K Number
K223025
Device Name
Tyvek Roll with CI for STERLINK Sterilizer
Manufacturer
Date Cleared
2023-05-09

(222 days)

Product Code
Regulation Number
880.6850
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Tyvek® Roll with CI for STERLINK™ Sterilizer, when used in pouch plus mode and chamber mode, is intended to provide health care workers with an effective method to enclose devices intended for sterilization in the STERLINK™ sterilizer. The device is intended to allow sterilization of enclosed devices and also to maintain sterility of the enclosed devices until used up to 1 month post sterilization. The maximum load weight that can be placed in the Tyvek® roll is 1 lb (450g) for pouch plus mode and 3.97 bs (1.8kg) for chamber mode. The roll is printed with a chemical indicator bar which is a process indicator (ISO 11140-1:2015) that changes from red to blue (or lighter) when exposed to hydrogen peroxide vapor during processing in the STERLINK™ sterilizer. The Tyvek® Roll with CI for STERLINK™ Sterilizer is offered in the following one type: · Sterilization roll, Flat
Device Description
Tyvek® Roll with CI for STERLINK™ Sterilizer is intended to be used to contain medical devices to be terminally sterilized in the STERLINK™ sterilization system. The medical devices are inserted into the roll, sealed, and then sterilized in the STERLINK™ sterilization system. After completion of the sterilization process, the roll maintains 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 for up to 1 month post sterilization. The roll is printed with a chemical indicator bar that changes from red to blue (or lighter) when exposed to hydrogen peroxide vapor during processing in the STERLINKTM sterilizer. The Tyvek® Roll with CI for STERLINK™ Sterilizer is offered in one type as a Flat Sterilization roll. The sterilization roll is made from a Tyvek® sheet and a clear plastic film that are heat sealed together on opposite two sides. After being cut into a suitable length, the product to be sterilized is placed inside and the two open ends are heat sealed. The process indicator printed on the Tyvek® will exhibit a color change after the roll is exposed to hydrogen peroxide (H2O2).
More Information

Not Found

No
The device is a sterilization roll with a chemical indicator, and the description focuses on its material properties and performance in sterilization. There is no mention of AI or ML.

No
The device is described as a sterilization roll intended to enclose medical devices for sterilization and maintain their sterility, not to provide therapy itself.

No

Explanation: The device is a sterilization roll used to enclose devices for sterilization and maintain their sterility, not to diagnose medical conditions. It includes a chemical indicator to show exposure to hydrogen peroxide vapor, but this is a process indicator for sterilization, not a diagnostic tool.

No

The device is a physical product (sterilization roll) made of Tyvek and plastic film, with a chemical indicator printed on it. It is not software.

Based on the provided text, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is to enclose medical devices for sterilization and maintain their sterility. This is a function related to the sterilization process and maintaining the sterility of other medical devices, not for diagnosing a condition or disease in a patient using in vitro methods.
  • Device Description: The description focuses on the physical properties of the roll (materials, sealing, chemical indicator) and its role in containing and maintaining the sterility of medical devices. There is no mention of analyzing samples from the human body or providing diagnostic information.
  • Lack of IVD Characteristics: The text does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in biological samples
    • Providing information for diagnosis, monitoring, or screening of diseases
    • Using reagents or assays for in vitro analysis

The device is a sterilization packaging material with an integrated chemical indicator, which falls under the category of medical devices used in the sterilization process.

N/A

Intended Use / Indications for Use

Tyvek® Roll with CI for STERLINK™ Sterilizer, when used in pouch plus mode and chamber mode, is intended to provide health care workers with an effective method to enclose devices intended for sterilization in the STERLINK™ sterilizer. The device is intended to allow sterilization of enclosed devices and also to maintain sterility of the enclosed devices until used up to 1 month post sterilization.

The maximum load weight that can be placed in the Tyvek® roll is 1 lb (450g) for pouch plus mode and 3.97 lbs (1.8kg) for chamber mode.

The roll is printed with a chemical indicator bar which is a process indicator (ISO 11140-1:2015) that changes from red to blue (or lighter) when exposed to hydrogen peroxide vapor during processing in the STERLINK™ sterilizer.

