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510(k) Data Aggregation

    K Number
    K210030
    Date Cleared
    2021-04-23

    (108 days)

    Product Code
    Regulation Number
    878.4040
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    K201479, K153496

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Medical 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 surgical 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 Medical Surgical Masks are single use, flat-pleated masks that are provided in blue. The Medical Surgical Masks are available in two types, which are Level 3 based on ASTM F2100-19. The outer and inner layers of the mask are made of spunbond polypropylene. The middle filter layer of Level 2 mask is made of one layer of meltblown polypropylene filter, and the middle filter layer of Level 3 mask is made of two layers of meltblown polypropylene filter. The nose clip is made of polyethylene (PE) and iron. Users can adjust the nose clip 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 Level 2 masks are ear-loop masks. The Level 3 masks are available in two types, ear-loop and Tie-on. The ear loops for Level 2 and Level 3 masks are made of spandex. The ties are made of spunbond polypropylene. The ear loops/ties are held in place over the users' mouth and nose by two ear loops/ties welded to the mask.

    AI/ML Overview

    The provided document (K210030 510(k) Summary for the Medical Surgical Mask) describes the performance and testing of a medical surgical mask, not an AI/ML powered device. Therefore, many of the questions related to AI/ML specific studies (e.g., sample size for training set, MRMC study, ground truth establishment for training, number of experts for test set ground truth) are not applicable to this submission.

    However, I can extract the acceptance criteria and performance data for the medical device described.

    Summary of Device Performance and Testing (Medical Surgical Mask)

    The submission focuses on demonstrating substantial equivalence to predicate devices through non-clinical testing against recognized standards. No clinical studies were included.


    1. Table of Acceptance Criteria and Reported Device Performance

    The device is evaluated against the requirements for ASTM F2100-19, which defines performance levels for medical face masks. The proposed device includes both Level 2 and Level 3 masks.

    Performance MetricAcceptance Criteria (ASTM F2100-19) - Level 2Reported Device Performance - Level 2 MaskAcceptance Criteria (ASTM F2100-19) - Level 3Reported Device Performance - Level 3 Mask
    Bacterial Filtration Efficiency (BFE)≥98%Average 99.7%≥98%Average 99.9%
    Particulate Filtration Efficiency (PFE)≥98% @ 0.1 micronAverage 99.71%≥98% @ 0.1 micronAverage 99.93%
    Differential Pressure (Delta P)
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