K972406 · Immunoprobe, Inc. · GOD · Dec 22, 1997 · Microbiology
Device Facts
Record ID
K972406
Device Name
ADENOVIRUS ANTIGEN DETECTION ELISA TEST SYSTEM
Applicant
Immunoprobe, Inc.
Product Code
GOD · Microbiology
Decision Date
Dec 22, 1997
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 866.3020
Device Class
Class 1
Attributes
Real-World Evidence, Pediatric
Real-World Evidence
Submission
Device
Sponsor
RWD Sources
RWE Use Summary
Key Tags
K972406 · Dec 22, 1997
ADENOVIRUS ANTIGEN DETECTION ELISA TEST SYSTEM
Immunoprobe, Inc.
Retrospective frozen fecal specimens from a University Virus Reference Laboratory; Retrospective frozen fecal specimens from a public health laboratory
Retrospective clinical samples were used to evaluate the sensitivity and specificity of the Adenovirus Antigen Detection ELISA compared to cell culture isolation and an alternate commercial EIA.
Retrospective clinical specimens; Diagnostic performance; Sensitivity and specificity
Clinical Evidence
Study Design
Population
Comparator
Key Endpoints
Retrospective comparative study
120 patients (90% adults) providing fecal specimens for routine testing; Sample Size: 120; Number of Sites: 1
Cell culture isolation
Sensitivity and specificity
Retrospective comparative study
481 patients (57% < 5 years old, 43% > 5 years old); Sample Size: 481; Number of Sites: 1
Alternate commercially available adenovirus EIA
Sensitivity and specificity
Indications for Use
The Adenovirus Antigen Detection ELISA Test System is an Enzyme-Linked Immunosorbent Assay (ELISA) for the qualitative determination of Adenovirus antigen in human fecal samples as an aid in the diagnosis of acute nonbacterial gastro-enteritis. Performance for this assay has not been established on children over the age of five and immunocompromised patients. The antibody utilized in this assay is a group specific antigen and cannot differentiate between types of adenovirus. Performance of this assay has not been established for specimens other than human feces.
Device Story
The Adenovirus Antigen Detection ELISA is an in vitro diagnostic test for human fecal samples. It utilizes a solid-phase microtiter well coated with purified monoclonal antibodies specific to adenovirus. The process involves adding a diluted fecal sample to the well; if adenovirus antigen is present, it binds to the monoclonal antibody. After washing, an enzyme-labeled anti-adenovirus polyclonal antibody conjugate is added, which binds to the captured antigen. A substrate solution is then added, causing a color change if the enzyme is present. The reaction is stopped, and color intensity is measured photometrically. This provides an indirect measurement of the antigen in the specimen. The test is performed in a laboratory setting by trained personnel. Results assist clinicians in diagnosing acute non-bacterial gastro-enteritis. The device benefits patients by providing a rapid, specific diagnostic tool for identifying adenovirus as the cause of gastrointestinal symptoms.
Clinical Evidence
Two clinical studies were conducted. Study 1 compared the device to cell culture isolation using 120 retrospective frozen fecal specimens (90% adults); results showed 100% sensitivity (95% CI: 96.0-100.0%) and 95.4% specificity (95% CI: 88.9-100.0%). Study 2 compared the device to an alternate commercial EIA using 481 retrospective frozen fecal specimens (57% <5 years old); results showed 88.13% sensitivity (95% CI: 83.01-93.24%) and 96.42% specificity (95% CI: 94.30-98.54%). Precision was evaluated using NCCLS EP5 methods across three sites with 216 determinations, showing no false positives or negatives.
Technological Characteristics
Enzyme-Linked Immunosorbent Assay (ELISA) using purified monoclonal antibody (solid phase) and enzyme-labeled polyclonal antibody (conjugate). Photometric measurement of color intensity. In vitro diagnostic kit format.
Indications for Use
Indicated for qualitative detection of Adenovirus antigen in human fecal samples to aid in diagnosis of acute non-bacterial gastro-enteritis. Not established for children >5 years or immunocompromised patients. Not for use with specimens other than human feces.
