K Number
K210405
Date Cleared
2021-12-15

(308 days)

Product Code
Regulation Number
878.4040
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

ProTEC-USA EZDoff Gown is intended to protect health care patients and health care personnel from the transfer of microorganisms, body fluids and particulate material. The ProTEC-USA EZDoff Gown is a single use, disposable gown provided non-sterile. The back of the gown is open and non-protective. The gown is not intended for use in the operating room.

Device Description

The ProTEC-USA EZDoff Gown is constructed of 41 gsm blue polyolefin (Polyethylene) film offered in one universal size. The body of the gown is provided with belt ties that are constructed of the same 41 gsm blue polyolefin (Polyethylene) film. The sleeves of the gown are sealed using a heat-sealing method.

AI/ML Overview

The document describes the acceptance criteria and study results for the ProTEC-USA EZDoff Gown, a non-sterile, single-use protective medical gown.

Here's a breakdown of the requested information:

1. Table of Acceptance Criteria and Reported Device Performance:

Test Method (Reference Standard)Acceptance CriteriaReported Device Performance
Flammability (CPSC, 16 CFR Part 1610)Average burn time ≥ 3.5sPass (Meets Class 1 Flammability)
Hydrostatic Pressure (AAMI PB70:2012)AATCC 127 ≥ 50 cm, AQL of 4.0Pass (Meets Level 3 liquid barrier requirements)
Water Impact (AAMI PB70:2012)AATCC 42 ≤ 1.0g, AQL of 4.0Pass (Meets Level 3 liquid barrier requirements)
Breaking Strength (ASTM D5034)The standard does not include an acceptance criteria.52N (Machine Direction), 41N (Transverse Direction)
Tearing Strength (ASTM D5587)The standard does not include an acceptance criteria.8N (Machine Direction), 22N (Transverse Direction)
Linting (ISO 9073-10)The standard does not include an acceptance criteria.Log10 < 4
Air Permeability (ASTM C522)The standard does not include an acceptance criteria.0 ft³/min/ft²
Cytotoxicity (ISO 10993-5:2009)Under the conditions of the studies ISO 10993-5:2009, the proposed device is non-cytotoxic.Pass
Sensitization (ISO 10993-10:2010)Under the conditions of the studies: ISO 10993-10:2010, the proposed device is non-sensitizing.Pass
Irritation (ISO 10993-10:2010)Under the conditions of the studies: ISO 10993-10:2010, the proposed device is non-irritating.Pass

2. Sample Size Used for the Test Set and Data Provenance:

  • Sample Size:
    • For Hydrostatic Pressure and Water Impact tests, "three (3) nonconsecutive lots" were utilized.
    • For Breaking Strength and Tearing Strength tests, "three (3) nonconsecutive lots" were utilized.
    • For Linting, "three (3) nonconsecutive lots" were utilized.
    • The specific number of units tested within each lot is not provided.
    • For Flammability, Cytotoxicity, Sensitization, and Irritation, a specific sample size is not explicitly stated beyond "Under the conditions of the studies."
  • Data Provenance: The document does not specify the country of origin of the data or whether the tests were retrospective or prospective. These were non-clinical, lab-based tests.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts:

This information is not applicable as the document describes non-clinical testing of a medical gown. The "ground truth" here refers to objective measurements against established international and national standards, not expert medical opinion.

4. Adjudication Method for the Test Set:

This information is not applicable as the tests were objective measurements against predefined standards, not subjective assessments requiring adjudication.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and the Effect Size of How Much Human Readers Improve with AI vs. without AI Assistance:

This information is not applicable. The device is a protective medical gown, not an AI-powered diagnostic or assistive tool for human readers. No MRMC study was performed.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done:

This information is not applicable. The device is a physical medical gown, not an algorithm.

7. The Type of Ground Truth Used:

The "ground truth" for the performance evaluation of the ProTEC-USA EZDoff Gown was established through objective measurements against established international and national standards (e.g., AAMI PB70:2012, CPSC 16 CFR Part 1610, ASTM D5034, ASTM D5587, ISO 9073-10, ASTM C522, ISO 10993-5, ISO 10993-10). These standards define the acceptable performance characteristics for medical gowns and materials.

8. The Sample Size for the Training Set:

This information is not applicable as the document describes non-clinical testing of a physical medical device, not a machine learning model that requires a training set.

9. How the Ground Truth for the Training Set Was Established:

This information is not applicable as there was no training set for an algorithm. The "ground truth" for evaluating the gown's performance was derived from the aforementioned standardized test methods.

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December 15, 2021

Cadillac Products, Inc. % Dennis Gucciardo Partner Morgan Lewis & Bockius LLP 1111 Pennsylvania Ave Washington, District of Columbia 20004-2541

Re: K210405

Trade/Device Name: ProTEC-USA EZDoff Gown Regulation Number: 21 CFR 878.4040 Regulation Name: Surgical Apparel Regulatory Class: Class II Product Code: OPC Dated: November 15, 2021 Received: November 15, 2021

Dear Dennis Gucciardo:

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.

