K Number
K102666
Device Name
KIMBERLY-CLARK SURGICAL DRAPES WITH AAMI LIQUID BARRIER LEVEL 4 CLAIM
Date Cleared
2010-11-09

(55 days)

Product Code
Regulation Number
878.4370
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Kimberly-Clark* Corporation intends to market the sterile Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim as devices made of natural or synthetic material intended to be used as a protective patient covering, such as to isolate a site of surgical incision from microbial and other contamination. The Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim meet the Level 4 requirements of the AAMI Liquid Barrier classifications. The Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim are also sold as bulk non-sterile, single use items, to repackager/relabeler establishments for further packaging and Ethylene Oxide (EtO) sterilization.
Device Description
The Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim are constructed with various base sheet and reinforcement fabric types, provided in various sizes and shapes, and may contain fluid collection pouches or clear film panels as components. The base sheet fabric is a three layer laminate comprised of polypropylene spunbond/polypropylene meltblown/polypropylene spunbond. Layers are thermally embossed together producing a single layer with various basis weights. Fabric is topically treated to enhance water repellency and to assure static dissipation. The drape reinforcement fabrics are constructed of various configurations of spunbond, meltblown and film. The reinforcement materials are either CONTROL PLUS*, a spunbond/meltblown/film laminate or SURROUND*, a spunbond/film laminate. The primary component of these materials is polypropylene with surfactant and blue pigment.
More Information

Not Found

No
The device description and performance studies focus on material properties and barrier performance, with no mention of AI or ML.

No.
The device acts as a protective barrier to isolate a surgical site from contamination, not to deliver a therapeutic effect to the patient.

No.
The device is a surgical drape intended to provide a protective barrier during surgery, not to diagnose a condition.

No

The device description clearly indicates it is a physical product made of various fabrics and materials, intended for use as a protective patient covering during surgery. It does not describe any software components.

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

Here's why:

  • Intended Use: The intended use is described as a "protective patient covering, such as to isolate a site of surgical incision from microbial and other contamination." This is a physical barrier function, not a diagnostic test performed on samples taken from the body.
  • Device Description: The description focuses on the materials and construction of a surgical drape, designed for physical protection.
  • Performance Studies: The performance studies mentioned relate to liquid barrier performance, biocompatibility, and compliance with standards for protective apparel and drapes. These are not diagnostic performance metrics.
  • Lack of Diagnostic Elements: There is no mention of analyzing biological samples, detecting analytes, or providing diagnostic information.

IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. This surgical drape does not fit that description.

N/A

Intended Use / Indications for Use

Kimberly-Clark* Corporation intends to market the sterile Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim as devices made of natural or synthetic material intended to be used as a protective patient covering, such as to isolate a site of surgical incision from microbial and other contamination. The Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim meet the Level 4 requirements of the AAMI Liquid Barrier classifications.

The Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim are also sold as bulk non-sterile, single use items, to repackager/relabeler establishments for further packaging and Ethylene Oxide (EtO) sterilization.

Product codes

KKX

Device Description

The Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim are constructed with various base sheet and reinforcement fabric types, provided in various sizes and shapes, and may contain fluid collection pouches or clear film panels as components. The base sheet fabric is a three layer laminate comprised of polypropylene spunbond/polypropylene meltblown/polypropylene spunbond. Layers are thermally embossed together producing a single layer with various basis weights. Fabric is topically treated to enhance water repellency and to assure static dissipation.

The drape reinforcement fabrics are constructed of various configurations of spunbond, meltblown and film. The reinforcement materials are either CONTROL PLUS*, a spunbond/meltblown/film laminate or SURROUND*, a spunbond/film laminate. The primary component of these materials is polypropylene with surfactant and blue pigment.

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

Not Found

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)

In addition to performance testing in accordance with industry recognized test methods, these drapes have been tested for biocompatibility using cytotoxicity, primary skin irritation tests and sensitization testing. Additionally, the Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim were tested in compliance with the requirements of :

  • · Level 4 liquid barrier performance of ANSI/AAMI PB70: 2003 "Liquid barrier performance and classification of protective apparel and drapes intended for use in health care facilities."
    All results of testing met acceptance criteria.

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

Not Found

Predicate Device(s)

K083234

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

0

K102666

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

Surgical Drapes with AAMI Liquid Barrier Level 4 claim

Date Summary was Prepared:November 3, 2010
NOV - 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 Trade
Name:Kimberly-Clark* Surgical Drapes
Device Common
namesSterile surgical drapes
Device Product
Codes and
Classification
Names:KKX Class II
Surgical Drapes (21 CFR 878.4370)
Predicate DevicesThe predicate device for these Kimberly-Clark* Surgical Drapes
with AAMI Liquid Barrier Level 4 claim are the Kimberly-Clark*
surgical drapes cleared in premarket notification
K083234 KC100 Surgical Drapes and Equipment Covers.
Device
Description:The Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier
Level 4 claim are constructed with various base sheet and
reinforcement fabric types, provided in various sizes and shapes,
and may contain fluid collection pouches or clear film panels as
components. The base sheet fabric is a three layer laminate
comprised of polypropylene spunbond/polypropylene
meltblown/polypropylene spunbond. Layers are thermally
embossed together producing a single layer with various basis
weights. Fabric is topically treated to enhance water repellency
and to assure static dissipation.