The Tyvek® Roll with CI for STERLINK™ Sterilizer is offered in the following one type:

• Sterilization roll, Flat

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

FRG, JOJ

Device Description

Tyvek® Roll with CI for STERLINK™ Sterilizer is intended to be used to contain medical devices to be terminally sterilized in the STERLINK™ sterilization system. The medical devices are inserted into the roll, sealed, and then sterilized in the STERLINK™ sterilization system. After completion of the sterilization process, the roll maintains 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 for up to 1 month post sterilization.

The roll is printed with a chemical indicator bar that changes from red to blue (or lighter) when exposed to hydrogen peroxide vapor during processing in the STERLINKTM sterilizer.

The Tyvek® Roll with CI for STERLINK™ Sterilizer is offered in one type as a Flat Sterilization roll. The sterilization roll is made from a Tyvek® sheet and a clear plastic film that are heat sealed together on opposite two sides. After being cut into a suitable length, the product to be sterilized is placed inside and the two open ends are heat sealed. The process indicator printed on the Tyvek® will exhibit a color change after the roll is exposed to hydrogen peroxide (H2O2).

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

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 Tyvek® Roll with CI for STERLINK™ Sterilizer has the identical intended use and indication for use as the predicate device. Testing of the roll material was previously conducted on the predicate K212198. The identical materials are used in the Tyvek® Roll with CI for STERLINK™ Sterilizer.

Performance Testing for Sterilant Penetration, Shelf-life, and Toxicological Properties (Biocompatibility Tests) were conducted and passed:

  • Sterilization efficacy test, Standard: ISO 14937, Result: Pass
  • CI of sterilization roll validation, Standard: ANSI/AAMI/ISO 11140-1, Result: Pass
  • Internal pressurization test, Standard: ASTM F1980-16 ASTM F1140/F1140M-13, Result: Pass
  • Visual inspection test, Standard: ASTM F1980-16 ASTM F1886/F1886M-16, Result: Pass
  • Dye penetration test, Standard: ASTM F1980-16 ASTM F1929-15, Result: Pass
  • Tensile strength of Tyvek®, Standard: ASTM F1980-16 ASTM D5035-11, Result: Pass
  • Tensile strength of plastic film, Standard: ASTM F1980-16 ASTM D882, Result: Pass
  • Seal strength, Standard: ASTM F1980-16 ASTM F88, Result: Pass
  • Tear resistance, Standard: ASTM F1980-16 ASTM D1922-20, Result: Pass
  • Microbial Barrier Test, Standard: ASTM F1980-16 DIN 58953-6, Result: Pass
  • CI of sterilization roll validation, Standard: ANSI/AAMI/ISO 11140-1, Result: Pass
  • Biocompatibility Tests, Standard: ISO 10993-5, Result: Pass
  • Residual sterilant on Tyvek® validation, Standard: Internal test standard, Result: Pass

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.

K212198

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). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo is in blue and includes the letters "FDA" followed by the words "U.S. Food & Drug Administration".

May 9, 2023

Plasmapp Co., Ltd. % Candace Cederman Consultant CardioMed Device Consultants LLC 1783 Forest Drive, Suite 254 Annapolis, Maryland 21401

Re: K223025

Trade/Device Name: Tyvek Roll with CI for STERLINK Sterilizer Regulation Number: 21 CFR 880.6850 Regulation Name: Sterilization Wrap Regulatory Class: Class II Product Code: FRG. JOJ Dated: April 7, 2023 Received: April 10, 2023

Dear Candace Cederman:

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 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, Christopher K. Dugard -2

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

2

Indications for Use

510(k) Number (if known)

K223025

Device Name

Tyvek® Roll with CI for STERLINK™ Sterilizer

Indications for Use (Describe)

Tyvek® Roll with CI for STERLINK™ Sterilizer, when used in pouch plus mode and chamber mode, is intended to provide health care workers with an effective method to enclose devices intended for sterilization in the STERLINK™ sterilizer. The device is intended to allow sterilization of enclosed devices and also to maintain sterility of the enclosed devices until used up to 1 month post sterilization.

The maximum load weight that can be placed in the Tyvek® roll is 1 lb (450g) for pouch plus mode and 3.97 bs (1.8kg) for chamber mode.

The roll is printed with a chemical indicator bar which is a process indicator (ISO 11140-1:2015) that changes from red to blue (or lighter) when exposed to hydrogen peroxide vapor during processing in the STERLINK™ sterilizer.

