K Number
K180661
Device Name
SIGMA Sterilization Pouch and Roll
Date Cleared
2018-06-05

(83 days)

Product Code
Regulation Number
880.6850
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The SIGMA sterilization pouch and roll are intended to provide health care workers with an effective method to enclose devices intended for sterilization in steam auto claves and via Ethylene Oxide (EO). The recommended steam sterilization cycle parameters are 30 minutes at 121°C. The recommended EO sterilization cycle is 4 hours at 55°C with a relative humidity between 50%-85% and a sterilant concentration of 600 mg/L. Furthermore, the sterilization pouch and roll maintains the enclosed devices up until 3 years post EO gas sterilization and maintains the enclosed devices up until 6 months post Steam sterilization. Lastly, the pouch's external chemical ink indicators are designed to indicate to the user that the pouch has undergone either a steam or EO sterilization process.
Device Description
The SIGMA sterilization pouch and roll are intended to provide health care workers with an effective method to enclose devices intended for sterilization in steam auto claves and via Ethylene Oxide (EO). The recommended steam sterilization cycle parameters are 30 minutes at 121°C. The recommended EO sterilization cycle is 4 hours at 55°C with a relative humidity between 50%-85% and a sterilant concentration of 600 mg/L. The medical devices are inserted into the Pouch/Roll, sealed, and then sterilized in the Sterilization System. After completion of the sterilization process, the Pouch/Roll maintain sterility of the enclosed medical devices until the seal is opened. The device is intended to allow sterilization of enclosed devices and also to maintain sterility of the enclosed devices until used up to 3 years post EO gas sterilization and maintains the enclosed devices up until 6 months post Steam sterilization. The Self-seal pouch permits sealing of the pouch without need of heat- sealing equipment, while the heat sealed pouches and rolls are heat sealed prior to processing in the steam/or EO Sterilization cycles. The chemical indicators ink printed on the medical grade paper will exhibit a color change after the pouch is exposed to steam or ethylene oxide gas. The color of Chemical Indicator changes from Blue to Greenish Black, when exposed to Steam. And the color changes from red to yellow, when exposed to EO gas. The Chemical Indicator offers an addition way to verity processing in the sterilization cycle. The Chemical Indicator should be used in addition to, not in place of, the biological indicator. The Chemical Indicators do not signify sterilization; they only indicate that the indicator has been exposed to Steam/or EO gas.
More Information

Not Found

No
The device is a sterilization pouch with chemical indicators, which are passive color-changing elements, not AI/ML technology.

No
The device is a sterilization pouch and roll intended to enclose and maintain sterility of medical devices, not to treat or diagnose patients.

No

Explanation: The device is a sterilization pouch and roll intended to enclose devices for sterilization and maintain their sterility, not to diagnose a condition. While it has chemical indicators, these only confirm exposure to a sterilant, not a diagnostic outcome.

No

The device is a physical sterilization pouch and roll with integrated chemical indicators, not a software application.

Based on the provided text, the SIGMA sterilization pouch and roll is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use is to enclose devices for sterilization and maintain their sterility. This is a function related to the preparation and storage of medical devices, not for performing tests on samples taken from the human body.
  • Device Description: The description focuses on the physical properties of the pouch/roll, its ability to withstand sterilization processes, maintain sterility, and the function of the chemical indicators to show exposure to sterilant. None of these functions involve analyzing biological samples.
  • Lack of IVD Characteristics: The text does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing samples (blood, urine, tissue, etc.)
    • Providing diagnostic information about a patient's health
    • Using reagents or assays
    • Measuring analytes

The SIGMA sterilization pouch and roll is a medical device used in the sterilization process of other medical devices. Its function is to facilitate and maintain the sterility of those devices, not to perform a diagnostic test.

N/A

Intended Use / Indications for Use

The SIGMA sterilization pouch and roll are intended to provide health care workers with an effective method to enclose devices intended for sterilization in steam auto claves and via Ethylene Oxide (EO). The recommended steam sterilization cycle parameters are 30 minutes at 121°C. The recommended EO sterilization cycle is 4 hours at 55°C with a relative humidity between 50%-85% and a sterilant concentration of 600 mg/L. Furthermore, the sterilization pouch and roll maintains the enclosed devices up until 3 years post EO gas sterilization and maintains the enclosed devices up until 6 months post Steam sterilization. Lastly, the pouch's external chemical ink indicators are designed to indicate to the user that the pouch has undergone either a steam or EO sterilization process.

The SIGMA sterilization pouch and roll is offered in the following 5 types:

  • Self-sealing sterilization pouches
  • Sterilization pouches, Flat
  • Sterilization pouches, Gusseted
  • Sterilization rolls. Flat
  • Sterilization rolls. Gusseted

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

FRG, JOJ

Device Description

The SIGMA sterilization pouch and roll are intended to provide health care workers with an effective method to enclose devices intended for sterilization in steam auto claves and via Ethylene Oxide (EO). The recommended steam sterilization cycle parameters are 30 minutes at 121°C. The recommended EO sterilization cycle is 4 hours at 55°C with a relative humidity between 50%-85% and a sterilant concentration of 600 mg/L. The medical devices are inserted into the Pouch/Roll, sealed, and then sterilized in the Sterilization System. After completion of the sterilization process, the Pouch/Roll maintain sterility of the enclosed medical devices until the seal is opened. The device is intended to allow sterilization of enclosed devices and also to maintain sterility of the enclosed devices until used up to 3 years post EO gas sterilization and maintains the enclosed devices up until 6 months post Steam sterilization.

The Self-seal pouch permits sealing of the pouch without need of heat- sealing equipment, while the heat sealed pouches and rolls are heat sealed prior to processing in the steam/or EO Sterilization cycles.

The chemical indicators ink printed on the medical grade paper will exhibit a color change after the pouch is exposed to steam or ethylene oxide gas. The color of Chemical Indicator changes from Blue to Greenish Black, when exposed to Steam. And the color changes from red to yellow, when exposed to EO gas.

The Chemical Indicator offers an addition way to verity processing in the sterilization cycle. The Chemical Indicator should be used in addition to, not in place of, the biological indicator. The Chemical Indicators do not signify sterilization; they only indicate that the indicator has been exposed to Steam/or EO gas.

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 workers / Not specified for care setting, but for sterilization of medical devices.

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)

The SIGMA sterilization pouch and roll has the identical intended use and indication for use as the predicate devices. The subject device was compared to the predicate device by testing the Sterilant Penetration, Drying Time, Aeration, Biocompatibility, Package Integrity, Material Compatibility, Sterility Maintenance, and Chemical Indicator Efficacy.

