(158 days)
Not Found
No
The 510(k) summary describes a standard surgical mask and its physical properties and performance against established standards. There is no mention of AI or ML technology.
No
The device is a medical surgical mask intended for infection control, not for therapeutic purposes like treating a disease or condition.
No
The device description indicates it is a surgical mask intended to protect against the transfer of microorganisms, body fluids, and particulate material, not to diagnose a condition.
No
The device description clearly outlines physical components (mask body, nose clip, ear loop) made of materials like polypropylene, plastic, iron wire, and spandex. The performance studies also focus on physical properties and material testing, not software validation.
Based on the provided information, this device is not an IVD (In Vitro Diagnostic).
Here's why:
- Intended Use: The intended use clearly states the mask is for protecting against the transfer of microorganisms, body fluids, and particulate material. This is a physical barrier function, not a diagnostic test performed in vitro (outside the body).
- Device Description: The description details the physical components and materials of the mask. There is no mention of reagents, assays, or any components used for analyzing biological samples.
- Performance Studies and Key Metrics: The performance studies focus on the physical properties and barrier effectiveness of the mask (fluid resistance, filtration efficiency, flammability, biocompatibility). These are not diagnostic performance metrics like sensitivity, specificity, or AUC related to detecting a disease or condition.
- Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.) or providing information about a person's health status.
IVD devices are used to examine specimens from the human body to provide information for diagnosis, monitoring, or screening. This surgical mask does not perform any such function.
N/A
Intended Use / Indications for Use
The Disposable Medical Surgical Mask is 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. This is a single use, disposable device(s), provided sterile.
Product codes (comma separated list FDA assigned to the subject device)
FXX
Device Description
The Disposable Medical Surgical Mask is composed of mask body, nose clip and ear loop. The body of the mask is composed of three layers: the inner and outer layers are made of Spun-bond polypropylene, and the middle layer is made of melt blown polypropylene filter, the nose clip is made of plastic materials and iron wire, ear loop is made of spandex.
The size of the Disposable Medical Surgical Mask is 17.5*9.5cm with tolerance +/- 0.2cm, the length of the ear loop is 17cm with tolerance +/-5 cm, and the length of the nose clip should no less than 8.0cm.
The outer layer of Disposable Medical Surgical Mask will be provided in blue, the inner layer of the Disposable Medical Surgical Mask will be provided in white, and it will be provided with sterile and is intended to be single use, disposable devices.
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 to verify that the proposed device met all design specifications as was similar to the predicate device. The test results demonstrated that the proposed device complies with the following standards and the requirements stated in the Guidance for Industry and FDA Staff: Surgical Masks - Premarket Notification [510(k)] Submission issued on March 5, 2004:
- 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 ForIrritation And Skin Sensitization
- A ASTM F2100, Standard Specification for Performance of Materials Used In MedicalFace Masks
- ASTM F1862, Standard Test Method for Resistance of Medical Face Masks To Penetration by A Synthetic Blood (Horizontal Projection of Fixed Volume At A Known Velocity);
- EN 14683. Medical Face Masks-Requirements and Test Methods:
- ASTM F2101, Standard Test Method for Evaluating the Bacterial Filtration Efficiency (BFE) Of Medical Face Mask Materials, Using A Biological Aerosol of Staphylococcus Aureus;
- ASTM F2299, Standard 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;
To demonstrate the Disposable Medical Surgical Mask sterility is maintained during the duration of the stated shelf-life, the final product and its primary packaging has tested for seal strength using following standard:
- ASTM F88/F88M-15: Standard test method for seal strength of flexible barrier materials
- A ASTM F1980-16 Standard Guide for Accelerated Aging of Sterile Barrier Systems for Medical Devices
The performance test results were:
- Fluid Resistance Performance ASTM F1862: 32 out of 32 pass at 120 mmHg (Acceptance Criteria: 29 out of 32 pass at 120 mmHg) - PASS
- Particulate Filtration Efficiency ASTM F2299: 99.9% (Acceptance Criteria: >= 98%) - PASS
- Bacterial Filtration Efficiency ASTM F2101: 99.9% (Acceptance Criteria: >= 98%) - PASS
- Differential Pressure (Delta P) EN 14683 Annex C: 3.26 mmH2O/cm squared (Acceptance Criteria:
§ 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.