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

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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,

For Clarence W. Murray, III, Ph.D. Assistant Director DHT4B: Division of Infection Control and Plastic Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health

Enclosure

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Indications for Use

  • 79 -

510(k) Number (if known) K210405

Device Name ProTEC-USA EZDoff Gown

Indications for Use (Describe)

ProTEC-USA EZDoff Gown is intended to protect health care patients and health care personnel from the transfer of microorganisms, body fluids and particulate material. The ProTEC-USA EZDoff Gown is a single use, disposable gown provided non-sterile. The back of the gown is open and non-protective. The gown is not intended for use in the operating room.

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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K210405

510(k) SUMMARY

Cadillac Product Inc.'s ProTEC USA EZDoff Gown

Submitter's Name, Address, Telephone Number, Contact Person and Date Prepared:

Cadillac Products, Inc. 5800 Crooks Road Suite 100 Troy, MI 48098

Phone: (248) 813-8200 Fax: (248) 813-8282

Contact Person: Andrew Stone Date Summary Prepared: December 11, 2021

Application Correspondent

Dennis C. Gucciardo, Partner

Morgan, Lewis & Bockius, LLP 1111 Pennsylvania Ave. NW Washington, DC 20004-2541

Phone: (202) 739-5278

Name of Device and Name:

ProTEC-USA EZDoff Gown

Common or Usual Name:

Singe Use/Non-Sterile Open Back Protective Gowns

Classification Name:

Class II, 21 CFR § 878.4040; Product Code QPC

Predicate Device

ValueCare®Open Back Protective Gown (K160337)

Intended Use / Indications for Use

ProTEC-USA EZDoff Gown is intended to protect health care patients and health care personnel from the transfer of microorganisms, body fluids and particulate material. The ProTEC-USA EZDoff Gown is a single use, disposable gown provided non-sterile. The back of the gown is open and nonprotective. The gown is not intended for use in the operating room.

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Device Description

The ProTEC-USA EZDoff Gown is constructed of 41 gsm blue polyolefin (Polyethylene) film offered in one universal size. The body of the gown is provided with belt ties that are constructed of the same 41 gsm blue polyolefin (Polyethylene) film. The sleeves of the gown are sealed using a heat-sealing method.

Comparison of Technological Characteristics with the Predicate Device

The technological characteristics of the ProTEC-USA EZDoff Gown are nearly identical to the cleared ValueCare®Open Back Protective Gown (K160337). Both devices are made from extruded plastic film and include sleeves that are sealed with a heat treatment. A summary of the technologies and characteristics between the predicate device and the ProTEC-USA EZDoff Gown are provided in the table below.

Predicate Device:ValueCare® Open BackProtective Gown (K160337)Proposed Device: ProTEC-USA EZDoff Gown(K210405)Comparison
Intended Use /Indications forUseThese gowns are intendedtoprotect health care patientsand health care personnelfrom the transferofmicroorganisms, body fluidsand particulate material. Theback of the gown is open andnon- protective. They are notintended for use in theoperating room.ProTEC-USA EZDoff Gownis intended to protect healthcare patients and healthcare personnel from thetransfer of microorganisms,body fluids and particulatematerial. The ProTEC-USAEZDoff Gown is a singleuse, disposable gownprovided non-sterile. Theback of the gown is openand non-protective. Thegown is not intended for usein the operating room.Same
DesignDesign includes open back,thumbloops,backperforation for easy removaland waist tieDesign includes open back,thumbloops,backperforation for easy removaland waist tieSame
MaterialCompositionMade from extruded plasticfilmMade from extruded plasticfilm(Polyolefin(Polyethylene) film)Same
SterilityNon-sterileNon-sterileSame
UseSingle use; disposableSingle use; disposableSame
ColorBlueBlueSame
Labeling ClaimsThese gowns are intendedtoprotect health care patientsand health care personnelfrom the transferofmicroorganisms, body fluidsand particulate material. Theback of the gown is open andnon- protective. They are notintended for use in theoperating room.Non-SterileThese gowns are intended toprotect health care patientsand health care personnelfrom the transferofmicroorganisms, body fluidsand particulate material. Theback of the gown is open andnon- protective. They are notintended for use in theoperating room.Non-SterileSame
- Not Made withNatural RubberLatexMeets ANSI/AAMIPB70: 2012 Level 3Open Back Non-protectiveSingleUse,Disposable- Not Made withNatural RubberLatexMeets ANSI/AAMIPB70: 2012 Level 3Open Back Non-protectiveSingle Use,Disposable
Flammability16 CFR 1610Meets Class 1 "normalflammability " in accordanceto 16 CFR Part 1610Meets Class 1 "normalflammability " in accordanceto 16 CFR Part 1610Same
Liquid BarrierPerformanceClassificationPropertiesDevice was tested inaccordance with AAMIPB70:2012 and meets Level3 requirements for anisolation gown.Device was tested inaccordance with AAMIPB70:2012 and meets Level3 requirements for anisolation gown.Same
BiocompatibilityPassISO 10993-1PassISO 10993-1Same
TearingStrength /ResistanceNot Reported8N (Machine Direction)22N (Transverse Direction)Not reported forcomparison
LintNot ReportedLog10<4Not reported forcomparison
Air PermeabilityNot Reported0 ft³/min/ft²Not reported forcomparison
Tensile StrengthNot Reported52N (Machine Direction)41N (Transverse Direction)Not reported forcomparison
SterilizationModalityNone(Non-Sterile)None(Non-Sterile)Same