The results of the SIGMA sterilization pouch and roll validation studies demonstrate that the sterilization pouches perform as intended. The results are summarized as follows:

  • The Sterilant Penetration, Drying Time, Aeration, testing performed as described in AAMI / ANSI / ISO 17665-1:2006/(R)2013 and ISO TS 17665-2:2009 for steam sterilization as well as AAMI / ANSI / ISO 11135:2014 for EO. The testing results demonstrate the ability of the sterilant to penetrate the Sigma Sterilization Pouch and Roll.
  • The Biocompatibility testing performed as described in ISO 10993-10:2010(E), ISO 10993-1:2009/Cor. 1:2010(E), ISO 10993-12:2012(E), and ISO/IEC 17025:2005. The testing results demonstrate the Sigma Sterilization Pouch and Roll showed "hegative reaction". And the SIGMA sterilization pouch and roll meets the requirements ISO 10993-10:2010(E). The EO sterilization residuals meets the requirements AAMI / AN-SI / ISO 10993-7:2008 (R) 2012.
  • The Package Integrity, Material Compatibility, Sterility Maintenance testing performed as described in AAMI / ANSI / ISO 11607-1:2006//A1:2014, "Packaging for terminally sterilized medical devices - Part 1: Requirements for materials, sterile barrier systems and packaging systems"; ASTM D882, "Standard Test Method for Tensile Properties of Thin Plastic Sheeting"; ASTM D 5035, "Standard Test Method for Breaking Force and Elongation of Textile Fabrics (Strip Method)": ASTM F 2251-03, "Standard Test Method for Thickness Measurement of Flexible Packaging Material"; ASTM D 1922. "Standard Test Method for Propagation Tear Resistance of Plastic Film and Thin Sheeting by Pendulum Method": ASTM F 1140-07, "Standard Test Methods for Internal Pressurization Failure Resistance of Unrestrained Packages"; ASTM F 1929-98 (04), "Standard Test Method for Detecting Seal Leaks in Porous Medical Packaging by Dye Penetration"; ASTM F88/F88M-09, "Standard Test Method for Seal Strength of Flexible Barrier Materials"; ASTM F 1980-2007, "Standard Guide for Accelerated Aging of Sterile Barrier Systems for Medical Devices"; DIN 58953-6:2010-05, "Sterilization - Sterile supply - Part 6: Microbial barrier testing of packaging materials for medical devices which are to be sterilized". The testing results demonstrate the ability of the Sigma Sterilization Pouch and Roll to maintain the package integrity over the claimed shelf life.

The Chemical Indicator Efficacy testing performed as described in AAMI / ANSI / ISO 11140-1:2014 "Sterilization of Health Care Products - Chemical Indicators - Part 1: General Requirements". There are two types of the Process Indicator ink printed on the SIGMA sterilization pouch and roll. The description of the two types ink as follows:

  • Class 1 Process Indicators for STEAM The testing demonstrates the ability of the Sigma Sterilization Pouch and Roll and its Class 1 Process Indicators for STEAM to remain stable before use based on its shelf life data, change color in the presence of the sterilant, and to maintain the endpoint stability of the color change after being in the presence of the sterilant. The STEAM Process Indicators ink printed on the SIGMA sterilization pouch and roll meets the requirements ISO 11140-1:2014.
  • Class 1 Process Indicators for EO gas The testing demonstrates the ability of the Sigma Sterilization Pouch and Roll and its Class 1 Process Indicators for STEAM to remain stable before use based on its shelf life data, change color in the presence of the sterilant, and to maintain the endpoint stability of the color change after being in the presence of the sterilant. The EO gas Process Indicators ink printed on the SIGMA sterilization pouch and roll meets the requirements ISO 11140-1:2014.

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.

K102158

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

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which consists of a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

June 5, 2018

Sigma Medical Supplies Corp. % Uta Shih Regulatory Affairs Manager Sen Mu Technology Co., LTD. 15F .- 2, No.1, Lane 26, Mincyuan 1st Rd., Lingya District Kaohsiung City, 802 Taiwan

Re: K180661

Trade/Device Name: SIGMA Sterilization Pouch and Roll Regulation Number: 21 CFR 880.6850 Regulation Name: Sterilization Wrap Regulatory Class: Class II Product Code: FRG Dated: February 27, 2018 Received: March 14, 2018

Dear Uta Shih:

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.

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

1

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.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely.

Geeta K. Pamidimukkala -S

for Tina Kiang, Ph.D. Acting Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control, and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Form Approved: OMB No. 0910-0120 Expiration Date: 06/30/2020 See PRA Statement below.

Indications for Use

510(k) Number (if known) K180661

Device Name SIGMA sterilization pouch and roll

Indications for Use (Describe)

The SIGMA sterilization pouch and roll are intended to provide health care workers with an effective method to enclose devices intended for sterilization in steam auto claves and via Ethylene Oxide (EO). The recommended steam sterilization cycle parameters are 30 minutes at 121°C. The recommended EO sterilization cycle is 4 hours at 55°C with a relative humidity between 50%-85% and a sterilant concentration of 600 mg/L. Furthermore, the sterilization pouch and roll maintains the enclosed devices up until 3 years post EO gas sterilization and maintains the enclosed devices up until 6 months post Steam sterilization. Lastly, the pouch's external chemical ink indicators are designed to indicate to the user that the pouch has undergone either a steam or EO sterilization process.

The SIGMA sterilization pouch and roll is offered in the following 5 types:

  • Self-sealing sterilization pouches
  • Sterilization pouches, Flat
  • Sterilization pouches, Gusseted
  • Sterilization rolls. Flat
  • Sterilization rolls. Gusseted

Type of Use (Select one or both, as applicable)

_ Prescription Use (Part 21 CFR 801 Subpart D)

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

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov "An agency may not conduct or sponsor, and a person is not required to respond to, a collection of

information unless it displays a currently valid OMB number."

FORM FDA 3881 (7/17)

3

The defining characteristics of the 5 types as follows:

  • · Self-sealing sterilization pouches: These pouches are made from a medical grade plastic film that is heat sealed on three sides. The forth side has an adhesive strip that is used to seal the pouch. Release paper used in the pouch is a laminated sheet with composing structure of PE/paper/PE. It is a strip to cover the adhesive area and is released before seal the pouch. The medical grade paper conforms to recognized material standards and can be sterilized by steam or ethylene oxide gas. The Process Indicators Ink printed on the medical grade paper will exhibit a color change after the pouch is exposed to steam or ethylene oxide gas.
  • · Sterilization pouches, Flat: These pouches has the same components with the Self-sealing sterilization pouches, except the forth side is left opened instead of an adhesive strip and will be heat-sealed when using.
  • · Sterilization pouches, Gusseted: These pouches are the same with the Sterilization pouches, flat, except that the plastic film is folded on both longest sides instead of flat. This design is convenient to enclose the medical devices with certain height.
  • · Sterilization rolls, Flat: These rolls are made from a medical grade paper and plastic film that are heat sealed on opposite two sides. It will be cut into the suitable length and the opened sides will be heatsealed. The indicators printed on the medical grade paper are the same with the self-sealing sterilization pouches.
  • · Sterilization rolls, Gusseted: These rolls are the same with the flat sterilization roll, except that the plastic film is folded on both longest sides instead of flat. This design is convenient to enclose the medical devices with certain height.

