K Number
K211105
Manufacturer
Date Cleared
2021-05-17

(34 days)

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

When properly worn, the Ear-Friendly Masks are intended to protect and healthcare workers from transfer of microorganisms, body fluids and particulate material. This device is non sterile and for single use only.

Device Description

The Ear-Friendly Masks are non-sterile, single use, 3 layers, flat-pleated style with ear loops and nose piece. The outer layer and inner facing layer of face mask consist of Spunbond Polypropylene, and the middle layer consists of Melt Blown Polypropylene Filter. Each mask contains ear loops to secure the mask over the user's face and mouth with nose piece to firmly fit over the nose. This device is not made from any natural rubber latex.

AI/ML Overview

Here's a breakdown of the acceptance criteria and study that proves the device meets them, based on the provided FDA 510(k) Summary for the "Ear-Friendly Mask."

Device Description:
The Ear-Friendly Mask is a non-sterile, single-use, 3-layer, flat-pleated surgical face mask with ear loops and a nose piece. It is intended to protect both patients and healthcare workers from the transfer of microorganisms, body fluids, and particulate material.


1. Acceptance Criteria and Reported Device Performance

The acceptance criteria for the Ear-Friendly Mask are based on the ASTM F2100 standard for the performance of materials used in surgical face masks, specifically for Level 3 performance. The table below outlines the acceptance criteria and the device's reported performance:

Test NameStandardAcceptance Criteria (ASTM F2100 - Level 3)Reported Device PerformanceMeets Criteria?
Fluid ResistanceASTM F1862160 mmHgPassYes
Particle Filtration Efficiency (PFE)ASTM F2299$\ge$ 98%PassYes (@ 0.1 micron)
Bacterial Filtration Efficiency (BFE)ASTM F2101$\ge$ 98%PassYes
Differential PressureMIL-M-36954C< 6.0 mmH2O/cm²PassYes
Flammability Test16 CFR part 1610Class 1PassYes
CytotoxicityISO 10993-5Non-cytotoxicNon-cytotoxicYes
SensitizationISO 10993-10Non-sensitizingNon-sensitizingYes
IrritationISO 10993-10Non-irritatingNon-irritatingYes

The document states, "All Result of testing met ASTM F2100 Level 3 acceptance Criteria."


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

The document does not explicitly state the specific sample sizes used for each of the performance tests (Fluid Resistance, PFE, BFE, Differential Pressure, Flammability, Biocompatibility).

Data Provenance: The studies were non-clinical (bench testing and biocompatibility), conducted by the manufacturer, RAY Co., Ltd., based in Anyang-si, Gyeonggi-do, Korea. The provenance is therefore prospective industrial testing aimed at regulatory submission.


3. Number of Experts Used to Establish Ground Truth and Qualifications

  • Not applicable (N/A). This submission pertains to a physical medical device (surgical face mask) and its performance characteristics (filtration, fluid resistance, etc.), along with its biocompatibility. The "ground truth" for these tests is established through standardized laboratory methods (e.g., ASTM F tests, ISO 10993). There is no mention or requirement for human experts (e.g., radiologists) to establish ground truth as would be the case for an AI/CADe device interpreting medical images.

4. Adjudication Method for the Test Set

  • Not applicable (N/A). As these are objective, standardized physical and chemical tests, there is no need for an adjudication method in the way one would adjudicate human expert interpretations in a clinical study. The tests yield quantitative results that are compared directly against the predefined numerical acceptance criteria.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

  • No, an MRMC comparative effectiveness study was not done. This device is a physical product (surgical face mask), not an AI-assisted diagnostic or imaging device. Therefore, studies involving human readers or their improvement with AI assistance are not relevant.

6. If a Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study Was Done

  • Not applicable (N/A). This device is a physical medical product, not an algorithm or software device. The concept of "standalone performance" for an algorithm is not relevant here. The tests performed are purely bench and biocompatibility tests on the physical mask itself.

7. The Type of Ground Truth Used

The ground truth for this device's performance relies on objective, standardized laboratory test results as defined by:

  • Consensus Standards: ASTM F2100 (for mask performance) and ISO 10993 (for biocompatibility).
  • Specific Test Methods: ASTM F1862 (Fluid Resistance), ASTM F2299 (PFE), ASTM F2101 (BFE), MIL-M-36954C (Differential Pressure), 16 CFR part 1610 (Flammability), ISO 10993-5 (Cytotoxicity), ISO 10993-10 (Sensitization/Irritation).

The "ground truth" is whether the quantitative results obtained from these tests meet the specified numerical acceptance criteria for a Level 3 surgical mask.


8. The Sample Size for the Training Set

  • Not applicable (N/A). This device is not an AI/ML product developed using training datasets. The 'training set' concept does not apply to the manufacturing and testing of a physical product like a surgical face mask.

