K Number
K210020
Device Name
Medical Mask
Date Cleared
2021-04-28

(114 days)

Product Code
Regulation Number
878.4040
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Medical Masks are intended to be worn to protect both the patient and healthcare personnel from transfer of microorganisms, body fluids and particulate material. These face masks are intended for use in infection control practices to reduce the potential exposure to blood and body fluids.
Device Description
The Medical Masks are single use, three-layer, flat masks with ear loops/straps and nose clamp. The Medical Masks are manufactured with three layers, the inner and outer layers are made of spun-bond polypropylene, and the middle laver is made of melt blown polvpropylene filter. The model of proposed device, Ear-loop, is held in place over the user's mouth and nose by two elastic ear loops welded to the face mask. The elastic ear loops are not made with natural rubber latex. The model of proposed device. Tie-on, is held in place over the user's mouth and nose by four ties welded to the face mask. The tie is made of spun-bond polypropylene. The nose clamp contained in the proposed device is in the layers of face mask to allow the user to fit the face mask around their nose, which is made of metal core plastic. The proposed devices are single use, disposable device, provided in both non-sterile and sterile forms.
More Information

Not Found

No
The device description and performance studies focus on the physical properties and filtration capabilities of a medical mask, with no mention of AI or ML.

No.
The device is described as a medical mask for protection against microorganisms, not for treating any specific medical condition or disease.

No
Explanation: The device is a medical mask intended to protect against the transfer of microorganisms, body fluids, and particulate material. It does not perform any diagnostic function.

No

The device description clearly outlines physical components (spun-bond polypropylene, melt blown polypropylene filter, metal core plastic nose clamp, elastic ear loops, ties) and the performance studies focus on physical properties and biological compatibility, not software functionality.

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

Here's why:

  • Intended Use: The intended use clearly states the masks are for protecting against the transfer of microorganisms, body fluids, and particulate material. This is a physical barrier function, not a diagnostic test performed on samples taken from the body.
  • Device Description: The description details the physical construction of the mask (layers, ear loops, nose clamp). There is no mention of reagents, assays, or any components used to analyze biological samples.
  • Performance Studies: The performance studies focus on the physical properties of the mask, such as fluid resistance, filtration efficiency, flammability, and biocompatibility (cytotoxicity, irritation, sensitization). These are tests of the mask's ability to act as a barrier and be safely worn, not tests of its ability to diagnose a condition.
  • Key Metrics: The key metrics reported are related to the mask's barrier and filtration capabilities (fluid resistance, PFE, BFE, differential pressure) and safety (flammability, cytotoxicity, irritation, sensitization). These are not diagnostic metrics like sensitivity, specificity, PPV, or NPV, which are used to evaluate the performance of diagnostic tests.

IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for the diagnosis, monitoring, or treatment of a disease or condition. This medical mask does not perform any such function.

N/A

Intended Use / Indications for Use

The Medical Masks are intended to be worn to protect both the patient and healthcare personnel from transfer of microorganisms, body fluids and particulate material. These face masks are intended for use in infection control practices to reduce the potential exposure to blood and body fluids.

Product codes

FXX

Device Description

The Medical Masks are single use, three-layer, flat masks with ear loops/straps and nose clamp. The Medical Masks are manufactured with three layers, the inner and outer layers are made of spun-bond polypropylene, and the middle laver is made of melt blown polvpropylene filter. The model of proposed device, Ear-loop, is held in place over the user's mouth and nose by two elastic ear loops welded to the face mask. The elastic ear loops are not made with natural rubber latex. The model of proposed device. Tie-on, is held in place over the user's mouth and nose by four ties welded to the face mask. The tie is made of spun-bond polypropylene. The nose clamp contained in the proposed device is in the layers of face mask to allow the user to fit the face mask around their nose, which is made of metal core plastic. The proposed devices are single use, disposable device, provided in both non-sterile and sterile forms.

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)

Non-clinical tests were conducted and conformed to the following standards and the requirements state in the Guidance for Industry and FDA Staff: Surgical Masks -Premarket Notification [510(k)] Submission issued on March 05, 2004.
Standards:

  • ASTM F2100-19 Standard Specification For Performance of Materials used in Medical Face Masks.
  • ASTM F1862-13 Standard Test Method For Resistance of Medical Face Masks to Penetration by Synthetic Blood.
  • ASTM F2299-03 Stand Test Method For Determining The Initial Efficiency Of ● Materials Used In Medical Face Masks To Penetration By Particulates Using Latex Spheres.
  • 16 CFR 1610 Standard For The Flammability Of Clothing Textiles.
  • ASTM F1980-16 Standard Guide for Accelerated Aging of Sterile Barrier Systems for Medical Devices.
  • ANSI/AAMI/ISO 11135:2014 Sterilization of health care products - Ethylene oxide - Requirements for Development, validation, and routine control of a sterilization process for Medical devices
  • ISO 10993-5: 2009 Biological Evaluation Of Medical Devices – Part 5: Tests For In Vitro Cytotoxicity.
  • ISO 10993-10: 2010 Biological Evaluation Of Medical Devices – Part 10: Tests For Irritation And Skin Sensitization.

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

Fluid Resistance Performance (ASTM F1862): Pass at 160 mmHg
Particulate Filtration Efficiency (ASTM F2299): > 98%
Bacterial Filtration Efficiency (ASTM F2101): > 98%
Differential Pressure (EN 14683:2019): 5.0mmH2O/cm2 (

§ 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.