4

The following table (Table 1) lists the model numbers of the SIGMA sterilization pouch and roll by type, model, dimensions, and content/max load (1bs):

TypeDimension in S.I.*Content / Max Load (lbs)
Self-Sealing Sterilization Pouches57 mm × 133 mmMetal 0.02
Self-Sealing Sterilization Pouches70 mm × 257 mmPlastic 0.01
Self-Sealing Sterilization Pouches90 mm × 162 mmLinens and Gauze 0.01
Self-Sealing Sterilization Pouches90 mm × 168 mm
Self-Sealing Sterilization Pouches70 mm × 257mm
Self-Sealing Sterilization Pouches90 mm × 257 mm
Self-Sealing Sterilization Pouches90 mm × 265 mm
Self-Sealing Sterilization Pouches90 mm × 594 mm
Self-Sealing Sterilization Pouches133 mm × 289 mmMetal 0.23
Self-Sealing Sterilization Pouches133 mm × 391 mmPlastic 0.27
Self-Sealing Sterilization Pouches135 mm × 193 mmLinens and Gauze 0.10
Self-Sealing Sterilization Pouches135mm × 283 mm
Self-Sealing Sterilization Pouches135 mm × 335 mm
Self-Sealing Sterilization Pouches150mm × 610 mm
Self-Sealing Sterilization Pouches190 mm × 358 mm
Self-Sealing Sterilization Pouches190 mm × 365 mm
Self-Sealing Sterilization Pouches200 mm x 435 mm
Self-Sealing Sterilization Pouches300 mm × 380 mm
Self-Sealing Sterilization Pouches300 mm × 474 mmMetal 1.13
Self-Sealing Sterilization Pouches300 mm × 485 mmPlastic 2.92
Self-Sealing Sterilization Pouches303 mm × 474 mmLinens and Gauze 1.00
Self-Sealing Sterilization Pouches305 mm × 416 mm
Self-Sealing Sterilization Pouches356 mm × 483 mmMetal 1.31 Plastic 3.38
Linens and Gauze 1.16
Self-Sealing Sterilization Pouches380 mm × 635 mmMetal 1.48 Plastic 4.42
Linens and Gauze 1.51
Self-Sealing Sterilization Pouches460 mm × 610 mmMetal 1.79 Plastic 5.34
Linens and Gauze 1.82
TypeDimension in S.I.*Content / Max Load (lbs)
Sterilization Pouches, Flat75 mm x 150 mmMetal 0.13
Sterilization Pouches, Flat75 mm × 200 mmPlastic 0.02
Sterilization Pouches, Flat75 mm x 300 mmLinens and Gauze 0.02
Sterilization Pouches, Flat100 mm × 200 mm
Sterilization Pouches, Flat100 mm × 300 mm
Sterilization Pouches, Flat100 mm ×550 mm
Sterilization Pouches, Flat120 mm x 250 mm
Sterilization Pouches, Flat120 mm × 280 mm
Sterilization Pouches, Flat150 mm × 200 mm
Sterilization Pouches, Flat150 mm x 250 mm
Sterilization Pouches, Flat150 mm x 300 mm
Sterilization Pouches, Flat150 mm x 380 mm
Sterilization Pouches, Flat150 mm x 550 mmMetal 0.23 Plastic 0.03
Linens and Gauze 0.03
Sterilization Pouches, Flat180 mm x 300 mmMetal 0.13 Plastic 0.02
Sterilization Pouches, Flat200 mm x 330 mmLinens and Gauze 0.02
Sterilization Pouches, Flat200 mm x 400 mmMetal 0.86 Plastic 1.13
Linens and Gauze 0.51
Sterilization Pouches, Flat200 mm x 600 mmMetal 1.29 Plastic 1.69
Linens and Gauze 0.76
Sterilization Pouches, Flat205 mm x 400 mmMetal 0.86
Sterilization Pouches, Flat250 mm x 300 mmPlastic 1.13
Sterilization Pouches, Flat250 mm x 450 mmLinens and Gauze 0.51
Sterilization Pouches, Flat300 mm × 380 mmMetal 0.75
Sterilization Pouches, Flat300 mm × 460 mmPlastic 3.28
Sterilization Pouches, Flat300 mm x 500 mmLinens and Gauze 1.61
Sterilization Pouches, Flat420 mm x 400 mm
Sterilization Pouches, Flat420 mm × 600 mmMetal 1.12 Plastic 4.92
Linens and Gauze 2.41
Sterilization Pouches, Gusseted100 mm × 40 mm ×300 mmMetal 0.21 Plastic 0.05
Sterilization Pouches, Gusseted150 mm × 50 mm × 400 mmLinens and Gauze 0.08
Sterilization Pouches, Gusseted200 mm × 50 mm × 400 mmMetal 0.87 Plastic 1.68
Sterilization Pouches, Gusseted250 mm × 60 mm × 480 mmLinens and Gauze 0.90
Sterilization Pouches, Gusseted300 mm × 70 mm × 500 mmMetal 1.45 Plastic 3.78
Linens and Gauze 1.82

Table 1. Recommended Sterilization Load

5

Table 1. (Continued) Recommended Sterilization Load
---------------------------------------------------------------

6

TypeDimension in S.I.*Content / Max Load (lbs)
Sterilization Rolls, Flat50 mm × 200 MMetal 0.02
Sterilization Rolls, Flat50.8 mm × 200 MPlastic 0.01
Sterilization Rolls, Flat75 mm × 200 MLinens and Gauze 0.01
Sterilization Rolls, Flat76.2 mm × 200 M
Sterilization Rolls, Flat100 mm × 200 M
Sterilization Rolls, Flat101.6 mm × 200 M
Sterilization Rolls, Flat150 mm × 200 M
Sterilization Rolls, Flat152.4 mm × 200 M
Sterilization Rolls, Flat200 mm × 200 MMetal 0.86
Sterilization Rolls, Flat203.2 mm × 200 MPlastic 1.13
Sterilization Rolls, Flat250 mm × 200 MLinens and Gauze 0.51
Sterilization Rolls, Flat254 mm × 200 M
Sterilization Rolls, Flat300 mm × 200 M
Sterilization Rolls, Flat304.8 mm × 200 M
Sterilization Rolls, Flat350 mm × 200 M
Sterilization Rolls, Flat400 mm × 200 MMetal 6.24 Plastic 2.99 Linens and Gauze 2.94
Sterilization Rolls, Flat50.8 mm × 30.5 MMetal 0.02
Sterilization Rolls, Flat76.2 mm × 30.5 MPlastic 0.01
Sterilization Rolls, Flat101.6 mm × 30.5 MLinens and Gauze 0.01
Sterilization Rolls, Flat152.4 mm × 30.5 M
Sterilization Rolls, Flat203.2 mm × 30.5 MMetal 0.86 Plastic 1.13
Sterilization Rolls, Flat254 mm × 30.5 MLinens and Gauze 0.51
Sterilization Rolls, Gusseted75 mm × 35 mm × 100 MMetal 0.12
Sterilization Rolls, Gusseted100 mm × 40 mm × 100 MPlastic 0.02
Sterilization Rolls, Gusseted150 mm × 50 mm × 100 MLinens and Gauze 0.03
Sterilization Rolls, Gusseted200 mm × 50 mm × 100 MMetal 0.87
Sterilization Rolls, Gusseted250 mm × 60 mm × 100 MPlastic 1.68
Sterilization Rolls, Gusseted300 mm × 70 mm × 100 MLinens and Gauze 0.90
Sterilization Rolls, Gusseted350 mm × 80 mm × 100 M
Sterilization Rolls, Gusseted400 mm × 80 mm × 100 MMetal 3.67 Plastic 3.00 Linens and Gauze 3.44

Table 1. (Continued) Recommended Sterilization Load

*Content:

  1. Metal: For example, scalpels, clips, forceps and trays. 2. Plastic: For example, infusion tubes, syringes, foley tubes and gloves, etc. 3. Linens and Cotton: For example, linens, drapes, and cotton wool, etc.