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Summary of Non-Clinical Testing Performed on the Proposed Device

Test MethodPurposeAcceptance CriteriaResults
FlammabilityTest performed inaccordance with(CPSC), 16 CFRPart 1610Average burn time ≥3.5sPassMeets Class 1Flammability.
Hydrostatic PressureTest performed inaccordance with AAMIPB70:2012 utilizingthree (3)nonconsecutive lots.AATCC 127 ≥ 50 cmAQL of 4.0PassMeets Level 3 liquidbarrier requirements.
Water ImpactTest performed inaccordance with AAMIPB70:2012 utilizingthree (3)nonconsecutive lots.AATCC 42 ≤ 1.0gAQL of 4.0PassMeets Level 3 liquidbarrier requirements.
Breaking strengthTest performed inaccordance withASTM D5034utilizing three (3)nonconsecutivelots.The standard does notinclude an acceptancecriteria.The test resultsreported values were52N (MachineDirection), 41N(TransverseDirection).
Tearing strengthTest performed inaccordance withASTM D5587The standard does notinclude an acceptancecriteria.The test resultsreportedvalues were

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utilizing three(3)nonconsecutivelots.8N (MachineDirection), 22N(TransverseDirection).
LintingTest performed inaccordance with ISO9073-10 utilizing three(3) nonconsecutive lots.The standard does notinclude an acceptancecriteria.The test resultsreported value was$Log_{10}<4$ .
Air PermeabilityTest performed inaccordance with ASTMC522.The standard does notinclude an acceptancecriteria.The test resultsreported value was 0 ft3/min/ft2

Biocompatibility Testing Performed on the Proposed Device

Test MethodPurposeAcceptance CriteriaResults
CytotoxicityTest performed inaccordance with ISO10993-5:2009.Under the conditionsof the studies ISO10993-5:2009, the proposeddevice is non-cytotoxic.Pass
SensitizationTest performed inaccordance with ISO10993-10:2010.Under the conditionsof the studies: ISO10993-10:2010, the proposeddevice is non-sensitizingPass
IrritationTest performed inaccordance with ISO10993-10:2010.Under the conditionsof the studies: ISO10993-10:2010, the proposeddevice is non-irritating.Pass

The EZDoff Gown was tested and conformed to the following standards and requirements:

StandardNumberStandardsOrganizationStandards TitleVersionDate
ASTM F2407American Societyfor Testing &MaterialsStandard Specification forSurgical Gowns Intended for Usein Healthcare Facilities2013May 2013
AAMIPB70:2012AmericanNational StandardLiquid Barrier PerformanceClassification of ProtectiveApparel and Drapes Intended foruse in Health Care Facilities20126/21/2012
(CPSC), 16 CFRPart 1610ConsumerProduct SafetyCommissionStandard for Flammability ofClothing Textiles20083/25/2008
ISO 10993-1:2009/(R)2013InternationalOrganization ofStandardizationBiological Evaluation of MedicalDevices - Part 1: Evaluation andtesting with a risk managementprocess201310/15/2013
ISO 10993-5:2009InternationalOrganization ofStandardizationBiological Evaluation of MedicalDevices - Part 5: Tests for In-Vitro Cytotoxicity20096/1/2009
ISO 10993-10:2010InternationalOrganization ofStandardizationBiological Evaluation of MedicalDevices - Part 10: Tests for20108/1/2010

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irritation and delayed-type ofhypersensitivity
ASTM D5587-15American Societyfor Testing &MaterialsStandard Test Method forTearing Strength of Fabrics byTrapezoid Procedure20197/1/2019
ASTM D5034-09American Societyfor Testing &MaterialsStandard Test Method forBreaking Strength andElongation of Textile Fabrics20177/15/2019
ASTM C522American Societyfor Testing &MaterialsStandard Test Method for AirflowResistance of AcousticalMaterials20164/1/2016

Summary of Clinical Testing

No clinical testing was performed.

Conclusion:

The conclusions drawn from the nonclinical testing demonstrate that the ProTEC-USA EZDoff Gown is as safe, as effective, and performs as well as or better than the legally marketed device predicate.

§ 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.