K Number
K023635
Device Name
SRI/SURGICAL EXPRESS SP REUSABLE SURGICAL GOWN
Date Cleared
2002-11-18

(20 days)

Product Code
Regulation Number
878.4040
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Surgical gowns are devices that are intended to be worn by health care personnel during surgical or other Ourgiour gowns are a vice that and the wearer from transfer of microorganisms, body fluids, and particulate material.
Device Description
reusable surgical ' gown manufactured with the W.L. Gore ASSIST™ medical fabric in the Critical Zones.
More Information

No
The summary describes a surgical gown and its physical and performance characteristics, with no mention of AI or ML.

No.
The device description and intended use clearly state that it is a surgical gown, used by healthcare personnel to provide a barrier against transfer of microorganisms and fluids, not to treat or cure a disease or condition.

No

Explanation: The device is a surgical gown, which is a protective barrier for healthcare personnel. Its intended use is to prevent the transfer of microorganisms, body fluids, and particulate material, not to diagnose a medical condition.

No

The device is a surgical gown, which is a physical product made of fabric. The 510(k) summary describes material properties, performance studies related to physical characteristics (biocompatibility, flammability, barrier performance, physical properties), and sterilization validation. There is no mention of software as the primary or sole component of the device.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly states that the surgical gown is "intended to be worn by health care personnel during surgical or other procedures" to protect the wearer from transfer of microorganisms, body fluids, and particulate material. This describes a physical barrier device used on a person, not a device used to examine specimens from the body to provide diagnostic information.
  • Device Description: The description focuses on the physical construction and material of the gown.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Providing diagnostic information about a patient's health status
    • Using reagents or analytical methods
    • Outputting results related to a disease or condition

The information provided describes a medical device used for personal protection in a healthcare setting, which falls under a different regulatory category than IVDs.

N/A

Intended Use / Indications for Use

Surgical gowns are devices that are intended to be worn by health care personnel during surgical or other invasive procedures to protect both the patient and the wearer from transfer of microorganisms, body fluids, and particulate material.

Product codes

FYA

Device Description

The purpose of this 510(k) submission is to obtain FDA clearance to market a reusable surgical ' gown manufactured with the W.L. Gore ASSIST™ medical fabric in the Critical Zones. The gown in this submission is substantially equivalent to the Sterile Recoveries. Inc. surgical gown as cleared under K920405. The results of safety and efficacy performance testing of the SRI/Surgical Express, Inc. reusable surgical gown as provided in this submission or as referenced in the W.L. Gore Product Master File MAF - 1138 are summarized below. The product is intended to be marketed sterile.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

health care personnel / surgical or other invasive procedures

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

  • Biocompatibility: The ASSIST™ medical fabric used in the Critical Zones of this surgical 1. gown complies with the requirements of ISO 10993-1 1997. Acceptable test results were obtained for the washed/dried/sterilized material using the specified test methodology. (Test results can be found in MAF - 1138)
  • Flammability: The ASSIST™ medical fabric used in the Critical Zones of this surgical 2. gown complies with the requirements of 16 CFR 1610 Standard for the Flammability of Clothing Textiles (CPSC 1954), Class 1. (Test results can be found in MAF - 1138) The gown also meets requirements of NFPA 99-1999 requlations for non-flammable anesthetizing locations.
  • Barrier Performance: The ASSIST™ medical fabric used in the Critical Zones of this 3. surgical gown achieved acceptable results throughout 125 wash/dry/steam autoclave cvcles using the test methods prescribed in AATCC 42-Impact Penetration, and AATCC 127-Water Resistance: Hydrostatic Pressure Test. (Test results can be found in MAF -1138.)
  • Physical Properties: The physical properties of ASSIST™ medical fabric were evaluated 4. using various recognized industry standards following 125 wash/dry/steam sterilization cycles. There are currently no limits established for the physical properties evaluated. however conclusions can be drawn to substantiate that the results obtained are comparable to those of currently marketed surgical gowns. Testing was conducted using the following standards: Spray Test, ASTM D3776-96 Standard Test method for mass per unit area (weight) of fabric, ASTM D5035-95 Standard Test Method for breaking force and elongation of textile fabrics (strip break), ASTM D5587-96 Standard test methods for water vapor transmission of materials, and IES-RP-CC003.3-93 Garment system considerations for cleanrooms and other controlled environments - Helmke drum test for garment particulation. (Test results can be found in MAF - 1138)

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K920405

Reference Device(s)

MAF - 1138

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

0

NOV 1 8 2002

K023635

SUMMARY AND CERTIFICATION SRI/SURGICAL EXPRESS, INC., SP™ REUSABLE SURGICAL GOWN

Class II (classification by the General Hospital and Personal use Device Panel)

Common Name: Surgical Gown

ICAL EXPRESS. INC

Classification Name: Surgical Gown

The purpose of this 510(k) submission is to obtain FDA clearance to market a reusable surgical ' gown manufactured with the W.L. Gore ASSIST™ medical fabric in the Critical Zones. The gown in this submission is substantially equivalent to the Sterile Recoveries. Inc. surgical gown as cleared under K920405. The results of safety and efficacy performance testing of the SRI/Surgical Express, Inc. reusable surgical gown as provided in this submission or as referenced in the W.L. Gore Product Master File MAF - 1138 are summarized below. The product is intended to be marketed sterile.