7

K180661 510(k) Summary

1 Sumitter's Information

Name:SIGMA Medical Supplies Corp.
Address:NO.34, Ding-Ping Road, Rui Fang Industrial Park, Rui Fang
Dist., New Taipei City 224, Taiwan (R.O.C.)
Establishment
Registration Number:3004970050
Contact:Mason Huang
Regulatory Affair Specialist
886-4-24366111 ext. 127
E-mail: mason@sigma-medical.com.tw
Or
Jack Wang
President /C.E.O
Date Prepared:May 30, 2018
2 Device Name
Trade Name:SIGMA Sterilization Pouch and Roll
Common/usual Name:SIGMA Sterilization Pouch and Roll
Device Classification Names:1) Wrap, Sterilization.
  1. Indicator, Physical/Chemical Sterilization Pro-
    cess |
    | Panel: | General Hospital |
    | Classification Product Code:
    Subsequent Product Code: | 1) FRG
  2. JOJ |
    | Device Classification: | Class II |
    | Regulation Number: | 1) 21 CFR 880.6850
  3. 21 CFR 880.2800 |

3 Predicate Devices

The predicate device [510(k) Notification K102158, cleared August 02, 2011] is the SIGMA Sterilization Pouch and Roll.

Manufacturer: SIGMA Medical Supplies Corp.

Product Code:1) FRG 2) JOJ

8

510(k) number:K102158

9

4 Indications for Use

The SIGMA sterilization pouch and roll are intended to provide health care workers with an effective method to enclose devices intended for sterilization in steam auto claves and via Ethylene Oxide (EO). The recommended steam sterilization cycle parameters are 30 minutes at 121℃. The recommended EO sterilization cycle is 4 hours at 55℃ with a relative humidity between 50%-85% and a sterilant concentration of 600 mg/L. Furthermore, the sterilization pouch and roll maintains the enclosed devices up until 3 years post EO gas sterilization and maintains the enclosed devices up until 6 months post Steam sterilization. Lastly, the pouch's external chemical ink indicators are designed to indicate to the user that the pouch has undergone either a steam or EO sterilization process.

The SIGMA sterilization pouch and roll is offered in the following 5 types:

  • · Self-sealing sterilization pouches
  • · Sterilization pouches, Flat
  • Sterilization pouches, Gusseted
  • Sterilization rolls, Flat
  • Sterilization rolls, Gusseted

The defining characteristics of the 5 types as follows:

  • · Self-sealing sterilization pouches: These pouches are made from a medical grade plastic film that is heat sealed on three sides. The forth side has an adhesive strip that is used to seal the pouch. Release paper used in the pouch is a laminated sheet with composing structure of PE/paper/PE. It is a strip to cover the adhesive area and is released before seal the pouch. The medical grade paper conforms to recognized material standards and can be sterilized by steam or ethylene oxide gas. The Process Indicators Ink printed on the medical grade paper will exhibit a color change after the pouch is exposed to steam or ethylene oxide gas.
  • · Sterilization pouches, Flat: These pouches has the same components with the Self-sealing sterilization pouches, except the forth side is left opened instead of an adhesive strip and will be heat-sealed when using.
  • · Sterilization pouches, Gusseted: These pouches are the same with the Sterilization pouches, flat, except that the plastic film is folded on both longest sides instead of flat. This design is convenient to enclose the medical devices with certain height.
  • · Sterilization rolls, Flat: These rolls are made from a medical grade paper and plastic film that are heat sealed on opposite two sides. It will be cut into the suitable length and the opened sides will be heat-sealed. The indicators printed on the medical grade paper are the same with the self-sealing sterilization pouches.
  • · Sterilization rolls, Gusseted: These rolls are the same with the flat sterilization roll, except that the plastic film is folded on both longest sides instead of flat. This design is convenient to enclose the medical devices with certain height.

The following table (Table 1) lists the model numbers of the SIGMA sterilization pouch and roll by type, model, dimensions, and content/max load(lbs):

10

TypeModelDimension in S.I.*Content/Max Load (lbs)
Self-Sealing
Sterilization
PouchesSMSE05713357 mm × 133 mmMetal 0.02
SMSE07025770 mm × 257 mmPlastic 0.01
SMSE09016290 mm × 162 mmLines and Gauze 0.01
SMSE09016890 mm × 168 mm
SMSE07025770 mm × 257mm
SMSE09025790 mm × 257 mm
SMSE09026590 mm × 265 mm
SMSE09059490 mm × 594 mmMetal 0.23
SMSE133289133 mm × 289 mmPlastic 0.27
SMSE133391133 mm × 391 mmLines and Gauze 0.10
SMSE135193135 mm × 193 mm
SMSE135283135 mm × 283 mm
SMSE180335135 mm × 335 mm
SMSE150610150 mm × 610 mm
SMSE190358190 mm × 358 mm
SMSE190365190 mm × 365 mm
SMSE200435200 mm × 435 mm
SMSE300380300 mm × 380 mm
SMSE300474300 mm × 474 mmMetal 1.13
SMSE300485300 mm × 485 mmPlastic 2.92
SMSE303474303 mm × 474 mmLines and Gauze 1.00
SMSE305416305 mm × 416 mm
SMSE356483356 mm × 483 mmMetal 1.31 Plastic 3.38
Linens and Gauze 1.16
SMSE380635380 mm × 635 mmMetal 1.48 Plastic 4.42
Lines and Gauze 1.51
SMSE460610460 mm × 610 mmMetal 1.79 Plastic 5.34
Lines and Gauze 1.82
TypeModelDimension in S.I.*Content/Max Load (lbs)
Sterilization Pouches, FlatSMFP07515075 mm × 150 mmMetal 0.13
Plastic 0.02
SMFP07520075 mm × 200 mmLinens and Gauze 0.02
SMFP07530075 mm × 300 mm
SMFP100200100 mm × 200 mm
SMFP100300100 mm × 300 mm
SMFP100550100 mm × 550 mm
SMFP120250120 mm × 250 mm
SMFP120280120 mm × 280 mm
SMFP150200150 mm × 200 mm
SMFP150250150 mm × 250 mm
SMFP150300150 mm × 300 mm
SMFP150380150 mm × 380 mm
Sterilization Pouches, FlatSMFP150550150 mm × 550 mmMetal 0.23 Plastic 0.03
Linens and Gauze 0.03
SMFP180300180 mm × 300 mmMetal 0.13 Plastic 0.02
Linens and Gauze 0.02
SMFP200330200 mm × 330 mmLinens and Gauze 0.02
SMFP200400200 mm × 400 mmMetal 0.86 Plastic 1.13
Linens and Gauze 0.51
SMFP200600200 mm × 600 mmMetal 1.29 Plastic 1.69
Linens and Gauze 0.76
SMFP205400205 mm × 400 mmMetal 0.86
SMFP250300250 mm × 300 mmPlastic 1.13
SMFP250450250 mm × 450 mmLinens and Gauze 0.51
SMFP300380300 mm × 380 mmMetal 0.75
SMFP300460300 mm × 460 mmPlastic 3.28
Linens and Gauze 1.61
SMFP300500300 mm × 500 mm
SMFP420400420 mm × 400 mm
SMFP420600420 mm × 600 mmMetal 1.12 Plastic 4.92
Linens and Gauze 2.41
Sterilization
Pouches, Gus-
setedSMGP100300100 mm × 40 mm × 300 mmMetal 0.21 Plastic 0.05
Linens and Gauze 0.08
SMGP150400150 mm × 50 mm × 400 mm
SMGP200400200 mm × 50 mm × 400 mmMetal 0.87 Plastic 1.68
Linens and Gauze 0.90
SMGP250480250 mm × 60 mm × 480 mm
SMGP300500300 mm × 70 mm × 500 mmMetal 1.45 Plastic 3.78
Linens and Gauze 1.82

