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510(k) Data Aggregation

    K Number
    K212398
    Date Cleared
    2021-12-15

    (135 days)

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

    Hubei Kimsoul Industrial Co., Ltd

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

    The masks are intended to be worn to protect both the patient and healthcare personnel from transfer of microorganisms, body fluids and particulate material. These masks are intended for adult use in infection control practices to reduce the potential exposure to blood and body fluids. This is a single use, disposable device(s), provided non-sterile.

    Device Description

    The proposed device is a three-layer, flat pleated mask. Each mask is composed of a mask body, a nose piece and two ear loops. The mask body is manufactured with three layers, the inner layer and the outer layer are made of polypropylene spunbond nonwoven fabric, and the middle layer is made of polypropylene meltblown nonwoven fabric. It is held in place over the user's mouth and nose by two elastic ear loops welded to the mask body. The elastic ear loops are made of polyester and polyurethane, not made from natural rubber latex. The nose piece is in the layers of face mask to allow the user to fit the face mask around his nose, which is made of polyethylene.

    The proposed device is provided non-sterile and is intended to be a single use, disposable device.

    AI/ML Overview

    The provided text is a 510(k) Summary for a Surgical Face Mask. It outlines the device, its intended use, and comparative data against predicate and reference devices to demonstrate substantial equivalence. However, this document does not describe the specific study design elements typically associated with proving a device meets acceptance criteria for an AI/ML-based medical device, as requested in the prompt.

    The document details performance testing for physical characteristics of a surgical face mask (e.g., fluid resistance, filtration efficiency, flammability, biocompatibility), which are relevant for demonstrating the safety and effectiveness of the mask itself. It does not contain information about an AI/ML algorithm or its performance.

    Therefore, I cannot fulfill the request to describe the acceptance criteria and the study that proves the AI/ML device meets the acceptance criteria based on the provided text. The text is for a physical medical device (surgical face mask), not an AI/ML device.

    If the request was simply to describe the acceptance criteria and study proving the surgical face mask meets its criteria, the following information can be extracted:

    1. A table of acceptance criteria and the reported device performance:

    TestPurposeAcceptance Criteria per ASTM F2100-20 (AQL=4.0%)Reported Device Performance (Statistics of three lots, 32 per lot)
    Biocompatibility Testing
    In vitro Cytotoxicity (ISO 10993-5)Verify that the proposed device extract is non-cytotoxic.The extract is non-cytotoxic under the research conditions.Pass
    Skin Irritation (ISO 10993-10)Verify that the proposed device extract is non-irritating.The polar and non-polar extracts are non-irritating under the research conditions.Pass
    Skin Sensitization (ISO 10993-10)Verify that the proposed device extract is non-sensitizing.The polar and non-polar extracts are non-sensitizing under the research conditions.Pass
    Performance Testing - Bench
    Fluid Resistance (ASTM F1862)Verify the fluid resistance of the proposed device can meet the requirements for Level 3 specified in ASTM F2100-20.Pass at 160 mmHg96 out of 96 pass at 160 mmHg
    Bacterial Filtration Efficiency (BFE) (ASTM F2101)Verify the bacterial filtration efficiency of the proposed device can meet the requirements for Level 3 specified in ASTM F2100-20.≥98%99.8%~>99.9% (Average: ≥99.9%)
    Particulate Filtration Efficiency (PFE) (ASTM F2299)Verify the particulate filtration efficiency of the proposed device can meet the requirements for Level 3 specified in ASTM F2100-20.≥98%99.0%~99.8% (Average: 99.6%)
    Differential Pressure (Delta-P) (EN 14683)Verify the differential pressure of the proposed device can meet the requirements for Level 3 specified in ASTM F2100-20.
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