FORESIGHT U120 URINE ANALYZER

K120124 · ACON Laboratories, Inc. · JIL · Mar 6, 2012 · Clinical Chemistry

Device Facts

• Record ID: K120124
• Device Name: FORESIGHT U120 URINE ANALYZER
• Applicant: ACON Laboratories, Inc.
• Product Code: JIL · Clinical Chemistry
• Decision Date: Mar 6, 2012
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 862.1340
• Device Class: Class 2

Intended Use

The Foresight™ U120 Urine Analyzer is intended for use in conjunction with the Foresight Urinalysis Reagent Strips for the semi-quantitative detection of the following analytes in urine: Glucose, Bilirubin, Ketone (Acetoacetic acid), Specific Gravity, pH, Blood, Protein, Urobilinogen, Leukocytes and Ascorbic Acid as well as the qualitative detection of Nitrite. The instrument is intended for professional, in vitro diagnostic use only. The measurement can be used in general evaluation of health, and aids in the diagnosis and monitoring of metabolic or systemic diseases that affect kidney function, endocrine disorders and diseases or disorders of the urinary tract.

Device Story

Foresight™ U120 Urine Analyzer (formerly ACON™ U120); semi-quantitative urine analyte determination; clinical laboratory use. Modification includes external housing redesign; altered dimensions; relocated external printer to rear; repositioned test strip tray under keypad. Fundamental scientific technology remains unchanged from predicate. Device processes urine test strips; provides semi-quantitative results for clinical decision-making.

Clinical Evidence

No clinical data; bench testing only. Substantial equivalence supported by design control activities, risk analysis, and verification of physical modifications.

Technological Characteristics

Reflectance photometry-based urine analyzer. Measures color intensity of reagent strips via optical sensors. Standalone benchtop instrument. Software-controlled processing of optical data. Designed for professional use.

Indications for Use

Indicated for professional, in vitro diagnostic use to detect analytes in urine (Glucose, Bilirubin, Ketone, Specific Gravity, pH, Blood, Protein, Urobilinogen, Leukocytes, Ascorbic Acid, Nitrite) to aid in the diagnosis and monitoring of metabolic, systemic, kidney, endocrine, and urinary tract diseases.

Regulatory Classification

Identification

A urinary glucose (nonquantitative) test system is a device intended to measure glucosuria (glucose in urine). Urinary glucose (nonquantitative) measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, hypoglycemia, and hyperglycemia.

Predicate Devices

• ACON™ U120 Urine Analyzer (K070929)

Submission Summary (Full Text)

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Image /page/0/Picture/11 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle or other bird-like figure with outstretched wings.

10903 New Hampshire Avenue Silver Spring, MD 20993

ACON Laboratories, Inc. c/o Qiyi Xie Sr. Staff, Regulatory and Clinical Affairs 10125 Mesa Rim Road San Diego, CA 92121

MAR - 6 2012

Re: k120124 Trade Name: Foresight U120 Urine Analyzer Regulation Number: 21 CFR §862.1340 Regulation Name: Urinary Glucose (non-quantitative) Test System Regulatory Class: Class II Product Codes: JIL, JIO, LJX, JRE, CEN, JMT, JIR, JIN, CDM, JJB, JMA, KQO Dated: February 6, 2012 Received: February 7, 2012

Dear Qiyi Xie:

We have reviewed your 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 May 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. 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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in Title 21, Code of Federal Regulations (CFR), Parts 800 to 895. 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 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 Parts 801 and 809); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); and good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820).

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If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of In Vitro Diagnostic Device Evaluation and Safety at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at [phone]. 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 the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the 1 ou half of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or ( 301 ) 796-5680 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

signature

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

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## Indications for Use Form

K120124 510(k) Number (if known):

Foresight™ U120 Urine Analyzer Device Name:

Indications for Use:

The Foresight™ U120 Urine Analyzer is intended for use in conjunction with the Foresight Urinalysis Reagent Strips for the semi-quantitative detection of the following analytes in urine: Glucose, Bilirubin, Ketone (Acetoacetic acid), Specific Gravity, pH, Blood, Protein, Urobilinogen, Leukocytes and Ascorbic Acid as well as the qualitative detection of Nitrite. The instrument is intended for professional, in vitro diagnostic use only. The measurement can be used in general evaluation of health, and aids in the diagnosis and monitoring of metabolic or systemic diseases that affect kidney function, endocrine disorders and diseases or disorders of the urinary tract.

X Over-The-Counter Use Prescription Use AND/OR (Part 21 CFR 801 Subpart D) (21 CFR 801 Subpart C)

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Concurrence of CDRH, Office of In Vitro Diagnostic Devices (OIVD)

Qh

Division Sian-Off Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) K120124

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