Table 1. The model numbers of SIGMA sterilization pouch and roll (Type, Model and Dimension and Content/Max Load)

11

Table 1. (Continued) The model numbers of SIGMA sterilization pouch and roll (Type, Model and Dimension and Content/Max Load)

12

TypeModelDimension in S.I.*Content/Max Load (lbs)
Sterilization
Rolls, FlatSMFR 02250 mm × 200 MMetal 0.02
Plastic 0.01
SMFR 90250.8 mm × 200 MLinens and Gauze 0.01
SMFR 03275 mm × 200 M
SMFR 91276.2 mm × 200 M
SMFR 042100 mm × 200 M
SMFR 922101.6 mm × 200 M
SMFR 062150 mm × 200 M
SMFR 932152.4 mm × 200 M
SMFR 082200 mm × 200 MMetal 0.86
SMFR 942203.2 mm × 200 MPlastic 1.13
Linens and Gauze 0.51
SMFR 102250 mm × 200 M
SMFR 952254 mm × 200 M
SMFR 122300 mm × 200 M
SMFR 962304.8 mm × 200 M
SMFR 142350 mm × 200 M
SMFR 162400 mm × 200 MMetal 6.24 Plastic 2.99
Linens and Gauze 2.94
Sterilization
Rolls, GussetedSMFR 02-150.8 mm × 30.5 MMetal 0.02
Plastic 0.01
SMFR 03-176.2 mm × 30.5 MLinens and Gauze 0.01
SMFR 04-1101.6 mm × 30.5 M
SMFR 06-1152.4 mm × 30.5 M
SMFR 08-1203.2 mm × 30.5 MMetal 0.86 Plastic 1.13
Linens and Gauze 0.51
SMFR 10-1254 mm × 30.5 M
SMGR 03175 mm × 35 mm × 100 MMetal 0.12
Plastic 0.02
SMGR 041100 mm × 40 mm × 100MLinens and Gauze 0.03
SMGR 061150 mm × 50 mm × 100 M
SMGR 081200 mm × 50 mm × 100 MMetal 0.87
SMGR 101250 mm × 60 mm × 100 MPlastic 1.68
Linens and Gauze 0.90
SMGR 121300 mm × 70 mm × 100 M
SMGR 141350 mm × 80 mm × 100 M
SMGR 161400 mm × 80 mm × 100 MMetal 3.67 Plastic 3.00
Linens and Gauze 3.44

Table 1. (Continued) The model numbers of SIGMA sterilization pouch and roll (Type, Model and Dimension and Content/Max Load)

*Content:

1.Metal: For example, scalpels, clips, pins, forceps and trays. 2. Plastic: For example, infusion tubes, syringes, foley tubes and gloves, etc. 3. Linens and Cotton: For example, linens, drapes, and cotton wool, etc.

13

5 Device Description

The SIGMA sterilization pouch and roll are intended to provide health care workers with an effective method to enclose devices intended for sterilization in steam auto claves and via Ethylene Oxide (EO). The recommended steam sterilization cycle parameters are 30 minutes at 121°C. The recommended EO sterilization cycle is 4 hours at 55°C with a relative humidity between 50%-85% and a sterilant concentration of 600 mg/L. The medical devices are inserted into the Pouch/Roll, sealed, and then sterilized in the Sterilization System. After completion of the sterilization process, the Pouch/Roll maintain sterility of the enclosed medical devices until the seal is opened. The device is intended to allow sterilization of enclosed devices and also to maintain sterility of the enclosed devices until used up to 3 years post EO gas sterilization and maintains the enclosed devices up until 6 months post Steam sterilization.

The Self-seal pouch permits sealing of the pouch without need of heat- sealing equipment, while the heat sealed pouches and rolls are heat sealed prior to processing in the steam/or EO Sterilization cycles.

The chemical indicators ink printed on the medical grade paper will exhibit a color change after the pouch is exposed to steam or ethylene oxide gas. The color of Chemical Indicator changes from Blue to Greenish Black, when exposed to Steam. And the color changes from red to yellow, when exposed to EO gas.

The Chemical Indicator offers an addition way to verity processing in the sterilization cycle. The Chemical Indicator should be used in addition to, not in place of, the biological indicator. The Chemical Indicators do not signify sterilization; they only indicate that the indicator has been exposed to Steam/or EO gas.

14

6 Technological Characteristic Comparison

A summary of the technological characteristics of the device subject of this premarket notification in comparison to those of the predicate devices is included in Table 2.

