K Number
K070432
Manufacturer
Date Cleared
2007-09-24

(223 days)

Product Code
Regulation Number
878.4370
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Disposable sterile drapes are used in the operating room as a protective covering, for both patient and operating room staff, from the transfer of body fluids, micro-organisms and particulates.

Drapes provided as sterile and non-sterile.

Non-sterile surgical drapes are to be sold to OEMs for EtO sterilization according to ISO 11135. Sterile Surgical Drapes are to be sold directly to users after EtO sterilization validation to ISO 11135.

Device Description

Not Found

AI/ML Overview

Welmed Surgical Drapes are disposable sterile or non-sterile drapes used in the operating room to protect patients and staff from the transfer of bodily fluids, microorganisms, and particulates. The device's performance was evaluated through a series of tests against established standards.

1. Table of Acceptance Criteria & Reported Device Performance

ParameterAcceptance Criteria (Standard)Reported Device Performance
Hydrostatic PressureAATCC Test Method 127-1998 (Water Resistance: Hydrostatic Pressure Test)Data Generated: Hydrostatic Pressure - Water Resistance
Impact PenetrationAATCC Test Method 42-2000 (Water Resistance: Impact Penetration Test)Data Generated: Impact Penetration - Water Resistance
Tensile StrengthASTM - D5034-95(2001) (Standard Test Method for Breaking Strength and Elongation of Textile Fabrics (Grab Test))Data Generated: Tensile Strength
Tearing StrengthASTM - D5734-95(2001) (Standard Test Method for Tearing Strength of Nonwoven Fabrics by Falling-Pendulum (Elmendorf) Apparatus)Data Generated: Elmendorf Tear
Lint and Particle GenerationISO 9073-10:2003 (Textiles -- Test methods for nonwovens -- Part 10: Lint and other particles generation in the dry state)Data Generated: Gelbo Flex - Lint
FlammabilityCPSC CS-191-53 Flammability Test Method (16 CFR 1610) (Standard for Flammability of Clothing Textiles)Data Generated: Flammability
BiocompatibilityAAMI / ANSI / ISO 10993-1:2003(E) (Biological evaluation of medical devices -- Part 1: Evaluation and testing)Data Generated: Biocompatibility Testing Evaluation
CytotoxicityAAMI / ANSI / ISO 10993-5:1999 (Biological evaluation of medical devices - Part 5: Tests for In Vitro cytotoxicity)Data Generated: Cytotoxicity
Skin Irritation/SensitizationAAMI / ANSI / ISO 10993-10:2002(E) (Biological evaluation of medical devices -- Part 10: Tests for irritation and sensitization)Data Generated: Skin Irritation, intra-cutaneous reactivity & sensitization

2. Sample Size Used for the Test Set and Data Provenance

The provided document does not specify the exact sample sizes for each test mentioned above. It simply states "Data Generated" for each test. The document does not provide information regarding the country of origin of the data or whether the studies were retrospective or prospective.

3. Number of Experts Used to Establish Ground Truth and Qualifications

This information is not applicable. The device's performance was assessed against established international and national standards for material properties and biocompatibility, not against expert-established ground truth in a clinical setting.

4. Adjudication Method for the Test Set

This information is not applicable. The testing involved measurements against predefined physical and biological standards, not subjective expert adjudication.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

A multi-reader multi-case (MRMC) comparative effectiveness study was not conducted for this device. The device is a surgical drape, and its effectiveness is determined by its physical and biological properties as tested against industry standards, not by human reader performance with or without AI assistance.

6. Standalone Performance Study

Yes, a standalone performance study was done in the sense that the device's material properties and biocompatibility were evaluated independently against specified standards, without the involvement of human interpretation or AI. The tests listed in the table (Hydrostatic Pressure, Tensile Strength, Biocompatibility, etc.) represent the standalone performance evaluation of the product.

7. Type of Ground Truth Used

The "ground truth" for evaluating the Welmed Surgical Drapes was based on established industry and regulatory standards and test methods. These standards define the acceptable performance characteristics for surgical drapes (e.g., water resistance, tensile strength, flammability, biocompatibility). The device was deemed substantially equivalent to a predicate device based on its compliance with these objective standards.

8. Sample Size for the Training Set

This information is not applicable. The product is a physical medical device (surgical drape), not an algorithm or an AI-powered system that requires a "training set."

9. How the Ground Truth for the Training Set was Established

This information is not applicable as there is no training set for this device.

