← Product Code [GGN](/submissions/HE/subpart-f%E2%80%94automated-and-semi-automated-hematology-devices/GGN) · K103314

# CLOTRAC HEPARINASE TEST CARTIDGE (HTC) COAGULATION CONTROL (K103314)

_Medtronic, Inc. · GGN · Dec 3, 2010 · Hematology · SESE_

**Canonical URL:** https://fda.innolitics.com/submissions/HE/subpart-f%E2%80%94automated-and-semi-automated-hematology-devices/GGN/K103314

## Device Facts

- **Applicant:** Medtronic, Inc.
- **Product Code:** [GGN](/submissions/HE/subpart-f%E2%80%94automated-and-semi-automated-hematology-devices/GGN.md)
- **Decision Date:** Dec 3, 2010
- **Decision:** SESE
- **Submission Type:** Special
- **Regulation:** 21 CFR 864.5425
- **Device Class:** Class 2
- **Review Panel:** Hematology

## Indications for Use

The CLOTtrac® Heparinase Test Cartridge (HTC) Coagulation Control is used to verify the performance of the ACT instrument and the Heparinase (HR-HTC) cartridges. For In Vitro Diagnostic Use.

## Device Story

The CLOTtrac® Heparinase Test Cartridge (HTC) Coagulation Control is an in vitro diagnostic device used to verify the performance of ACT instruments and Heparinase (HR-HTC) cartridges. The device contains porcine-derived USP heparin. It is used by healthcare professionals in clinical settings to ensure the accuracy and reliability of coagulation testing equipment. The device does not perform automated analysis itself but serves as a quality control standard to validate the operational integrity of the associated testing system, thereby supporting clinical decision-making regarding patient anticoagulation status.

## Clinical Evidence

No clinical data. Bench testing only.

## Technological Characteristics

In vitro diagnostic control containing porcine-derived USP heparin. The device functions as a quality control standard for ACT instruments and Heparinase cartridges. No software or complex electronic sensing components are described; the device is a chemical control reagent.

## Regulatory Identification

A multipurpose system for in vitro coagulation studies is a device consisting of one automated or semiautomated instrument and its associated reagents and controls. The system is used to perform a series of coagulation studies and coagulation factor assays.

## Special Controls

*Classification.* Class II (special controls). A control intended for use with a multipurpose system for in vitro coagulation studies is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 864.9.

## Predicate Devices

- CLOTtrac® Heparinase Test Cartridge (HTC) Coagulation Control ([K042175](/device/K042175.md))

## Submission Summary (Full Text)

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SPECIAL 510(k): Device Modification

Review Memorandum

To: THE FILE

RE: DOCUMENT NUMBER K103314

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:

1. CLOTtrac® HTC Coagulation Control, k042175; previously cleared device.
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 (labeling changes are permitted as long as they do not affect the intended use). (see section 2 and Appendices A and B).
3. A description of the device modification, including clearly labeled diagrams, engineering drawings, photographs, user's and/or service manuals in sufficient detail to demonstrate that the fundamental technology of the modified device has not changed.

This change was for the modification of the current control is to replace old USP heparin with revised USP heparin based on revision of the heparin sodium monograph. The source of the heparin remains as porcine.

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

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. (see section 8)
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. (see section 8 and Appendix D)
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, (see section 9)
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. (see section 9)

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), (listed respectively under sections 11, 6, and 2).

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/HE/subpart-f%E2%80%94automated-and-semi-automated-hematology-devices/GGN/K103314](https://fda.innolitics.com/submissions/HE/subpart-f%E2%80%94automated-and-semi-automated-hematology-devices/GGN/K103314)

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