LZI AMPHETAMINE-SPECIFIC ORAL FLUID HOMOGENEOUS ENZTME IMMUNOASSAY: LZI AMPHETAMINE ORAL FLUID CALIBRATORS AND CONTROLS

K063024 · Lin-Zhi International, Inc. · DKZ · Oct 30, 2006 · Clinical Toxicology

Device Facts

• Record ID: K063024
• Device Name: LZI AMPHETAMINE-SPECIFIC ORAL FLUID HOMOGENEOUS ENZTME IMMUNOASSAY: LZI AMPHETAMINE ORAL FLUID CALIBRATORS AND CONTROLS
• Applicant: Lin-Zhi International, Inc.
• Product Code: DKZ · Clinical Toxicology
• Decision Date: Oct 30, 2006
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 862.3100
• Device Class: Class 2

Intended Use

The Amphetamine-Specific Enzyme Immunoassays for Drugs of Abuse in Oral Fluid is a homogeneous enzyme immunoassay system to detect amphetamine in human saliva with a cutoff of 45 ng/mL when testing oral fluid specimen collected with Salivette collector (manufactured by Sarstedt) and diluted with 1 mL of buffer. The calibrators and controls of the analyte (d-amphetamine) are prepared with oral fluid buffer so that it can be used to verify and validate the assay. The assay is intended for use in the qualitative determination for amphetamine. The assay is designed for professional use with a number of automated clinical chemistry analyzers. The Oral Fluid Amphetamine-Specific Enzyme Immunoassay is a homogeneous enzyme immunoassay system provides only a preliminary analytical test result. A more specific alternative chemical method must be used to obtain a confirmed analytical result. Gas chromatography/mass spectrometry (GC/MS) is the preferred confirmatory method. Clinical consideration and professional judgment should be applied to any drug-of-abuse test result, particularly when preliminary positive results are used.

Device Story

Liquid reagent, homogeneous enzyme immunoassay; detects amphetamine in human saliva. Principle: competition between drug-labeled G6PDH enzyme and free drug in saliva sample for fixed antibody; drug concentration proportional to enzyme activity. Enzyme activity measured spectrophotometrically at 340 nm via conversion of NAD to NADH. Used in clinical laboratories by professionals on automated chemistry analyzers. Provides preliminary qualitative results; requires confirmatory testing (GC/MS) for clinical decision-making. Benefits: rapid screening for drugs of abuse in oral fluid.

Clinical Evidence

Method comparison study performed on 112 clinical oral fluid specimens comparing LZI EIA to GC/MS. Results showed 97.1% agreement (56 true positives, 44 true negatives, 2 false positives, 1 false negative). Precision studies (replicates of 6, twice daily for 10 days) showed within-run CV 0.46-0.63% and total precision CV 0.70-1.02%. Analytical specificity evaluated against various compounds; MDA showed cross-reactivity.

Technological Characteristics

Homogeneous enzyme immunoassay; liquid reagents. Sensing principle: spectrophotometric measurement of G6PDH enzymatic activity at 340 nm. Analyzers: automated clinical chemistry systems (e.g., Hitachi 717). Storage: 2-8 °C. Qualitative assay; no linearity. Calibrators/controls: buffer matrix spiked with d-amphetamine.

Indications for Use

Indicated for the qualitative detection of amphetamine in human saliva specimens collected via Sarstedt Salivette. Intended for professional use in clinical chemistry laboratories for preliminary analytical screening. Not for point-of-care use.

Regulatory Classification

Identification

An amphetamine test system is a device intended to measure amphetamine, a central nervous system stimulating drug, in plasma and urine. Measurements obtained by this device are used in the diagnosis and treatment of amphetamine use or overdose and in monitoring levels of amphetamine to ensure appropriate therapy.

Special Controls

*Classification.* Class II (special controls). An amphetamine test system is not exempt if it is intended for any use other than employment or insurance testing or is intended for Federal drug testing programs. The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9, provided the test system is intended for employment and insurance testing and includes a statement in the labeling that the device is intended solely for use in employment and insurance testing, and does not include devices intended for Federal drug testing programs (*e.g.,* programs run by the Substance Abuse and Mental Health Services Administration (SAMHSA), the Department of Transportation (DOT), and the U.S. military).