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

  • Not applicable (N/A). As there is no training set for an AI/ML model, there is no ground truth to be established for it. The product's compliance is demonstrated through a series of physical and chemical performance tests.

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Image /page/0/Picture/0 description: The image contains 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 the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG" in blue, and below that, the word "ADMINISTRATION" in blue.

March 8, 2022

Ray Co., Ltd. % Rafael Aguila Responsible Third Party Official Accelerated Device Approval Services 6800 S.W. 40th Street, Ste. 403 Ludlum, Florida 33155

Re: K211105

Trade/Device Name: Ear-Friendly Mask Regulation Number: 21 CFR 878.4040 Regulation Name: Surgical Apparel Regulatory Class: Class II Product Code: FXX

Dear Rafael Aguila:

The Food and Drug Administration (FDA) is sending this letter to notify you of an administrative change related to your previous substantial equivalence (SE) determination letter dated May 17, 2021. Specifically, FDA is updating this SE Letter for an incorrect date as an administrative correction.

Please note that the 510(k) submission was not re-reviewed. For questions regarding this letter please contact Clarence W. Murray III, PhD., OHT4: Office of Surgical and Infection Control Devices, 301-796-0270, clarence.murray@fda.hhs.gov.

Sincerely,

Liqun Zhao -S

For Clarence W. Murray III, PhD. 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

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Image /page/1/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health and Human Services seal on the left and the FDA acronym along with the full name of the agency on the right. The FDA part of the logo is in blue, with the acronym in a solid blue square and the words "U.S. FOOD & DRUG ADMINISTRATION" in a lighter blue next to it.

May 17, 2017

Ray Co., Ltd. % Rafael Aguila Responsible Third Party Official Accelerated Device Approval Services 6800 S.W. 40th Street, Ste. 403 Ludlum, Florida 33155

Re: K211105

Trade/Device Name: Ear-Friendly Mask Regulation Number: 21 CFR 878.4040 Regulation Name: Surgical Apparel Regulatory Class: Class II Product Code: FXX Dated: May 4, 2021 Received: May 6, 2021

Dear Rafael Aguila:

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 mediation-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,

Bifeng Qian -S

For Ryan Ortega, Ph.D. 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) K211105

Device Name Ear-Friendly Mask

Indications for Use (Describe)

When properly worn, the Ear-Friendly Masks are intended to protect and healthcare workers from transfer of microorganisms, body fluids and particulate material. This device is non sterile and for single use only.

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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K211105 510(k) Summary

1. 510(k) Summary

The summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of 21 CFR Part 807.92.

2. Date:May 14, 2021
3. 510(K) Number:K211105
4. Administrative Information
Sponsor InformationRAY Co.,Ltd
ADDRESS38, Simin-daero, Manan-gu, Anyang-si, Gyeonggi-do, 14098, Korea
ManufacturerRAY Co.,Ltd38, Simin-daero, Manan-gu, Anyang-si, Gyeonggi-do, 14098, Korea
TEL : +82-31-605-1000FAX : +82-2-6280-5534
Contact PersonChanghwan LeeTitle : RA ManagerPhone: +82-31-605-1000Fax: +82-2-6280-5534e-mail : ch0406.lee@raymedical.co.kr

5. Device Information

Device Name

Trade/Proprietary Name: Ear-Friendly Mask Common Name: Surgical Face Mask

Classification

Classification Name: Surgical Face Mask Regulation Number : 21 CFR 878.4040 Class : Il Product code : FXX Panel : General and Plastic Surgery

6. Predicate device

ParameterPredicate Device
-----------------------------

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Device NameAvianz® Surgical Face Mask
ManufacturerMEXPO INTERNATIONAL INC
510(K) NumberK200847
Classification nameSurgical Face Mask
Regulation number878.4040
Primary product codeFXX

7. Device Description

The Ear-Friendly Masks are non-sterile, single use, 3 layers, flat-pleated style with ear loops and nose piece. The outer layer and inner facing layer of face mask consist of Spunbond Polypropylene, and the middle layer consists of Melt Blown Polypropylene Filter. Each mask contains ear loops to secure the mask over the user's face and mouth with nose piece to firmly fit over the nose. This device is not made from any natural rubber latex.

8. Indication for use

When properly worn, the Ear-Friendly Masks are intended to protect both patient and healthcare workers from transfer of microorganisms, body fluids and particulate material. This device is non sterile and for single use only.

9. Comparison of Technological Characteristics with Predicate Device

A summary of the technological characteristics of the subject device as compared to the predicate device is listed below in Table.