The Tyvek® Roll with CI for STERLINK™ Sterilizer is offered in the following one type:

· Sterilization roll, Flat

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 - K223025

1. General Information

| Applicant/Submitter: | Plasmapp Co., Ltd.
BVC-111, 125, Gwahak-ro,
Yuseong-gu, Daejeon, 34141,
Rep. of Korea (South Korea)
Tel: +82 (0)42 716 2115 |
|----------------------|-----------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person: | Candace Cederman |
| Address: | CardioMed Device Consultants LLC
1783 Forest Drive
Suite 254
Annapolis, MD 21401
Tel: +1 410 674 2060 |
| Preparation Date: | May 9, 2023 |

2. Device Name and Code

Device Trade Name:Tyvek® Roll with CI for STERLINK™ Sterilizer
Common Name:Tyvek® Roll for VH2O2 Sterilizer
Classification Name:1) Sterilization Wrap
2) Sterilization Process Indicator
Product Code:1) FRG
2) JOJ
Regulation Number:1) 21 CFR 880.6850
2) 21 CFR 880.2800
Classification:Class II
Review Panel:General Hospital

3. Indications / Intended Use

Tyvek® Roll with CI for STERLINK™ Sterilizer, when used in pouch plus and chamber mode, is intended to provide health care workers with an effective method to enclose devices intended for sterilization in the STERLINK™ sterilizer. The device is intended to allow sterilization of enclosed devices and also to maintain sterility of the enclosed devices until used up to 1 month post sterilization.

The maximum load weight that can be placed in the Tyvek® roll is 1 1b (450 g) for pouch plus mode and 3.97 lbs (1.8 kg) for chamber mode.

4

The roll is printed with a chemical indicator bar which is a process indicator (ISO 11140-1:2005) that changes from red to blue (or lighter) when exposed to hydrogen peroxide vapor during processing in the STERLINK™ sterilizer.

The Tyvek® Roll with CI for STERLINK™ Sterilizer is offered in the follow one type:

  • Sterilization roll. Flat .

4. Device Description

Tyvek® Roll with CI for STERLINK™ Sterilizer is intended to be used to contain medical devices to be terminally sterilized in the STERLINK™ sterilization system. The medical devices are inserted into the roll, sealed, and then sterilized in the STERLINK™ sterilization system. After completion of the sterilization process, the roll maintains 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 for up to 1 month post sterilization.

The roll is printed with a chemical indicator bar that changes from red to blue (or lighter) when exposed to hydrogen peroxide vapor during processing in the STERLINKTM sterilizer.

The Tyvek® Roll with CI for STERLINK™ Sterilizer is offered in one type as a Flat Sterilization roll. The sterilization roll is made from a Tyvek® sheet and a clear plastic film that are heat sealed together on opposite two sides. After being cut into a suitable length, the product to be sterilized is placed inside and the two open ends are heat sealed. The process indicator printed on the Tyvek® will exhibit a color change after the roll is exposed to hydrogen peroxide (H2O2).

5. Technical Characteristics in Comparison to the Predicate Device

The proposed subject device uses identical technology as the cited predicate device and has the same intended uses. Based upon the overall performance characteristics for the sterilization wrap and process indicator used with the pouch plus mode of the STERLINK™ FPS-15s Plus sterilizer, Plasmapp Co., Ltd. believes that no significant differences in usage of its underlying technological principles between subject and predicate devices.

A summary of the technical characteristics of the subject device and predicate device can be found in the table below.

