K Number
K221352
Date Cleared
2023-03-13

(307 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 Surgical Face Mask is intended to be worn to protect both the patient and healthcare persomel 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 non-sterile.

Device Description

The Surgical Face Mask is 3-layer, and it is two model is HSD-TYP2R (Ear loops) and HSD-TYP2RT (Tie-On). Flat-folded masks constructed of nonwoven polypropylene materials. The mask is provided with ear loops (spandex and polyester) or tie tapes (spun-bond polypropylene). A malleable nose clip is placed in the layers of facemask for comfort and individualized fit. The surgical face mask color is blue. Product is Level 3 based on ASTM F2100-19. The surgical face mask is single-use, disposable devices, provided non-sterile.

AI/ML Overview

This document is a 510(k) Premarket Notification from Wuhan Huashida Protective Products Co., Ltd. for their Surgical Face Mask. It is a submission to the FDA demonstrating that their device is substantially equivalent to a legally marketed predicate device.

The premise of a 510(k) submission is to demonstrate "substantial equivalence' to a legally marketed device, not necessarily to prove the device's independent safety and effectiveness through extensive clinical trials as would be required for a PMA (Premarket Approval) application. For a device like a surgical face mask, the FDA generally relies on performance testing against recognized standards rather than clinical studies, especially if the device is similar in design and materials to existing cleared devices.

Therefore, the information provided below is based on the provided document and tailored to how a 510(k) submission addresses "acceptance criteria" through non-clinical testing.

Here's an analysis of the provided text in relation to your request about acceptance criteria and the study proving the device meets them:

1. A table of acceptance criteria and the reported device performance

The document provides a table of acceptance criteria and results from non-clinical performance and biocompatibility testing.

ItemsPurposeAcceptance CriteriaResult
For Surgical Face Mask Performance
Fluid Resistance PerformanceThe purpose of the performance testing is to demonstrate the functionality of the subject device29 out of 32 pass at 160 mmHgPass
Particulate Filtration Efficiency(Implied: To demonstrate the mask's ability to filter particulate material)$\geq$ 98%Pass
Bacterial Filtration Efficiency(Implied: To demonstrate the mask's ability to filter microorganisms)$\geq$ 98%Pass
Differential Pressure(Implied: To measure the breathability of the mask)<6.0 mmH2O/cm²Pass
Flammability(Implied: To assess the flammability risk of the mask material)Class 1Pass
For Surgical Face Mask Biocompatibility
CytotoxicityThe purpose of the testing is to demonstrate safety of the subject deviceNon-CytotoxicUnder the conditions of the study, the device is non-cytotoxic.
Irritation(Implied: To assess potential skin irritation from mask materials)Non-IrritatingUnder the conditions of the study, the device is non-irritating.
Sensitization(Implied: To assess potential allergic reactions or sensitization from mask materials)Non-SensitizingUnder the conditions of the study, the device is non-sensitizing.

2. Sample sized used for the test set and the data provenance (e.g., country of origin of the data, retrospective or prospective)

  • Sample Size:
    • For "Fluid Resistance Performance," the sample size is explicitly stated as 32 (29 out of 32 pass).
    • For other performance and biocompatibility tests, specific sample sizes are not explicitly stated in this summary document. They would typically be defined within the testing protocols for each standard (e.g., ASTM F2299, ASTM F2101, ISO 10993-5, etc.).
  • Data Provenance: The tests were conducted by the manufacturer, Wuhan Huashida Protective Products Co., Ltd., in China. The data would be considered prospective as it involves new testing performed specifically for this submission.

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

This type of information is not applicable to this submission. This document addresses a physical medical device (surgical face mask) evaluated through non-clinical performance testing against recognized standards. The "ground truth" for such devices is established by the specifications in the standards themselves (e.g., a BFE of >=98% is the target). There are no human "experts" establishing a subjective ground truth like in a diagnostic AI study. The results are quantitative measurements.

4. Adjudication method (e.g., 2+1, 3+1, none) for the test set

This is not applicable for non-clinical performance and biocompatibility testing. Adjudication methods like 2+1 or 3+1 are used in studies where human readers (e.g., radiologists) are involved in interpreting medical images or data, and their disagreements need to be resolved to establish a "ground truth" or reference standard. This document pertains to physical device testing.

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

This is not applicable. An MRMC study is relevant for evaluating the performance of AI-assisted diagnostic tools where human interpretation plays a role. This submission pertains to a surgical face mask, which is a physical barrier device, not an AI diagnostic tool. The document explicitly states: "No clinical study is included in this submission."

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

This is not applicable. This question refers to the performance of an AI algorithm in isolation. The product is a surgical face mask, not an algorithm. The testing performed is standalone in the sense that it's the mask's performance being measured directly against established standards.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

The "ground truth" in this context is based on pre-defined, quantitative performance specifications established by relevant industry standards and regulatory guidance. For example:

  • Fluid Resistance: Resistance to penetration by synthetic blood at a specified pressure (ASTM F1862).
  • Filtration Efficiency (Particulate & Bacterial): Percentage of particles/bacteria filtered out (ASTM F2299, ASTM F2101).
  • Differential Pressure: How easily air can pass through (EN 14683).
  • Flammability: A classification based on burn rate (16 CFR 1610).
  • Biocompatibility: Absence of cytotoxic, irritating, or sensitizing effects as per ISO 10993 standards.