Regulatory Classification
Identification
Adenovirus serological reagents are devices that consist of antigens and antisera used in serological tests to identify antibodies to adenovirus in serum. Additionally, some of these reagents consist of adenovirus antisera conjugated with a fluorescent dye and are used to identify adenoviruses directly from clinical specimens. The identification aids in the diagnosis of disease caused by adenoviruses and provides epidemiological information on these diseases. Adenovirus infections may cause pharyngitis (inflammation of the throat), acute respiratory diseases, and certain external diseases of the eye (e.g., conjunctivitis).
Submission Summary (Full Text)
{0}------------------------------------------------
## 510(k) Summary Adenovirus Antigen Detection ELISA Test Kit
KA72406
DEC 2 4 1997
I. Trinity Biotech plc. Three Rocks Road Sandyford Industrial Estate Dublin 18, Ireland Contact person: Sinead Flynn Telephone: 011-353-1-295-5111 Date of preparation: June 23, 1997
#### II. Description of Device
The Adenovirus Antigen Detection ELISA Test System is an Enzyme-Linked Immunosorbent Assay (ELISA) for the qualitative determination of Adenovirus antigen in human fecal samples as an aid in the diagnosis of acute non-bacterial gastro-enteritis. Performance for this assay has not been established on children over the age of five and immunocompromised patients. The antibody utilized in this assay is a group specific antigen and cannot differentiate between types of adenovirus. Performance of this assay has not been established for specimens other than human feces. For in vitro diagnostic use only.
The Adenovirus Antigen Detection ELISA test is an enzyme linked immunosorbent assay to detect adenovirus antigen in fecal samples. Purified monoclonal antibody specific to adenovirus is attached to a solid phase microtiter well. Diluted fecal sample is added to each well. If the adenovirus antigen is present, it will bind to the monoclonal antibody in the well. After incubation the wells are washed to remove unbound antigen. An enzyme labeled anti-adenovirus polyclonal antibody is added to each well. If antigen is present the conjugate antibody will bind to the antigen attached to the antibody on the well. After incubation the wells are washed to remove unbound conjugate. A substrate solution is added to each well. If enzyme is present the substrate will undergo a color change. After an incubation period the reaction is stopped and the color intensity is measured photometrically, producing an indirect measurement of specific antibody in the patient specimen.
#### III. Predicate Device
The Adenovirus Antigen Detection ELISA test is substantially equivalent to cell culture of adenovirus from fecal samples. Equivalence is demonstrated by the following comparative results:
{1}------------------------------------------------
# Performance Characteristics
1. Relative sensitivity and specificity. One hundred and twenty retrospective frozen fecal specimens sent to a University Virus Reference Laboratory in Ireland for routine testing were tested with the Trinity Adenovirus Antigen detection ELISA and by cell culture isolation. 90% of the specimens were from adults. The samples were approximately 50% solid, and 50% liquid. The data in Table 1 illustrates good sensitivity and specificity of the Adenovirus Antigen Detection ELISA relative to cell culture isolation.
## Table 1 Adenovirus Antigen Detection ELISA Sensitivity & Specificity Relative to Cell Culture Study 1
### Wampole Adenovirus Antigen Detection ELISA
| | + | E | - | Total |
|-----------------|----|---|----|-------|
| Cell<br>Culture | 75 | 2 | 0 | 77 |
| - | 2 | 0 | 41 | 43 |
| Total | 77 | 2 | 41 | 120 |
Equivocals are not included in the following calculations:
| Sensitivity = 75/75 = 100.0% | 95% Confidence Interval = 96.0-100.0%* |
|------------------------------|----------------------------------------|
| Specificity = 41/43 = 95.4% | 95% Confidence Interval = 88.9-100.0% |
| Agreement = 116/118 = 98.3% | 95% confidence Interval = 95.9-100.0% |
The 95% confidence intervals were calculated using the regular method. * The 95% confidence interval was calculated assuming one false negative.
Note: The positive cultures were identified by cytopathic effect (CPE) and confirmed by electron microscopy (EM) using a standard negative staining technique, which is considered presumptive for adenovirus types 40 and 41 when using fecal samples.