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April 28, 2021

Zhende Medical Co., Ltd. % Joyce Yang Consultant Shenzhen Jovantech Consulting Co., Ltd. 1713A, 17th Floor, Block A, Zhongguan Times Square, Nanshan District Shenzhen, Guangdong 518100 China

Re: K210020

Trade/Device Name: Medical Mask Regulation Number: 21 CFR 878.4040 Regulation Name: Surgical Apparel Regulatory Class: Class II Product Code: FXX Dated: March 24, 2021 Received: March 29, 2021

Dear Joyce Yang:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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.

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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) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

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/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE(@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely.

Ryan Ortega -S

Ryan Ortega PhD Acting Assistant Director DHT4B: Division of Infection Control and Plastic Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K210020

Device Name Medical Mask

Indications for Use (Describe)

The Medical Masks are intended to be worn to protect both the patient and healthcare personnel from transfer of microorganisms, body fluids and particulate material. These face masks are intended for use in infection control practices to reduce the potential exposure to blood and body fluids.

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

Prescription Use (Part 21 CFR 801 Subpart D)

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

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510(k) Summary

510(k) Number: K210020

Date of Summary prepared: April 27, 2021

1. Submission Sponsor

Applicant NameZhende Medical Co., Ltd.
AddressGaobu Town, 312035, Shaoxing, Zhejiang, P.R.
China.
Contact personChen Ming
Phone+86-575-88770363

Submission correspondent 2.

NameShenzhen Joyantech Consulting Co., Ltd
Address1713A, 17th Floor, Block A, Zhongguan Times
Square, Nanshan District, Shenzhen
Post Code518000
Phone No.+86-755-86069197
Contact PersonJoyce Yang
Emailjoyce@cefda.com

Device Identification 3.

Type of 510(k) submission:Traditional
Trade Name:Medical Mask
Classification name:Mask, Surgical
Review Panel:Surgical Apparel
Product Code:FXX
Device Class:II
Regulation Number:878.4040

4. Legally Marketed Predicate Device

Trade NameSingle-use Surgical Mask
Regulation number878.4040
Regulation classII
Regulation nameSurgical Apparel
510(k) NumberK200923
Product CodeFXX
ManufacturerBYD Precision Manufacturer Co.,Ltd.

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5. Device Description

The Medical Masks are single use, three-layer, flat masks with ear loops/straps and nose clamp. The Medical Masks are manufactured with three layers, the inner and outer layers are made of spun-bond polypropylene, and the middle laver is made of melt blown polvpropylene filter.

The model of proposed device, Ear-loop, is held in place over the user's mouth and nose by two elastic ear loops welded to the face mask. The elastic ear loops are not made with natural rubber latex.

The model of proposed device. Tie-on, is held in place over the user's mouth and nose by four ties welded to the face mask. The tie is made of spun-bond polypropylene.

The nose clamp contained in the proposed device is in the layers of face mask to allow the user to fit the face mask around their nose, which is made of metal core plastic.

The proposed devices are single use, disposable device, provided in both non-sterile and sterile forms.

6. Intended Use/ Indications for Use

The Medical Masks are intended to be worn to protect both the patient and healthcare personnel from transfer of microorganisms, body fluids and particulate material. These face masks are intended for use in infection control practices to reduce the potential exposure to blood and body fluids.

7. Technological characteristics comparison

The Medical Mask is compared with the predicate device Single-use Surgical Mask(K200923). The product characteristics are shown as follow:

| Comparison

itemSubject Device (K210020)Predicate Device (K200923)Comments
Product
CodeFXXFXXSame
Regulation
Number21 CFR § 878.404021 CFR § 878.4040Same
ClassificationClass IIClass IISame
OTC useYesYesSame
The Medical Masks are
intended to be worn to protect
both the patient and healthcare
personnel from transfer of
microorganisms, body fluids and
particulate material. These faceThe Single-use Surgical Face
Masks are intended to be worn
to protect both the patient and
healthcare personnel from
transfer of microorganisms,
body fluids and particulate
Indications for
Usemasks are intended for use in
infection control practices to
reduce the potential exposure to
blood and body fluids.material. These face masks are
intended for use in infection
control practices to reduce the
potential exposure to blood and
body fluids. This is a single use,
disposable device, provided non-
sterile.Same
LevelLevel 3Level 3Similar
Design featureEar-loop, Tie-on Flat Pleated, 3
layersEar-loop Flat Pleated, 3 layersSimilar
UsageSingle useSingle useSame
ColorBlueBlueSame
SizeWidth: 18.0cm+/-1.0cm,
14.0cm +/-1.0cm
Length: 9.5cm+/-1.0cmWidth: 17.5cm+/-0.4cm
Length: 9.5cm+/-0.4cmDifferent
SterileNon-sterile, SterileNon-sterileDifferent
Sterilization
methodEO/Different
MaterialOuter layer: Spun-bond
polypropyleneOuter layer: Spun-bond
polypropyleneSame
Middle layer: Melt blown
polypropyleneMiddle layer: Melt blown
polypropyleneSame
Inner layer: Spun-bond
polypropyleneInner layer: Spun-bond
polypropyleneSame
Nose clamp: Metal Core Plastic
Ear loops: Polyester and
spandex/Elastic laminate Straps:
Spun-bond polypropyleneNose piece: Metal Core Plastic
Ear loops: PolyesterDifferent
Fluid Resistance
Performance
(ASTM F1862)Pass at 160 mmHgPass at 160 mmHgSame
Particulate
Filtration
Efficiency
(ASTM F2299)> 98%> 98%Same
Bacterial
Filtration
Efficiency
(ASTM F2101)> 98%> 98%Same
Differential
Pressure (EN
14683:2019)5.0mmH2O/cm2
(