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510(k) Data Aggregation

    K Number
    K211295
    Date Cleared
    2021-11-24

    (210 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 Surgical Mask is intended for single use by operating room personnel and other general healthcare workers to protect both patients and healthcare workers against transfer of microorganisms, blood and body fluids, and particulate materials.

    Device Description

    Medical surgical mask is Sterile, single use, 3 layers, flat-pleated style with ear loops and nose clip. The outer layer and inner facing layer of face mask consist of Spunbond Polypropylene, and the middle layer consists of Melt Blown Polypropylene Filter. Each mask contains ear loops to secure the mask over the users' mouth and face and includes a nose clip to provide a firm fit over the nose. The mask is a single use, disposable device, provided Sterile.

    AI/ML Overview

    This document describes the non-clinical testing performed for the HKZ-01 Surgical Mask (subject device) to demonstrate its substantial equivalence to a legally marketed predicate device (Surgical Face Mask, K202843).

    1. Table of Acceptance Criteria and Reported Device Performance

    Test MethodPurposeAcceptance CriteriaReported Device Performance
    Fluid Resistance ASTM F1862Verify the fluid resistance meets ASTM F2100 Level 2 requirements32 Out of 32 pass at 120 mmHgPass
    Particulate Filtration Efficiency ASTM F2299Verify the particulate filtration efficiency meets ASTM F2100 Level 2 requirements≥ 98%Pass
    Bacterial Filtration Efficiency ASTM F2101Verify the bacterial filtration efficiency meets ASTM F2100 Level 2 requirements≥ 98%Pass
    Flammability Class 16 CFR 1610Verify the flammability meets Class 1 requirementsClass 1Pass
    Differential Pressure (Delta-P) ASTM F2100-19Verify the differential pressure meets ASTM F2100 Level 2 requirements
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