← Product Code [JMO](/submissions/CH/subpart-b%E2%80%94clinical-chemistry-test-systems/JMO) · K041793

# OLYMPUS UNSATURATED IRON BINDING CAPCITY REAGENT, OSR6124/0SR6524 (K041793)

_Olympus America, Inc. · JMO · Jul 16, 2004 · Clinical Chemistry · SESE_

**Canonical URL:** https://fda.innolitics.com/submissions/CH/subpart-b%E2%80%94clinical-chemistry-test-systems/JMO/K041793

## Device Facts

- **Applicant:** Olympus America, Inc.
- **Product Code:** [JMO](/submissions/CH/subpart-b%E2%80%94clinical-chemistry-test-systems/JMO.md)
- **Decision Date:** Jul 16, 2004
- **Decision:** SESE
- **Submission Type:** Special
- **Regulation:** 21 CFR 862.1415
- **Device Class:** Class 1
- **Review Panel:** Clinical Chemistry

## Indications for Use

An iron-binding capacity test system is a device intended to measure iron-binding capacity in serum and plasma. Iron-binding capacity measurements are used in the diagnosis and treatment of anemia.

## Device Story

The Olympus Unsaturated Iron Binding Capacity test system is an in vitro diagnostic device used to measure iron-binding capacity in serum and plasma samples. It is intended for use by healthcare professionals in clinical laboratory settings to assist in the diagnosis and treatment of anemia. The device functions as a chemical test system; it provides quantitative results that clinicians use to assess iron status and guide therapeutic decisions for patients suspected of having anemia.

## Clinical Evidence

No clinical data provided; bench testing only.

## Technological Characteristics

Reagent R2a modified from powder to liquid state; linearity range 400-450 µg/dL.

## Regulatory Identification

An iron-binding capacity test system is a device intended to measure iron-binding capacity in serum. Iron-binding capacity measurements are used in the diagnosis and treatment of anemia.

## Submission Summary (Full Text)

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SPECIAL 510(k): Device Modification ODE Review Memorandum

To: THE FILE

RE: DOCUMENT NUMBER K041793

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

1. The name and 510(k) number of the SUBMITTER'S previously cleared device. (For a preamendments device, a statement to this effect has been provided.)
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, package labeling, and, if available, advertisements or promotional materials.
3. 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.

This change was for reagent R2a going from a powder to a liquid. The linearity extended from 400 to 450 µg/dL.

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

5. 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
c) A declaration of conformity with design controls. The declaration of conformity should include:

i) A statement signed by the individual responsible, 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 statement signed by the individual responsible, 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 (and Class III Summary for Class III devices).

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.

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**Source:** [https://fda.innolitics.com/submissions/CH/subpart-b%E2%80%94clinical-chemistry-test-systems/JMO/K041793](https://fda.innolitics.com/submissions/CH/subpart-b%E2%80%94clinical-chemistry-test-systems/JMO/K041793)

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