K Number
K082554
Device Name
KIMGUARD STERILIZATION WRAP, MODELS KC100, KC200, KC300, KC400, KC500 AND KC600
Date Cleared
2009-05-01

(240 days)

Product Code
Regulation Number
880.6850
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
KIMGUARD* Sterilization Wrap is intended to be used to enclose another medical device that is to be sterilized by a health care provider by pre-vacuum steam at 270°F/132°C for 4 minutes or by 100% ethylene oxide (EtO) with a concentration of 725-735 mg/L at 131°F/ 55°C and 40% - 80% relative humidity for 60 minutes. The wrap is intended to allow sterilization of the enclosed medical device(s) and also to maintain sterility of the enclosed device(s) until opened. The wrap was validated for aeration times for EtO sterilization of 8 hours at 55 ℃ or 12 hours at 43.3 ℃. The wrap was validated for dry times for pre-vacuum steam sterilization of 20 minutes for Models 100, 200, and 300 and for dry times of 30 minutes for Models 400, 500, and 600. KIMGUARD* Sterilization Wrap is not indicated for use for gravity steam sterilization.
Device Description
The sheets of sterilization wrap are square or rectangular fabric produced using a polypropylene three-layer SMS (spunbond-meltblown-spunbond) process.
More Information

Not Found

No
The device is a physical sterilization wrap and the description focuses on its material properties and performance in sterilization processes, with no mention of AI or ML.

No
The device is a sterilization wrap intended to maintain sterility of other medical devices, not to provide therapy directly to a patient.

No

Explanation: The device is a sterilization wrap intended to enclose other medical devices for sterilization and maintain sterility. It does not perform any diagnostic function.

No

The device is a physical sterilization wrap made of polypropylene fabric, 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 device is used to enclose other medical devices for sterilization and maintain their sterility. It does not mention any use in examining specimens derived from the human body to provide information for diagnosis, monitoring, or treatment.
  • Device Description: The device is described as a fabric wrap, not a reagent, instrument, or system used for in vitro testing.
  • 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.)
    • Detecting or measuring substances in samples
    • Providing diagnostic information
    • Using reagents or calibrators

The device is a sterilization packaging system, which is a different category of medical device.

N/A

Intended Use / Indications for Use

KIMGUARD* Sterilization Wrap is intended to be used to enclose another medical device that is to be sterilized by a health care provider by pre-vacuum steam at 270°F/132°C for 4 minutes or by 100% ethylene oxide (EtO) with a concentration of 725-735 mg/L at 131°F/ 55°C and 40% - 80% relative humidity for 60 minutes. The wrap is intended to allow sterilization of the enclosed medical device(s) and also to maintain sterility of the enclosed device(s) until opened. The wrap was validated for aeration times for EtO sterilization of 8 hours at 55 ℃ or 12 hours at 43.3 ℃. The wrap was validated for dry times for pre-vacuum steam sterilization of 20 minutes for Models 100, 200, and 300 and for dry times of 30 minutes for Models 400, 500, and 600.

KIMGUARD* Sterilization Wrap is not indicated for use for gravity steam sterilization.

Product codes (comma separated list FDA assigned to the subject device)

FRG

Device Description

The KIMGUARD* Sterilization Wrap (Models KC100, KC200, KC300, The KIMGUAHD Glonically are substantially equivalent to the KC400, RC300, and RO000) are oabstanding - Treations of Sterile Wraps.

The KIMGUARD* Sterilization Wrap is substantially equivalent to the predicates in intended use, design, and materials. The predicate devices were constructed of a three-layer laminate composed of a layer of meltblown polypropylene bonded on both surfaces with a layer of spunbonded polypropylene. The sheets of sterilization wrap are square or rectangular fabric produced using a polypropylene three-layer SMS (spunbond-meltblown-spunbond) process.

