Accu-Chek Guide Me Blood Glucose Monitoring System

K181131 · Roche Diabetes Care · NBW · Dec 13, 2018 · Clinical Chemistry

Device Facts

• Record ID: K181131
• Device Name: Accu-Chek Guide Me Blood Glucose Monitoring System
• Applicant: Roche Diabetes Care
• Product Code: NBW · Clinical Chemistry
• Decision Date: Dec 13, 2018
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 862.1345
• Device Class: Class 2
• Attributes: Pediatric

Intended Use

The Accu-Chek Guide Me Blood Glucose Monitoring System is intended for single-patient use only.

Device Story

System measures blood glucose via Accu-Chek Guide test strips and meter; uses amperometric detection with FAD-GDH enzyme. Input: 600 nanoliter capillary blood sample. Output: quantitative glucose concentration (20-600 mg/dL) displayed on fixed-segment LCD. Used by patients with diabetes for self-monitoring; intended for single-patient use. Meter features 3-button interface, BLE connectivity for data transfer (fixed PIN pairing), and USB port. Device aids in monitoring glucose control effectiveness; results inform patient self-management decisions. No strip ejector, strip light, or pattern detection included compared to predicate.

Clinical Evidence

Bench testing only. No clinical data presented. Substantial equivalence supported by comparison of technological characteristics and performance specifications to the predicate device.

Technological Characteristics

Glucose monitoring system; fixed segment LCD display; BLE connectivity (single device pairing); external meter materials validated for chemical resistance to Super Sani-Cloth Wipes. Fundamental sensing technology unchanged from predicate.

Indications for Use

Indicated for single-patient use for the quantitative measurement of glucose in fresh capillary whole blood from the fingertip, palm, or upper arm as an aid in monitoring the effectiveness of diabetes control programs.

Regulatory Classification

Identification

A glucose test system is a device intended to measure glucose quantitatively in blood and other body fluids. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic hypoglycemia, and of pancreatic islet cell carcinoma.

Special Controls

*Classification.* Class II (special controls). The device, when it is solely intended for use as a drink to test glucose tolerance, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.

Predicate Devices

• Accu-Chek Guide Blood Glucose Monitoring System (k160944)

Submission Summary (Full Text)

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left, there is a symbol representing the Department of Health & Human Services - USA. To the right of the symbol, there is the FDA logo in blue, with the words "U.S. FOOD & DRUG" stacked on top of the word "ADMINISTRATION".

December 13, 2018

Roche Diabetes Care Ginger Emrich Regulatory Affairs Principal 9115 Hague Road Indianapolis, IN 46250

Re: K181131

Trade/Device Name: Accu-Chek Guide Me Blood Glucose Monitoring System Regulation Number: 21 CFR 862.1345 Regulation Name: Glucose test system Regulatory Class: Class II Product Code: NBW Dated: November 12, 2018 Received: November 13, 2018

Dear Ginger Emrich:

We have reviewed vour Section 510(k) premarket notification of intent to market the device referenced above and 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 Mav 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) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal

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statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801 and Part 809); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.html; good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803). please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerelv.

# Kellie B. Kelm -S

for Courtney H. Lias, Ph.D. Director Division of Chemistry and Toxicology Devices Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health

Enclosure

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## Indications for Use

510(k) Number (if known) k181131

#### Device Name

Accu-Chek Guide Me Blood Glucose Monitoring System

#### Indications for Use (Describe)

The Accu-Chek Guide Me Blood Glucose Monitoring System is comprised of the Accu-Chek Guide Me meter and the Accu-Chek Guide test strips.

The Accu-Chek Guide Me Blood Glucose Monitoring System is intended to quantitatively measure glucose in fresh capillary whole blood from the fingertip, palm, and upper arm as an aid in monitoring the effectiveness of glucose control.

The Accu-Chek Guide Me Blood Glucose Monitoring System is intended for in vitro diagnostic single-patient use by people with diabetes.

The Accu-Chek Guide Me Blood Glucose Monitoring System is intended to be used by a single person and should not be shared.