FeatureProposed devicePredicate deviceComparison
Device nameSIGMA sterilization pouch and rollSIGMA sterilization pouch and roll (K102158)
Material CompositionMedical Grade Paper, CPP, PET, PU adhesive, EO and Steam Process Indicator
Print InkMedical Grade Paper, CPP, PET, PU adhesive, EO and Steam Process Indicator
Print InkSame
Intended useThe sterilization pouch and roll are intended to provide health care workers with an effective method to enclose devices intended for sterilization in steam auto claves and via Ethylene Oxide (EO). The recommended steam sterilization cycle parameters are 30 minutes at 121°C. The recommended EO sterilization cycle is 4 hours at 55°C with a relative humidity between 50%-85% and a sterilant concentration of 600 mg/L. Furthermore, the sterilization pouch and roll maintains the enclosed devices up until 3 years post EO gas sterilization and maintains the enclosed devices up until 6 months post Steam sterilization. Lastly, the pouch's external chemical ink indicators are designed to indicate to the user that the pouch has undergone either a steam or EO sterilization process.The sterilization pouch and roll are intended to provide health care workers with an effective method to enclose devices intended for sterilization in steam auto claves and via Ethylene Oxide (EO). The recommended steam sterilization cycle parameters are 30 minutes at 121°C. The recommended EO sterilization cycle is 4 hours at 55°C with a relative humidity between 50%-85% and a sterilant concentration of 600 mg/L. Furthermore, the sterilization pouch and roll maintains the enclosed devices up until 3 years post sterilization. Lastly, the pouch's external chemical ink indicators are designed to indicate to the user that the pouch has undergone either a steam or EO sterilization process.Only the maintenance of sterility is different.
The proposed device maintains the enclosed devices up until 3 years post EO gas sterilization and maintains the enclosed devices up until 6 months post Steam sterilization.
Pouch TypesSelf-sealing sterilization pouches Sterilization pouches, Flat Sterilization pouches, Gusseted Sterilization rolls, Flat Sterilization rolls, GussetedSelf-sealing sterilization pouches Sterilization pouches, Flat Sterilization pouches, Gusseted Sterilization rolls, Flat Sterilization rolls, GussetedSame
Device models (Configurations/Dimensions)Self-Sealing Sterilization Pouches Model Dimension (mm) SMSE057133 $57 \text{ mm } \times 133 \text{ mm}$ SMSE070257 $70 \text{ mm } \times 257 \text{ mm}$ SMSE090162 $90 \text{ mm } \times 162 \text{ mm}$ SMSE090168 $90 \text{ mm } \times 168 \text{ mm}$ SMSE070257 $70 \text{ mm } \times 257 \text{ mm}$ SMSE090257 $90 \text{ mm } \times 257 \text{ mm}$ SMSE090265 $90 \text{ mm } \times 265 \text{ mm}$ SMSE090594 $90 \text{ mm } \times 594 \text{ mm}$ SMSE133289 $133 \text{ mm } \times 289 \text{ mm}$ SMSE133391 $133 \text{ mm } \times 391 \text{ mm}$ SMSE135193 $135 \text{ mm } \times 193 \text{ mm}$ SMSE135283 $135 \text{ mm } \times 283 \text{ mm}$ SMSE180335 $135 \text{ mm } \times 335 \text{ mm}$ SMSE150610 $150 \text{ mm } \times 610 \text{ mm}$ SMSE190358 $190 \text{ mm } \times 358 \text{ mm}$ SMSE190365 $190 \text{ mm } \times 365 \text{ mm}$ SMSE200435 $200 \text{ mm } \times 435 \text{ mm}$ SMSE300380 $300 \text{ mm } \times 380 \text{ mm}$ SMSE300474 $300 \text{ mm } \times 474 \text{ mm}$ SMSE300485 $300 \text{ mm } \times 485 \text{ mm}$ SMSE303474 $303 \text{ mm } \times 474 \text{ mm}$ SMSE305416 $305 \text{ mm } \times 416 \text{ mm}$ SMSE356483 $356 \text{ mm } \times 483 \text{ mm}$ SMSE380635 $380 \text{ mm } \times 635 \text{ mm}$ SMSE460610 $460 \text{ mm } \times 610 \text{ mm}$Self-Sealing Sterilization Pouches Model Dimension (mm) SMSE057133 $57 \text{ mm } \times 133 \text{ mm}$ SMSE090162 $90 \text{ mm } \times 162 \text{ mm}$ SMSE070257 $70 \text{ mm } \times 257 \text{ mm}$ SMSE090257 $90 \text{ mm } \times 257 \text{ mm}$ SMSE135283 $135 \text{ mm } \times 283 \text{ mm}$ SMSE180335 $135 \text{ mm } \times 335 \text{ mm}$ SMSE190358 $190 \text{ mm } \times 358 \text{ mm}$ SMSE300380 $300 \text{ mm } \times 380 \text{ mm}$ SMSE300474 $300 \text{ mm } \times 474 \text{ mm}$The models (dimensions) of type "Self-Sealing Sterilization Pouches" are different. There are 16 additional models in Proposed device.
The additional models (Type, Model and Dimension) of Proposed device are shown in Table 3.

Table 2. Summary of the Proposed and Predicate Devices Technological Characteristics

15

FeatureProposed device: SIGMA sterilization pouch and rollPredicate devices: SIGMA sterilization pouch and roll (K102158)Comparison
Device models
(Configurations/Dimensions)Sterilization Pouches, FlatThe models (dimensions) of type "Sterilization Pouches, Flat" are different. There are 17 additional models in Proposed device. The additional models (Type, Model and Dimension) of Proposed device are shown in Table 3.
ModelDimension (mm)
SMFP07515075 mm × 150 mm
SMFP07520075 mm × 200 mm
SMFP07530075 mm × 300 mm
SMFP100200100 mm × 200 mm
SMFP100300100 mm × 300 mm
SMFP100550100 mm ×550 mm
SMFP120250120 mm × 250 mm
SMFP120280120 mm × 280 mm
SMFP150200150 mm × 200 mm
SMFP150250150 mm × 250 mm
SMFP150300150 mm × 300 mm
SMFP150380150 mm × 380 mm
SMFP150550150 mm × 550 mm
SMFP180300180 mm × 300 mm
SMFP200330200 mm × 330 mm
SMFP200400200 mm × 400 mm
SMFP200600200 mm × 600 mm
SMFP205400205 mm × 400 mm
SMFP250300250 mm × 300 mm
SMFP250450250 mm × 450 mm
SMFP300380300 mm × 380 mm
SMFP300460300 mm × 460 mm
SMFP300500300 mm × 500 mm
SMFP420400420 mm × 400 mm
SMFP420600420 mm × 600 mm
Sterilization Pouches, Gusseted
ModelDimension (mm)Same
SMGP100300100mm×40mm×300mm
SMGP150400150mm×50mm×400mm
SMGP200400200mm×50mm×400mm
SMGP250480250mm×60mm×480mm
SMGP300500300mm×70mm×500mm

Table 2. (Continued) Summary of the Proposed and Predicate Devices Technological Characteristics

16

Table 2 (Continued) Summary of the Proposed and Predicate Devices Technological Characteristics

FeatureProposed device: SIGMA sterilization pouch and rollPredicate devices: SIGMA sterilization pouch and roll (K102158)Comparison
Device models (Configurations/Dimensions)Sterilization Rolls, Flat Model Dimension (mm) SMFR 022 50 mm × 200 M SMFR902 50.8 mm × 200 M SMFR 032 75 mm × 200 M SMFR912 76.2 mm × 200 M SMFR 042 100 mm × 200 M SMFR922 101.6 mm × 200 M SMFR 062 150 mm × 200 M SMFR932 152.4 mm × 200 M SMFR 082 200 mm × 200 M SMFR942 203.2 mm × 200 M SMFR 102 250 mm × 200 M SMFR952 254 mm × 200 M SMFR 122 300 mm × 200 M SMFR962 304.8 mm × 200 M SMFR 142 350 mm × 200 M SMFR 162 400 mm × 200 M SMFR02-1 50.8 mm x 30.5 M SMFR03-1 76.2 mm x 30.5 M SMFR04-1 101.6 mm x 30.5 M SMFR06-1 152.4 mm x 30.5 M SMFR08-1 203.2 mm × 30.5 M SMFR10-1 254 mm x 30.5 MSterilization Rolls, Flat Model Dimension (mm) SMFR 022 50 mm × 200 M SMFR 032 75 mm × 200 M SMFR 042 100 mm × 200 M SMFR 062 150 mm × 200 M SMFR 082 200 mm × 200 M SMFR 102 250 mm × 200 M SMFR 122 300 mm × 200 M SMFR 142 350 mm × 200 M SMFR 162 400 mm × 200 MThe models (dimensions) of type "Sterilization Rolls, Flat" are different. There are 13 additional models in Proposed device. The additional models (Type, Model and Dimension) of Proposed device are shown in Table 3.
Sterilization Rolls, Gusseted Model Dimension (mm) SMGR 031 75mm×35mm×100 M SMGR 041 100mm×40mm×100M SMGR 061 150mm×50mm×100M SMGR 081 200mm×50mm×100M SMGR 101 250mm×60mm×100M SMGR 121 300mm×70mm×100M SMGR 141 350mm×80mm×100M SMGR 161 400mm×80mm×100MSterilization Rolls, Gusseted Model Dimension (mm) SMGR 031 75mm×35mm×100 M SMGR 041 100mm×40mm×100M SMGR 061 150mm×50mm×100M SMGR 081 200mm×50mm×100M SMGR 101 250mm×60mm×100M SMGR 121 300mm×70mm×100M SMGR 141 350mm×80mm×100M SMGR 161 400mm×80mm×100MSame