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 provider

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)

KIMGUARD* Sterilization Wrap performance has been tested in accordance with the applicable requirements recommended in Premarket Notification [510(k)] Submissions for Medical Sterilization Packaging Systems in Health Care Facilities; Draft Guidance for Industry and FDA (March 7, 2002). Testing included biocompatibility (i.e., irritation and sensitization) in compliance with the methods of ISO 10993, sterilant penetration, dry time, and physical integrity. The Wrap has also been tested for the ability to maintain sterility of pack contents after sterilization for up to 30 days under standard conditions. All results of testing met acceptance criteria.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K881471

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 880.6850 Sterilization wrap.

(a)
Identification. A sterilization wrap (pack, sterilization wrapper, bag, or accessories, is a device intended to be used to enclose another medical device that is to be sterilized by a health care provider. It is intended to allow sterilization of the enclosed medical device and also to maintain sterility of the enclosed device until used.(b)
Classification. Class II (performance standards).

0

K082554

Predicate

Devices:

510(k) Summary for the Kimberly-Clark* Corporation KIMGUARD* Sterilization Wrap (Models KC100, KC200, KC300, KC400, KC500, and KC600)

Date Summary was Prepared:April 14, 2009
510(k) Submitter:Thomas Kozma
Director, Regulatory Affairs
Kimberly-Clark Health Care
1400 Holcomb Bridge Road
Roswell, GA 30076
Ph: 770.587.8393
FAX: 920.225.3408
Email: thomas.kozma@kcc.com
Primary Contact for this 510(k) Submission:Lisa Peacock, Consultant to Kimberly-Clark Health Care
SciMed, Inc.
Ph: 706.216.3413
FAX: 800.713.7754
Email: lisa.peacock@kcc.com
Device Common Name:Sterilization Wrap
Classification Name:Sterilization Wrap (21 CFR 880.6850)
Product Code:FRG
Intended Use:KIMGUARD* Sterilization Wrap is intended to be used to enclose
another medical device that is to be sterilized by a health care provider
by pre-vacuum steam at 270°F/132°C for 4 minutes or by 100%
ethylene oxide (EtO) with a concentration of 725-735 mg/L at 131°F/
55°C and 40% - 80% relative humidity for 60 minutes. The wrap is
intended to allow sterilization of the enclosed medical device(s) and
also to maintain sterility of the enclosed device(s) until opened. The
wrap was validated for aeration times for EtO sterilization of 8 hours at
55 °C or 12 hours at 43.3 °C. The wrap was validated for dry times for
pre-vacuum steam sterilization of 20 minutes for Models 100, 200, and
300 and for dry times of 30 minutes for Models 400, 500, and 600.
KIMGUARD* Sterilization Wrap is not indicated for use for gravity
steam sterilization.

See Wrap Model Recommendations on Page 3.

MAY - 1 2009

The KIMGUARD* Sterilization Wrap (Models KC100, KC200, KC300, The KIMGUAHD Glonically are substantially equivalent to the KC400, RC300, and RO000) are oabstanding - Treations of Sterile Wraps

Page 1 of 3 - 510(k) Summary

ਾ ਵ

1

(K881471)

and the control control control control controllers and

・・

| Substantial
Equivalence: | The KIMGUARD* Sterilization Wrap is substantially equivalent to the
predicates in intended use, design, and materials. The predicate
devices were constructed of a three-layer laminate composed of a layer
of meltblown polypropylene bonded on both surfaces with a layer of
spunbonded polypropylene. The sheets of sterilization wrap are square
or rectangular fabric produced using a polypropylene three-layer SMS
(spunbond-meltblown-spunbond) process. |
|-----------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Summary of
Testing: | KIMGUARD* Sterilization Wrap performance has been tested in
accordance with the applicable requirements recommended in
Premarket Notification [510(k)] Submissions for Medical Sterilization
Packaging Systems in Health Care Facilities; Draft Guidance for
Industry and FDA (March 7, 2002). Testing included biocompatibility
(i.e., irritation and sensitization) in compliance with the methods of ISO
10993, sterilant penetration, dry time, and physical integrity. The Wrap
has also been tested for the ability to maintain sterility of pack contents
after sterilization for up to 30 days under standard conditions. All
results of testing met acceptance criteria. |