This system is not for use in diagnosis or screening of diabetes mellitus, nor for neonatal use.

Alternative site testing should be done only during steady-state times (when glucose is not changing rapidly).

Type of Use (Select one or both, as applicable)

| <input type="checkbox"/> Prescription Use (Part 21 CFR 801 Subpart D) |
|---------------------------------------------------------------------------------|
| <input checked="" type="checkbox"/> Over-The-Counter Use (21 CFR 801 Subpart C) |

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Image /page/3/Picture/0 description: The image shows the Roche logo. The logo consists of the word "Roche" in blue, enclosed within a blue hexagon. The hexagon is horizontally oriented, with the word "Roche" centered inside it.

# 510(k) SUMMARY: k181131

# INTRODUCTION

According to the requirements of 21 CFR 807.92, the following information is intended to introduce the Accu-Chek Guide Me Blood Glucose Monitoring System, and provide sufficient detail to support a determination of substantial equivalence for k181131.

| Submission Number | k181131 |
|-----------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Submission Type | Special 510(k) |
| Submitter Name | Roche Diabetes Care |
| Address | 9115 Hague Road<br>Indianapolis, IN 46250 |
| Contact | Primary: Ginger Emrich<br>Phone: [phone]<br>Email: [e-mail]<br><br>Secondary: Susan Hollandbeck<br>Phone: [phone]<br>Email: [e-mail] |
| Date Prepared | November 12, 2018 |
| Proprietary Names | Accu-Chek Guide Me Blood Glucose Monitoring System |
| Common Names | Glucose test system |
| Classification Names /<br>Product Codes | Blood Glucose Test System, Over the Counter<br>(21 C.F.R. § 862.1345, Product Code NBW); Class II |
| Predicate Device | Accu-Chek Guide Blood Glucose Monitoring System<br>(k160944), clearance received on August 31, 2016. |

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Image /page/4/Picture/0 description: The image shows the Roche logo. The logo consists of the word "Roche" in blue font, enclosed within a blue hexagon. The hexagon is horizontally oriented.

## DEVICE DESCRIPTION

The Accu-Chek Guide Me Blood Glucose Monitoring System makes use of the Accu-Chek Guide Me meter, and the Accu-Chek Guide test strips. This system is a single-patient use blood glucose monitoring system intended to be used to quantitatively measure glucose in fresh capillary whole blood from the finger, palm, and upper arm as an aid in monitoring the effectiveness of glucose control.

The Accu-Chek Guide Me Blood Glucose Monitoring System consists of the following:

- Accu-Chek Guide Me meter
- Accu-Chek Guide test strips (previously cleared in k160944) ●

# INTENDED USE

The Intended Use is identical to the predicate device with the exception of the device name. The intended use of the modified device, as described in the labeling, has not changed as a result of the modification(s).

The Accu-Chek Guide Me Blood Glucose Monitoring System is comprised of the Accu-Chek Guide Me meter and the Accu-Chek Guide test strips.

The Accu-Chek Guide Me Blood Glucose Monitoring System is intended to quantitatively measure glucose in fresh capillary whole blood from the finger, palm, and upper arm as an aid in monitoring the effectiveness of glucose control.

The Accu-Chek Guide Me Blood Glucose Monitoring System is intended for in vitro diagnostic single-patient use by people with diabetes.

The Accu-Chek Guide Me Blood Glucose Monitoring System is intended to be used by a single person and should not be shared.

This system is not for use in diagnosis or screening of diabetes mellitus, nor for neonatal use.

Alternative site testing should be done only during steady-state times (when glucose is not changing rapidly).

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Image /page/5/Picture/0 description: The image shows the Roche logo. The logo consists of the word "Roche" in blue, enclosed within a blue hexagon. The hexagon is horizontally oriented, with the word "Roche" centered inside.

## TECHNOLOGICAL CHARACTERISTICS

The Accu-Chek Guide test strip, measurement engine, and measurement principle used with the Accu-Chek Guide Me system have not been modified. System claims and performance have not changed.