0
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January 4, 2022
Jiangxi Bestgrand Health Technology Co., Ltd. % Ivy Wang Consultant Shanghai Sungo Management Consulting Company Limited 14th Floor, 1500# Central Avenue Shanghai, Shanghai 200122 China
Re: K212375
Trade/Device Name: Disposable Medical Surgical Mask Regulation Number: 21 CFR 878.4040 Regulation Name: Surgical Apparel Regulatory Class: Class II Product Code: FXX Dated: December 6, 2021 Received: December 6, 2021
Dear Ivy Wang:
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
1
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,
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 Ouality Center for Devices and Radiological Health
Enclosure
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Indications for Use
510(k) Number (if known) K212375
Device Name Disposable Medical Surgical Mask
Indications for Use (Describe)
The Disposable Medical Surgical Mask is 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. This a single use, disposable device(s), provided sterile.
| 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)
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510(K) Summary K212375
Document prepared date: 2022/1/4
A. Applicant:
Jiangxi Bestgrand Health Technology Co.,Ltd. Address: BeGrand Industrial Park, Pingxiang Development Zone, Pingxiang City, Jiangxi Province, China Contact Person: Jian Neng Chen Tel: +86 18179908058 Mail: Kenny.chen@chinaloda.com
Submission Correspondent: Primary contact: Ms. Ivy Wang Shanghai SUNGO Management Consulting Co., Ltd. 14th Floor, Dongfang Building, 1500# Century Ave., Shanghai 200122, China Tel: +86-21-58817802 Email: haiyu.wang@sungoglobal.com Secondary contact: Mr. Raymond Luo 14th Floor, Dongfang Building, 1500# Century Ave., Shanghai 200122, China Tel: +86-21-68828050 Email: fda.sungo@gmail.com
B. Device:
Trade Name: Disposable Medical Surgical Mask Common Name: Surgical Face Mask Model: Plane-type with loops
Regulatory Information Classification Name: Surgical Face Mask Classification: Class II Product code: FXX Regulation Number: 878.4040 Review Panel: Surgical Apparel
C. Predicate device:
K100846 IMC Surgical Face Mask (non-sterile and sterile, yellow) International Medsurg Connection
4
D. Indications for use of the device:
The Disposable Medical Surgical Mask is 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. This is a single use, disposable device(s), provided sterile.
E. Device Description:
The Disposable Medical Surgical Mask is composed of mask body, nose clip and ear loop. The body of the mask is composed of three layers: the inner and outer layers are made of Spun-bond polypropylene, and the middle layer is made of melt blown polypropylene filter, the nose clip is made of plastic materials and iron wire, ear loop is made of spandex.
The size of the Disposable Medical Surgical Mask is 17.5*9.5cm with tolerance +/- 0.2cm, the length of the ear loop is 17cm with tolerance +/-5 cm, and the length of the nose clip should no less than 8.0cm.
The outer layer of Disposable Medical Surgical Mask will be provided in blue, the inner layer of the Disposable Medical Surgical Mask will be provided in white, and it will be provided with sterile and is intended to be single use, disposable devices.
