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510(k) Data Aggregation

    K Number
    K210815
    Date Cleared
    2021-05-13

    (56 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 Disposable 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 face 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 Disposable Face Mask is single use, three-layer, flat-pleated mask with ear loops and nose clip. The inner and outer layers of the mask are made of spun-bond polypropylene, and the middle layer is made of melt blown polypropylene. The ear loops are held in place over the users' mouth and nose by two elastic ear straps. The ear loops are made of spandex and nylon. The nose clip is a malleable iron wire covered by polyethylene. Users can adjust the nose clip according to the shape of the nose and fix the mask on the bridge of the nose to prevent the mask from falling off. The Disposable Face Mask is blue and provided non-sterile.

    AI/ML Overview

    The document describes the non-clinical tests performed on the Disposable Face Mask (K210815) to demonstrate its safety and effectiveness, and its substantial equivalence to the predicate device (K202211).

    Here's a breakdown of the requested information:

    1. Table of Acceptance Criteria and Reported Device Performance

    No.Performance TestAcceptance CriteriaReported Device Performance (Average)
    1Bacterial Filtration (BFE)Level 2: >98%Lot 1: 99.40%, Lot 2: 99.45%, Lot 3: 99.46% (All >98%)
    2Differential PressureLevel 2: 98%Lot 1: 99.50%, Lot 2: 99.46%, Lot 3: 99.47% (All >98%)
    5Resistance to PenetrationLevel 2: 120 mmHgPass at 120 mmHg (All lots)
    Biocompatibility
    In Vitro Cytotoxicity TestNo Cytotoxicity ObservedPassed: No Cytotoxicity Observed
    Skin Sensitization TestNo Skin Sensitization ObservedPassed: No Skin Sensitization Observed
    Skin Irritation TestNo Skin Irritation ObservedPassed: No Skin Irritation Observed

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

    • Sample Size for performance tests: 32 samples per lot for 3 non-consecutive lots (total 96 samples for each performance test).
    • Data Provenance: The document does not explicitly state the country of origin of the data or whether it was retrospective or prospective. It refers to "Non-Clinical Test Conclusion," implying laboratory testing rather than human subject studies. Given the manufacturer's location in China (Biobase Scientific (Shandong) Co., Ltd.), it's highly probable the testing was conducted in China.

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

    • Not Applicable (N/A): This study involves non-clinical laboratory testing of a physical device (face mask) against established performance standards, not diagnostic or interpretive tasks requiring human expert ground truth.

    4. Adjudication Method for the Test Set

    • Not Applicable (N/A): This study does not involve human adjudication for ground truth. It relies on objective laboratory measurements against defined performance criteria.

    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 (N/A): This document describes the testing of a medical device (face mask), not an AI-powered diagnostic tool. Therefore, an MRMC comparative effectiveness study is irrelevant.

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

    • Not Applicable (N/A): This is a physical medical device, not an algorithm.

    7. The Type of Ground Truth Used

    • Objective Laboratory Measurements: The "ground truth" for the device's performance is established through quantitative measurements obtained from standardized laboratory tests (e.g., Bacterial Filtration Efficiency, Differential Pressure, Particulate Filtration, Flammability, Resistance to Penetration, and Biocompatibility tests) according to recognized international and national standards (ASTM, EN, ISO, CFR).

    8. The Sample Size for the Training Set

    • Not Applicable (N/A): This is a physical medical device, not a machine learning model, so there is no "training set."

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

    • Not Applicable (N/A): There is no training set for a physical medical device.
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