K080796 · Sri/Surgical Express · KKX · Nov 17, 2008 · General, Plastic Surgery
Device Facts
Record ID
K080796
Device Name
SRI LP DRAPE
Applicant
Sri/Surgical Express
Product Code
KKX · General, Plastic Surgery
Decision Date
Nov 17, 2008
Decision
SESE
Submission Type
Abbreviated
Regulation
21 CFR 878.4370
Device Class
Class 2
Intended Use
The SRI/Surgical Express SRI LP Drapes are reusable drapes, including back table covers (model numbers 1616, 1822, 3010, 3015, 3020, 3025, 3030, and 6113), mayo stand covers (model numbers 1247C, 3000, 30004, 3006, and 6247A), and drape sheets (model numbers 3870, 3871, 3872, and 3873) that are intended to be used by health care personnel during surgical procedures to protect both the surgical patient and the operating room personnel from transfer of microorganisms, body fluids, and particulate material.
Device Story
SRI/Surgical Express Level IV Drapes are reusable surgical drapes, including back table covers, mayo stand covers, and drape sheets. Used in operating rooms by healthcare personnel to create a sterile barrier; prevents transfer of microorganisms, body fluids, and particulate material between patients and staff. Device functions as a physical barrier; no electronic or mechanical components.
Clinical Evidence
No clinical data provided; device relies on bench testing for barrier performance.
Technological Characteristics
Reusable surgical drapes (back table covers, mayo stand covers, drape sheets). Physical barrier material. No electronic components, software, or energy sources.
Indications for Use
Indicated for use by healthcare personnel during surgical procedures to provide a barrier against microorganisms, body fluids, and particulate matter for both patients and operating room staff.
Regulatory Classification
Identification
A surgical drape and drape accessories is a device made of natural or synthetic materials intended to be used as a protective patient covering, such as to isolate a site of surgical incision from microbial and other contamination. The device includes a plastic wound protector that may adhere to the skin around a surgical incision or be placed in a wound to cover its exposed edges, and a latex drape with a self-retaining finger cot that is intended to allow repeated insertion of the surgeon's finger into the rectum during performance of a transurethral prostatectomy.
Special Controls
*Classification.* Class II (special controls). The device, when it is an ear, nose, and throat surgical drape, a latex sheet drape with self-retaining finger cot, a disposable urological drape, a Kelly pad, an ophthalmic patient drape, an ophthalmic microscope drape, an internal drape retention ring (wound protector), or a surgical drape that does not include an antimicrobial agent, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 878.9.
Related Devices
K023432 — MEDLINE ASEP PLUS SURGICAL DRAPES · Medline Industries, Inc. · Nov 4, 2002
K080723 — SRI LP GOWN · Sri/Surgical Express, Inc. · Nov 13, 2008
K051625 — BARRIER SURGICAL DRAPES · Molnlycke Health Care, Inc. · Jul 14, 2005
K031362 — LAC-MAC LIMITED INNERBLOC VARIOUS O.R. DRAPE BASED ON THE REPEL, PLUS AND GORE SURGICAL BARRIER FABRIC MATERIALS · Lac Mac, Ltd. · May 30, 2003
K052169 — IMC SURGICAL DRAPES · International Medsurg Connection, Inc. · Nov 17, 2005
Submission Summary (Full Text)
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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with its wings spread, and the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle. The logo is black and white.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
# NOV 1 7 2008
SRI/Surgical Express, Incorporated C/O Mr. Jeffrey O. Stull President International Personnel Protection, Incorporated P.O.Box 92493 Austin, Texas 78709
Re: K080796
Trade/Device Name: SRI/Surgical Express Level IV Drapes Regulation Number: 21 CFR 878.4370 Regulation Name: Surgical Drape and Drape Accessories Regulatory Class: II Product Code: KKX Dated: October 24, 2008 Received: October 28, 2008
Dear Mr. Stull:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate 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) that do not require approval of a premarket approval application (PMA). 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 (PMA), 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 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
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### Page 2 - Mr. Stull
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
This letter will allow you to begin marketing your device as described in your Section 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), please contact the Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.
Sincerely vours.
CARS
Chiu S. Lin, Ph. D Division Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health
#### Enclosure
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#### 510(k) Number (if known):
## Device Name: SRI/Surgical Express Level IV Drapes
#### Indications for Use:
The SRI/Surgical Express SRI LP Drapes are reusable drapes, including back table covers (model numbers 1616, 1822, 3010, 3015, 3020, 3025, 3030, and 6113), mayo stand covers (model numbers 1247C, 3000, 30004, 3006, and 6247A), and drape sheets (model numbers 3870, 3871, 3872, and 3873) that are intended to be used by health care personnel during surgical procedures to protect both the surgical patient and the operating room personnel from transfer of microorganisms, body fluids, and particulate material.
## (PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IP NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
St. A. Murphy, b
(Division Sign-Off)
Division of Dental, Infection Control, and General Hospital Devices
510(k) Number
0807 a
Prescription Use (Per 21 CFR 801.109) OR
Over-The-Counter Use *X*
(Optional Format 1-2-96)
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