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510(k) Data Aggregation

    K Number
    K212120
    Device Name
    Surgical Masks
    Date Cleared
    2022-01-28

    (205 days)

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

    The surgical 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 bloody fluids. This is a single-use, disposable device, provided non-sterile.

    XX0009 Ear loop Level: Level 1, Level 2 and Level 3
    XX0008 Tie-on Level: Level 1, Level 2 and Level 3
    XX0006 Tie-on with shield Level: Level 1, Level 2 and Level 3
    XX0005 Ear loop with shield Level: Level 1, Level 2 and Level 3

    Device Description

    The surgical masks are single use, flat-pleated masks that are provided in blue. The outer and inner layers of the mask are made of spunbond polypropylene. The middle filter is made of one layer of meltblown polypropylene filter. The Surgical Masks are available in four types due to different configurations, including ear loop, tie-on, ear loop with shield and tie-on with shield. Detail configurations of them are presented in Table 1 Surgical Masks Description. The ties are made of spunbond polypropylene and the ear loops are made of spandex. The shield is made of PET. The nose piece is made of iron wire and polypropylene. Users can adjust the nose piece according to the shape of the bridge of the nose, and fix the mask on the bridge of the nose to prevent the mask from falling off. The proposed devices are provided in non-sterile. The proposed devices contain four (4) types of masks: XX0009, XX008, XX0006 and XX0005. Each of these types have three different levels, level 2, and level 3. Therefore, the proposed devices have 12 models in toto, and detailed model information is provided in Table 1.

    AI/ML Overview

    The provided text is a 510(k) Summary for Surgical Masks (K212120), focusing on demonstrating substantial equivalence to a predicate device (K160269) through non-clinical testing. It does not describe a study involving an AI (Artificial Intelligence) or medical imaging device, nor does it involve a multi-reader multi-case (MRMC) study. Therefore, many of the requested details, such as human reader improvement with AI assistance, ground truth establishment for AI training/test sets, or the number of experts for adjudication, are not applicable to this document.

    However, I can extract the relevant information regarding the acceptance criteria and the study that proves the device meets those criteria, specifically for the surgical masks.

    Acceptance Criteria and Device Performance for Surgical Masks (Based on Non-Clinical Tests)

    1. Table of Acceptance Criteria and Reported Device Performance

    The non-clinical tests were conducted to verify that the proposed device met all design specifications. The performance levels (Level 1, Level 2, Level 3) refer to classifications defined by ASTM F2100: 2019 "Standard Specification for Performance of Materials Used in Medical Face Masks."

    Test MethodologyPurposeAcceptance CriteriaReported Device Performance
    Particulate Filtration Efficiency (PFE)Determines the particle filtration efficiency (PFE) of the test article (ASTM F2299/F2299M-03 (2017))Level 1: ≥95%Level 2: ≥98%Level 3: ≥98%Level 1: Pass at 96.17%Level 2: Pass at 98.95%Level 3: Pass at 99.06%
    Bacterial Filtration Efficiency (BFE)Determines the bacterial filtration efficiency (BFE) of the test article using a biological aerosol of Staphylococcus aureus (ASTM F2101: 2019)Level 1: ≥95%Level 2: ≥98%Level 3: ≥98%Level 1: Pass at 96.80%Level 2: Pass at 98.90%Level 3: Pass at 99.04%
    Differential PressureMeasures the breathability of the mask (EN 14683:2019+AC: 2019 Annex C)Level 1: <5.0 mmH₂O/cm²Level 2: <6.0 mmH₂O/cm²Level 3: <6.0 mmH₂O/cm²Level 1: Pass at 4.0 mmH₂O/cm²Level 2: Pass at 5.1 mmH₂O/cm²Level 3: Pass at 5.2 mmH₂O/cm²
    FlammabilityDetermines the flammability of the mask material (16 CFR Part 1610)Class 1Class 1
    Resistance to Penetration by Synthetic BloodEvaluates the effectiveness of the sample from possible exposure to blood and other body fluids (ASTM F1862/F1862M: 2017)Level 1: No penetration at 80 mmHgLevel 2: No penetration at 120 mmHgLevel 3: No penetration at 160 mmHgLevel 1: Pass at 80 mmHgLevel 2: Pass at 120 mmHgLevel 3: Pass at 160 mmHg
    CytotoxicityEvaluates the cytotoxicity of the test sample (ISO 10993-5:2009)Viability ≥ 70% of the blank; 50% extract viability ≥ 100% extract viabilityViability ≥ 70% of the blank; 50% extract had higher viability than 100% extract. Proposed device was non-cytotoxic.
    SensitizationEvaluates the sensitization potential of the test sample (ISO 10993-10:2010)Non-sensitizingUnder the conditions of the study, the proposed device was non-sensitizing.
    IrritationEvaluates the irritation potential of the test sample (ISO 10993-10:2010)Non-irritatingUnder the conditions of the study, the proposed device was non-irritating.

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

    The document does not explicitly state the specific sample size (number of masks or material samples) used for each non-clinical test. These tests are typically conducted on a statistically significant number of samples per batch or according to the specific standard's requirements, but the exact count is not detailed in this summary.

    The provenance of the data is that these are non-clinical laboratory test results performed to demonstrate compliance with recognized consensus standards (ASTM, ISO, EN, CFR). The tests were performed for a Chinese manufacturer (Hubei Xinxin Non-woven Co., Ltd.) for submission to the U.S. FDA. The data is implicitly prospective testing conducted specifically for this regulatory submission.

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

    Not applicable. These are physical and biological performance tests on a device (surgical masks), not image-based diagnostic tests or AI performance evaluations requiring expert radiologists or similar medical professionals for ground truth establishment. The "ground truth" for these tests is defined by the objective measurement results according to the specified standard methods.

    4. Adjudication Method for the Test Set

    Not applicable. This is not a study that requires human adjudication of subjective data. The results are based on objective, standardized laboratory measurements.

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done

    No, an MRMC comparative effectiveness study was not done. This submission is for surgical masks, not an AI or imaging device that would typically involve a human-in-the-loop diagnostic task.

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

    Not applicable. This is a physical medical device (surgical mask), not a software algorithm.

    7. The Type of Ground Truth Used

    The "ground truth" for the performance of the surgical masks is established by objective, standardized laboratory measurements performed according to internationally recognized consensus standards (e.g., ASTM, ISO, EN). For biocompatibility, it's the biological response observed based on in-vitro (cytotoxicity) and in-vivo (irritation, sensitization) assays against defined criteria.

    8. The Sample Size for the Training Set

    Not applicable. This device is not an AI model, and therefore, it does not have a "training set" in the context of machine learning.

    9. How the Ground Truth for the Training Set Was Established
    Not applicable, as there is no training set for this device.

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