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510(k) Data Aggregation

    K Number
    K212451
    Device Name
    Surgical Mask
    Manufacturer
    Date Cleared
    2021-09-10

    (36 days)

    Product Code
    Regulation Number
    878.4040
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Disposable Surgical Face Masks are intended to be worn to protect both the patient and healthcare personnel from transfer of microorganisms, body fluids and particulate material. These face masks are intended for use in infection control practices to reduce the potential exposure to blood and body fluids. This is a single use, disposable device provided nonsterile.

    Device Description

    The surgical face masks are non-sterile, single use, 3 layers, flat-pleated style with ear loops and nose piece. The outer layer and inner facing layer of face mask consists of Spunbond Polypropylene, and the middle layer consists of Melt Blown Polypropylene Filter. Each mask contains ear loops to secure the mask over the user's face and mouth with a nose piece to firmly fit over the nose. This device is not made from any natural rubber latex.

    AI/ML Overview

    The provided text is for a 510(k) summary for a "Surgical Mask" and details a series of non-clinical (benchtop) performance tests and biocompatibility tests. It does not describe a study involving human readers or AI assistance. Therefore, some of the requested information regarding human-in-the-loop performance, multi-reader multi-case studies, and expert qualifications is not applicable.

    Here's the breakdown of the acceptance criteria and performance data for the Surgical Mask:

    1. Table of Acceptance Criteria and Reported Device Performance

    ItemPurposeAcceptance CriteriaReported Device Performance
    Benchtop Performance Testing
    Resistance to Penetration by Synthetic Blood (ASTM F1862)To demonstrate the Resistance to Penetration by Synthetic Blood ASTM F1862 of the subject device.29 out of 32 pass at 160 mmHgThree non-sequential lots of 32 (total of 96, AQL 4.0) passed at 160mmHg. Lot 1: 32/32 passed. Lot 2: 32/32 passed. Lot 3: 32/32 passed.
    Particulate Filtration Efficiency (ASTM F2299)To demonstrate the Particulate Filtration Efficiency ASTM F2299 of the subject device.≥ 98%Three non-sequential lots of 32 (total of 96, AQL 4.0) passed at ≥98%. Lot 1: 32/32 passed. Lot 2: 32/32 passed. Lot 3: 32/32 passed.
    Bacterial Filtration Efficiency (ASTM F2101)To demonstrate the Bacterial Filtration Efficiency ASTM F2101 of the subject device.≥ 98%Three non-sequential lots of 32 (total of 96, AQL 4.0) passed at ≥98%. Lot 1: 32/32 passed. Lot 2: 32/32 passed. Lot 3: 32/32 passed.
    Differential Pressure (EN 14683:2019)To demonstrate the Differential Pressure EN 14683:2019 of the subject device.< 6.0 mmH2O/cm²Three non-sequential lots of 32 (total of 96, AQL 4.0) passed at <6.0 H2O/cm². Lot 1: 32/32 passed. Lot 2: 32/32 passed. Lot 3: 32/32 passed.
    Flammability (16 CFR 1610)To demonstrate the Flammability 16 CFR 1610 of the subject device.Class 1: < 3.5 second burn timeThree non-sequential lots of 32 (total of 96, AQL 4.0) passed Class 1 16 CFR 1610. Lot 1: 32/32 passed (DNI). Lot 2: 32/32 passed (DNI). Lot 3: 32/32 passed (DNI).
    Biocompatibility Testing (ISO 10993-1:2018)
    Cytotoxicity - ISO 10993-5Non-CytotoxicPass
    Skin Sensitization - ISO 10993-10Non- SensitizingPass
    Skin Irritation - ISO 10993-10Non-IrritatingPass

    2. Sample size used for the test set and the data provenance

    For each of the benchtop performance tests, the sample size was 96 devices, consisting of three non-sequential lots of 32 devices each. The data provenance is not specified beyond being "non-clinical performance testing" and conforming to specified standards, which typically implies laboratory testing. The country of origin of the data is not mentioned, and it is by nature prospective testing for the purpose of regulatory submission.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

    Not applicable. The tests are benchtop performance tests on physical devices, not image analysis or diagnostic studies requiring expert review for ground truth establishment.

    4. Adjudication method for the test set

    Not applicable. The tests are objective measurements against defined standards, not requiring adjudication of subjective interpretations.

    5. If a multi reader multi case (MRMC) comparative effectiveness study was done, if so, what was the effect size of how much human readers improve with AI vs without AI assistance

    Not applicable. This submission is for a physical medical device (surgical mask), not an AI-powered diagnostic tool. No human reader or AI assistance studies were conducted or are relevant.

    6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

    Not applicable. This is not an AI algorithm.

    7. The type of ground truth used

    For the benchtop physical performance tests, the "ground truth" is defined by the objective measurement standards outlined in the listed ASTM and EN standards (e.g., specific thresholds for particulate filtration efficiency, bacterial filtration efficiency, differential pressure, synthetic blood penetration, and flammability). For biocompatibility, the "ground truth" is based on the results of validated biological tests against the criteria of ISO 10993.

    8. The sample size for the training set

    Not applicable. This is for a physical device, not a machine learning model.

    9. How the ground truth for the training set was established

    Not applicable. This is for a physical device, not a machine learning model.

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