{2}------------------------------------------------
Four hundred eighty one sera were tested on the Adenovirus Antigen Detection ELISA and an alternate commercially available adenovirus EIA at a large public health lab in the UK. 57% of the samples were from patients less than 5 years old and 43 % were from patients greater than five years old. All were retrospective frozen fecal specimens with half being solid and half liquid. After retesting discrepants, the remaining descrepants were tested by EM. The data in Table 2 illustrates good sensitivity and specificity of the Adenovirus Antigen Detection ELISA relative to an alternate commercially available EIA.
### Table 2 Adenovirus Antigen Detection ELISA Sensitivity & Specificity Relative to an Alternate adenovirus EIA Study 2
### Wampole Adenovirus Antigen Detection ELISA
| | + | E | - | Total | |
|--------------------|-------|-----|----|-------|-----|
| Alternate<br>ELISA | + | 141 | 8 | 19 | 168 |
| | - | 11 | 6 | 296 | 313 |
| | Total | 152 | 14 | 315 | 481 |
Equivocals are not included in the following calculations:
| Sensitivity = 141/160 = 88.13% | 95% Confidence Interval = 83.01 - 93.24% |
|--------------------------------|------------------------------------------|
| Specificity = 296/307 = 96.42% | 95% Confidence Interval = 94.30 - 98.54% |
| Agreement = 437/467 = 93.58% | 95% confidence Interval = 91.31 - 95.85% |
The 95% confidence intervals were calculated using the normal method.
After retesting discordant samples on the Wampole Adenovirus Antigen Detection ELISA, 15 samples remained discordant and were tested by Electron Microscopy (EM). Eight of the 15 discordants were false negatives and two were false positives versus EM.
Please be advised that 'relative' refers to the comparison of this assay's results to that of a similar assay. There was not an attempt to correlate the assay's results with disease presence or absence. No judgment can be made on the comparison assay's accuracy to predict disease.
{3}------------------------------------------------
2. Limit of Detection. Plaque assays were carried out in HEK-293 cells on fecal clinical samples of 2. Limit of Detection. Plaque assays were carrict our in rial played online milliliter
containing Adenovirus 40 and Adenovirus 41. The number of plaqued and assaved on the containing Adenovirus 40 and Adenovitus +1. The names. Wy diluted and assayed on the (PFU/mL) was established for each specificit with was found to be 125 PFU for Adenovirus 40 and 39 PFU for Adenovirus 41.
| Limits of Detection: Enteric Adenoviruses | | | | | |
|-------------------------------------------|--------|----------------|------------------------------------|--------|----------------|
| Adenovirus 40: 2 X $10^4$ PFU/mL | | | Adenovirus 41: 2.5 X $10^3$ PFU/mL | | |
| Dilution | OD | PFU/100ul | Dilution | OD | PFU/100ul |
| Neat | 0.521 | 2 X $10^3$ | Neat | 0.259 | 2.5 X $10^2$ |
| 1/8 | 0.385 | 0.25 X $10^3$ | 1/8 | 0.161 | 0.312 X $10^2$ |
| 1/16 | 0.201* | 0.125 X $10^3$ | 1/16 | 0.271 | 0.156 X $10^2$ |
| 1/32 | 0.165 | 0.062 X $10^3$ | 1/32 | 0.201 | 0.078 X $10^2$ |
| 1/64 | 0.063 | 0.031 X $10^3$ | 1/64 | 0.183* | 0.039 X $10^2$ |
| 1/128 | 0.061 | 0.015 X $10^3$ | 1/128 | 0.126 | 0.019 X $10^2$ |
| 1/256 | 0.053 | 0.007 X $10^3$ | 1/256 | 0.092 | 0.009 X $10^2$ |
| 1/512 | 0.121 | 0.003 X $10^3$ | 1/512 | 0.063 | 0.004 X $10^2$ |
| 1/1024 | 0.041 | 0.001 X $10^3$ | 1/1024 | 0.065 | 0.002 X $10^2$ |
| 1/2048 | - | | 1/2048 | 0.052 | 0.001 X $10^2$ |
*Limit of Detection
{4}------------------------------------------------
3. Precision. Six samples containing Type 2 adenovirus from cell culture and the positive and negative controls were each run in triplicate on three consecutive days at three different sites. The results are shown below in Table 3.
