K Number
K955835
Date Cleared
1996-11-19

(329 days)

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

The Fluid Barrier Boot is intended to be used in the hospital environment to provide protection from all types of fluids in the Operating Room, Central Sterile and in the Emergency Room.

Device Description

The Fluid Barrier Boot is manufactured from 6 gauge Poly Vinyl and is available in both knee-high or ankle high boots is small, medium or large sizes. The boots are secured with straps both at the ankle and over the call on the knee-high boot. The ankle-high boot secures only at the ankle.

AI/ML Overview

Here's a breakdown of the acceptance criteria and the study details for the Fluid Barrier Knee-High Boots:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance CriterionReported Device Performance
Viral PenetrationAll 32 tested samples passed the "Viral Penetration Test" ASTM Method F1671-95, showing no ΦX174 on assay plates.

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

  • Sample Size: 35 samples were initially prepared, with 32 samples used for the passing/failing assessment.
  • Data Provenance: Not explicitly stated, but the test (ASTM Method F1671-95) is a standardized laboratory test; it's retrospective in the sense that the test was conducted on manufactured samples.

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

  • This device is a physical barrier product, and its performance is assessed through a standardized laboratory test (ASTM Method F1671-95). Therefore, there is no "expert" involvement in establishing ground truth in the traditional sense of clinical interpretation. The ground truth is determined by the objective results of the viral penetration assay.

4. Adjudication Method for the Test Set

  • No adjudication method (e.g., 2+1, 3+1) was used. The test results are objective and based on the presence or absence of ΦX174 on assay plates following the ASTM F1671-95 methodology.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

  • No MRMC comparative effectiveness study was done. This is not applicable for a physical barrier product being tested for viral penetration.

6. Standalone (Algorithm Only Without Human-in-the-Loop) Performance

  • This is not applicable as the device is a physical product, not an algorithm. The performance described is inherently "standalone" in the sense that it's the product's performance under specific test conditions, without human interpretation influencing the result.

7. Type of Ground Truth Used

  • The ground truth used is based on objective laboratory test results from the "Viral Penetration Test" ASTM Method F1671-95, which measures the passage of a surrogate virus (ΦX174) through the material.

8. Sample Size for the Training Set

  • This information is not applicable. The device is a manufactured physical product, not a machine learning model, so there is no "training set."

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

  • This information is not applicable, as there is no training set for this type of device.

{0}------------------------------------------------

K95835

Nov 1 9 1896

510(k) Summary of Safety and Effectiveness

Submitter:Instrument Makar, Inc.2950 E. Mount HopeOkemos, MI 48864Date of Summary:12/21/95
Phone:(517) 332-3593
Fax:(517) 332-1870
Contact:Autumn Johnson
Product:Classification Name:Surgical Apparel (21 CFR 878.4040)
Generic Name:Shoe Cover
Trade/Proprietary Name:Fluid Barrier Knee-High Boots

Substantially Equivalent Product:

Depuy .................. Sterile View Knee-High Boots

Description:

The Fluid Barrier Boot is manufactured from 6 gauge Poly Vinyl and is available in both knee-high or ankle high boots is small, medium or large sizes. The boots are secured with straps both at the ankle and over the call on the knee-high boot. The ankle-high boot secures only at the ankle.

Intended Use:

The Fluid Barrier Boot will be used in indications which are the same as that for other shoe covers. Specifically, the Fluid Barrier Boot is intended to be used in the hospital environment to provide protection from all types of fluids in the Operating Room, Central Sterile and in the Emergency Room.

The Fluid Barrier Boot is a disposable product intended for single use only.

Comparison to Substantially Equivalent Product:

The Fluid Barrier Boot has the same intended use as the Sterile View Boot.

{1}------------------------------------------------

ு. இத

K952835

Summary of Safety and Effectiveness

The Fluid Barrier Boots, developed by Instrument Makar, Inc., are substantially equivalent to the Sterile View Knee-High Boots from Depuy (K914702)

These products compare as shown in the table below.

Instrument Makar, Inc. DepuyFluid BarrierKnee-High BootsSterile ViewKnee-High Boots
Intended UscProtect user from fluids inhospital environmentProtect user from fluids inhospital environment
DesignHeat Sealed boot providesprotection to just below the knee.It is secured at both the ankleand calf by two vinyl strapsmanufactured with the samematerial.Boot provides protection to justbelow the knee. It is secured atthe ankle by a strap and at thecalf by a stretch release top.
Materials6 gauge Heat Sealed Poly-VinylTyvek and Vinyl
Physical SafetyEmbossed Vinyl to preventslippageSkid-resistance surface on soleof boot
Target PopulationHospital PersonnelHospital Personnel
BiocompatibilityBoot is worn over shoes andscrubs, therefore, will not be incontact with user's skin.Boot is worn over shoes andscrubs, therefore, will not be incontact with user's skin.
Anatomical SitesFootwearFootwear
Additional NotesSold Non-SterileSold Non-Sterile

The claim of the fluid barner name was substantiated by Instrument Makar's 6 gauge Poly-Vinyl passing the "Viral Ponetration Tost" ASTM Method F1671-95. Thirty-live samples were actor failurs. All samples 32 samples passed showing no $X174 on the assay plates.

§ 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.