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510(k) Data Aggregation

    K Number
    K202069
    Manufacturer
    Date Cleared
    2020-12-01

    (127 days)

    Product Code
    Regulation Number
    878.4040
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Base4 Group, Inc.

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    When properly worn, the surgical face masks are intended to patient and healthcare workers from transfer of microorganisms, body fluids and airborne particles. This device is non-sterile and for single use only.

    Device Description

    The surgical face mask is a non-sterile, single use, three-layer, flat, pleated style with ear loops and a nose piece. The outer and inner layers are spunbond polypropylene, and the middle layer consists of melt-blown polypropylene filter. Each mask is secured to the face with ear loops with a nosepiece to conform the mask to the shape of the nose.

    AI/ML Overview

    This document describes the premarket notification (510(k)) for the BASE4 Disposable Medical Mask, outlining its acceptance criteria and the studies performed to demonstrate its performance.

    1. Table of Acceptance Criteria and Reported Device Performance

    TestReported Device PerformanceAcceptance CriteriaResult
    Fluid Resistance Performance (ASTM F1862)31 out of 32 pass at 80 mm Hg; 30 out of 32 pass at 120 mm Hg29 out of 32 pass at 120 mm HgPass (Level 2)
    Particulate Filtration Efficiency (ASTM F2299)98.8%≥ 98%Pass
    Bacterial Filtration Efficiency (ASTM F2101)> 99.9%≥ 98%Pass
    Differential Pressure (Delta P) MIL-M-36954C4.4 mmH2O/cm²
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