2

Table 1. Wrap Model Recommendations'
---------------------------------------------

| KIMGUARD*
Sterilization
Wrap Models | Intended Loads | Maximum
Wrapped
Package
Content
Weights Used in
Sterility
Maintenance
Validation
Study2 | Descriptions of Loads Used in Sterility
Maintenance Validation Study2 |
|-------------------------------------------|------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| KC100 | Very Light Weight
Package (for
example: towel
packs) | 3 lbs | 16 huck towels (17"x 29") |
| KC200 | Light Weight Package
(for example:
standard linen packs) | 6 lbs | 2 huck towels (17"x 29")
2 fluid resistant U-drape (68"x109")
1 fluid resistant universal bar drape
(70" x 108") |
| KC300 | Light to Moderate
Weight Package (for
example: general use
medical instruments) | 9 lbs | For Pre-Vacuum Steam:
15 huck towels (17"x 29")
1 small fluid resistant drape (60"x 76")
5 lbs of metal mass
FOR EtO:
16 huck towels
2 fluid resistant large drapes (76"x100")
1 fluid resistant small drape (76"x60")
1 fluid resistant table cover (60"x 90") |
| KC4003 | Moderate to Heavy
Weight Package (for
example: general use
medical instruments) | 13 lbs | 4 tray liners 20" x 25" stacked
10" x 10" x 3 ½ " tray containing 11 lbs of
metal mass |
| KC5003 | Heavyweight
Package (for
example: general use
medical instruments) | 17 lbs | 4 tray liners 20" x 25" stacked
10" x 10" x 3 ½ " tray containing
15 lbs of metal mass |
| KC6003 | Very Heavy Weight
Package (for
example: general
use medical
instruments) | 25 lbs | 4 tray liners 20" x 25" stacked
10" x 10" x 3 ½ " tray containing
23 lbs of metal mass |

ndividual results may differ due to factions in handling practices, wrapping techniques, and folding Individual results may aller one to facilis such as vaniating which may put added stress on the memors. Hasulti may also onlie use of itself which wrapped online on associated on accommended use.
wrap. Each healthcare facility should determine for itself which wrappen

wap. Each neallity should columnis for noal which within weights indicated for each wag model.
4 It is recommended to not exceed the maximum wrapped package twape that was It is recommended to not exceed the number, weight, and size of individual content types that were Futhermore, It is recommended to for exceed the number and size of the fluid resistant linens of the weight of the metal mass).

the metal mass).
The KC400, KC500, and KC500 model waps were validated for sterilianting overs with these model Intelling and RC600 model waps well validation in steriit ating in steriit atincently this oncles will these models. It is linen, and it is recommended to hot exceed 3 tos of normal resistant inemal of the mail of the mail.
recommended that the user not include fluid-resistant linens in KC400 mod fluid resistant materials has not been evaluated with these models.

3

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three stripes forming its body and wings. The eagle is positioned to the right of a circular seal that contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" around the perimeter.

MAY - 1 2009

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Kimberly-Clark Corporation C/o Ms. Lisa Peacock Scimed, Incorporated 172 Conductor Drive Dawsonville, Georgia 30534

Re: K082554

Trade/Device Name: KIMGUARD* Sterilization Wrap (Models KC100, KC200, KC300, KC400, KC500, and KC600) Regulation Number: 21 CFR 880.6850 Regulation Name: Sterilization Wrap Regulatory Class: II Product Code: FRG Dated: April 15, 2009 Received: April 17, 2009

Dear Ms. Peacock:

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 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 statutes and regulations administered by other Federal agencies.

4

Page 2- Ms. Peacock

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 (reporting of medical device-related adverse events) (21 CFR 803); 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.

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 the reporting of adverse events under the MDR regulation (21 CFR Part 803), please contact the CDRH/Office of Surveillance and Biometrics/Division of Postmarket Surveillance at 240-276-3464. For more information regarding the reporting of adverse events, please go to http://www.fda.gov/cdrh/mdr/.

