§ 864.1870 Early growth response 1 (EGR1) gene fluorescence in-situ hybridization (FISH) test system for specimen characterization.

(a) Identification. An early growth response 1 (EGR1) gene fluorescence in-situ hybridization (FISH) test system for specimen characterization is a device intended to detect the EGR1 probe target on chromosome 5q in bone marrow specimens from patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). The assay results are intended to be interpreted only by a qualified pathologist or cytogeneticist. These devices do not include automated systems that directly report results without review and interpretation by a qualified pathologist or cytogeneticist. These devices also do not include any device intended for use to select patient therapy, predict patient response to therapy, or to screen for disease as well as any device with a claim for a particular diagnosis, prognosis, monitoring, or risk assessment. (b) Classification. Class II (special controls). The special controls for this device are: (1) Premarket notification submissions must also include the following information: (i) A detailed description of all probes included in the kit; (ii) Purpose of each probe; (iii) Probe molecular specificity; (iv) Probe specificity; (v) Probe limits; (vi) Probe sensitivity; (vii) Specification of required ancillary reagents, instrumentation, and equipment; (viii) Specification of the specimen collection, processing, storage and slide preparation methods; (ix) Specification of the assay procedure; (x) Specification of control elements that are incorporated into the recommended testing procedures; (xi) Specification of risk mitigation elements: Description of all additional procedures, methods, and practices incorporated into the directions for use that mitigate risks associated with testing; (xii) Specification of the criteria for test result interpretation and reporting; (xiii) Device analytical sensitivity data; (xiv) Device analytical specificity data; (xv) Device reference limit data; (xvi) Device precision/reproducibility data; (xvii) Device stability data to include: (A) Real-time stability, (B) Freeze-thaw stability, (C) Transport and temperature stability, (D) Post-hybridization signal stability, (E) Photostability of probe, and (xviii) Documentation that demonstrates the clinical validity of the device. The documentation must include data from clinical studies, a minimum of two peer-reviewed published literature references using the specific device seeking marketing clearance, or both. Documentation for the clinical studies and peer-reviewed published literature references cited must include the following elements: (A) Documentation that the sponsor's probe was used in the literature reference, (B) Number and type of specimens, (C) Target population studied, (D) Upper reference limit, and (E) Range of positive probe results. (2) Your § 809.10(b)(12) of this chapter compliant labeling must include a statement summarizing the data identified in paragraphs (b)(1)(xiii) through (xviii) of this section and a description of the studies supporting the information, including the pre-specified acceptance criteria for these performance studies, justification for the pre-specified acceptance criteria, and whether the pre-specified acceptance criteria were met. (3) Your § 809.10 of this chapter compliant labeling must include: (i) A warning that reads “The assay results are intended to be interpreted only by a qualified pathologist or cytogeneticist.” (ii) A warning that reads “This device is not for high-risk uses such as selecting therapy, predicting therapeutic response or disease screening.” (iii) A warning that reads “The use of this device for diagnosis, monitoring or risk assessment has not been established.”