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

1

K102666

The drape reinforcement fabrics are constructed of various configurations of spunbond, meltblown and film. The reinforcement materials are either CONTROL PLUS*, a spunbond/meltblown/film laminate or SURROUND*, a spunbond/film laminate. The primary component of these materials is polypropylene with surfactant and blue pigment.

The Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Intended Use: Level 4 claim are devices made of natural or synthetic material intended to be used as a protective patient covering, such as to isolate a site of surgical incision from microbial and other contamination. These drapes meet the Level 4 requirements of the AAMI Liquid Barrier Classifications.

The Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim are also sold as bulk non-sterile, single use items, to repackager/relabeler establishments for further packaging and Ethylene Oxide (EtO) sterilization.

Technological Characteristics and Substantial Equivalence:

The Kimberly-Clark* Surgical Drape with AAMI Liquid Barrier Level 4 claim, that is subiect of this premarket notification is substantially equivalent to the predicate KC100 Surgical Drapes and Equipment Covers (K083234) in intended use, design and biocompatibility. The performance attributes of the Kimberly-Clark* Surgical Drape with AAMI Liquid Barrier Level 4 claim are substantially equivalent to the predicate drape. The key difference is the drapes subject of this submission have been tested for compliance to Level 4 liquid barrier performance of ANSI/AAMI PB70: 2003 "Liquid barrier performance and classification of protective apparel and drapes intended for use in health care facilities."

Summary of In addition to performance testing in accordance with industry Testing: recognized test methods, these drapes have been tested for biocompatibility using cytotoxicity, primary skin irritation tests and sensitization testing. Additionally, the Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim were tested in compliance with the requirements of :

  • · Level 4 liquid barrier performance of ANSI/AAMI PB70: 2003 "Liquid barrier performance and classification of protective apparel and drapes intended for use in health care facilities."
    All results of testing met acceptance criteria.

2

Image /page/2/Picture/0 description: The image shows the text "DEPARTMENT OF HEALTH & HUMAN SERVICES" in all capital letters. The text is in a simple, sans-serif font and is horizontally oriented. The text is likely part of a document header or title, indicating the affiliation or subject matter related to health and human services.

Public Health Service

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

Kimberly-Clark Corporation C/O Mr. Ned Devine Responsible Third Party Official Underwriters Laboratories, Incorporated 333 Pfingsten Road Northbrook, Illinois 60062

NOV - 9 2.0.0

Re: K102666

Trade/Device Name: Kimberly-Clark Surgical Drapes with AAMI Liquid Barrier Level 4 claim Model Numbers List Attached Regulation Number: 21 CFR 878.4370 Regulation Name: Surgical Drape and Drape Accessories Regulatory Class: II Product Code: KKX Dated: September 14, 2010 Received: September 15, 2010

Dear Mr. Devine:

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- Mr. Ed Devine

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/Offices/ucm115809.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,

Jans Itodo

for

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

Enclosure

4

Indications for Use

510(k) Number (if known):

Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim Device Name: Model Numbers List Attached

Indications for Use:

Kimberly-Clark* Corporation intends to market the sterile Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim as devices made of natural or synthetic material intended to be used as a protective patient covering, such as to isolate a site of surgical incision from microbial and other contamination. The Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim meet the Level 4 requirements of the AAMI Liquid Barrier classifications.

The Kimberly-Clark* Surgical Drapes with AAMI Liquid Barrier Level 4 claim are also sold as bulk non-sterile, single use items, to repackager/relabeler establishments for further packaging and Ethylene Oxide (EtO) sterilization.

Prescription Use (Part 21 CFR 801 Subpart D) Over-The-Counter Use × (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)

Elysabeth S. Clavie-Wallace

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

510(k) Number: K102666

Page 1 of 2

5

Indications for Use Model Number List

Product NameModel NumberDrape Materials
nonsterilesterile
Breast Drape7923689236SMS base panel with SF reinforcement
Laparoscopic Abdominal
Drape7923389233SMS base panel with SF reinforcement
EENT Split Drape7935189352SMS base panel with SF reinforcement
Laparotomy Drape w/ Arm
Board Covers7922889228SMS base panel with SMF reinforcement
Laparotomy Drape w/
Troughs7923489234SMS base panel with SMF reinforcement
Laparotomy Drape7921089211SMS base panel with SMF reinforcement
Cardiovascular Split Drape7945189451SMS base panel with SMF reinforcement
Hip Drape7934189341SMS base panel with SMF reinforcement
CVARTS* CV Incise Drape7946689466SMS base panel with SMF reinforcement
ORTHOARTS* Hip Drape7934689346SMS base panel with SMF reinforcement
ORTHOARTS* Lower
Extremity Drape7927889278SMS base panel with SMF reinforcement

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