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 vours.

Susan Runner
Susan Runner, D.D.S., M.A.

Susan Runner, D.D.S., MA Acting Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

Indications for Use

510(k) Number (if known): _K082554

Device Name: _ KIMGUARD* Sterilization Wrap (Models KC100, KC200, KC300, KC400, KC500, and KC600)

Indications for Use:

KIMGUARD* Sterilization Wrap is intended to be used to enclose another medical device that is to be sterilized by a health care provider by pre-vacuum steam at 2709E/1329C for 4 minutes or by 100% ethylene oxide (EtO) with a concentration of 725-735 mg/L at 131°F/ 55°C and 40% - 80% relative humidity for 60 minutes. The wrap is intended to allow sterilization of the enclosed medical device(s) and also to maintain sterility of the enclosed device(s) until opened. The wrap was validated for aeration times for EtO sterilization of 8 hours at 55 ℃ or 12 hours at 43.3 ℃. The wrap was validated for dry times for pre-vacuum steam sterilization of 20 minutes for Models 100, 200, and 300 and for dry times of 30 minutes for Models 400, 500, and 600.

KIMGUARD* Sterilization Wrap is not indicated for use for gravity steam sterilization.

See Wrap Model Recommendations on Page 2.

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

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Shale A Murphy
(Division Sign-Off)

Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number: K082554

6

Indications for Use

| Wrap Model Recommendations
KIMGUARD*
Sterilization Wrap

ModelsIntended LoadsMaximum Wrapped Package Content Weights Used in Sterility Maintenance Validation StudyDescriptions of Loads Used in Sterility Maintenance Validation Study
KC100Very Light Weight Package (for example: towel packs)3 lbs16 huck towels (17"x 29")
KC200Light Weight Package (for example: standard linen packs)6 lbs2 huck towels (17"x 29")
2 fluid resistant U-drape (68"x109")
1 fluid resistant universal bar drape (70" x 108")
KC300Light to Moderate Weight Package (for example: general use medical instruments)9 lbsFOR Steam:
15 huck towels (17" x 29")
1 small fluid resistant drape (60" x 76")
5 lbs metal mass
FOR EtO:
16 huck towels
2 fluid resistant large drapes (76"x100")
1 fluid resistant small drape (76"x60")
1 fluid resistant table cover (60"x 90")
KC4003Moderate to Heavy Weight Package (for example: general use medical instruments)13 lbs4 tray liners 20" x 25" stacked
10" x 10" x 3 ½ " tray containing 11 lbs of metal mass
KC5003Heavyweight Package (for example: general use medical instruments)17 lbs4 tray liners 20" x 25" stacked
10" x 10" x 3 ½ " tray containing 15 lbs of metal mass
KC6003Very Heavy Weight Package (for example: general use medical instruments)25 lbs4 tray liners 20" x 25" stacked
10" x 10" x 3 ½ " tray containing 23 lbs of metal mass

Individual results may differ due to factors such as variations in handling practices, wrepping techniques and holling methods individual riskuller the use of irregularly shaped contents, which may put added stress on the wap. Each healthcare Hesults may also differ do the abo of wrop model is most appropriate for each intended use.

Itality shulld delefthing for itself which wapped package contant weights indicated for each wrap model. Furthernes, it is If is recommended to not exceed the namun wapped package contact were whole were with and the mail of the Maria Maria National is recommended to not exceed the number, weight, and size of the weight of the weight the metal mass).
Sterilization Wraps (i.e.: the number and size of the fluid resistant l

Stenization Vriaps (i.e. the namber and size of the nailed for sterilant penetration with 3 lbs of non-fluid resistent linen, and it consemped that is recommented to not exceed 3 lbs of norther perfilms proles with bless model hit is recommended to recommended be is recommended to tot exceed 3 ibs of nor-libration of the model wrops, as use of such fluid resistent materials and not been evaluated with these models.