17

| Feature | Proposed Device:
SIGMA sterilization pouch and roll | Predicate devices:
SIGMA sterilization pouch and roll (K102158) | Comparison | |
|----------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------|---------|
| Steam
Sterilization
cycle | The recommended steam sterilization cycle parameters are 30 minutes at 121°C. | The recommended steam sterilization cycle parameters are 30 minutes at 121°C. | Same | |
| EO gas
Sterilization
cycle | The recommended EO sterilization cycle is 4 hours at 55°C with a relative humidity between 50%-85% and a sterilant concentration of 600 mg/L. | The recommended EO sterilization cycle is 4 hours at 55°C with a relative humidity between 50%-85% and a sterilant concentration of 600 mg/L. | Same | |
| Design
features | Self-sealing sterilization pouches:
These pouches are made from a medical grade plastic film that is heat sealed on three sides. The fourth side has an adhesive strip that is used to seal the pouch. Release paper used in the pouch is a laminated sheet with composing structure of PE/paper/PE. It is a strip to cover the adhesive area and is released before seal the pouch. The medical grade paper conforms to recognized material standards and can be sterilized by steam or ethylene oxide gas. The Process Indicators Ink printed on the medical grade paper will exhibit a color change after the pouch is exposed to steam or ethylene oxide gas.
Sterilization pouches, Flat:
These pouches has the same components with the Self-sealing sterilization pouches, except the fourth side is left opened instead of an adhesive strip and will be heat-sealed when using.
Sterilization pouches, Gusseted:
These pouches are the same with the Sterilization pouches, flat, except that the plastic film is folded on both longest sides instead of flat. This design is convenient to enclose the medical devices with certain height.
Sterilization rolls, Flat:
These rolls are made from a medical grade paper and plastic film that are heat sealed on opposite two sides. It will be cut into the suitable length and the opened sides will be heat-sealed. The indicators printed on the medical grade paper are the same with the self-sealing sterilization pouches.
Sterilization rolls, Gusseted:
These rolls are the same with the flat sterilization roll, except that the plastic film is folded on both longest sides instead of flat. This design is convenient to enclose the medical devices with certain height. | Self-sealing sterilization pouches:
These pouches are made from a medical grade plastic film that is heat sealed on three sides. The fourth side has an adhesive strip that is used to seal the pouch. Release paper used in the pouch is a laminated sheet with composing structure of PE/paper/PE. It is a strip to cover the adhesive area and is released before seal the pouch. The medical grade paper conforms to recognized material standards and can be sterilized by steam or ethylene oxide gas. The Process Indicators Ink printed on the medical grade paper will exhibit a color change after the pouch is exposed to steam or ethylene oxide gas.
Sterilization pouches, Flat:
These pouches has the same components with the Self-sealing sterilization pouches, except the fourth side is left opened instead of an adhesive strip and will be heat-sealed when using.
Sterilization pouches, Gusseted:
These pouches are the same with the Sterilization pouches, flat, except that the plastic film is folded on both longest sides instead of flat. This design is convenient to enclose the medical devices with certain height.
Sterilization rolls, Flat:
These rolls are made from a medical grade paper and plastic film that are heat sealed on opposite two sides. It will be cut into the suitable length and the opened sides will be heat-sealed. The indicators printed on the medical grade paper are the same with the self-sealing sterilization pouches.
Sterilization rolls, Gusseted:
These rolls are the same with the flat sterilization roll, except that the plastic film is folded on both longest sides instead of flat. This design is convenient to enclose the medical devices with certain height. | Same | |
| Steam
Chemical
Indicator Device Design | The color of Chemical Indicator changes from Blue to Greenish Black, when exposed to Steam. | The color of Chemical Indicator changes from Blue to Greenish Black, when exposed to Steam. | Same | |
| EO gas
Chemical
Indicator Device Design | The color changes from red to yellow, when exposed to EO gas. | The color changes from red to yellow, when exposed to EO gas. | Same | |
| Feature | | Proposed Device:
SIGMA sterilization | Predicate Devices:
SIGMA sterilization pouch | Compar- |
| Performance Testing | | pouch and roll | and roll (K102158) | ison |
| Sterilant
Penetration | Half-Cycle Efficacy | The test meet the require-
ment of SAL 10-6 | The test meet the require-
ment of SAL 10-6 | Same |
| | Chemical Indicator (CI) Func-
tionality and Endpoint | The sterilant penetrated
through the pouch configu-
ration and affected the CI
color change to the end-
point color | The sterilant penetrated
through the pouch configu-
ration and affected the CI
color change to the end-
point color | Same |
| Package
Integrity
(Physical
Properties) | Thickness Variations (mm)
ASTM F 2251 | Passed | Passed | Same |
| | Tensile strength of plastic film *
(kgf/mm2)
ASTM D882 | Passed | Passed | Same |
| | Tensile strength of paper*
(N/15mm)
ISO 1924-2 | Passed | Passed | Same |
| | Air permeance of paper* (lb/in)
ISO 5636-3 | Passed | Passed | Same |
| | Thickness Variation (mm)
ASTM F2251 | Passed | Passed | Same |
| | Tear Resistance Test (kgf/cm2)
ASTM D 1004 | Passed | Passed | Same |
| | Burst Strength (kPa)
ASTM F1140 ; ISO 11607-1 | Passed | Passed | Same |
| | Bubble Leak Test
ASTM D 3078 ; ASTM-F 2096 | Passed | Passed | Same |
| | Seal Peel Test (g/15mm)
ASTM F88/F88M ; ISO 11607-1 | Passed | Passed | Same |
| | Dye penetration Test
ASTM F 1929 ;ISO 11607-1 | Passed | Passed | Same |
| | Microbial Barrier Test
DIN 58953-6 ;or ASTM F 1608 | Passed | Passed | Same |
| | Toxicological Properties
(Biocompatibility Test)
ANSI/AAMI/ISO 10993-10 | Passed | Passed | Same |
| | Durability: Accelerated Aging
Test
ASTM F 1980 ; ISO 11607-1 | Passed | Passed | Same |
| End Point /
Post Pro-
cessing Col-
or Stability | after steam sterilization | 6 months | 6 months | Same |
| | after EO sterilization | 3 Years | 3 Years | Same |
| Shelf Life | Chemical Indicator (CI)
Functionality | 3 Years | 3 Years | Same |
| | Accelerated aging test
(Seal Strength) | 3 Years | 3 Years | Same |

Table 2. (Continued) Summary of the Proposed and Predicate Devices Technological Characteristics

18

Table 2 (Continued) Summary of the Proposed and Predicate Devices Technological Characteristics

Note: *the test items were performed on materials of the products; there is no specification requirements.