F. Comparison with predicate device
Table 1 General Comparison
| Device | Proposed Device | Predicate Device | Conclusion |
|---|---|---|---|
| Manufacturer | Jiangxi Bestgrand Health | ||
| Technology Co.,Ltd. | International Medsurg | ||
| Connection | NA | ||
| 510K number | K212375 | K100846 | NA |
| Classification | Class II Device, FXX | ||
| (21 CFR878.4040) | Class II Device, FXX | ||
| (21 CFR878.4040) | Same | ||
| Indications | |||
| for use | The Disposable Medical | ||
| Surgical 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. This a | |||
| single use, disposable device(s), | |||
| provided | This device is 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. | Similar |
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| sterile. | ||||
|---|---|---|---|---|
| Design feature | Ear Loops, Flat Pleated, 3 layers | Ear Loops, Tie-On, Flat | ||
| Pleated, 3 layers | Similar | |||
| Outer layer | Spun-bond polypropylene | Spun-bond polypropylene | Same | |
| Middle layer | Melt blown polypropylene filter | Melt blown polypropylene filter | Same | |
| Mater | ||||
| ial | Inner layer | Spun-bond polypropylene | Spun-bond polypropylene | Same |
| Nose clips | PE material + iron with Zn | |||
| plating | NA | Different | ||
| Ear loops | Spandex and polyester | NA | Different | |
| Color | Blue | Yellow | Different | |
| Dimension | ||||
| (Length) | 17.5+/-0.2 cm | 17.8cm (7 inches) | Different | |
| Dimension (Width) | 9.5+/-0.2 cm | 8.9cm (3.5inches) | Different | |
| OTC use | Yes | Yes | Same | |
| Sterility | Sterile | Sterile& Non-Sterile | Similar | |
| Use | Single Use, Disposable | Single Use, Disposable | Same | |
| ASTM F2100 | Level 2 | Level 1,2 | Similar | |
| Biocompatibility | ISO10993: Non-Cytotoxic, | |||
| Non-Irritating, and Non- | ||||
| Sensitizing. | ISO10993: Non-Cytotoxic, | |||
| Non-Irritating, and Non- | ||||
| Sensitizing. | Same |
Difference analysis: The proposed device has different nose clip & ear loops material, color, and dimension to the predicate device, but the performance and biocompatibility of the device has been tested, the result has shown the different does not affect the safety of the proposed device.
G. Summary of Technological Characteristic
Non-clinical tests were conducted to verify that the proposed device met all design specifications as was similar to the predicate device. The test results demonstrated that the proposed device complies with the following standards and the requirements stated in the Guidance for Industry and FDA Staff: Surgical Masks - Premarket Notification [510(k)] Submission issued on March 5, 2004:
-
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 ForIrritation And Skin Sensitization
- A ASTM F2100, Standard Specification for Performance of Materials Used In MedicalFace Masks
- ASTM F1862, Standard Test Method for Resistance of Medical Face Masks To Penetration by A Synthetic Blood (Horizontal Projection of Fixed Volume At A Known Velocity);
-
EN 14683. Medical Face Masks-Requirements and Test Methods:
-
ASTM F2101, Standard Test Method for Evaluating the Bacterial Filtration Efficiency (BFE) Of Medical Face Mask Materials, Using A Biological Aerosol of Staphylococcus Aureus;
- ASTM F2299, Standard test method for determining the initial efficiency of materials >
6
used in medical face masks to penetration by particulates using latex spheres;
-
16 CFR 1610, Standard for the Flammability of clothing textiles;
To demonstrate the Disposable Medical Surgical Mask sterility is maintained during the duration of the stated shelf-life, the final product and its primary packaging has tested for seal strength using following standard: -
ASTM F88/F88M-15: Standard test method for seal strength of flexible barrier materials >
-
A ASTM F1980-16 Standard Guide for Accelerated Aging of Sterile Barrier Systems for Medical Devices
| Item | Proposed device | Acceptance Criteria (level 2) | Result |
|---|---|---|---|
| Fluid Resistance Performance | |||
| ASTM F1862 | 32 out of 32 pass at | ||
| 120 mmHg | 29 out of 32 pass at 120 mmHg | PASS | |
| Particulate Filtration Efficiency | |||
| ASTM F2299 | 99.9% | ≥ 98% | PASS |
| Bacterial Filtration Efficiency | |||
| ASTM F2101 | 99.9% | ≥ 98% | PASS |
| Differential Pressure (Delta P) | |||
| EN 14683 Annex C | 3.26 mmH2O/cm² |