U by Kotex® Click® Unscented Menstrual Tampons

K223749 · Kimberly-Clark Corporation · HEB · Jan 6, 2023 · Obstetrics/Gynecology

Device Facts

• Record ID: K223749
• Device Name: U by Kotex® Click® Unscented Menstrual Tampons
• Applicant: Kimberly-Clark Corporation
• Product Code: HEB · Obstetrics/Gynecology
• Decision Date: Jan 6, 2023
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 884.5470
• Device Class: Class 2
• Attributes: 3rd-Party Reviewed

Indications for Use

U by Kotex® Click® Unscented Menstrual Tampon is an unscented tampon inserted into the vagina to absorb menstrual fluid.

Device Story

U by Kotex® Click® Unscented Menstrual Tampon is a conventional unscented menstrual tampon; consists of absorbent rayon-fiber pledget and telescoping three-piece plastic applicator. Pledget features radially wound rayon core, non-woven overwrap, and rayon-polyester withdrawal string. Applicator includes outer barrel with textured grip, clear middle telescope, and plunger. Device is for over-the-counter use; inserted into vagina by user to absorb menstrual fluid. Device is single-use; disposed of after use. Modifications from predicate include withdrawal string placement distance, minor applicator barrel diameter changes, and regular pledget weight adjustment. These changes do not alter fundamental principle of operation or safety profile.

Clinical Evidence

No clinical tests were performed. Safety and performance were established through bench testing and biocompatibility assessments per ISO 10993 standards (genotoxicity, cytotoxicity, mucosal irritation, sensitization, acute systemic toxicity) and FDA guidance for menstrual tampons (absorbency, chemical residues, string strength, fiber shedding, integrity, expulsion force).

Technological Characteristics

Materials: Rayon fiber core, non-woven overwrap, rayon-polyester withdrawal string, plastic applicator (barrel, telescope, plunger). Design: Radially wound, grooved, bullet-shaped pledget. Dimensions: Regular, Super, Super Plus absorbencies. Connectivity: None. Sterilization: Non-sterile. Compliance: ISO 10993 series, FDA 2005 guidance for menstrual tampons.

Indications for Use

Indicated for menstruating women for the absorption of menstrual fluid.

Regulatory Classification

Identification

An unscented menstrual tampon is a device that is a plug made of cellulosic or synthetic material that is inserted into the vagina and used to absorb menstrual or other vaginal discharge. This generic type of device does not include menstrual tampons treated with scent (i.e., fragrance materials) or those with added antimicrobial agents or other drugs.

Predicate Devices

• U by Kotex® Click® Unscented Menstrual Tampon (K172118)

Submission Summary (Full Text)

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January 6, 2023

Kimberly-Clark Corporation % Dave Yungvirt Official Correspondent Third Party Review Group, LLC 25 Independence Blvd Warren, NJ 07059

Re: K223749

> Trade/Device Name: U by Kotex® Click® Unscented Menstrual Tampon Regulation Number: 21 CFR§ 884.5470 Regulation Name: Unscented menstrual tampon Regulatory Class: II Product Code: HEB Dated: December 11, 2022 Received: December 14, 2022

Dear Dave Yungvirt:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies.

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You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatoryinformation/postmarketing-safety-reporting-combination-products); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely,

# Jason Roberts -S

Jason R. Roberts, Ph.D. Assistant Director DHT3B: Division of Reproductive. Gynecology and Urology Devices OHT3: Office of GastroRenal, ObGyn, General Hospital and Urology Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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# Indications for Use

510(k) Number (if known) K223749

#### Device Name

U by Kotex® Click® Unscented Menstrual Tampon

Indications for Use (Describe)

U by Kotex® Click® Unscented Menstrual Tampon is an unscented tampon inserted into the vagina to absorb menstrual fluid.

Type of Use (Select one or both, as applicable)| | Prescription Use (Part 21 CFR 801 Subpart D)

| X | Over-The-Counter Use (21 CFR 801 Subpart C)

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Image /page/3/Picture/0 description: The image shows the logo for Kimberly-Clark Corporation. The logo consists of a stylized symbol to the left of the company name. The text "Kimberly-Clark Corporation" is written in a bold, sans-serif font, with the "Corporation" part in a slightly lighter weight font. The entire logo is in black and white.