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K070432

Section 5: 510(k) Summary

1.0 Submitted By:

Dave Fliss, President Welmed, Inc. 691 Lake Street Grayslake, IL 60030 Establishment Registration Number: 3005841027

Primary Contact: Glen Feye, President Accurate Consultants, Inc. 1340 West Pennsylvania Ave. San Diego, CA 92103 Telephone: 619-291-3695 Fax: 619-393-0582 glenfeye@earthlink.net

2.0 Date Submitted:

February 8, 2007

3.0 Device Name(s):

3.1 Proprietary Names

Welmed, Inc. Surgical Drapes

3.2 Classification Name

21CFR 878.4370 (Surgical Drapes)

Product code - KKX (Surgical drape and drape accessories)

Welmed, Inc. Section 510(k) Notification Surgical Drapes Welmed+Drapes+510K+Draft+2-8-07

SEP 2 4 2007

Page 5 of 46

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4.0 Predicate Devices:

CandidatePredicateManufacturerDocketNumber
Welmed SurgicalDrapesIMC SurgicalDrapesInternational MedsurgConnections, Inc.K052169

5.0 Intended Uses:

Surgical Drapes:

Disposable sterile drapes are used in the operating room as a protective covering, for both patient and operating room staff, from the transfer of body fluids, micro-organisms and particulates.

Drapes provided as sterile and non-sterile.

Non-sterile surgical drapes are to be sold to OEMs for EtO sterilization according to ISO 11135. Sterile Surgical Drapes are to be sold directly to users after EtO sterilization validation to ISO 11135.

6.0 Comparison to Predicate(s):

The following table shows similarities and differences between the predicate identified in Section 4.0 of this summary.

ProductAspect/CharacteristicComments
WelmedSurgicalDrapesBasic Intended UseMaterials UsedConfigurations/DesignSame as IMCSurgical Drapes

Similarities to the Predicates

There are no significant differences between the Welmed drapes and their respective predicate product.

7.0 Summary of Performance Data:

The information in the Premarket Notification on safety and effectiveness supports a finding of substantial equivalence to devices already in commercial distribution. Equivalence is demonstrated through intended use, materials, design and testing methods.

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K 070432

Standard or Guidance DocumentData GeneratedRelevantSection ofSubmission
AATCC Test Method 127-1998Water Resistance: Hydrostatic PressureTestHydrostaticPressure - WaterResistance18
AATCC Test Method 42-2000Water Resistance: Impact Penetration TestImpact Penetration- Water Resistance18
ASTM - D5034-95(2001) Standard TestMethod for Breaking Strength andElongation of Textile Fabrics (Grab Test)Tensile Strength18
ASTM - D5734-95(2001) Standard TestMethod for Tearing Strength of NonwovenFabrics by Falling-Pendulum (Elmendorf)ApparatusElmendorf Tear18
ISO 9073-10:2003 - Textiles -- Testmethods for nonwovens -- Part 10: Lint andother particles generation in the dry stateGelbo Flex - Lint18
CPSC CS-191-53 Flammability TestMethod (16 CFR 1610) Standard forFlammability of Clothing TextilesFlammability18
AAMI / ANSI / ISO 10993-1:2003(E),Biological evaluation of medical devices --Part 1: Evaluation and testingBiocompatibilityTesting Evaluation15
AAMI / ANSI / ISO 10993-5:1999, Biologicalevaluation of medical devices - Part 5:Tests for In Vitro cytotoxicityCytotoxicity15
AAMI / ANSI / ISO 10993-10:2002(E),Biological evaluation of medical devices --Part 10: Tests for irritation and sensitizationSkin Irritation, intra-cutaneousreactivity &sensitization15

:

·

Test Data Provided in this Submission

:

.

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Image /page/3/Picture/1 description: The image shows the logo for the Department of Health & Human Services (HHS). The logo features a stylized eagle with three lines representing its body and wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

SEP 2 4 2007

SEP 24 200

Welmed, Incorporated C/O Mr. Glen Feye President Accurate Consultants, Incorporated 1340 West Pennsylvania Avenue San Diego, California 92103

Re: K070432

Trade/Device Name: General Surgical Drapes Sterile and Non-Sterile Regulation Number: 878.4370 Regulation Name: Surgical Drape and Drape Accessories Regulatory Class: II Product Code: KKX Dated: September 4, 2007 Received: September 4, 2007

Dear Mr. Feye:

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. Feye

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). please contact the Office 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 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/industry/support/index.html.