These standards define the 'truth' or expected performance for a surgical mask of a certain level.

8. The sample size for the training set

This is not applicable. This device is a manufactured medical product, not an AI algorithm that requires a "training set."

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

This is not applicable, as there is no "training set" for this type of device submission.

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March 13, 2023

Wuhan Huashida Protective Products Co., Ltd. Mei Chen Manager No. 511 Weihu Rd, Shamao St, Hannan District Wuhan, Hubei 430090 China

Re: K221352

Trade/Device Name: Surgical Face Mask Regulation Number: 21 CFR 878.4040 Regulation Name: Surgical Apparel Regulatory Class: Class II Product Code: FXX Dated: February 27, 2023 Received: February 27, 2023

Dear Mei Chen:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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.

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

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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); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Katherine D. Kavlock -S

for

Brent Showalter, Ph.D. Assistant Director DHT6B: Division of Spinal Devices OHT6: Office of Orthopedic Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K221352

Device Name Surgical Face Mask

Indications for Use (Describe)

The Surgical Face Mask is intended to be worn to protect both the patient and healthcare persomel 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 non-sterile.

Type of Use (Select one or both, as applicable)

| Prescription Use (Part 21 CFR 801 Subpart D)

× Over-The-Counter Use (21 CFR 801 Subpart C)

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510(k) summary

I Submitter

Device submitter:Wuhan Huashida Protective Products Co., Ltd.
No.511 Weihu Rd, Shamao St, Hannan district, Wuhan, Hubei, China
Contact person:Chen Mei
Manager
Phone: +86-18971272798
E-mail: Happy@huashida168.cn

II Proposed Device

Trade/Device Name:Surgical Face Mask
Regulation Number:21 CFR 878.4040
Regulation Name:Surgical Apparel
Regulatory Class:Class II
Product code:FXX
Review Panel:General Hospital

III Predicate Devices

510(k) Number:K202903
Trade/Device Name:Surgical Face Mask
Regulation Number:21 CFR 878.4040
Regulation Name:Surgical Apparel
Classification:Class II
Product Code:FXX
ManufacturerRizhao Sanqi Medical & Health Articles Co., Ltd

IV Indication for use

The Surgical Face Mask is 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 non-sterile.

V Device Description

The Surgical Face Mask is 3-layer, and it is two model is HSD-TYP2R (Ear loops) and HSD-TYP2RT (Tie-On). Flat-folded masks constructed of nonwoven polypropylene materials.

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The mask is provided with ear loops (spandex and polyester) or tie tapes (spun-bond polypropylene). A malleable nose clip is placed in the layers of facemask for comfort and individualized fit. The surgical face mask color is blue. Product is Level 3 based on ASTM F2100-19. The surgical face mask is single-use, disposable devices, provided non-sterile.

ItemSubject devicePredicate device (K202903)Discussion
Product nameSurgical Face MaskSurgical Face MaskNA
Product modelHSD-TYP2R, HSD-TYP2RTLevel 3 Surgical Face Mask models: SQ-3001, SQ-3001HNA
ClassificationClass II Device, FXX (21 CFR878.4040)Class II Device, FXX (21 CFR878.4040)Identical
Intended useThe Surgical Face Mask is 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 non-sterile.The Surgical Face Mask is intended to be worn to protect both the patient and healthcare personnel from transfer of microorganisms, body fluids, and particulate material. When worn properly, 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 non-sterile. This is a single use, disposable device(s), provided non-sterileIdentical
Component and MaterialsStructureMaterialsStructureMaterialsDifferent
Outer layerSpun-bond polypropyleneOuter layerPolypropylene
Inner layerpolypropyleneInner layerPolypropylene
Filter layermelt-blown polypropyleneFilter layer3 Flat leated: Melt-blown Polypropylene
Nose clipmalleable aluminum wireNose clipSteel coated by polypropylene
Ear loopsspandex and polyesterEar loopsSpandex
Tie Tapesspun-bond polypropyleneTie TapesSpunbond Polypropylene

VI Summary of Technological characteristics

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ItemSubject devicePredicate device(K202903)Discussion
Mask styleFlat-pleatedFlat-pleatedIdentical
DesignFeaturesEar Loops, Tie-onEar Loops, Tie-onIdentical
Mask style3 Flat Pleated3 Flat Pleated4 Flat PleatedSimilar
ColorBlueBlue, white, pink, green, yellowSimilar
Dimension(Length)175±10mm175±5mmSimilar
Dimension(Width)90±10mm95±5mmSimilar
ASTM F2100LevelLevel 3Level 3Identical
OTC useYesYesIdentical
SterilityNon-SterileNon-SterileIdentical
UseSingle Use, DisposableSingle Use, DisposableIdentical
ParticulatefiltrationefficiencyMeet ASTM F2299-17Meet ASTM F2299-17Identical
BacterialfiltrationefficiencyMeet ASTM F2101-19Meet ASTM F2101-19Identical
DifferentialpressureMeet EN 14683: 2019, Annex CMeet EN 14683: 2019, Annex CIdentical
FlammabilityMeet 16 CFR 1610Meet 16 CFR 1610Identical
FluidresistanceMeet ASTM F1862-17Meet ASTM F1862-17Identical
BiocompatibilityNon-cytotoxic, Non-sensitizing,non-irritatingNon-cytotoxic, Non-sensitizing,non-irritatingIdentical