# 510(k) Summary

#### 1. Submitter Information

| Applicant | Kimberly-Clark Corporation |
|-----------|------------------------------------------|
| Address: | 2100 Winchester Road<br>Neenah, WI 54956 |

#### 2. Correspondent Information

| Contact: | Jeremy D. Paulsen |
|----------|----------------------------------------|
| | Sr. Regulatory Affairs Product Manager |
| Address: | 2100 Winchester Road |
| | Neenah, WI 54956 |
| Phone: | [phone] |
| Email: | [e-mail] |

- 3. Date Prepared: January 3, 2023
#### 4. Device Information

| Trade Name: | U by Kotex® Click® Unscented Menstrual Tampon |
|-----------------------|-----------------------------------------------|
| Common Name: | Tampon, Menstrual, Unscented |
| Regulation Number: | 21 CFR 884.5470 |
| Regulation Name: | Unscented Menstrual Tampon |
| Regulatory Class: | Class II |
| Product Code: | HEB |
| Classification Panel: | OBGYN, Obstetrics/Gynecology |

#### 5. Predicate Device Information

Kimberly-Clark's U by Kotex® Click® Unscented Menstrual Tampon (K172118). This device has not been subject to a design-related recall.

#### 6. Device Description

The U by Kotex® Click® Unscented Menstrual Tampon is a conventional unscented menstrual tampon consisting of an absorbent pledget and a telescoping three-piece plastic applicator. The device will be manufactured in Regular, Super, and Super Plus absorbencies. The absorbent pledget consists of an absorbent core of radially wound rayon ribbon compressed into a grooved cylinder with a rounded, bullet-like tip, a non-woven overwrap cover, and a rayon-polyester blend withdrawal string.

The three-piece applicator consists of an outer insertion tube (barrel) with a textured grip and formed with a closed, rounded tip in a petal-like design, a clear middle telescopic tube (telescope), and an elongated insertion tube (plunger). Each tampon is individually sealed in a plastic film primary wrapper and then packaged in sealed multi-unit containers for retail sale.

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# 3 Kimberly-Clark Corporation

## 7. Indications for Use

The Kimberly-Clark U by Kotex® Click® Unscented Menstrual Tampon is an unscented menstrual tampon inserted into the vagina to absorb menstrual fluid.

### 8. Comparison of Intended Use and Technological Characteristics with the Predicate Device

The subject device and the predicate device have the same functional design, intended use and indications for use. In addition, both have the same material composition and are produced using the same manufacturing processes.

#### Summary of technological characteristics compared to the predicate device:

The device is the same as the predicate device with respect to materials and functional design.

The difference between the subject and predicate device is the placement distance of the withdrawal string from the edge of the absorbent pledget ribbon prior to rolling and compressing. There are minor differences in the applicator's barrel diameter and weight of the reqular absorbent pledget compared to that of the predicate device. The subject device applicator is the same as the predicate device applicator in all other respects. There will also be minor changes to the packaging artwork and labeling.

Table 05-01 below compares the U by Kotex® Click® Unscented Menstrual Tampon to the predicate device with respect to indications for use, principles of operation, technological characteristics, and materials.

| | Table 05-01: Summary of technological characteristics compared to the predicate |
|---------|----------------------------------------------------------------------------------|
| device: | |

| Characteristic<br>Description | Subject Device | Predicate Device |
|-----------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Trade Name | Same | U by Kotex® Click®<br>Unscented Menstrual<br>Tampon |
| Product Code | Same | HEB |
| 510(k) Number | TBD | K172118 |
| Common<br>Name | Same | Tampon, Menstrual,<br>Unscented |
| Classification<br>Name | Same | Tampon, Menstrual,<br>Unscented (21 CFR<br>884.5470, Product Code<br>HEB) |
| Indications for<br>use | Same | The Kimberly-Clark U by<br>Kotex® Click® Unscented<br>Menstrual Tampon is an |
| Characteristic<br>Description | Subject Device | Predicate Device |
| | | unscented menstrual<br>tampon inserted into the<br>vagina to absorb menstrual<br>fluid. |
| Patient<br>Population | Same | Menstruating Women |
| Absorbencies | Same | Regular (6-9g), Super (9-<br>12g), Super Plus (12-15g) |
| Sterile | Same | No |
| Single Use | Same | Yes |
| Description of<br>the device: | Same | Conventional unscented<br>menstrual tampon<br>consisting of an absorbent<br>pledget and a plastic<br>applicator.<br><br>The absorbent pledget<br>consists of a ribbon of rayon<br>fibers. A rayon -polyester<br>blend withdrawal string is<br>placed on the ribbon and<br>the ribbon is radially wound,<br>then compressed into a<br>traditional eight groove<br>bullet-shaped pledget,<br>overwrapped with a non-<br>woven cover material. The<br>absorbent pledget is<br>inserted into a three-piece<br>plastic applicator consisting<br>of an inner tube (plunger), a<br>clear middle telescopic tube<br>(telescope), and an outer<br>insertion tube (barrel)<br>formed with a closed,<br>rounded tip.<br><br>Each tampon (absorbent<br>pledget with applicator) is<br>wrapped in an individual<br>plastic film wrapper, and<br>packaged in a sealed multi-<br>unit container for retail sale. |
| Withdrawal<br>String | Similar | String target location: |
| Characteristic<br>Description | Subject Device | Predicate Device |
| Location from<br>the edge of the<br>rayon ribbon | Subject and predicate<br>devices differ with regards<br>to where the withdrawal<br>string is looped around<br>rayon ribbon. This<br>difference does not raise<br>new concerns of safety or<br>efficacy as supported by the<br>performance data.<br>String target location:<br>150mm | 80mm |
| Applicator<br>Barrel<br>Diameter for<br>Super | 12.9mm inner, and 14.16<br>mm outer diameter | 14.20 mm inner, and 15.60<br>mm outer diameter |
| Absorbent<br>Pledget:<br>Composition &<br>Weight:<br>Regular | 1.53 g | 1.48 g |
| Complies with<br>ISO 10993<br>series | Same | Yes |
| Complies with<br>pre-clinical<br>microbiology<br>requirements<br>of FDA<br>Guidance for<br>Tampons* | Same | Yes |