Subject DevicePredicate Device
510(k) SponsorPlasmapp Co., Ltd.Same
ManufacturerSigma Medical Supplies Corp.Same
Device NameTyvek® Roll with CI for STERLINK™
SterilizerSame
510(k) Number-K212198
Device Classification
Name1) Sterilization Wrap
  1. Sterilization Process Indicator | Same |
    | Classification Product
    Code | 1) FRG
  2. JOJ | Same |
    | | Subject Device | Predicate Device |
    | Regulation Number | 1) 21 CFR 880.6850
  3. 21 CFR 880.2800 | Same |
    | | Tyvek® Roll with CI for STERLINK™
    Sterilizer, when used in pouch plus and
    chamber mode, is intended to provide health
    care workers with an effective method to
    enclose devices intended for sterilization in
    the STERLINK™ sterilizer. The device is
    intended to allow sterilization of enclosed
    devices and also to maintain sterility of the
    enclosed devices until used up to 1 month
    post sterilization. | Tyvek® Roll with CI for STERLINK™
    Sterilizer, when used in CHAMBER mode,
    is intended to provide health care workers
    with an effective method to enclose devices
    intended for sterilization in the
    STERLINK™ sterilizer. The device is
    intended to allow sterilization of enclosed
    devices and also to maintain sterility of the
    enclosed devices until used up to 1 month
    post sterilization. |
    | Intended Use | The maximum load weight that can be
    placed in the Tyvek® roll is 1 lb (450 g) for
    pouch plus mode and 3.97 lbs (1.8 kg) for
    chamber mode. | The maximum load weight that can be
    placed in the Tyvek® roll is 3.97lbs (1.8kg). |
    | | The roll is printed with a chemical indicator
    bar which is a process indicator (ISO 11140-
    1:2005) that changes from red to blue (or
    lighter) when exposed to hydrogen peroxide
    vapor during processing in the
    STERLINK™ sterilizer. | The roll is printed with a chemical indicator
    bar which is a process indicator (ISO 11140-
    1:2005) that changes from red to blue (or
    lighter) when exposed to hydrogen peroxide
    vapor during processing in the
    STERLINK™ sterilizer. |
    | | The Tyvek® Roll with CI for STERLINK™
    Sterilizer is offered in the follow one type:
    • Sterilization roll, Flat | The Tyvek® Roll with CI for STERLINK™
    Sterilizer is offered in the follow one type:
    • Sterilization roll, Flat |
    | Pouch Types | The subject device includes a subset of the
    predicate device types:
    Sterilization roll, Flat | Same |
    | Device models
    (Configurations
    /Dimensions) | Sterilization Roll, Flat | |
    | | Model
    FR400100 | Same |
    | | Dimensions
    400 mm × 100 M | |
    | Material Composition | Tyvek®, PET, PE, Water, CH3COOH,
    Alcohol, n-Heptane adhesive, Hydrogen
    peroxide vapor Process Indicator Print Ink | Same |
    | Sterilization Cycle | STERLINK™ FPS-15s Plus - Pouch plus
    mode (overall cycle: 14 minutes) | |
    | | STERLINK™ FPS-15s Plus - Chamber
    mode (overall cycle: 36 minutes) | STERLINK™ FPS-15s Plus - Chamber
    mode (overall cycle: 36 minutes) |
    | Design Feature | Sterilization roll, Flat: This roll is made
    from a Tyvek® 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 Tyvek® are the same with the self-sealing
    sterilization roll. | Same |
    | Chemical Indicator
    Device Design | The color of the Chemical Indicator changes
    from red to blue (or lighter) when exposed to
    hydrogen peroxide. | Same |

5

Tyvek® Roll with CI for STERLINK™ Sterilizer 510(k) Summary - K223025

6

6. Summary of Non-Clinical Testing

The Tyvek® Roll with CI for STERLINK™ Sterilizer has the identical intended use and indication for use as the predicate device. Testing of the roll material was previously conducted on the predicate K212198. The identical materials are used in the Tyvek® Roll with CI for STERLINK™ Sterilizer.

Performance TestingStandardResult
Sterilant
PenetrationSterilization efficacy testISO 14937Pass
CI of sterilization roll validationANSI/AAMI/ISO 11140-1Pass
Shelf-lifeInternal pressurization testASTM F1980-16
ASTM F1140/F1140M-13Pass
Visual inspection testASTM F1980-16
ASTM F1886/F1886M-16Pass
Dye penetration testASTM F1980-16
ASTM F1929-15Pass
Tensile strength of Tyvek®ASTM F1980-16
ASTM D5035-11Pass
Tensile strength of plastic filmASTM F1980-16
ASTM D882Pass
Seal strengthASTM F1980-16
ASTM F88Pass
Tear resistanceASTM F1980-16
ASTM D1922-20Pass
Microbial Barrier TestASTM F1980-16
DIN 58953-6Pass
CI of sterilization roll validationANSI/AAMI/ISO 11140-1Pass
Toxicological Properties
(Biocompatibility Tests)ISO 10993-5Pass
Residual sterilant on Tyvek® validationInternal test standardPass

7. Conclusions

The conclusions drawn from the non-clinical tests demonstrates that the subject device in the 510(k) submission, the Tyvek® Roll with CI for STERLINK™ Sterilizer, is as safe, as effective, and performs as well or better than the legally marketed predicate device cleared under K212198.