K Number
K041540
Device Name
COMBOSAFE (EUROPE) AND PROMAX (US) SURGICAL GOWNS
Date Cleared
2005-05-05

(331 days)

Product Code
Regulation Number
878.4040
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
COMBOsafe/Promax Surgical Gowns are medical devices that are intended to be worn by operating room personnel during surgical procedures to protect them by inhibiting the migration of liquids through the surface of the critical areas of the gown. COMBOsafe/Promax Surgical Gowns will function as surgical gowns when processed according to instructions through 75 complete wash, dry and sterilization cycles. These products will be manufactured and distributed as non-sterile surgical gowns that are intended to be sterilized and processed by health care facilities and/or contract sterilization/laundry companies.
Device Description
All fabric components used in COMBOsafe™ Surgical Gowns are made from 100% polyester. dyed blue and/or green and are laminated with a urethane film. COMBOsafe Surgical Gowns will function as surgical gowns when processed according to instructions through 75 complete wash, dry and sterilization cycles. These products will be manufactured and distributed as non-sterile surgical gowns that are intended to be sterilized and processed by health care facilities and/or contract sterilization/laundry companies.
More Information

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Not Found

No
The device description and intended use clearly define the product as surgical gowns made of polyester and urethane film, designed for barrier protection and durability through processing cycles. There is no mention of any software, algorithms, or data processing capabilities that would indicate the use of AI or ML. The performance studies listed are standard material and barrier tests for surgical gowns.

No
The device is a surgical gown, which is intended for protection during surgical procedures, not for treating a disease or condition.

No

The device is a surgical gown, which is intended to protect personnel by inhibiting the migration of liquids. It does not diagnose any condition or disease.

No

The device is a surgical gown, which is a physical product made of fabric and film, not software. The description focuses on material properties, barrier performance, and durability through processing cycles.

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

Here's why:

  • Intended Use: The intended use is to protect operating room personnel by inhibiting the migration of liquids. This is a physical barrier function, not a diagnostic test performed on a sample from the human body.
  • Device Description: The description focuses on the material composition and durability of the surgical gowns. There is no mention of analyzing biological samples or providing diagnostic information.
  • Performance Studies: The performance studies listed are related to the physical properties and barrier performance of the gowns (flammability, barrier testing, strength, lint, toxicity, sterilization, durability, colorfastness). These are not diagnostic performance metrics.
  • Lack of Diagnostic Elements: There is no mention of analyzing samples, detecting analytes, or providing any kind of diagnostic result.

IVD devices are specifically designed to be used in vitro (outside the body) to examine specimens derived from the human body (such as blood, urine, tissue) to provide information for diagnostic, monitoring, or compatibility purposes. This surgical gown does not fit that definition.

N/A

Intended Use / Indications for Use

COMBOsafe/Promax Surgical Gowns are medical devices that are intended to be worn by operating room personnel during surgical procedures to protect them by inhibiting the migration of liquids through the surface of the critical areas of the gown.

COMBOsafe/Promax Surgical Gowns will function as surgical gowns when processed according to instructions through 75 complete wash, dry and sterilization cycles. These products will be manufactured and distributed as non-sterile surgical gowns that are intended to be sterilized and processed by health care facilities and/or contract sterilization/laundry companies.

Product codes

FYA

Device Description

All fabric components used in COMBOsafe™ Surgical Gowns are made from 100% polyester. dyed blue and/or green and are laminated with a urethane film.

Mentions image processing

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Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

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Anatomical Site

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Indicated Patient Age Range

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Intended User / Care Setting

Operating room personnel / health care facilities and/or contract sterilization/laundry companies

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

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

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Summary of Performance Studies

The tests that have been successfully completed include:
a. Flammability 16 CFR Part 1610.
b. Barrier Performance
i. Suter Hydrostatic Testing AATCC #127-1989
ii. Mullens Hydrostatic Testing ASTM D751-95 Procedure A
iii. Viral Resistance Testing ASTM 1671-97
c. Strength ASTM #D-1682-87
d. Lint EDANA 220.0-96
e. Toxicity Cytotoxicity MEM Elution (MG023) Acute Systemic Toxicity (ISO 10993)
f. Primary Skin Irritation (ISO 10993)
g. Sterilization Product sold non-sterile; can be sterilized using prevacuum steam cycles.
h. Durability through 75 processing (wash, dry and sterilization).
i. Colorfastness to Commercial Laundering AATCC #61-1993(4A).

COMBOsafe surgical gowns with the patented "inverted" 2-ply sleeve designs are classified as a Level 4 Barrier per ANSI/AAMI PB70:2003.

Key Metrics

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Predicate Device(s)

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Reference Device(s)

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Predetermined Change Control Plan (PCCP) - All Relevant Information

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§ 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

Image /page/0/Picture/0 description: The image shows a black and white emblem. The emblem is in the shape of a shield. Inside the shield is a large letter 'S' with a smaller letter 'C' above it.

STANDARD T

MAY - 5 2005

K041540

COMBOsafe™ SURGICAL GOWNS SAFETY AND EFFFECTIVNESS SUMMARY

The following information is being supplied in accordance with the Safe Medical Device Act of 1990.