The Accu-Chek Guide Me meter reflects the following modifications of the cleared Accu-Chek Guide meter:

- Updated user interface -
- -Fixed segment display
- -3 button interface
- -Modified meter housing - design / materials
- No strip eject, strip port light, target range indicator or beeper / reminders -
- -No pattern detection or meal indicator
- BLE pairing with fixed PIN (on meter backlabel); only supports one pairing at a time -

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Image /page/6/Picture/0 description: The image features the Roche logo, which consists of the word "Roche" in a blue, sans-serif font. The word is enclosed within a blue hexagon shape. The logo is simple and clean, with the blue color providing a sense of trust and reliability. The hexagon shape adds a modern and corporate feel to the overall design.

# Similarities to Predicate Device

The following table shows the similarities of the modified device to the predicate device.

| | Accu-Chek Guide<br>Predicate (k160944) | Accu-Chek Guide Me<br>Modified Device |
|-----------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------|
| Indications for Use | Quantitatively measure glucose in fresh capillary whole blood from the finger, palm, and upper arm as an aid in monitoring the effectiveness of glucose control | Same |
| Alternative Site Testing | Palm and Upper arm | Same |
| Enzyme | FAD-GDH | Same |
| Test Principle | Amperometric Detection | Same |
| Primary Container (Vial) | Black, flip top oval vial, holds up to 50 strips<br>Closed vial height: 51 mm<br>Width at widest point: 18.3 mm<br>Width at narrowest point: 15.3 mm | Same |
| Sample Volume | 600 nanoliters | Same |
| Measurement Range | 20 - 600 mg/dL | Same |
| Hematocrit Range | 10 - 65% | Same |
| Operating Temperature<br>Range | 6 - 45 °C | Same |
| Operating Relative<br>Humidity Range | 10 - 90% | Same |
| Auto Control Solution<br>Identification | Yes | Same |
| Connectivity | USB for PC connectivity and BLE (Bluetooth Low Energy) for wireless connectivity | Same |
| Maximum Altitude | 10,150 feet | Same |
| Underdose Detection | Yes | Same |
| Coding | No | Same |
| Averages | 7, 14, 30, and 90 Day Average | Same |
| System Integrity Fail-safe<br>checks | Same | Same |
| Strip Handling / Dosing | Same | Same |

Table 1: Similarities to Predicate Device

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Image /page/7/Picture/0 description: The image shows the Roche logo. The logo consists of the word "Roche" in blue, enclosed in a blue hexagon. The hexagon has a thick blue border. The word "Roche" is written in a simple, sans-serif font.

# Differences to Predicate Device

The following table shows the differences of the modified device to the predicate device.

| Table 2: Differences to Predicate Device | | |
|------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------|
| | Accu-Chek Guide<br>Predicate (k160944) | Accu-Chek Guide Me<br>Modified Device |
| Target Range<br>Indication | Yes | No |
| Pattern Detection | Yes | No |
| Meal Indication | Yes | No |
| Beeper / Reminders | Yes | No |
| Strip Light | Yes | No |
| Strip Ejector | Yes | No |
| BLE Pairing | BLE pairing with variable<br>PIN (new PIN generated<br>electronically at each pairing);<br>able to pair with 5 devices at a<br>time | BLE pairing with fixed PIN (on<br>meter backlabel); only supports<br>one pairing at a time |
| Screen / Display | Dot Matrix LCD Display<br>with Backlight | Fixed Segment LCD Display<br>without Backlight |
| Meter Buttons | Hard cap front button<br><br>4-way rocker design including<br>OK/Power, back, and<br>up/down functions | One Hard cap OK/Power button<br>on the side<br><br>2 soft buttons for memory<br>recall, and forwards /<br>backwards functions |
| Meter Housing<br>Materials | PET, IMD, PC,<br>TPF, and ABS/PC | PET, IMD, PC,<br>and Silicone Rubber |

Table 2: Differences to Predicate Device

# SUBSTANTIAL EQUIVALENCE

The submitted information in this premarket notification supports a substantial equivalence decision. The differences between predicate and modified devices do not impact the indications for use or fundamental scientific technology.