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510(k) Data Aggregation

    K Number
    K202161
    Date Cleared
    2021-03-10

    (219 days)

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

    The Surgical Face 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, provided non-sterile.

    Device Description

    The proposed devices are single use, three-layer, flat masks with straps and nose piece. The Surgical Face Masks are manufactured with three layers, the inner and outer layers are made of spun-bond polypropylene, and the middle layer is made of melt blown polypropylene filter.

    The model of proposed device, YX011, is held in place over the user's mouth and nose by two elastic ear loops welded to the face mask. The elastic ear loops are not made with natural rubber latex.

    The model of proposed device, YX121, is held in place over the user's mouth and nose by four ties welded to the face mask. The tie is made of spun-bond polypropylene.

    The nose piece contained in the proposed device is in the layers of face mask to allow the user to fit the face mask around their nose, which is made of polyethylene and iron.

    The proposed devices are sold non-sterile and are intended to be single use, disposable devices.

    AI/ML Overview

    This document is a 510(k) summary for a "Surgical Face Mask" (Trade Name) from Hunan EEXI Technology & Service Co., Ltd. It's a regulatory submission to the FDA to demonstrate substantial equivalence to a legally marketed predicate device.

    Therefore, this document does not describe the acceptance criteria and the study that proves an AI/algorithm-based device meets acceptance criteria. It discusses the performance criteria for a physical medical device (a surgical face mask).

    The request asks about aspects of an AI/algorithm study (e.g., sample size for training/test sets, expert adjudication, MRMC studies, ground truth establishment). These concepts are not applicable to the evaluation of a physical surgical face mask as described in this 510(k) submission.

    However, I can extract the acceptance criteria and reported device performance for the Surgical Face Mask based on the provided text, and explain why other aspects of your question are not relevant here.


    Acceptance Criteria and Reported Device Performance (for the Surgical Face Mask)

    The acceptance criteria for this medical device are based on the ASTM F2100-19 standard for the "Performance of Materials Used in Medical Face Masks" and ISO 10993-1 for biocompatibility. The device is intended to meet Level 3 performance based on ASTM F2100.

    Here's a table summarizing the performance standards (acceptance criteria) and the reported performance of the subject device (Surgical Face Mask, K202161) and comparison to its predicate device (K153496):

    Table of Acceptance Criteria and Reported Device Performance

    Performance Test / CharacteristicAcceptance Criteria (Target for Subject Device)Reported Device Performance (Subject Device K202161)Predicate Device Performance (K153496)Comments to Predicate
    Material/Design
    Product NameSurgical Face MaskSurgical Face MaskDisposable Surgical Face MaskSimilar
    Product CodeFXXFXXFXXSame
    Regulation Number21 CFR § 878.404021 CFR § 878.404021 CFR § 878.4040Same
    ClassificationClass IIClass IIClass IISame
    OTC useYesYesYesSame
    Intended UseAs described in section 6As described in section 6Similar to subject deviceSame
    Design FeatureEar-loop, Tie-onEar-loop, Tie-onEar-loop, Tie-onSame
    UsageSingle useSingle useSingle useSame
    ColorBlueBlueBlueSame
    Size(175±10) mm×(95±10)mm(175±10) mm×(95±10)mm(17.5±1) cm×(9.5±1)cmSame (unit conversion)
    SterileNon-sterileNon-sterileNon-sterileSame
    Material (Outer Layer)Spun-bond polypropyleneSpun-bond polypropyleneSpun-bond polypropyleneSame
    Material (Middle Layer)Melt blown polypropylene filterMelt blown polypropylene filterMelt blown polypropylene filterSame
    Material (Inner Layer)Spun-bond polypropyleneSpun-bond polypropyleneSpun-bond polypropyleneSame
    Nose piecePolyethylene and ironPolyethylene and ironMalleable aluminum wireSimilar
    Ear-loopsElastic fiberElastic fiberPolyesterSimilar
    Tie-onSpun-bond polypropyleneSpun-bond polypropyleneSpun-bond polypropyleneSame
    Performance (ASTM F2100)Level 3 RequirementsMeets Level 3 ClassificationMeets Level 2 ClassificationSubject device meets higher level
    Fluid Resistance (ASTM F1862-13)Meets Level 3Met Level 3 RequirementsMet Level 2 RequirementsSimilar (higher performance)
    Particulate Filtration Efficiency (ASTM F2299)Meets Level 3Met Level 3 RequirementsMet Level 2 RequirementsSimilar (higher performance)
    Bacterial Filtration Efficiency (ASTM F2101)Meets Level 3Met Level 3 RequirementsMet Level 2 RequirementsSimilar (higher performance)
    Differential Pressure (EN 14683:2019+AC:2019)Meets Level 3Met Level 3 RequirementsMet Level 2 RequirementsSimilar (higher performance)
    Flammability (16CFR 1610)Class 1Class 1Class 1Same
    Biocompatibility (ISO 10993)
    CytotoxicityNon cytotoxic (ISO 10993-5)Non cytotoxicNon cytotoxicSame
    IrritationNon irritating (ISO 10993-10)Non irritatingNon irritatingSame
    SensitizationNon sensitizing (ISO 10993-10)Non sensitizingNon sensitizingSame

    Response to AI/Algorithm-Specific Questions (Not Applicable to this document)

    The following points are pertinent to AI/algorithm-based devices but are not discussed or applicable in this 510(k) submission for a physical surgical face mask. This document focuses on material properties, physical dimensions, and established performance standards for protective apparel.

    1. Sample sizes used for the test set and the data provenance: Not applicable. Tests are conducted on physical samples of the face mask, not a 'test set' of data in the AI sense.
    2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. Performance is measured objectively through standardized laboratory tests (e.g., measuring particulate filtration). Ground truth is established by the test method's result, not expert consensus.
    3. Adjudication method: Not applicable. No human interpretation or adjudication as in AI model evaluation.
    4. If a multi reader multi case (MRMC) comparative effectiveness study was done: Not applicable. This is for AI-assisted human reading, not for a physical mask.
    5. If a standalone (i.e. algorithm only without human-in-the loop performance) was done: Not applicable. No algorithm is involved.
    6. The type of ground truth used: For physical masks, "ground truth" is typically defined by the results of the standardized physical and material tests (e.g., a certain percentage of particles were blocked, a certain fluid penetration resistance was achieved).
    7. The sample size for the training set: Not applicable. There is no 'training set' as this is not an AI/ML device.
    8. How the ground truth for the training set was established: Not applicable.

    In summary, the provided document is a regulatory submission for a physical medical device (surgical face mask) and its evaluation against established performance standards for such products. It does not pertain to the development or validation of an AI/algorithm-based medical device.

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