Table 3
| Adenovirus Antigen Detection ELISA Inter Assay Precision Between Sites | | | | |
|------------------------------------------------------------------------|-------|-------|-------|----|
| Inter-Assay (n=27) | | | | |
| # | X | SD | CV | n |
| 1. | 1.558 | 0.091 | 5.87% | 27 |
| 2. | 1.275 | 0.051 | 4.01% | 27 |
| 3. | 0.501 | 0.018 | 3.65% | 27 |
| 4. | 0.435 | 0.016 | 3.78% | 27 |
| 5. | 0.295 | 0.012 | 4.12% | 27 |
| 6. | 0.054 | 0.005 | 9.22% | 27 |
| PC | 1.211 | 0.051 | 4.23% | 27 |
| NC | 0.050 | 0.003 | 6.11% | 27 |
A total of 216 determinations were made at the three sites. In all 216 determinations there was not a case a positive result for a negative sample or a negative result for a positive sample.
X = Mean O.D. SD = standard deviation CV = coefficient of variation = SD/X x 100
The methods in NCCLS EP5 were utilized for precision parameters.
12
{5}------------------------------------------------
# 4. Cross-Reactivity.
The following common intestinal pathogens and other organisms occasionally found in feces were The tonewing common antigen detection kit. Specimens from the bacteria panel contained 3 X 10 particles per mL. The Chlamydia trachomatis L2 strain contained 1 X 106 inclusion forming units per ml. With the exception of Norwalk virus and Hepatitis A virus, all the viruses included in the panel were cell culture isolates which were passaged at least once. The titers of the viruses were unknown. The Norwalk virus was obtained from a vomitus sample shown to be positive by immune electron microscopy. The Hepatitis A sample was obtained from a hepatitis A specific immunoglobulin assay kit. The organisms were spiked with Type 2 adenovirus from cell culture harvests (titer unknown).
### Bacteria Panel
| Bacteria Panel | | |
|---------------------------------|----------------|-------------------------|
| | Organism alone | Organism and Adenovirus |
| Haemophilus influenza | 0.025 | 0.605 |
| Actinobacter spp. | 0.022 | 0.595 |
| Bacillus spp. | 0.017 | 0.554 |
| Shigella sunnei | 0.021 | 0.489 |
| Neisseria meningitiidis | 0.032 | 0.582 |
| Pseudomonas aeruginosa | 0.043 | 0.519 |
| Candida albicans | 0.022 | 0.441 |
| Campylobacter spp. | 0.029 | 0.489 |
| Clostridium welchii | 0.041 | 0.475 |
| Escherichia coli | 0.023 | 0.534 |
| Aeromonas spp. | 0.022 | 0.548 |
| Salmonella spp. | 0.037 | 0.526 |
| Gardinella spp. | 0.031 | 0.628 |
| Klebsiella pneumoniae | 0.026 | 0.497 |
| Staphylococcus aureus (Cowan) | 0.028 | 0.483 |
| Streptococcus pneumoniae | 0.035 | 0.440 |
| Streptococcus group G | 0.029 | 0.486 |
| Streptococcus group F | 0.034 | 0.573 |
| Streptococcus group A | 0.035 | 0.495 |
| Chlamydia trachomatis L2 strain | 0.026 | 0.562 |
{6}------------------------------------------------
:
:
-
# Viral Panel
| Varicella Zoster virus | 0.022 | 0.655 |
|------------------------|-------|-------|
| Herpes Simplex type 1 | 0.026 | 0.770 |
| Herpes Simplex type 2 | 0.027 | 0.653 |
| Cytomegalovirus | 0.018 | 0.762 |
| Epstein-Barr virus | 0.038 | 0.837 |
| Rhinovirus | 0.021 | 0.827 |
| Poliovirus 1 | 0.022 | 0.655 |
| Poliovirus 2 | 0.025 | 0.689 |
| Poliovirus 3 | 0.035 | 0.741 |
| Coxsackievirus B5 | 0.032 | 0.602 |
| Coxsackievirus B4 | 0.028 | 0.676 |
| Echovirus 7 | 0.042 | 0.592 |
| Echovirus 20 | 0.035 | 0.681 |
| RS virus | 0.023 | 0.786 |
| Parainfluenza virus 1 | 0.029 | 0.666 |
| Parainfluenza virus 2 | 0.023 | 0.833 |
| Parainfluenza virus 3 | 0.032 | 0.846 |
| Influenza A virus | 0.026 | 0.553 |
| Influenza B virus | 0.022 | 0.694 |
| Hepatitis A virus | 0.033 | 0.764 |
| Rotavirus | 0.022 | 0.712 |
| Norwalk virus | 0.031 | 0.654 |
- - -
{7}------------------------------------------------
Image /page/7/Picture/1 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 with its wings spread, symbolizing the department's mission to protect the health of all Americans.