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# erly-Clark Corporation

*2005 FDA guidance document "Menstrual Tampons and Pads: Information for Premarket Notification Submissions (510(k)s) - Guidance for Industry and Staff"

## 9. Overview of Non-Clinical Performance Data

#### Safety Assessment:

No clinical tests were performed as part of this device modification.

In addition to verifying performance and characteristics, the subject 510(k) device has been assessed for safety according to ISO 10993-1 (2018) and the FDA guidance for Use of International Standard ISO 10993-1, "Biological evaluation of medical devices - Part 1:

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# 3 Kimberly-Clark Corporation

Evaluation and testing within a risk management process" (2020) and US FDA Blue Book Memorandum #G95-1 "Use of International Standard ISO-10993, "Biological Evaluation of Medical Devices Part 1: Evaluation and Testing." Biocompatibility of the subject device is inclusive of the absorbent pledget (includes absorbent core, overwrap cover, and withdrawal string) and three-piece plastic applicator consisting of an inner tube (plunger), a clear middle telescopic tube (telescope), and an outer insertion tube (barrel). Table 05-02 below provides a brief description of the biological endpoints assessed by recognized standards.

| Preclinical Tests | Standard | Performance |
|-------------------------------------------|---------------------|------------------------|
| Genotoxicity Test (MLA) | ISO 10993-3 (2014) | Non-Genotoxic |
| Genotoxicity Test (AMES) | ISO 10993-3 (2014) | Non-Genotoxic |
| Genotoxicity Test (Mouse<br>Micronucleus) | ISO 10993-3 (2014) | Non-Genotoxic |
| Cytotoxicity Test | ISO 10993-5 (2009) | Non-cytotoxic |
| Mucosal Irritation Test | ISO 10993-23 (2021) | Non-irritating |
| Mucosal Sensitization Test | ISO 10993-10 (2021) | Non-sensitizing |
| Acute Systemic Toxicity Test | ISO 10993-11 (2017) | Not Systemically Toxic |

# Table 05-02: Preclinical Toxicology (Biocompatibility) Tests

The finished subject device, U by Kotex® Click® Unscented Menstrual Tampon, is identical in composition, manufacturing processes, toxicologic profile, and performance to the commercially available predicate. As there are no new or different risks identified, there is no change to the strategy for safety, biocompatibility assessment, or pre-clinical microbiological risk, necessitating additional testing.

## Performance Characteristics

The following performance characteristics were assessed in accordance with the 2005 FDA quidance document "Menstrual Tampons and Pads: Information for Premarket Notification Submission (510(k)s) - Guidance for Industry and FDA Staff"

Absorbency range Chemical residues Withdrawal string strength Fiber Shedding Wet and Dry Tampon Integrity Expulsion Force

## 10. Conclusion/Statement of Substantial Equivalence

The subject and predicate devices have the same intended use and fundamental technological characteristics. The difference in technological characteristics between the subject and predicate devices does not raise new questions of safety or effectiveness. The performance data demonstrate that the U by Kotex® Click® Unscented Menstrual Tampon is substantially equivalent to the predicate device.