K Number
K093115
Device Name
KIMBERLY-CLARK KC100 SURGICAL GOWN, MODEL KC100
Date Cleared
2010-03-19

(168 days)

Product Code
Regulation Number
878.4040
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Kimberly-Clark* KC100 Surgical Gowns are sterile, single use devices 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. The Kimberly-Clark* KC100 Surgical Gowns are also sold as bulk non-sterile, single use items, to repackager/relabeler establishments for further packaging and Ethylene Oxide (EtO) sterilization.
Device Description
Disposable gowns are used in the OR as a protective covering, for operating room staff, from the transfer of microorganisms, body fluids and particulates. Kimberly-Clark's KC100 Surgical Gowns are comprised of a single layer of SMS (spunbond/meltblown/spunbond polypropylene) fabric. The gowns consist of 100% polyester cuffs sewn to the end of the sleeves using polyester thread. The gowns also have a manual closure system.
More Information

No
The device description and intended use clearly define a physical garment (surgical gown) with no mention of software, data processing, or any technology related to AI/ML.

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

No
The device, Kimberly-Clark* KC100 Surgical Gowns, is described as protective covering for operating room staff to prevent transfer of microorganisms and fluids. It does not perform any diagnosis or provide diagnostic information.

No

The device is a surgical gown, which is a physical product made of fabric and other materials, not software.

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

Here's why:

  • Intended Use: The intended use clearly states the gowns are for protecting operating room personnel and patients from the transfer of microorganisms, body fluids, and particulate material during surgical procedures. This is a barrier function, not a diagnostic one.
  • Device Description: The description focuses on the physical properties and materials of the gown, designed for protection.
  • Lack of Diagnostic Elements: There is no mention of the device being used to examine specimens from the human body (like blood, urine, tissue, etc.) to provide information for diagnosis, monitoring, or screening.
  • Performance Studies: The performance studies listed focus on barrier properties, strength, repellency, flammability, and linting – all related to the protective function of the gown, not diagnostic accuracy.

IVD devices are specifically designed to perform tests on samples taken from the body to provide medical information. This surgical gown does not fit that description.

N/A

Intended Use / Indications for Use

The Kimberly-Clark* KC100 Surgical Gowns are sterile, single use devices 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.

The Kimberly-Clark* KC100 Surgical Gowns are also sold as bulk non-sterile, single use items, to repackager/relabeler establishments for further packaging and Ethylene Oxide (EtO) sterilization.

Product codes

FYA

Device Description

Disposable gowns are used in the OR as a protective covering, for operating room staff, from the transfer of microorganisms, body fluids and particulates. Kimberly-Clark's KC100 Surgical Gowns are comprised of a single layer of SMS (spunbond/meltblown/spunbond polypropylene) fabric. The gowns consist of 100% polyester cuffs sewn to the end of the sleeves using polyester thread. The gowns also have a manual closure system.

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

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)

Testing included biocompatibility (i.e., cytotoxicity, irritation, and sensitization) in compliance with the methods of ISO 10993, barrier properties, tensile and tear strength, alcohol repellency, flammability, and linting. All results of testing met acceptance criteria

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

Not Found

Predicate Device(s)

K091097

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

Image /page/0/Picture/0 description: The image shows the Kimberly-Clark logo. The logo consists of a stylized "K" symbol on the left, followed by the text "Kimberly-Clark" in bold, sans-serif font. The "K" symbol is a geometric shape with intersecting lines, enclosed in a circle.

