RNA IVT | • Internal RNA Control
- Contains RNA IVT
• Control stocks manufactured in house |
| | Positive | • PC does not require dilution;
- PC is provided as “at use concentration” | • End user must dilute PC 1:10 prior to use for RT-PCR |

# 5. A Design Control Activities Summary:

a. Identification of Risk Analysis method used to assess the impact of the modification on the device and its components, and the results of the analysis;

Failure Mode and Effects Analysis (FMEA) was performed to determine whether the current design changes create new risks or failure modes or affect the risk priority number (RPN) value. No additional risk or change in RPN value was identified in the Risk Analysis.

b. To demonstrate that the modifications in Internal Control do not change the assay performance, Analytical Studies and a Comparison Study were conducted.

- Analytical Performances:

- Analytical Sensitivity Confirmation

The LoD, which was established in K091053, was confirmed for Parainfluenza I, Parainfluenza 2, and Parainfluenza 3 when tested with the UIC-A side by side with the current RIC. The confirmed LoDs are as follows:

HPIV-1 $1 \times 10^{2} \mathrm{TCID}_{50} / \mathrm{mL}$

HPIV-2 $1 \times 10^{2} \mathrm{TCID}_{50} / \mathrm{mL}$

HPIV-3 $5 \times 10^{1} \mathrm{TCID}_{50} / \mathrm{mL}$

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- IC Interference Study
The IC Interference Study demonstrated that the new control, UIC-A, did not inhibit the detection of target organisms at levels close to LoD.

- Sample Stability Study
The study demonstrated that the stability of the samples would not be affected by a change in the internal control.

- Extractor Equivalency Studies
The study for equivalency of nucleic acid extraction methods between the bioMérieux NucliSENS easyMAG automated extractor and Roche MagNA Pure LC extractor demonstrated the equivalency between the two extraction methods.

- Comparison Study:
The comparison study was conducted for all Pro+ Series Assays including ProFlu+, ProhMPV+, ProParaflu+, ProFAST+, and ProAdeno+ using 366 positive samples and 66 negative samples. Among the 366 positive samples, 330 were retrospective pre-selected archived NPS specimens with 30 positive samples per target (11 targets total) and 36 were contrived samples, generated by spiking individual negative retrospective NPS samples with whole organism (Influenza A/Seasonal H1 or Parainfluenza 2). Each sample was split into 3 aliquots; one aliquot was tested using the current Internal RNA Control (RIC), one aliquot was tested using the Universal Internal Control (UIC-A), and one aliquot was tested using the current Universal Internal Control (UIA-P) for ProAdeno+ Assay. All samples were then split into 72 panels with 6 samples per panel, extracted and tested by four different operators. Half of the panel samples were extracted using the bioMérieux NucliSENS easyMAG method and the other half using the Roche MagNA Pure LC method. Of the 432 samples utilized in the study, 27 samples were removed from analysis due to the invalid controls or incomplete test results. The results for ProParaflu+ Assay are summarized in the following tables:

| ProParaflu+ Assay Parainfluenza 1 Results | | | | | |
| --- | --- | --- | --- | --- | --- |
| | | Samples with RIC | | | |
| Samples with UIC-A | | Positive | Negative | Total | Comments |
| | Positive | 28 | 0 | 28 | Percent Positive Agreement 100% (87.9% - 100%) 95% CI |
| | Negative | 0 | 377 | 377 | Percent Negative Agreement 100% (99.0% - 100%) 95% CI |
| Total | | 28 | 377 | 405 | |
| ProParaflu+ Assay Parainfluenza 2 Results | | | | | |
| --- | --- | --- | --- | --- | --- |
| | | Samples with RIC | | | |
| Samples with UIC-A | | Positive | Negative | Total | Comments |
| | Positive | 30 | 1* | 31 | Percent Positive Agreement 96.8% (83.8% - 99.4%) 95% CI |
| | Negative | 1** | 373 | 374 | Percent Negative Agreement 99.7% (98.5% - 100%) 95% CI |
| Total | | 31 | 374 | 405 | |

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*Sample Parainfluenza 2 positive with original source laboratory method (Luminex RVP)
**Sample Parainfluenza 2 positive with original source laboratory method (Luminex RVP)

| ProParaflu+ Assay Parainfluenza 3 Results | | | | | |
| --- | --- | --- | --- | --- | --- |
| | | Samples with RIC | | Total | |
| Samples with UIC-A | | Positive | Negative | Total | Comments |
| | Positive | 28 | 0 | 28 | Percent Positive Agreement 93.3% (78.7% - 98.2%) 95% CI |
| | Negative | 2* | 375 | 377 | Percent Negative Agreement 100% (99.0% - 100.0%) 95% CI |
| Total | | 30 | 375 | 405 | |

*Samples Parainfluenza 3 positive with original source laboratory method (Luminex RVP)

The results of analytical studies and the clinical study confirmed the original performance claims of the ProParaflu+ Assay and demonstrated that assay performance was not affected by the incorporation of the modified Universal Internal Control (UIC-A). The ProParaflu+ Assay package insert has been updated to reflect the changes in the controls

c. To evaluate whether eliminating customer dilution prior to RT-PCR setup will affect the effectiveness of the Positive Control at detecting any errors occurred in the target channels, several defective mixtures that either lacked the Taq polymerase or MMLV, or did not include sufficient concentration of reverse primers, or contained a PCR inhibitor were tested with Positive Control at supplied concentration without customer dilution. The study demonstrated that the Positive Control used at the supplied concentration can effectively detect any global errors in the target channels. The ProParaflu+ Assay package insert has been updated to reflect the changes in the Positive Control.

d. A declaration of conformity with design controls was submitted for the manufacturing facility which includes:

i) A statement signed by the Senior Director of R & D, Gen-Probe Prodesse, Inc., was submitted confirming that, as required by the risk analysis, all verification and validation activities were performed by the designated individual(s) and the results demonstrated that the predetermined acceptance criteria were met, and
ii) A "Declaration of Conformity" statement signed by the Associate Director of Quality and Regulatory, Gen-Probe Prodesse, Inc., was submitted stating that the manufacturing facility is in conformance with design control procedure requirements as specified in 21 CFR 820.30 and the records are available for review.

6. A Truthful and Accurate Statement, a 510(k) Summary or Statement and the Indications for Use Enclosure.

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.