Predicate Devices

• LZI Oral Fluid Cocaine Enzyme Immunoassay (k050945)
• LZI Opiate Oral Fluid Enzyme Immunoassay (k050988)
• LZI Oral Fluid Methadone Enzyme Immunoassay (k051058)
• OraSure Amphetamine-Specific Intercept Micro-plate oral fluid EIA (k992918)

Submission Summary (Full Text)

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# 510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY ASSAY ONLY TEMPLATE

A. 510(k) Number:
k063024

B. Purpose for Submission:
Clearance of new device

C. Measurand:
Amphetamine

D. Type of Test:
Qualitative Enzyme Immunoassay

E. Applicant:
Lin-Zhi International, Inc.

F. Proprietary and Established Names:
LZI Oral Fluid Amphetamine-Specific Enzyme Immunoassay
LZI Oral Fluid Amphetamine Metabolite Calibrators
LZI Oral Fluid Amphetamine Metabolite Controls

G. Regulatory Information:
1. Regulation section:
21 CFR §862.3100, Amphetamine test system
§862.3200, Clinical toxicology calibrator
§862.3280, Clinical toxicology control material
2. Classification:
Class II (test system, calibrator)
Class I, reserved (control material)
3. Product code:
DKZ, enzyme immunoassay, amphetamine
DLJ, calibrators, drug specific
LAS, drug specific control materials

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4. Panel:
Toxicology (91)

H. Intended Use:

1. Intended use(s):
See indications for use below.

2. Indication(s) for use:
The Amphetamine-Specific Enzyme Immunoassays for Drugs of Abuse in Oral Fluid is a homogeneous enzyme immunoassay system to detect amphetamine in human saliva with a cutoff of 45 ng/mL when testing oral fluid specimen collected with Salivette collector (manufactured by Sarstedt) and diluted with 1 mL of buffer. The calibrators and controls of the analyte (d-amphetamine) are prepared with oral fluid buffer so that it can be used to verify and validate the assay. The assay is intended for use in the qualitative determination for amphetamine. The assay is designed for professional use with a number of automated clinical chemistry analyzers.

The Oral Fluid Amphetamine-Specific Enzyme Immunoassay is a homogeneous enzyme immunoassay system provides only a preliminary analytical test result. A more specific alternative chemical method must be used to obtain a confirmed analytical result. Gas chromatography/mass spectrometry (GC/MS) is the preferred confirmatory method. Clinical consideration and professional judgement should be applied to any drug-of-abuse test result, particularly when preliminary positive results are used.

3. Special conditions for use statement(s):
For prescription, professional use only in clinical chemistry laboratories.

The assay is not designated for use in point-of-care settings.

4. Special instrument requirements:
The assay is designed for professional use with a number of clinical chemistry analyzers. Performance data submitted was obtained using the Hitachi 717 analyzer.

I. Device Description:
The assay consists of ready-to-use liquid reagents. Reagent 1 contains mouse

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monoclonal antibody to amphetamine, glucose-6-phosphate (G6P), nicotinamide adenine dinucleotide (NAD) and stabilizers. Reagent 2 contains amphetamine labeled glucose-6-phosphate dehydrogenase (G6PDH) in buffer.

The calibrator standards are sold separately. They are used to construct the standard curve used to calculate the concentration of the unknown samples as well as to qualitatively determine the presences or absences of amphetamine in the sample. They consist of 3 levels of a buffer matrix spiked with known concentrations of the drug analyte, ranging in concentration from 0-90 µg/mL.

Assayed controls are sold separately and are run with the samples to monitor the performance of the assay. They consist of oral fluid with amphetamine added.

## J. Substantial Equivalence Information:

1. Predicate device name(s):

LZI Oral Fluid Cocaine Enzyme Immunoassay, LZI Opiate Oral Fluid Enzyme Immunoassay and LZI Oral Fluid Methadone Enzyme Immunoassay OraSure Amphetamine-Specific Intercept Micro-plate oral fluid EIA

2. Predicate 510(k) number(s):

k050945
k050988
k051058
k992918

3. Comparison with predicate:

| Similarities | | |
| --- | --- | --- |
| Item | Device | Predicate |
| Intended Use | Qualitative detection of amphetamine | Same |
| Assay Type | Enzyme immunoassay | Same |
| Matrix | Oral Fluid | Same |
| Controls | 2 levels | Same |
| Differences | | |
| --- | --- | --- |
| Item | Device | Predicate |
| Cutoff | 45 ng/mL | 100 ng/mL |
| Calibrators | 3 levels | 2 levels |

The LZI predicate devices are similar in assay type, matrix, calibrators and controls. They differ in that they measure different analytes.