ParameterProposed DevicePredicate DeviceComparison
ManufacturerRAY Co., Ltd.MEXPOINTERNATIONAL INC-
Device nameEar-Friendly MaskAvianz® Surgical FaceMask-
510(K) NumberK211105K200847(Traditional)-
CommonNameSurgical ApparelSurgical ApparelSame
Indicationsfor useWhen properly worn, theEar-Friendly Masks areintended to protect bothpatient and healthcareworkers from transfer ofmicroorganisms, bodyfluids and particulatematerial. This device isnon sterile and for singleuse only.When properly worn, thesurgical face masks areintended to protect bothpatient and healthcareworkers from transfer ofmicroorganisms, bodyfluids and airborneparticles. This device isnon-sterile and for singleuse only.SimilarNote 1
Materials
Outer Facing LayerSpunbond PolypropyleneSpunbond PolypropyleneSame
Middle LayerMelt Blown Polypropylene FilterMelt Blown Polypropylene FilterSame
Inner Facing LayerSpunbond PolypropyleneSpunbond PolypropyleneSame
Nose PieceSingle Galvanize wire, coated By PESingle Galvanize wire, coated By PESame
Ear LoopsElastic non-woven Fabric (Made With PE&PP mixed)not made with natural rubber latexSimilar Note2.
Design Features
ColorWhiteWhiteSame
Style3 Ply, Ear Loops, Flat-Pleated Style3 Ply, Ear Loops, Flat-Pleated StyleSame
Dimension(Width)$95mm \pm 10mm$$90 mm \pm 5mm$Similar Note3
Dimension(Length)$175mm \pm 10mm$$175 mm \pm 5mm$Similar Note3
Single UseYesYesSame
Sterility
SterileNon-SterileNon-SterileSame
Biocompatibility
CytotoxicityUnder the conditions of the studies, the subject device is non-cytotoxicUnder the conditions of the studies, the subject device is non-cytotoxicSame
SensitizationUnder the conditions of the studies, the subject device is non-sensitizingUnder the conditions of the studies, the subject device is non-sensitizingSame
IrritationUnder the conditions of the studies, the subject device is non-irritatingUnder the conditions of the studies, the subject device is non-irritatingSame
Non-clinical Tests Performed on the device
ASTM LevelLevel 3Level 2Different (Note 1)
Bacterial Filtration Efficiency(BFE)Pass at ≥98%Pass at ≥98%Same
Particle Filtration Efficiency(PFE)Pass at ≥98% @ 0.1 micronPass at ≥98% @ 0.1 micronSame
Synthetic Blood PenetrationPassed at 160mm HgPassed at 120mm HgDifferent
Differential Pressure OnlyPass at $<6.0 mmH2O/cm^2$Pass at $<5.0 mmH2O/cm^2$Different
Flammability TestClass 1Class 1Same

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Comparison in Detail(s):

Note 1. Although the subject device is little difference with predicate device, it meets the requirement of essential performance standard ASTM F2100. The differences between the predicate device and subject device will not affect the safety and effectiveness of the subject device.

Note 2. Although the "Elastic non-woven Fabric" of subject device is little difference with predicate device, it meets the requirement of essential performance standard ISO 10993(cytotoxicity, Sensitization and Irritation). The differences between the predicate device and subject device will not

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affect the safety and effectiveness of the subject device.

Note 3. Although the "Dimension" of subject device is little bigger than predicate device, it meets the requirement of essential performance standard ASTM F2100 (Fluid Resistance, PFE, BFE, Differential Pressure and Flammability). The differences between the predicate device and subject device will not affect the safety and effectiveness of the subject device.

10. Summary of Non-clinical Testing

10.1 Biocompatibility Testing

The Ear-Friendly Mask has been subjected to biocompatibility studies to demonstrate the safety of device. The biocompatibility studies are in accordance with ISO 10993 :

  • In vitro Cytotoxicity (ISO 10993-5) : under the conditions of the test, the device was non-cytotoxic;

  • Sin Sensitization (ISO 10993-10) : under the conditions of the test, the device was non-sensitizing;

  • Skin Irritation (ISO 10993-10) : under the conditions of the device was non- irritating.

There is no additional safety risk for the proposed device when compared with the predicate device.

10.2 Performance testing - Bench

The Ear-Friendly Mask have been tested according to ASTM F2100 and standards which comprise ASTM F2100, Standard Specification for Performance of Materials Used in Surgical Face Mask. See the table to blow.

Test NameStandardAcceptance Criteria perASTM F2100-Level 3Test Result
Fluid ResistanceASTM F1862160 mmHgPass
Particle FiltrationEfficiency(PFE)ASTM F2299$\ge$ 98%Pass
Bacterial FiltrationEfficiency(BFE)ASTM F2101$\ge$ 98%Pass
Differential PressureMIL-M-36954C< 6.0 mmH2O/cm²Pass
Flammability Test16 CFR part 1610Class 1Pass

All Result of testing met ASTM F2100 Level 3 acceptance Criteria.

11. Summary of Clinical Testing

Not applicable

12. Conclusions

The conclusions drawn from the non-clinical tests demonstrate that the subject Ear-Friendly Mask is as safe, as effective, and performs as well as or better than the legally marketed predicate device cleared under K200847.

§ 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.