Sincerely yours,

Cluts

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

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Section 4: Indications for Use Statements

Indications for Use

510(k) Number (if known): K 070432

Device Name: Welmed Surgical Drapes

Indications for Use:

Disposable sterile drapes are used in the operating room as a protective covering, for both patient and operating room staff, from the transfer of body fluids, micro-organisms and particulates.

Drapes provided as sterile and non-sterile.

Non-sterile surgical drapes are to be sold to OEMs for EtO sterilization according to ISO 11135. Sterile Surgical Drapes are to be sold directly to users after EtO sterilization validation to ISO 11135.

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

Over-The-Counter Use X (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. Murphy K.

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

Number: K070432

Welmed, Inc. Section 510(k) Notification Surgical Drapes Welmed+Drapes+510K+Draft+2-8-07

Page 1 of

Page 4 of 4

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Welmed Item

Drapes

K070432

Flat/Basic Drapes:

Comments of Acres of Acres of Acres of Acres of Children Comments of Children Comments of
1220-100Drape Sheet 40" x 57"
1220-110Half Drape 40" x 70"
1000 100 - 14 11 - 7 14 Th ------ 52 " -- 97" -- 97" -- 97" -- 97" -- 97" -- 97" -- 970
  • Medium 3/4 Drape 53" x 77" opens 77" first 1220-120
  • Medium 3/4 Drape 53" x 77" Fan-Folded opens 53" first 1220-12OFF

Medium 3/4 Drape 53" x 77" - Reinforced - opens 53" first 1220-125

  • Large Drape 70" x 100" 1220-130
  • Leggings SIV 11VIS 1220-160
  • Clear Leggings 1220-163
  • Utility Drape w/tape 14x26 1220-170
  • Utility Drape w/tape 20x30 1220-175
  • Abdominal Drape, with Tape, 1220-178

General Surgery Drapes:

produced the first and the controlled in the contract and any and the comments of the first of the first of the first of the first of the first of the first of the first of t1220-183Top Drape 100" x 53"
1220-181Bottom Drape 75' x 53"
  • Side Drape 38" x 77" 1220-182

Laparoscopic Drapes:

Laparoscopic Drapes.
1220-2110Laparotomy Drape, 1 00"x77"x 122", 4x 12" Fenestration
1220-2 120Laparotomy Drape, 100"x77"x122", w/two 8"x38" Troughs
1220-2 125Pediatric Laparotomy Drape 77" x 121", 14"x4" Fenestration
1220-2 130Transverse Lap Drape, 100"x77"x119", 14"x4" Fenestration, with/ABC

Laparotomy Drapes:

1220-2160Laparoscopic/Cholecystectomy Drape 1 00"x77"x 124"
1220-2170Laparoscopic/Cholecystectomy/Endo Drape 98"x77"x 123"
1220-2180Laparoscopic Abdominal Drape, 1 00"x76"x 124", 1 2x 13" Fenestration
1220-2190Laparoscopy T w/ABC & Fenestration, 97"x38"x97"

Breast/Chest Drapes:

Chest / Breast Drape 100"x77"x122" 1220-2152

Thyroid Drapes:

1220-2 140Thyroid Drape 77"x124" 5"xS" Diamond Fenestration
1220-2 14 1Thyroid Drape 100"x77"x124" 5"xS" Diamond Fenestration

Split Drapes:

Split Drapes:
1220-1900Poly U Drape, 60" x 60", 6" x 21" Slit
1220-1910Poly U Drape, 60" x 72", 6" x 21" Slit
1220-1920Poly U Drape 60" x 70", 21" x 4" Slit
1220-1905Poly U Drape, 60" x 84", 8" x 30" Slit
1220-1925Poly U Drape 60" x 81", 31" x 4.5" Slit
1220-19227DRAPE U 80"xl 10" PE W/GROIN COVERS
1220-19228DRAPE U 80"xl 10" W/TAPE PE
1220-19229DRAPE U 77"xl 10" W/TAPE Sontara
1220-1950Split Drape 77"x108", 37"x 2.5" Split
1220-1960Ortho Split Drape 77"x120", 46"x6" split
1220-5000Cysto Drape 64"x38"x 90",w/3"x6" Fenestration
1220-6000EENT Drape

Orthopedic Drapes

Extremity Drapes

Universal Extremity Drape 86"x 127" 1220-8410

§ 878.4370 Surgical drape and drape accessories.

(a)
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.(b)
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.