Food and Drug Administration 2098 Gaither Road Rockville MD 20850
DEC 2 2 1997
William L. Boteler, Jr. President Immuno Probe, Inc. 1306F Bailes Lane Frederick, Maryland 21701
Re: K972406
> Trade Name: Adenovirus Antigen Detection ELISA Test System Regulatory Class: I Product Code: GOD Dated: October 3, 1997 Received: October 6, 1997
Dear Mr. Boteler:
We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). 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 (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.
{8}------------------------------------------------
### Page 2
Under the Clinical Laboratory Improvement Amendments of 1988 (CLIA-88), this device may require a CLIA complexity categorization. To determine if it does, you should contact the Centers for Disease Control and Prevention (CDC) at (770)488-7655.
This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4588. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll free number (800) 638-2041 or at (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html"
Sincerely yours.
Steven Autman
Steven I. Gutman, M.D., M.B.A. Director Division of Clinical Laboratory Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
{9}------------------------------------------------
## 510(k) Summary Adenovirus Antigen Detection ELISA Test Kit
KA72406
DEC 2 4 1997
I. Trinity Biotech plc. Three Rocks Road Sandyford Industrial Estate Dublin 18, Ireland Contact person: Sinead Flynn Telephone: 011-353-1-295-5111 Date of preparation: June 23, 1997
#### II. Description of Device
The Adenovirus Antigen Detection ELISA Test System is an Enzyme-Linked Immunosorbent Assay (ELISA) for the qualitative determination of Adenovirus antigen in human fecal samples as an aid in the diagnosis of acute non-bacterial gastro-enteritis. Performance for this assay has not been established on children over the age of five and immunocompromised patients. The antibody utilized in this assay is a group specific antigen and cannot differentiate between types of adenovirus. Performance of this assay has not been established for specimens other than human feces. For in vitro diagnostic use only.
The Adenovirus Antigen Detection ELISA test is an enzyme linked immunosorbent assay to detect adenovirus antigen in fecal samples. Purified monoclonal antibody specific to adenovirus is attached to a solid phase microtiter well. Diluted fecal sample is added to each well. If the adenovirus antigen is present, it will bind to the monoclonal antibody in the well. After incubation the wells are washed to remove unbound antigen. An enzyme labeled anti-adenovirus polyclonal antibody is added to each well. If antigen is present the conjugate antibody will bind to the antigen attached to the antibody on the well. After incubation the wells are washed to remove unbound conjugate. A substrate solution is added to each well. If enzyme is present the substrate will undergo a color change. After an incubation period the reaction is stopped and the color intensity is measured photometrically, producing an indirect measurement of specific antibody in the patient specimen.
#### III. Predicate Device
The Adenovirus Antigen Detection ELISA test is substantially equivalent to cell culture of adenovirus from fecal samples. Equivalence is demonstrated by the following comparative results:
{10}------------------------------------------------
# Performance Characteristics
1. Relative sensitivity and specificity. One hundred and twenty retrospective frozen fecal specimens sent to a University Virus Reference Laboratory in Ireland for routine testing were tested with the Trinity Adenovirus Antigen detection ELISA and by cell culture isolation. 90% of the specimens were from adults. The samples were approximately 50% solid, and 50% liquid. The data in Table 1 illustrates good sensitivity and specificity of the Adenovirus Antigen Detection ELISA relative to cell culture isolation.
