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510(k) Data Aggregation

    K Number
    K201974
    Date Cleared
    2021-03-07

    (235 days)

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

    Single-use medical face mask is intended for use by healthcare workers during procedures to protect both patients and healthcare workers against transfer of microorganisms, bodily fluids, and particulate materials. This device is single-use and provided non-sterile.

    Device Description

    The proposed device is single-use medical face mask. It is non-sterile and for single use. The single-use medical face mask is manufactured with three-layers, the inner and outer layers are made of spun-bond polyethylene, and the middle layer is made of melt blown Polyethylene. The elastic ear loop of proposed device is made of spandex and polyester, not natural rubber latex. The nose piece contained in the proposed device allows the user to fit the face mask around their nose, which is made from zinc strip. It is a self-inhalation filter mask, which works by filtering the air through the filter material of the mask before being inhaled or exhaled.

    AI/ML Overview

    This document is a 510(k) summary for a Single-use medical face mask. It focuses on demonstrating substantial equivalence to a predicate device through non-clinical performance testing.

    Here's the breakdown of the requested information:

    1. Table of Acceptance Criteria and Reported Device Performance

    ItemTest MethodsReported Device PerformanceAcceptance Criteria
    Resistance to Penetration by synthetic blood (mmHg)ASTM F2100-19 / ASTM F1862/ASTM F1862-201780Level 1: 80
    Sub-Micron Particulate Filtration Efficiency (PFE) at 0.1 micron (%)ASTM F2100-19 / ASTM F2299 / ASTM F2299-2003(2017)Average 99.8%Level 1: ≥95%
    Bacterial Filtration Efficiency Test (BFE), %ASTM F2100-19 / ASTM F2101-19Average 99.9%Level 1: ≥95%
    FlammabilityASTM F2100-19 / 16 CFR Part 1610-2019NA (result implicit Class 1)Class 1
    Differential Pressure Test mm H₂O/cm²ASTM F2100-19 / EN 14683:2019+AC:2019(E) Annex CAverage 2.44Level 1: <5.0
    Cytotoxicity (ISO 10993-5)ISO 10993-5: 2009Non-cytotoxicNon-cytotoxic
    Sensitization (ISO 10993-10)ISO 10993-10:2010Non-sensitizingNon-sensitizing
    Irritation (ISO 10993-10)ISO 10993-10:2010Non-irritatingNon-irritating

    2. Sample size used for the test set and the data provenance

    The document does not specify the exact sample sizes for each performance test. It only mentions that "Performance testing was conducted on the single-use medical face mask." The data provenance is North America (as per ASTM standards), but the manufacturing country is China. The study is a non-clinical, retrospective study based on laboratory testing of the device.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

    Not applicable. The ground truth for this device's performance is established through standardized laboratory testing (e.g., ASTM standards) rather than expert consensus on images or clinical cases. The "experts" would be the certified laboratories performing these specific biomechanical/material tests, adhering to the outlined standards. Their qualifications are inherent in their accreditation to perform such tests.

    4. Adjudication method for the test set

    Not applicable. The tests are objective measurements against defined standards, not subjective assessments requiring adjudication.

    5. 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 medical face mask, not an AI-powered diagnostic device. No human reader or AI comparative effectiveness study was performed or is relevant.

    6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

    Not applicable. This is a physical medical device (face mask), not an algorithm.

    7. The type of ground truth used

    The ground truth used is based on standardized test methods and predefined quantitative acceptance criteria from regulatory and industry standards such as ASTM F2100-19, ASTM F1862, ASTM F2299, ASTM F2101-19, 16 CFR Part 1610, EN 14683:2019+AC:2019(E) Annex C, and ISO 10993 for biocompatibility.

    8. The sample size for the training set

    Not applicable. This is a physical medical device, not a machine learning model requiring a training set.

    9. How the ground truth for the training set was established

    Not applicable, as there is no training set for a physical medical device.

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