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510(k) Data Aggregation

    K Number
    K201517
    Date Cleared
    2020-09-04

    (88 days)

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

    The Plain Surgical Face Mask is intended to be worn to protect both the patient and healthcare personnel from transfer of microorganisms, body fluids and particulate material. The face mask is intended for use in infection control practices to reduce the potential exposure to blood and body fluids. This is a single use, disposable device, provided non-sterile.

    Device Description

    The Plain Surgical Face Mask is a single use, three-layer, flat-folded masks with ear loops and adjustable clips and nose piece. The Plain Surgical Face Mask is manufactured with three layers, the inner and outer layers are made of spunbonded polypropylene, and the middle layer is made of melt blown polypropylene filter. The ear loops are held in place over the users' mouth and nose by two elastic ear loops welded to the facemask and with adjustable clips. The elastic ear loops are not made with natural rubber latex. The nose piece in the layers of facemask is to allow the user to fit the facemask around their nose, which is made of malleable polyethylene wire. The surgical face masks are sold non-sterile and are intended to be single use, disposable devices.

    AI/ML Overview

    The provided text describes the acceptance criteria and the results of a study conducted for the AOK Tooling Limited's "Plain Surgical Face Mask" (K201517) to demonstrate its substantial equivalence to a predicate device.

    Here's a breakdown of the requested information:

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

    DescriptionAcceptance CriteriaReported Device Performance
    Fluid Resistance (ASTM F1862)29 out of 32 pass at 120 mmHg29 out of 32 pass at 120 mmHg
    Flammability Class (16 CFR Part 1610)Meets Class I, No flame spread on 5 of 5Class I Non-Flammable (Meets Class I, No flame spread on 5 of 5)
    Particulate Filtration Efficiency (ASTM F2299)≥ 98% EfficiencyAverage 99.79% Efficiency
    Bacterial Filtration Efficiency (ASTM F2101)≥ 98% Efficiency>99% Efficiency
    Differential Pressure (Delta P) (ASTM F2100-9 & EN 14683:2019)
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