  • Biocompatibility: The ASSIST™ medical fabric used in the Critical Zones of this surgical 1. gown complies with the requirements of ISO 10993-1 1997. Acceptable test results were obtained for the washed/dried/sterilized material using the specified test methodology. (Test results can be found in MAF - 1138)
  • Flammability: The ASSIST™ medical fabric used in the Critical Zones of this surgical 2. gown complies with the requirements of 16 CFR 1610 Standard for the Flammability of Clothing Textiles (CPSC 1954), Class 1. (Test results can be found in MAF - 1138) The gown also meets requirements of NFPA 99-1999 requlations for non-flammable anesthetizing locations.
  • Barrier Performance: The ASSIST™ medical fabric used in the Critical Zones of this 3. surgical gown achieved acceptable results throughout 125 wash/dry/steam autoclave cvcles using the test methods prescribed in AATCC 42-Impact Penetration, and AATCC 127-Water Resistance: Hydrostatic Pressure Test. (Test results can be found in MAF -1138.)
  • Physical Properties: The physical properties of ASSIST™ medical fabric were evaluated 4. using various recognized industry standards following 125 wash/dry/steam sterilization cycles. There are currently no limits established for the physical properties evaluated. however conclusions can be drawn to substantiate that the results obtained are comparable to those of currently marketed surgical gowns. Testing was conducted using the following standards: Spray Test, ASTM D3776-96 Standard Test method for mass per unit area (weight) of fabric, ASTM D5035-95 Standard Test Method for breaking force and elongation of textile fabrics (strip break), ASTM D5587-96 Standard test methods for water vapor transmission of materials, and IES-RP-CC003.3-93 Garment system considerations for cleanrooms and other controlled environments - Helmke drum test for garment particulation. (Test results can be found in MAF - 1138)

STERILE RECOVERIES, INC

12425 RACE TRACK ROAD
TAMPA, FL 33626

TEL 813-891-9550
FAX 813-925-8388

1

  • Sterilization: The gown in this submission has been validated to meet a Sterility દ. Assurance Level of 10 using ANSI/AAMI/ISO 11134:1993 Sterilization of health care products - Requirements for validation and routine control - Industrial moist heat sterilization.
  • Care and Handling: The gown in this submission shall be processed in accordance with 6. the requirements of ANSI/AAMI ST65: 2000 Processing of surgical textiles for use in health care facilities, the care and handling instructions from the manufacturer of the ASSIST™ medical fabric, and SRI/Surgical Express' internal quality system procedures to assure the safety and efficacy of the delivered product. No user instructions related to reprocessing the gown are required since the end-users are advised to return all soiled linen to SRI/Surgical Express, Inc. for reprocessing and sterilization.

Signature of Certifier:

Typed Name: Jack Hamilton

Date: 10/22/02

Title: VP, Product & Process Engineering

2

Image /page/2/Picture/0 description: The image shows a logo for the Department of Health and Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH" around the top and "SERVICES USA" around the bottom. Inside the circle is a stylized image of a human figure with outstretched arms. The figure is made up of three curved lines that represent the head, body, and legs. The logo is black and white.

DEPARTMENT OF HEALTH & HUMAN SERVICES

NOV 18 2002

9200 Corporate Boulevard Rockville MD 20850

Mr. Jack A. Hamilton VP. Product & Process Engineering SRI/Surgical Express, Incorporated 12425 Race Track Road Tampa, Florida 33626

Re: K023635

Trade/Device Name: SRI/Surgical Express SP™ Reusable Surgical Gown Regulation Number: 878.4040 Regulation Name: Surgical Apparel Regulatory Class: II Product Code: FYA Dated: October 22, 2002 Received: October 29, 2002

Dear Mr. Hamilton:

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.

3

Page 2 – Mr. Hamilton

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 (QS) 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 and additionally 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4618. 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" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours.

Patricia Cucentoffer

Timothy A. Ulatowski Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

4

INDICATIONS FOR USE STATEMENT

Applicant:

SRI/Surgical Express, Inc.

510(k) Number:

023635

Device Name:

SRI/Surgical Express SP™ Reusable Surgical Gown

Indications for Use:

Surgical gowns are devices that are intended to be worn by health care personnel during surgical or other Ourgiour gowns are a vice that and the wearer from transfer of microorganisms, body fluids, and particulate material.

PLEASE DO NOT WRITE BELOW THIS LINE – CONTINUE ON AÑOTHER PAGE IF NEEDED)

Concurrence of CDRH Office of Device Evaluation (ODE)

Prescription Use Per 21 CFR 801.109 Over the Counter _ Yes

Scanned for Clari

vision Sign-Off Division of Anesthesiology, General Hospital, Infection Control, Dental Devices

510(k) Number_