19

TypeModelDimension in S.I.
Self-Sealing Sterilization PouchesSMSE07025770 mm × 257 mm
SMSE09016890 mm × 168 mm
SMSE09026590 mm × 265 mm
SMSE09059490 mm × 594 mm
SMSE133289133 mm × 289 mm
SMSE133391133 mm × 391 mm
SMSE135193135 mm × 193 mm
SMSE150610150 mm × 610 mm
SMSE190365190 mm × 365 mm
Self-Sealing Sterilization PouchesSMSE200435200 mm × 435 mm
Self-Sealing Sterilization PouchesSMSE300485300 mm × 485 mm
Self-Sealing Sterilization PouchesSMSE303474303 mm × 474 mm
Self-Sealing Sterilization PouchesSMSE305416305 mm × 416 mm
Self-Sealing Sterilization PouchesSMSE356483356 mm × 483 mm
Self-Sealing Sterilization PouchesSMSE380635380 mm × 635 mm
Self-Sealing Sterilization PouchesSMSE460610460 mm × 610 mm
Sterilization Pouches, FlatSMFP07515075 mm × 150 mm
SMFP100550100 mm ×550 mm
SMFP120250120 mm × 250 mm
SMFP120280120 mm × 280 mm
SMFP150200150 mm × 200 mm
SMFP150250150 mm × 250 mm
SMFP150380150 mm × 380 mm
SMFP150550150 mm × 550 mm
SMFP180300180 mm × 300 mm
SMFP200330200 mm × 330 mm
SMFP200600200 mm × 600 mm
SMFP205400205 mm × 400 mm
SMFP250300250 mm × 300 mm
SMFP300380300 mm × 380 mm
SMFP300460300 mm × 460 mm
SMFP420400420 mm × 400 mm
Sterilization Pouches, FlatSMFP420600420 mm × 600 mm
Sterilization Rolls, FlatSMFR 90250.8 mm × 200 M
SMFR 91276.2 mm × 200 M
SMFR 922101.6 mm × 200 M
SMFR 932152.4 mm × 200 M
SMFR 942203.2 mm × 200 M
SMFR 952254 mm × 200 M
SMFR 962304.8 mm × 200 M
SMFR 02-150.8 mm × 30.5 M
SMFR 03-176.2 mm × 30.5 M
SMFR 04-1101.6 mm × 30.5 M
SMFR 06-1152.4 mm × 30.5 M
SMFR 08-1203.2 mm × 30.5 M
Sterilization Rolls, FlatSMFR 10-1

Table 3 Additional models of SIGMA sterilization pouch and roll (Type, Model and Dimension)

20

7 Summary of Non-Clinical Testing

The SIGMA sterilization pouch and roll has the identical intended use and indication for use as the predicate devices. The subject device was compared to the predicate device by testing the Sterilant Penetration, Drying Time, Aeration, Biocompatibility, Package Integrity, Material Compatibility, Sterility Maintenance, and Chemical Indicator Efficacy.

The results of the SIGMA sterilization pouch and roll validation studies demonstrate that the sterilization pouches perform as intended. The results are summarized as follows:

  • · The Sterilant Penetration, Drying Time, Aeration, testing performed as described in AAMI / ANSI / ISO 17665-1:2006/(R)2013 and ISO TS 17665-2:2009 for steam sterilization as well as AAMI / ANSI / ISO 11135:2014 for EO. The testing results demonstrate the ability of the sterilant to penetrate the Sigma Sterilization Pouch and Roll.
  • · The Biocompatibility testing performed as described in ISO 10993-10:2010(E), ISO 10993-1:2009/Cor. 1:2010(E), ISO 10993-12:2012(E), and ISO/IEC 17025:2005. The testing results demonstrate the Sigma Sterilization Pouch and Roll showed "hegative reaction". And the SIGMA sterilization pouch and roll meets the requirements ISO 10993-10:2010(E). The EO sterilization residuals meets the requirements AAMI / AN-SI / ISO 10993-7:2008 (R) 2012.
  • · The Package Integrity, Material Compatibility, Sterility Maintenance testing performed as described in AAMI / ANSI / ISO 11607-1:2006//A1:2014, "Packaging for terminally sterilized medical devices - Part 1: Requirements for materials, sterile barrier systems and packaging systems"; ASTM D882, "Standard Test Method for Tensile Properties of Thin Plastic Sheeting"; ASTM D 5035, "Standard Test Method for Breaking Force and Elongation of Textile Fabrics (Strip Method)": ASTM F 2251-03, "Standard Test Method for Thickness Measurement of Flexible Packaging Material"; ASTM D 1922. "Standard Test Method for Propagation Tear Resistance of Plastic Film and Thin Sheeting by Pendulum Method": ASTM F 1140-07, "Standard Test Methods for Internal Pressurization Failure Resistance of Unrestrained Packages"; ASTM F 1929-98 (04), "Standard Test Method for Detecting Seal Leaks in Porous Medical Packaging by Dye Penetration"; ASTM F88/F88M-09, "Standard Test Method for Seal Strength of Flexible Barrier Materials"; ASTM F 1980-2007, "Standard Guide for Accelerated Aging of Sterile Barrier Systems for Medical Devices"; DIN 58953-6:2010-05, "Sterilization - Sterile supply - Part 6: Microbial barrier testing of packaging materials for medical devices which are to be sterilized". The testing results demonstrate the ability of the Sigma Sterilization Pouch and Roll to maintain the package integrity over the claimed shelf life.

The Chemical Indicator Efficacy testing performed as described in AAMI / ANSI / ISO 11140-1:2014 "Sterilization of Health Care Products - Chemical Indicators - Part 1: General Requirements". There are two types of the Process Indicator ink printed on the SIGMA sterilization pouch and roll. The description of the two types ink as follows: - Class 1 Process Indicators for STEAM

The testing demonstrates the ability of the Sigma Sterilization Pouch and Roll and its Class 1 Process Indicators for STEAM to remain stable before use based on its shelf life data, change color in the presence of the sterilant, and to maintain the endpoint stability of the color change after being in the presence of the sterilant. The STEAM Pro

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cess Indicators ink printed on the SIGMA sterilization pouch and roll meets the requirements ISO 11140-1:2014.

  • Class 1 Process Indicators for EO gas

The testing demonstrates the ability of the Sigma Sterilization Pouch and Roll and its Class 1 Process Indicators for STEAM to remain stable before use based on its shelf life data, change color in the presence of the sterilant, and to maintain the endpoint stability of the color change after being in the presence of the sterilant. The EO gas Process Indicators ink printed on the SIGMA sterilization pouch and roll meets the requirements ISO 11140-1:2014.

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8 CONCLUSION

The conclusions drawn from the nonclinical tests demonstrate that SIGMA Sterilization Pouch and Roll is as safe, as effective, and performs as well as or better than the predicate K102158.