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K. Standard/Guidance Document Referenced (if applicable):

None referenced.

L. Test Principle:

The assay is based on competition between drug labeled with glucose-6-phosphate dehydrogenase (G6PDH) enzyme and free drug from the saliva sample for a fixed amount of specific antibody. In the absence of free drug from the sample the antibody binds to the drug labeled G6PDH enzyme thus decreasing the enzymatic activity of the G6PDH. The G6PDH activity is measured spectrophotometrically at 340 nm because of conversion of NAD to NADH.

M. Performance Characteristics (if/when applicable):

1. Analytical performance:

a. Precision/Reproducibility:

Precision studies were performed by using the negative, cutoff and high calibrators and two levels of controls. Testing was performed in replicates of 6, twice a day for 10 days for all concentrations. The within-run % CV ranged from 0.46 to 0.63% and the Total precision % CV ranged from 0.70 to 1.02%.

The recovery study showed that the assay correctly identified spiked samples at approximately 50% above the cutoff as positive and at approximately 50% below the cutoff as negative.

b. Linearity/assay reportable range:

Not applicable. This is a qualitative assay.

c. Traceability, Stability, Expected values (controls, calibrators, or methods):

A commercially available standard solution is made into a secondary (lower concentration) stock solution. The secondary stock solution is then spiked into the calibrators and controls to the desired concentration. The concentrations are confirmed by GC/MS.

Stability Studies:

Real time and accelerated studies have been conducted. Protocols and acceptance criteria were described and found to be acceptable. The manufacturer claims the following expiration date:

When stored at 2-8 °C product is good until expiration date which is 18 months.

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Stability of amphetamine in the Salivette collection device was determined by taking a pool of negative oral fluid samples spiked at three different concentrations and split into three hundred and thirty-three samples. On day 1, samples were run to determine the baseline that subsequent runs were compared to. Of the remaining 100 samples for each concentration half were stored at 2-8 °C and the other half were stored frozen -20 °C. The study was conducted over 22 days and samples were run on days 1, 2, 8, 12, 15 and 22. The sample is stable for 21 days when stored at refrigerator 2-8 °C or frozen -20 °C.

d. Detection limit:

See the Precision/Reproducibility section above for performance around the stated cutoff concentration.

e. Analytical specificity:

Various potentially interfering substances were evaluated to determine whether they interfere with assay results. Test compounds were spiked into the drug-free calibrator to various concentrations and evaluated against the cutoff calibrator. The labeling lists the concentration of each compound that gave a response approximately equal to that of the cutoff calibrator (as positive) or the maximal concentration of compound tested that remained negative. The only compound that was seen to significantly cross-react was MDA (see below).

| Compound | ng/mL Positive |
| --- | --- |
| d-amphetamine | 30 |
| MDA | 85 |
| PMA | 300 |

f. Assay cut-off:

The stated cutoff of this assay, which includes the dilution of the sample with the Salivette collection device, is 45 ng/mL. Characterization of how the device performs analytically around the claimed cutoff concentration appears in the precision/reproducibility section above.

2. Comparison studies:

a. Method comparison with predicate device:

One hundred and twelve clinical oral fluid specimens were collected. The oral fluid specimens were tested with LZI Oral Fluid Amphetamine-Specific Enzyme Immunoassay and compared to a Gas Chromatography/ Mass Spectrophotometer (GC/MS).

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Results from the study are presented below. The table describes the agreement between the device and the GC/MS.

| | GC/MS | | |
| --- | --- | --- | --- |
| | | Positive | Negative |
| LZI EIA | Positive | 56 | 2* |
| | Negative | 1** | 44 |

*Two samples contain less than 45 ng/mL of amphetamine

**One sample contains amphetamine of 45 ng/mL

% Agreement = 97.1%

b. Matrix comparison:

Not applicable. This device is intended for use with only one matrix.

3. Clinical studies:

a. Clinical Sensitivity:

Not applicable

b. Clinical specificity:

Not applicable

c. Other clinical supportive data (when a. and b. are not applicable):

Not applicable

4. Clinical cut-off:

Not applicable

5. Expected values/Reference range:

Not applicable

N. Proposed Labeling:

The labeling is sufficient and it satisfies the requirements of 21 CFR Part 809.10.

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O. Conclusion:

The submitted information in this premarket notification is complete and supports a substantial equivalence decision.

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