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510(k) Data Aggregation

    K Number
    K202761
    Date Cleared
    2021-04-11

    (202 days)

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

    The 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 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 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 spunbond polypropylene nonwoven fabric, and the middle layer is made of meltblown polypropylene nonwoven fabric. The model of the proposed device, ear-loop, 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 knitted elastic loops (made of nylon and spandex). The nose piece is in the layers of face mask to allow the user to fit the face mask around his nose, which is a galvanized wire with polyethylene covering. The proposed device is provided non-sterile and is intended to be a single use, disposable device.

    AI/ML Overview

    This document describes the premarket notification (510(k)) for a Medical Surgical Mask (Non-sterile). The acceptance criteria and performance study details are provided in the "Non-clinical Testing" section, specifically in Table 2 "Performance Testing" and Table 3 "Biocompatibility Testing".

    Here's the breakdown of the requested information:

    1. Table of Acceptance Criteria and Reported Device Performance

    The device is a medical surgical mask and its performance is evaluated against the ASTM F2100-19 standard for materials used in medical face masks. The acceptance criteria are specified for Level 1, Level 2, and Level 3 requirements, and the device reports performance that meets all these levels.

    TestPurposeAcceptance Criteria (ASTM F2100-19)Reported Device Performance (Statistics of three lots)Verdict
    Fluid Resistance (ASTM F1862)Verify the fluid resistance of the proposed device can simultaneously meet the requirements for Level 1, Level 2 and Level 3 specified in ASTM F2100-19.Level 1: ≥29 out of 32 pass at 80 mmHg32 out of 32 pass at 80 mmHgPass
    Level 2: ≥29 out of 32 pass at 120 mmHg32 out of 32 pass at 120 mmHgPass
    Level 3: ≥29 out of 32 pass at 160 mmHg32 out of 32 pass at 160 mmHgPass
    Bacterial Filtration Efficiency (BFE) (ASTM F2101)Verify that bacterial filtration efficiency of the proposed device can simultaneously meet the requirements for Level 1, Level 2 and Level 3 specified in ASTM F2100-19.Level 1: ≥95%99.56%~99.99%Pass
    Level 2: ≥98%(Same as above)Pass
    Level 3: ≥98%(Same as above)Pass
    Particulate Filtration Efficiency (PFE) (ASTM F2299)Verify that particulate filtration efficiency of the proposed device can simultaneously meet the requirements for Level 1, Level 2 and Level 3 specified in ASTM F2100-19.Level 1: ≥95%98.07%~99.24%Pass
    Level 2: ≥98%(Same as above)Pass
    Level 3: ≥98%(Same as above)Pass
    Differential Pressure (Delta-P) (EN 14683)Verify that differential pressure of the proposed device can simultaneously meet the requirements for Level 1, Level 2 and Level 3 specified in ASTM F2100-19.Level 1:
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