Section 3-510(k) Summary

Different - Patient Contacting Material

The patient contacting material for the proposed device is different from the predicate devices. However, biocompatibility test has been performed on the proposed device and the results does not show any adverse effect. Thus, this difference will not affect the safety and effectiveness between the proposed device and the two predicate devices.

VII Non-Clinical Test Conclusion

Non-clinical tests were conducted to verify that the proposed device met all design specifications as was same to the predicate device. The test results demonstrated that the proposed device complies with the following standards and the requirements stated in the

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Guidance for Industry and FDA Staff: Surgical Masks - Premarket Notification [510(k)] Submission issued on March 5, 2004:

  • A 16 CFR Part 1610 Standard for the Flammability of Clothing Textiles;
  • A ASTM F1862 Standard Test Method for Resistance of Medical Face Masks to Penetration by Synthetic Blood (Horizontal Projection of Fixed Volume at a Known Velocity)
  • ASTM F2299 Standard Test Method for Determining the Initial Efficiency of Material Used in medical Face Masks to Penetration by Particulates using Latex Spheres

  • A ASTM F2101 Standard Test Method for Evaluating the Bacterial Filtration Efficiency (BFE) of Medical Face Mask Materials, Using a Biological Aerosol of Staphylococcus aureus
  • ASTM F2100 Standard Specification for Performance of Materials Used in Medical Face Masks

  • EN 14683 Medical face masks- Requirements and test methods

  • A ISO 10993-5:2009 Biological evaluation of medical device- Part 5: Tests for in vitro cytotoxicity
  • A ISO 10993-10:2010 Biological evaluation of medical device- Part 10: Tests for irritaion and skin sensitization
ItemsPurposeAcceptance CriteriaResult
Fluid ResistancePerformanceThe purpose of theperformance testingis to demonstrateThe functionality ofthe subject device29 out of 32pass at 160 mmHgPass
Particulate FiltrationEfficiency$\geq$ 98%Pass
Bacterial FiltrationEfficiency$\geq$ 98%Pass
Differential Pressure<6.0 mmH2O/cm²Pass
FlammabilityClass 1Pass

For Surgical Face Mask Performance

For Surgical Face Mask Biocompatibility

ItemsPurposeAcceptanceCriteriaResult
CytotoxicityThe purpose ofthe testing is todemonstratesafety of thesubject deviceNon-CytotoxicUnder the conditions of the study, thedevice is non-cytotoxic.
IrritationNon-IrritatingUnder the conditions of the study, thedevice is non-irritating.
SensitizationNon-SensitizingUnder the conditions of the study, thedevice is non-sensitizing.

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VIII Clinical Test Conclusion

No clinical study is included in this submission.

IX Conclusion

The conclusions drawn from the nonclinical tests demonstrate that the subject device is as safe, as effective, and performs as well as or better than the legally marketed predicate device K202903.

§ 878.4040 Surgical apparel.

(a)
Identification. Surgical apparel are devices that are intended to be worn by operating room personnel during surgical procedures to protect both the surgical patient and the operating room personnel from transfer of microorganisms, body fluids, and particulate material. Examples include surgical caps, hoods, masks, gowns, operating room shoes and shoe covers, and isolation masks and gowns. Surgical suits and dresses, commonly known as scrub suits, are excluded.(b)
Classification. (1) Class II (special controls) for surgical gowns and surgical masks. A surgical N95 respirator or N95 filtering facepiece respirator is not exempt if it is intended to prevent specific diseases or infections, or it is labeled or otherwise represented as filtering surgical smoke or plumes, filtering specific amounts of viruses or bacteria, reducing the amount of and/or killing viruses, bacteria, or fungi, or affecting allergenicity, or it contains coating technologies unrelated to filtration (e.g., to reduce and or kill microorganisms). Surgical N95 respirators and N95 filtering facepiece respirators are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 878.9, and the following conditions for exemption:(i) The user contacting components of the device must be demonstrated to be biocompatible.
(ii) Analysis and nonclinical testing must:
(A) Characterize flammability and be demonstrated to be appropriate for the intended environment of use; and
(B) Demonstrate the ability of the device to resist penetration by fluids, such as blood and body fluids, at a velocity consistent with the intended use of the device.
(iii) NIOSH approved under its regulation.
(2) Class I (general controls) for surgical apparel other than surgical gowns and surgical masks. The class I device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 878.9.