GAUZE SPONGES: LAPAROTOMY SPONGE, X-RAY DETECTABLE

K990584 · Broadline Medical Industries · EFQ · Apr 23, 1999 · SU

Device Facts

• Record ID: K990584
• Device Name: GAUZE SPONGES: LAPAROTOMY SPONGE, X-RAY DETECTABLE
• Applicant: Broadline Medical Industries
• Product Code: EFQ · SU
• Decision Date: Apr 23, 1999
• Decision: SESE
• Submission Type: Traditional
• Device Class: Class U
• Attributes: Therapeutic

Intended Use

The intended uses of gauze sponges are absorption of blood and body fluids, wound dressing, prepping and scrubbing, and debridement. This product is patient contacting material.

Device Story

Broadline Gauze Sponges and X-ray Detectable Gauze Sponges are medical-grade sponges used for wound management. They function as absorbent materials for blood and body fluids, wound dressings, and tools for surgical prepping, scrubbing, and debridement. Used in clinical settings by healthcare professionals. X-ray detectable variants include radiopaque elements to allow identification via imaging if retained. These devices provide passive absorption and mechanical assistance during wound care and surgical procedures, aiding in infection control and site preparation.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Gauze sponges; X-ray detectable variants include radiopaque material. Standard absorbent textile construction. Non-sterile or sterile (implied by GMP requirements).

Indications for Use

Indicated for patients requiring wound care, including absorption of blood and body fluids, wound dressing, prepping, scrubbing, and debridement.

Submission Summary (Full Text)

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

APR 2 3 1999

Ms. Anna M. Ramza Quality Assurance Manager Broadline Medical Industries, Inc. 1432 Shire Circle Inverness, Illinois 60067

> K990584 Trade Name: Broadline Gauze Sponges Broadline X-ray Detectable Gauze Sponges Regulatory Class: Unclassified and II Product Code: EFO and GDY Dated: February 19, 1999 Received: February 23, 1999

Dear Ms. Ramza:

Re:

We have reviewed your Section 510(k) notification of intent to market the devices referenced above and we have determined the devices are substantially equivalent (for the indications for use stated in the enclosure) to 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). You may, therefore, market the devices, subject to the general controls provisions of the Act. 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.

If your devices are classified (see above) into either class II (Special Controls) or class III (Premarket Approval), they may be subject to such additional controls. Existing major regulations affecting your devices can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition. FDA may publish further announcements concerning your devices in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

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Page 2 – Ms. Anna M. Ramza

This letter will allow you to begin marketing your devices as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your devices to legally marketed predicate devices results in a classification for your devices and thus, permits your devices to proceed to the market.

If you desire specific advice for your devices on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at [phone]. Additionally, for questions on the promotion and advertising of your devices. please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number [phone] or [phone] or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

Colin M. Wittwer, Ph.D., M.D.

Celia M. Witten, Ph.D., M.D. Director Division of General and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Device Name:___GAUZE SPONGES:_________________________________________________________________________________________________________________________________________________

Indications For Use:

The intended uses of gauze sponges are absorption of blood and body fluids, wound dressing, prepping and scrubbing, and debridement. This product is patient contacting material.

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(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

| Concurrence of CDRH, Office of Device Evaluation (ODE) | |
|--------------------------------------------------------|--------------------------|
| (Division Sign-Off) | |
| Division of General Restorative Devices | |
| 510(k) Number | K990584 |
| Prescription Use | X |
| (Per 21 CFR 801.109) | |
| | OR |
| | Over-The-Counter Use |
| | (Optional Format 1-2-96) |

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