## Table 1 Adenovirus Antigen Detection ELISA Sensitivity & Specificity Relative to Cell Culture Study 1
### Wampole Adenovirus Antigen Detection ELISA
| | + | E | - | Total |
|-----------------|----|---|----|-------|
| Cell<br>Culture | 75 | 2 | 0 | 77 |
| - | 2 | 0 | 41 | 43 |
| Total | 77 | 2 | 41 | 120 |
Equivocals are not included in the following calculations:
| Sensitivity = 75/75 = 100.0% | 95% Confidence Interval = 96.0-100.0%* |
|------------------------------|----------------------------------------|
| Specificity = 41/43 = 95.4% | 95% Confidence Interval = 88.9-100.0% |
| Agreement = 116/118 = 98.3% | 95% confidence Interval = 95.9-100.0% |
The 95% confidence intervals were calculated using the regular method. * The 95% confidence interval was calculated assuming one false negative.
Note: The positive cultures were identified by cytopathic effect (CPE) and confirmed by electron microscopy (EM) using a standard negative staining technique, which is considered presumptive for adenovirus types 40 and 41 when using fecal samples.
{11}------------------------------------------------
Four hundred eighty one sera were tested on the Adenovirus Antigen Detection ELISA and an alternate commercially available adenovirus EIA at a large public health lab in the UK. 57% of the samples were from patients less than 5 years old and 43 % were from patients greater than five years old. All were retrospective frozen fecal specimens with half being solid and half liquid. After retesting discrepants, the remaining descrepants were tested by EM. The data in Table 2 illustrates good sensitivity and specificity of the Adenovirus Antigen Detection ELISA relative to an alternate commercially available EIA.
### Table 2 Adenovirus Antigen Detection ELISA Sensitivity & Specificity Relative to an Alternate adenovirus EIA Study 2
### Wampole Adenovirus Antigen Detection ELISA
| | + | E | - | Total | |
|--------------------|-------|-----|----|-------|-----|
| Alternate<br>ELISA | + | 141 | 8 | 19 | 168 |
| | - | 11 | 6 | 296 | 313 |
| | Total | 152 | 14 | 315 | 481 |
Equivocals are not included in the following calculations:
| Sensitivity = 141/160 = 88.13% | 95% Confidence Interval = 83.01 - 93.24% |
|--------------------------------|------------------------------------------|
| Specificity = 296/307 = 96.42% | 95% Confidence Interval = 94.30 - 98.54% |
| Agreement = 437/467 = 93.58% | 95% confidence Interval = 91.31 - 95.85% |
The 95% confidence intervals were calculated using the normal method.
After retesting discordant samples on the Wampole Adenovirus Antigen Detection ELISA, 15 samples remained discordant and were tested by Electron Microscopy (EM). Eight of the 15 discordants were false negatives and two were false positives versus EM.
Please be advised that 'relative' refers to the comparison of this assay's results to that of a similar assay. There was not an attempt to correlate the assay's results with disease presence or absence. No judgment can be made on the comparison assay's accuracy to predict disease.
{12}------------------------------------------------
2. Limit of Detection. Plaque assays were carried out in HEK-293 cells on fecal clinical samples of 2. Limit of Detection. Plaque assays were carrict our in rial played online milliliter
containing Adenovirus 40 and Adenovirus 41. The number of plaqued and assaved on the containing Adenovirus 40 and Adenovitus +1. The names. Wy diluted and assayed on the (PFU/mL) was established for each specificit with was found to be 125 PFU for Adenovirus 40 and 39 PFU for Adenovirus 41.
