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510(k) Data Aggregation

    K Number
    K210518
    Date Cleared
    2021-06-14

    (111 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 Face Mask is intended for single use by operation 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

    The proposed device, Surgical Face Mask is a three-layer, single-use, flat-pleated mask. The mask body is made of 25g/m² PP non-woven cloth. The mask contains tie strings or ear loops to secure the mask over the users' mouth and face and includes a nosepiece to provide a firm fit over the nose. Ear loops are made of Nylon and Spandex, and tie strings are made of 25g/m² PP non-woven cloth. The nose clip which is made of high-density polyethylene and Galvanized wire. The device is provided in sterile.

    AI/ML Overview

    This document is a 510(k) Premarket Notification for a Surgical Face Mask. The request asks for details about acceptance criteria and a study proving the device meets those criteria, typically found in AI/ML medical device submissions. However, this document is for a physical medical device (a surgical face mask), not an AI/ML device. Therefore, many of the requested categories (like number of experts for ground truth, MRMC studies, training set details, etc.) are not applicable and are not present in the provided text.

    This document focuses on the performance of the surgical face mask based on established ASTM and ISO standards for biocompatibility and barrier protection.

    Here's a breakdown of the available information based on your request, with a clear indication of what is not applicable for this type of device submission:

    1. Table of Acceptance Criteria and Reported Device Performance

    The document provides two tables: "Table 1 Summary of Biocompatibility Test Results" and "Table 2 Summary of Performance Testing".

    Table 1: Summary of Biocompatibility Test Results

    Test/PurposeTest Method/StandardAcceptance CriteriaResult
    In Vitro Cytotoxicity TestISO 10993-5: 2009Reduction of cell viability shall be not more than 30%.Passed: No Cytotoxicity Observed
    Skin Sensitization TestISO 10993-10: 2010The skin reactions grades shall be less than 1.Passed: No Skin Sensitization Observed
    Skin Irritation TestISO 10993-10: 2010The irritation response category shall be slight or less.Passed: No Skin Irritation Observed

    Table 2: Summary of Performance Testing (for Level 2 Mask - as per ASTM F2100-19)

    Performance Test/PurposeTest StandardAcceptance CriteriaTest Results (Lot #1)Test Results (Lot #2)Test Results (Lot #3)
    Bacterial FiltrationASTM F2101-2019Level 2: >98%MIN: 98.99% AVG: 99.53%MIN: 98.46% AVG: 99.10%MIN: 98.36% AVG: 99.2%
    Differential PressureEN 14683 Annex CLevel 2: <6.0 mm H2O/cm²MAX: 4.05 AVG: 3.79MAX: 4.18 AVG: 3.83MAX: 4.12 AVG: 3.75
    Flammability16 CFR Part 1610Level 2: Class IClass IClass IClass I
    Particulate FiltrationASTM F2299/F2299M-03 (2017)Level 2: >98%MIN: 98.99% AVG: 99.58%MIN: 98.30% AVG: 99.25%MIN: 98.45% AVG: 99.11%
    Resistance to PenetrationASTM F1862/F1862M-17Level 2: 120 mmHgPass at 120 mmHgPass at 120 mmHgPass at 120 mmHg
    Seal strength of immediate packageASTM F88/F88M-15Seal strength >= 2N/15mmMIN: 2.2 AVG: 3.04MIN: 3.2 AVG: 3.54MIN: 2.2 AVG: 2.9
    Seal leak of immediate packageASTM F1929-15No apparent solution channel through the whole seal edge in the whole seal areaNoNoNo
    EO ECH ResidueISO 10993-7:2008EO residue <= 4mg/device ECH residue <= 9mg/deviceEO: 0.01 mg/device ECH: 0.0053 mg/deviceEO: 0.0053 mg/device ECH: 0.0027 mg/deviceEO: 0.006 mg/device ECH: 0.01 mg/device

    2. Sample Size Used for the Test Set and Data Provenance

    • Sample Size: The document refers to testing "Lot #1, Lot #2, Lot #3" for performance tests. The specific number of masks/samples within each lot that were tested for each criterion is not stated in the provided text. This information would typically be found in the full test reports, which are summarized here.
    • Data Provenance: The device manufacturer is "Shandong Haidike Medical Products Co., Ltd." located in Heze City, Shandong Province, China. The testing was performed according to international standards (ASTM, ISO, EN) and US regulations (CFR). This implies an origin from China, and the data is prospective as it's generated from physical testing of the manufactured product lots for the purpose of this submission.

    3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

    Not Applicable. This is a physical device. "Ground truth" in this context refers to the measured performance against established physical standards rather than expert interpretation of medical images or data. The "ground truth" is defined by the test methods and the acceptance criteria established by the various ASTM, ISO, and EN standards.

    4. Adjudication Method for the Test Set

    Not Applicable. As this is a physical device, there's no "adjudication" in the sense of reconciling human expert opinions on a test set. Objective physical measurements are taken.

    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 for a physical medical device (surgical mask), not an AI/ML device. There are no "human readers" or AI assistance involved in its function or evaluation.

    6. If a Standalone (i.e. algorithm only without human-in-the-loop performance) Was Done

    Not Applicable. This is for a physical medical device. There is no algorithm.

    7. The Type of Ground Truth Used

    For this physical device, the "ground truth" is based on:

    • Standardized Test Methods and Acceptance Criteria: As defined by the listed ASTM, ISO, and EN standards (e.g., ISO 10993 for biocompatibility, ASTM F2101 for bacterial filtration, EN 14683 for differential pressure).
    • Objective Physical Measurements: The device's performance is measured against these established quantitative and qualitative criteria.

    8. The Sample Size for the Training Set

    Not Applicable. This is a physical product, not an AI/ML model that requires a "training set." The masks are manufactured and then tested to meet standards.

    9. How the Ground Truth for the Training Set Was Established

    Not Applicable. See point 8.

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