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510(k) Data Aggregation

    K Number
    K214108
    Date Cleared
    2022-05-06

    (128 days)

    Product Code
    Regulation Number
    878.4040
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    Medline Orbis Chemo Surgical Gown

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

    The Medline Orbis Chemo Surgical Gown is intended to be worn by operating room personnel during surgical procedures to protect operating room personnel from transfer of microorganisms, body fluids, and particulate material. Additionally the gown is intended to protect healthcare personnel from exposure to chemotherapy drugs during their preparation, handling, and administration. Non-sterile gowns are to be sold in bulk to re-packager/re-labeler establishments for ethylene oxide (EtO) sterilization according to ISO 11135-1 prior to marketing to the end users and Sterile surgical gowns are to be sold directly to users after EtO sterilization validation to ISO 11135-1.

    The Medline Orbis Chemo Surgical Gown meets the level 3 barrier protection requirements in accordance with ANSI/AAMI Standard PB70:2012 "Liquid Barrier Performance and Classification of Protective Apparel and Drapes intended for use in Health Care Facilities"

    The Medline Orbis Chemo Surgical gown has been evaluated for resistance to permeation of various chemotherapy drugs per ASTM F739-12 "Standard Test Method for Permeation of Liquids and Gases Through Protective Clothing Materials Under Conditions of Continuous Contact."

    Carmustine [3.3 mg/ml] >480 Cisplatin [1.0 mg/ml] >480 Cyclophosphamide [20 mg/ml] >480 Cytarabine Hydrochloride [100 mg/ml] >480 Dacarbazine [10 mg/ml] >480 Daunorubicin Hydrochloride [5 mg/ml] >480 Doxorubicin Hydrochloride [2 mg/ml] > 480 Etopside [20 mg/ml] >480 Fluorouracil [50 mg/ml] >480 Ifosfamide [50 mg/ml] > 480 Methotrexate [25 mg/ml] >480 Mitomycin C [0.5 mg/ml] >480 Mitoxantrone [2.0 mg/ml] >480 Paclitaxel [6 mg/ml] >480 Thiotepa [10 mg/ml] >480 Vincristine Sulfate [1 mg/ml] >480

    Gown selection should be specifically chosen for the type of chemotherapy agent used. Users are recommended to review Material Safety Data Sheets for Chemotherapy Drugs being used to determine the required level of protection.

    Device Description

    The Medline Orbis Chemo Surgical Gown is a single-use, disposable, level 3 surgical gown available in sterile and non-sterile configurations. The multiple configurations and sizes are described in Table 1 below. The Medline Orbis Chemo Surgical Gown is manufactured using a nonwoven polypropylene spunbond. Each gown is designed with a hook and loop closure at the neck, four ties at the waist, knitted polyester cuffs at the end of the sleeves as well as a transfer tab for ease in donning.

    AI/ML Overview

    The document describes the acceptance criteria and the performance studies for the Medline Orbis Chemo Surgical Gown. Since this is a physical medical device (surgical gown), the studies are non-clinical (laboratory testing) rather than clinical studies involving human or AI readers. Therefore, several of the requested categories (e.g., sample size for test set, number of experts, adjudication method, MRMC study, standalone performance, training set size) are not applicable in the context of this device.

    Here's a breakdown of the requested information based on the provided text:

    Acceptance Criteria and Device Performance

    StandardNameAcceptance CriteriaReported Device Performance
    ISO 10993-5ISO MEM Elution Using L-929 Mouse Fibroblast CellsCytotoxicityPass
    ISO 10993-10ISO Intracutaneous Irritation TestIrritation and SensitizationPass
    AATCC 42-17Water ResistanceWater ResistancePass
    AATCC 127-18Hydrostatic PressureWater ResistancePass
    ASTM D5034-09Breaking Strength and Elongation of Textile Fabrics (Grab Test)Tensile StrengthPass
    ASTM D5587-15Tearing Strength of Fabrics by Trapezoid ProcedureTrapezoid TearPass
    ASTM D3776/D3776M-09aBasis Weight-Mass Per Unit Area (Weight) of FabricMaterial WeightPass
    ASTM D3786/D3786M-13Bursting Strength of Textile Fabrics-Diaphragm Bursting Strength Tester MethodBurst StrengthPass
    ASTM D1683-17Standard Test Method for Failure in Sewn Seams of Woven Apparel FabricsSeam StrengthPass
    16 CFR 1610Flammability of Clothing TextilesFlammabilityPass
    ANSI/AAMI/ISO 10993-7: 2008(R)2012Biological evaluation of medical devices –Part 7: Ethylene oxide sterilization residualsEO and ECH ResidualsPass
    ANSI AAMI PB70:2012Liquid Barrier and Performance Classification of Protective Apparel and Surgical Drapes Intended for Use in Healthcare FacilitiesFluid Resistance (AAMI Level 3)Pass (Meets Level 3)
    ASTM F739-12Permeation of Liquids and Gases Through Protective ClothingChemical Penetration (various chemotherapy drugs, >480 minutes breakthrough time)Pass (>480 minutes without breakthrough)
    ISO 9073-10-2004Test methods for nonwovens Lint and other particles generation in the dry stateParticulatePass

    Specific Chemotherapy Drug Permeation Results (ASTM F739-12):
    For the following chemotherapy drugs, the device showed no average standardized breakthrough for up to 480 minutes:

    • Carmustine [3.3 mg/ml]
    • Cisplatin [1.0 mg/ml]
    • Cyclophosphamide [20 mg/ml]
    • Cytarabine Hydrochloride [100 mg/ml]
    • Dacarbazine [10 mg/ml]
    • Daunorubicin Hydrochloride [5 mg/ml]
    • Doxorubicin Hydrochloride [2 mg/ml]
    • Etopside [20 mg/m1]
    • Fluorouracil [50 mg/ml]
    • Ifosfamide [50 mg/ml]
    • Methotrexate [25 mg/ml]
    • Mitomycin C [0.5 mg/ml]
    • Mitoxantrone [2.0 mg/ml]
    • Paclitaxel [6 mg/m]]
    • Thiotepa [10 mg/ml]
    • Vincristine Sulfate [1 mg/m]]

    Additional Requested Information:

    1. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective):

      • Sample Size: Not explicitly stated in terms of number of gowns, but standard testing for such products involves a specific number of samples as dictated by each ASTM/ISO/AATCC standard. The tests are laboratory-based, not based on a "test set" of patient data.
      • Data Provenance: Not specified, but generally, such non-clinical tests are performed in certified laboratories, likely within the manufacturer's operational region or by contract testing facilities. The tests are prospective in nature, as they are performed specifically to evaluate the device.
    2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience):

      • Not Applicable. This is a non-clinical device that relies on standardized laboratory test methods for performance evaluation, not expert-derived ground truth from human observations or medical imaging.
    3. Adjudication method (e.g. 2+1, 3+1, none) for the test set:

      • Not Applicable. The performance is determined by objective laboratory measurements against defined acceptance criteria, not through expert adjudication.
    4. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:

      • Not Applicable. This is a physical medical device (surgical gown), not an AI-powered diagnostic or assistive tool for human readers.
    5. If a standalone (i.e. algorithm only without human-in-the loop performance) was done:

      • Not Applicable. This is a physical medical device, not an algorithm.
    6. The type of ground truth used (expert consensus, pathology, outcomes data, etc):

      • Objective Test Standards and Criteria: The "ground truth" for this device's performance is established by the specific, objective measurement methods and acceptance criteria defined within internationally recognized standards (e.g., ISO, ASTM, AATCC, ANSI/AAMI). For example, "Pass" for cytotoxicity per ISO 10993-5 means the material did not exhibit cytotoxic effects according to that standard's defined procedure.
    7. The sample size for the training set:

      • Not Applicable. This is a physical device, and there is no "training set" in the context of machine learning or AI.
    8. How the ground truth for the training set was established:

      • Not Applicable. As there is no training set for a physical device, this question is irrelevant.
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