| Limits of Detection: Enteric Adenoviruses | | | | | |
|-------------------------------------------|----------------------------------|------------------------------------|----------|--------|----------------|
| | Adenovirus 40: 2 X $10^4$ PFU/mL | Adenovirus 41: 2.5 X $10^3$ PFU/mL | | | |
| Dilution | OD | PFU/100ul | Dilution | OD | PFU/100ul |
| Neat | 0.521 | 2 X $10^3$ | Neat | 0.259 | 2.5 X $10^2$ |
| 1/8 | 0.385 | 0.25 X $10^3$ | 1/8 | 0.161 | 0.312 X $10^2$ |
| 1/16 | 0.201* | 0.125 X $10^3$ | 1/16 | 0.271 | 0.156 X $10^2$ |
| 1/32 | 0.165 | 0.062 X $10^3$ | 1/32 | 0.201 | 0.078 X $10^2$ |
| 1/64 | 0.063 | 0.031 X $10^3$ | 1/64 | 0.183* | 0.039 X $10^2$ |
| 1/128 | 0.061 | 0.015 X $10^3$ | 1/128 | 0.126 | 0.019 X $10^2$ |
| 1/256 | 0.053 | 0.007 X $10^3$ | 1/256 | 0.092 | 0.009 X $10^2$ |
| 1/512 | 0.121 | 0.003 X $10^3$ | 1/512 | 0.063 | 0.004 X $10^2$ |
| 1/1024 | 0.041 | 0.001 X $10^3$ | 1/1024 | 0.065 | 0.002 X $10^2$ |
| 1/2048 | - | | 1/2048 | 0.052 | 0.001 X $10^2$ |
*Limit of Detection
{13}------------------------------------------------
3. Precision. Six samples containing Type 2 adenovirus from cell culture and the positive and negative controls were each run in triplicate on three consecutive days at three different sites. The results are shown below in Table 3.
Table 3
| Adenovirus Antigen Detection ELISA Inter Assay Precision Between Sites | | | | |
|------------------------------------------------------------------------|-------|-------|-------|----|
| Inter-Assay (n=27) | | | | |
| # | X | SD | CV | n |
| 1. | 1.558 | 0.091 | 5.87% | 27 |
| 2. | 1.275 | 0.051 | 4.01% | 27 |
| 3. | 0.501 | 0.018 | 3.65% | 27 |
| 4. | 0.435 | 0.016 | 3.78% | 27 |
| 5. | 0.295 | 0.012 | 4.12% | 27 |
| 6. | 0.054 | 0.005 | 9.22% | 27 |
| PC | 1.211 | 0.051 | 4.23% | 27 |
| NC | 0.050 | 0.003 | 6.11% | 27 |
A total of 216 determinations were made at the three sites. In all 216 determinations there was not a case a positive result for a negative sample or a negative result for a positive sample.
X = Mean O.D. SD = standard deviation CV = coefficient of variation = SD/X x 100
The methods in NCCLS EP5 were utilized for precision parameters.
12
{14}------------------------------------------------
# 4. Cross-Reactivity.
The following common intestinal pathogens and other organisms occasionally found in feces were The tonewing common antigen detection kit. Specimens from the bacteria panel contained 3 X 10 particles per mL. The Chlamydia trachomatis L2 strain contained 1 X 106 inclusion forming units per ml. With the exception of Norwalk virus and Hepatitis A virus, all the viruses included in the panel were cell culture isolates which were passaged at least once. The titers of the viruses were unknown. The Norwalk virus was obtained from a vomitus sample shown to be positive by immune electron microscopy. The Hepatitis A sample was obtained from a hepatitis A specific immunoglobulin assay kit. The organisms were spiked with Type 2 adenovirus from cell culture harvests (titer unknown).
