K Number
K081633
Device Name
PRIMAGARD 80, 120, 160 FLUID RESISTANT PROCEDURE/SURGICAL FACE MASKS
Date Cleared
2008-08-11

(61 days)

Product Code
Regulation Number
878.4040
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
PRIMAGARD™ Surgical Masks are surgical apparel as identified in 21 CFR 878.4040 and are intended to be worn by operating room personnel during surgical procedured to protect both the surgical patient and the operating room personnel from transfer of microcogniss is, body fluids, and particulate material. The PRIMAGARD™ Surgical Masks may also be worn outide of the operating room for non-surgical procedure use.
Device Description
These surgical masks are rectangular, waterfall-pleated or soft-bill devices manufactured from selected non-woven materials (polypropylene or wet-laid cellulose) designed to provide optimal breathability, particulate filtration and a fluid-penetration barrier relative, to the degree w of protection required during intended use.
More Information

Not Found

No
The device description and intended use clearly define the product as a surgical mask made of non-woven materials for physical barrier protection. There is no mention of any computational or analytical functions that would involve AI or ML.

No
The device, a surgical mask, is intended to protect from transfer of microorganisms, body fluids, and particulate material, not to treat or cure a disease or condition.

No
Explanation: The device is a surgical mask intended to prevent the transfer of microorganisms, body fluids, and particulate material, not to diagnose medical conditions.

No

The device description clearly states it is a physical surgical mask made from non-woven materials, which is a hardware device, not software.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly states that the masks are for protecting surgical patients and operating room personnel from the transfer of microorganisms, body fluids, and particulate material. This is a barrier function, not a diagnostic one.
  • Device Description: The description focuses on the physical properties of the mask (materials, construction) designed for breathability, filtration, and fluid penetration resistance. These are characteristics of a protective barrier, not a diagnostic tool.
  • Lack of Diagnostic Elements: There is no mention of the device being used to analyze samples (blood, urine, tissue, etc.), detect specific substances, or provide information about a patient's health status.
  • Regulatory Classification: The intended use references 21 CFR 878.4040, which is the regulation for surgical apparel. IVDs are regulated under different sections of the CFR (typically 21 CFR Part 809).

In summary, the PRIMAGARD™ Surgical Mask is a protective barrier device, not a diagnostic one.

N/A

Intended Use / Indications for Use

PRIMAGARD™ Surgical Masks are surgical apparel as identified in 21 CFR 878.4040 and are intended to be worn by operating room personnel during surgical procedured to protect both the surgical patient and the operating room personnel from transfer of microcogniss is, body fluids, and particulate material. The PRIMAGARD™ Surgical Masks may also be worn outide of the operating room for non-surgical procedure use.

Product codes

FXX

Device Description

These surgical masks are rectangular, waterfall-pleated or soft-bill devices manufactured from selected non-woven materials (polypropylene or wet-laid cellulose) designed to provide optimal breathability, particulate filtration and a fluid-penetration barrier relative, to the degree w of protection required during intended use.

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

operating room personnel / operating room, non-surgical 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)

Not Found

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

Not Found

Predicate Device(s)

K001951

Reference Device(s)

Not Found

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

510(k) Summary

| Submitted by: | priMED Medical Products Inc.
#900, 10707-100 Avenue
Edmonton, Alberta T5J 3M1
Telephone: 780-497-7600 | AUG 11 2008 |
|----------------------|----------------------------------------------------------------------------------------------------------------|-------------|
| Contact Person: | Raymond G. Marusyk | |
| Date Prepared: | June 10, 2008 | |
| Proprietary Name: | PRIMAGARD™ Surgical Mask | |
| Common Name: | Surgical Mask | |
| Classification Name: | Surgical Mask, 878.4040; Product Code FXX | |
| Predicate Device: | Surgical Mask
510(k) #K001951 | |

Description of the Device: These surgical masks are rectangular, waterfall-pleated or soft-bill devices manufactured from selected non-woven materials (polypropylene or wet-laid cellulose) designed to provide optimal breathability, particulate filtration and a fluid-penetration barrier relative, to the degree w of protection required during intended use.

Intended Use of the Device: PRIMAGARD™ Surgical Masks are surgical apparel as identified in 21 CFR 878.4040 and are intended to be worn by operating room personnel during surgical procedured to protect both the surgical patient and the operating room personnel from transfer of microcogniss is, body fluids, and particulate material. The PRIMAGARD™ Surgical Masks may also be worn outide of the operating room for non-surgical procedure use.

Technological Characteristics: PRIMAGARD™ Surgical Masks are technologically similar to the predicate device (K001951) in that both devices consist of non-woven barrier materials sected and arranged in such a manner as to provide, at the time of design, and under the conditions of use, optimal breathability and particulate filtration. The PRIMAGARD™ Surgical Masks are an improvement in that non-woven materials production technologies have advanced and there is a better undersvanions of the physical aspects of the filtration capability. Accordingly, the non-woven products unlilianed in the PRIMAGARD™ Surgical Masks, when used in specific weight (gsm, grams per square meter) combinations are able to provide defined fluid resistance (as measured by the ASTM F2100-07 Stindard Synthetic Blood Fluid Resistance test).

1

Image /page/1/Picture/1 description: The image is a black and white logo for the U.S. Department of Health and Human Services. The logo features 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 eagle is composed of three thick, curved lines that suggest feathers. The text is in a simple, sans-serif font.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Raymond G. Marusyk Director, Design and Development PriMED Medical Products, Incorporated #900, 10707-100 Avenue Edmonton, Alberta, Canada T5J-3M1

AUG 1 1 2008

Re: K081633

Trade/Device Name: PrimaGARD™ 80, 120, 160 Surgical Face Masks Regulation Number: 878.4040 Regulation Name: Surgical Apparel Regulatory Class: II Product Code: FXX Dated: July 31, 2008 Received: August 1, 2008

Dear Mr. Marusyk:

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.

2

Page 2 -- Mr. Marusyk

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 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 yours,

Chris S. Lim, Ph.D.

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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Indications for Use Statement

KOBI633

510(k) Number (if known) K001951 (original for which modification is requested)

Device Name PRIMAGARD™ Surgical Masks

PRIMAGARD™ Surgical Masks (see complete list of specific Indications For Use model names and numbers on following page) are surgical apparel as identified in 21 CFR 878.4040 and 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.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801. 109) OR Over-The-Counter Use

Shule A Murphy
(Division Sign-Off)

Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number: K081633

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Mask NameModel Number
primaGARD 80PG4-1201
primaGARD 80PG4-2121
primaGARD 80PG4-2421
primaGARD 80PG4-4021
primaGARD 80PG4-4241
primaGARD 120PG4-1092
primaGARD 120PG4-1592
primaGARD 120PG4-2092
primaGARD 120PG4-2592
primaGARD 160PG4-1073
primaGARD 160PG4-1573
primaGARD 160PG4-2073
primaGARD 160PG4-2473
primaGARD 160PG4-3073
primaGARD 160PG4-3473
primaGARD 160PG4-3573
primaGARD 160PG4-4073
primaGARD 160PG4-5073

:

:

. .

List of PRIMAGARD™ Surgical Masks Included as Subjects of this Submission