K093//5

510(k) Summary for the Kimberly-Clark* Corporation KC100 Surgical Gowns

Date Summary was Prepared:March 4, 2010MAR 1 9 2010
510(k) Submitter:Marcia Johnson, RAC
Technical Leader, Regulatory Affairs
Kimberly-Clark Health Care
1400 Holcomb Bridge Road
Roswell, GA 30076
Ph: 770.587.8566
FAX: 920.380.6351
Email: Marcia.johnson@kcc.com
Primary Contact for this 510(k) Submission:Marcia Johnson, RAC
Technical Leader, Regulatory Affairs
Kimberly-Clark Health Care
1400 Holcomb Bridge Road
Roswell, GA 30076
Ph: 770.587.8566
FAX: 920.380.6351
Email: Marcia.johnson@kcc.com
Device Common Name:Sterile surgical gowns
Trade Name:KC100 Surgical Gowns
Device Product Codes and Classification Names:FYA Surgical Gowns
Predicate Device:K091097 proMedical Surgical Gowns
Device Description:Disposable gowns are used in the OR as a protective covering, for operating room staff, from the transfer of microorganisms, body fluids and particulates. Kimberly-Clark's KC100 Surgical Gowns are comprised of a single layer of SMS (spunbond/meltblown/spunbond polypropylene) fabric. The gowns consist of 100% polyester cuffs sewn to the end of the sleeves using polyester thread. The gowns also have a manual closure system.

Page 1 of 2 - Section 6 510(k) Summary

1

K093115

Intended Use:

The Kimberly-Clark* KC100 Surgical Gowns are sterile, single use devices 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.

The Kimberly-Clark* KC100 Surgical Gowns are also sold as bulk non-sterile, single use items, to repackager/relabeler establishments for further packaging and Ethylene Oxide (EtO) sterilization.

Technological Characteristics The Kimberly-Clark* KC100 Surgical Gowns have the same design, material and chemical characteristics of the predicate device.

Summary of Testing:

The KC100 Surgical Gowns are identical to, and meet the same acceptance testing criteria as, their predicate gowns in K091097. Testing included biocompatibility (i.e., cytotoxicity, irritation, and sensitization) in compliance with the methods of ISO 10993, barrier properties, tensile and tear strength, alcohol repellency, flammability, and linting. All results of testing met acceptance criteria

Substantial Equivalence:

The surgical gowns described in this 510(k) submission are identical in all specifications to the predicate device models identified in K091097.

2

Image /page/2/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized graphic of an eagle or bird-like figure with three curved lines representing its wings or feathers.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

MAR 1 9 2010

Ms. Marcia Johnson Regulatory Affairs Kimberly-Clark Corporation 1400 Holcomb Bridge Road Roswell, Georgia 30076

Re: K093115

Trade/Device Name: KC100 Surgical Gowns Regulation Number: 21CFR 878.4040 Regulation Name: Surgical Apparel Regulatory Class: II Product Code: FYA Dated: March 9, 2010 Received: March 12, 2010

Dear Ms. Johnson:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

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.

3

Page 2- Ms. Johnson

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) 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 go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ ucm 1 15809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. 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 go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours.

Susan Quiñones
Anthony D. Watson, B.S., M.S., M.B.A:

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

510(k) Number (if known): __ _ _ K093115

Device Name: KC100 Surgical Gowns

Indications for Use:

The Kimberly-Clark* KC100 Surgical Gowns are sterile, single use devices intended to be worn by operating room personnel during surgical procedures to protect hoth the surgical patient and the operating room personnel from transfer of microorganisms, body fluids, and particulate material.

The Kimberly-Clark* KC100 Surgical Gowns are also sold as bulk non-sterile, single use items, to repackager/relabeler establishments for further packaging and Ethylene Oxide (EtO) sterilization.

See Page 2 for product list.

Prescription Use (Part 21 CFR 801 Subpart D)

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Geetha Jayou.

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

510(k) Number:__K093115

5

Page 2 of 2

KO93115

:

Addendum

The KC100 Surgical Gowns are available under the following Reference Numbers and descriptions.

:

.

Sterile Gowns
99284KC100 Surgical Gown, Large
99285KC100 Surgical Gown, X-Large
99294KC100 Surgical Gown, Large, X-Long
99295KC100 Surgical Gown, X-Large, X-Long
Non-Sterile Gowns
79284KC100 Surgical Gown, Large
79285KC100 Surgical Gown, X-Large
79294KC100 Surgical Gown, Large, X-Long
79295KC100 Surgical Gown, X-Large, X-Long