### Bacteria Panel
| Bacteria Panel | | |
|---------------------------------|----------------|-------------------------|
| | Organism alone | Organism and Adenovirus |
| Haemophilus influenza | 0.025 | 0.605 |
| Actinobacter spp. | 0.022 | 0.595 |
| Bacillus spp. | 0.017 | 0.554 |
| Shigella sunnei | 0.021 | 0.489 |
| Neisseria meningitiidis | 0.032 | 0.582 |
| Pseudomonas aeruginosa | 0.043 | 0.519 |
| Candida albicans | 0.022 | 0.441 |
| Campylobacter spp. | 0.029 | 0.489 |
| Clostridium welchii | 0.041 | 0.475 |
| Escherichia coli | 0.023 | 0.534 |
| Aeromonas spp. | 0.022 | 0.548 |
| Salmonella spp. | 0.037 | 0.526 |
| Gardinella spp. | 0.031 | 0.628 |
| Klebsiella pneumoniae | 0.026 | 0.497 |
| Staphylococcus aureus (Cowan) | 0.028 | 0.483 |
| Streptococcus pneumoniae | 0.035 | 0.440 |
| Streptococcus group G | 0.029 | 0.486 |
| Streptococcus group F | 0.034 | 0.573 |
| Streptococcus group A | 0.035 | 0.495 |
| Chlamydia trachomatis L2 strain | 0.026 | 0.562 |
{15}------------------------------------------------
:
:
-
# Viral Panel
| Varicella Zoster virus | 0.022 | 0.655 |
|------------------------|-------|-------|
| Herpes Simplex type 1 | 0.026 | 0.770 |
| Herpes Simplex type 2 | 0.027 | 0.653 |
| Cytomegalovirus | 0.018 | 0.762 |
| Epstein-Barr virus | 0.038 | 0.837 |
| Rhinovirus | 0.021 | 0.827 |
| Poliovirus 1 | 0.022 | 0.655 |
| Poliovirus 2 | 0.025 | 0.689 |
| Poliovirus 3 | 0.035 | 0.741 |
| Coxsackievirus B5 | 0.032 | 0.602 |
| Coxsackievirus B4 | 0.028 | 0.676 |
| Echovirus 7 | 0.042 | 0.592 |
| Echovirus 20 | 0.035 | 0.681 |
| RS virus | 0.023 | 0.786 |
| Parainfluenza virus 1 | 0.029 | 0.666 |
| Parainfluenza virus 2 | 0.023 | 0.833 |
| Parainfluenza virus 3 | 0.032 | 0.846 |
| Influenza A virus | 0.026 | 0.553 |
| Influenza B virus | 0.022 | 0.694 |
| Hepatitis A virus | 0.033 | 0.764 |
| Rotavirus | 0.022 | 0.712 |
| Norwalk virus | 0.031 | 0.654 |
- - -
{16}------------------------------------------------
Image /page/16/Picture/1 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 with its wings spread, symbolizing the department's mission to protect the health of all Americans.
Food and Drug Administration 2098 Gaither Road Rockville MD 20850
DEC 2 2 1997
William L. Boteler, Jr. President Immuno Probe, Inc. 1306F Bailes Lane Frederick, Maryland 21701
Re: K972406
> Trade Name: Adenovirus Antigen Detection ELISA Test System Regulatory Class: I Product Code: GOD Dated: October 3, 1997 Received: October 6, 1997
Dear Mr. Boteler:
We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). 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 (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.
{17}------------------------------------------------
### Page 2
Under the Clinical Laboratory Improvement Amendments of 1988 (CLIA-88), this device may require a CLIA complexity categorization. To determine if it does, you should contact the Centers for Disease Control and Prevention (CDC) at (770)488-7655.
This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4588. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll free number (800) 638-2041 or at (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html"
Sincerely yours.
Steven Autman
Steven I. Gutman, M.D., M.B.A. Director Division of Clinical Laboratory Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
{18}------------------------------------------------
Page 1 of 1
510(k) Number: K972406
Device Name: Adenovirus Antigen Detection ELISA
Indications For Use: The Adenovirus Antigen Detection ELISA Test System is an Enzyme-Linked Immunosorbent Assay (ELISA) for the qualitative determination of Adenovirus antigen in human fecal samples as an aid in the diagnosis of acute nonbacterial gastro-enteritis. Performance for this assay has not been established on children over the age of five and immunocompromised patients. The antibody utilized in this assay is a group specific antigen and cannot differentiate between types of adenovirus. Performance of this assay has not been established for specimens other than human feces.
## PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Prescription Use (Per 21 CFR 801.109)
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OR
Over-The Counter Use (Optional Format 1-2-96)
Sally 1. Selipuk
An J. Teccehied
(Division Sign-Off) Division of Clinical Laboratory Devices
510(k) Number ***_***
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Learn the FDA Browser
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.