807.92(a)

    1. Standard Textile Co., Inc. One Knollcrest Drive Cincinnati, Ohio 45237
      Contact Person: Brad Bushman (513) 761-9255 Ext. 455
    1. Device Name: COMBOsafe™ Surgical Gowns (Europe) ProMax Surgical Gowns (US) Common/Usual Name: Non-Sterile Surgical Gown, Operating Room Gown, Isolation Gown Classification Name: Surgical Apparel 21 C.F.R. § 878.4040
  • ന് All fabric components used in COMBOsafe™ Surgical Gowns are made from 100% polyester. dyed blue and/or green and are laminated with a urethane film.

COMBOsafe Surgical Gowns will function as surgical gowns when processed according to instructions through 75 complete wash, dry and sterilization cycles. These products will be manufactured and distributed as non-sterile surgical gowns that are intended to be sterilized and processed by health care facilities and/or contract sterilization/laundry companies.

  • ব COMBOsafe Surgical Gowns are intended to be worn by operating room personnel during surgical procedures to protect them by inhibiting the migration of liquids through the surface of the critical areas of the gown. Per ANSI/AAMI PB70:2003, COMBOsafe surgical gowns with the patented "inverted" 2-ply sleeve designs are classified as a Level 4 Barrier.
  • The tests that have been successfully completed include: ട്.
    • Flammability 16 CFR Part 1610. a.
    • Barrier Performance b.
      • Suter Hydrostatic Testing AATCC #127-1989 1.
      • Mullens Hydrostatic Testing ASTM D751-95 Procedure A ii.
      • Viral Resistance Testing ASTM 1671-97 iii.
    • Strength ASTM #D-1682-87 C.
    • Lint EDANA 220.0-96 ರ.
    • Toxicity Cytotoxicity MEM Elution (MG023) e. Acute Systemic Toxicity (ISO 10993)
    • f. Primary Skin Irritation (ISO 10993)
    • Sterilization Product sold non-sterile; can be sterilized using prevacuum steam cycles. ்.
    • h. Durability through 75 processing (wash, dry and sterilization).
    • Colorfastness to Commercial Laundering AATCC #61-1993(4A). i.

To the best of my knowledge, all data and information in the 510(k) are truthful and accurate, and that no material fact has been omitted.

Bradley J. Bush 6/4/04
Bradley J. Bushman

ONE KNOLLCHEST D 80 x 37 x 37 1805 CINCINNATI OHIO 15222-1805

513 761 9255
513 761-0467 ^/
1 800 939 0400

1

Image /page/1/Picture/1 description: The image shows the logo for the United States Department of Health and Human Services. The logo consists of a stylized eagle with three lines representing its body and wings. The text "DEPARTMENT OF HEALTH AND HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle.

MAY - 5 2005

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Bradley J. Bushman Vice President, Technical Affairs Standard Textile Company Limited One Knollcrest Drive Cincinnati, Ohio 45237

Re: K041540

Trade/Device Name: COMBOsafe/Promax Surgical Gowns Regulation Number: 878.4040 Regulation Name: Surgical Apparel Regulatory Class: II Product Code: FYA Dated: April 28, 2005 Received: April 29, 2005

Dear Mr. Bushman:

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 referenced as over and in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device mendie conmise of prives 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 (1 writ), it may of backed of Federal Regulations, Title 21, Parts 800 to 898. In your device ear. 80 foundsh further announcements concerning your device in the Federal Register.

2

Page 2 – Mr. Bushman

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. or the For or any 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 und libing (21 es 1 forth in the quality systems (QS) regulation (21 CFR Part 820); and if requirements as lectronic 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) Print reter mification. The FDA finding of substantial equivalence of your device to a promation in the can be 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), 11 Jou decire of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the maj South 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/industry/support/index.html.

Sincerely yours,

Chiu Lin, Ph.D.

Chiu Lin, Ph.D. Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

3

Indications for Use

#K041540 510(k) Number (if known):

COMBOsafe/Promax Surgical Gowns Device Name:

Indications For Use:

COMBOsafe/Promax Surgical Gowns are medical devices that are intended to be worn by
the migral and the false in the provised procedures to protect them by inhibiting the migr COMBOsafe/Promax Surgical Gowns are medical devices to protect them by inhibiting the migration
operating room personal processfores of the gotties areas of the gown. operating room personnel during surgicul province of the gown.
of liquids through the surface of the critical areas of the gown.

of agence in the promote will function as surgical gowns will function when processed according
will be COMBOsafe/Promax Surgical Gowns will thirdinal surgical govine These products will be
to instructions the the belows wash, dry and sterlized on be sterlized and to instructions through 75 complete wash, dry and sternization cover. manufactured and distributed as non-steries surgical governments are and

Prescription Use (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use ﻜﺮ (21 CFR 807 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED.)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Shule H. Mungber, 5/15/05
Sion-City

Insion of Anesthesiolooy, General Hospital, Intection Control, Dental Devices

(K) Number: K 41540

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