CYGNUS INSTRUMENT PROTECTORS

K964256 · Madison Polymeric Engineering · FRG · May 6, 1997 · General Hospital

Device Facts

Record IDK964256
Device NameCYGNUS INSTRUMENT PROTECTORS
ApplicantMadison Polymeric Engineering
Product CodeFRG · General Hospital
Decision DateMay 6, 1997
DecisionSESE
Submission TypeTraditional
Regulation21 CFR 880.6850
Device ClassClass 2

Indications for Use

The primary purpose of the device is to protect surgical instruments during sterilization, storage and transportation to the surgical suite. This product is intended to be used by hospital staff during the preparation of the sterile instrument kits. - The liners are first placed into the empty sterilization tray. - The instruments are then placed onto the Cygnus liner (or in the pouch) and the trays are wrapped in CSR wrap using conventional wrapping methods. - Cygnus tray liners are to be used with steam autoclave sterilization only at temperature settings ranging between -121°C to 134°C. - The sterile wrapped kit remains closed until arrival within the sterile prepped operating room. - The liners may continue to be used during the procedure as a sterile field on which to place instruments. - Upon the completion of the procedure the liners are disposed of in accordance with applicable medical waste regulations.

Device Story

Cygnus Instrument Protectors consist of reticulated polyurethane ester foam liners and pouches; designed to pad surgical instruments within sterilization trays. Hospital staff place instruments on liners or in heat-sealed pouches before wrapping trays in CSR wrap. Device facilitates steam autoclave sterilization (121°C to 134°C); open-cell structure allows air, moisture, and heat flow. Used in hospital sterile processing departments; liners may serve as sterile field during surgery. Disposable; non-sterile upon shipment. Benefits include instrument protection during handling and transport, reducing damage risk.

Clinical Evidence

Bench testing only. Physical properties (tensile strength 30 lbs. psi, elongation 200%, tear strength 4.0 lbs. psi, density 1.9 lb./cu. ft., porosity 50 Pore per sq. in.) demonstrate consistency with intended use and predicate device performance.

Technological Characteristics

Material: Reticulated polyurethane ester foam. Physical specs: Tensile strength 30 lbs. psi, elongation 200%, tear strength 4.0 lbs. psi, density 1.9 lb./cu. ft., porosity 50 Pore per sq. in. Form factor: Precut sheets, rolls, and heat-sealed pouches. Sterilization compatibility: Steam autoclave (121°C to 134°C).

Indications for Use

Indicated for hospital staff to protect surgical instruments during steam autoclave sterilization, storage, and transport to the surgical suite; may be used as a sterile field during procedures.

Regulatory Classification

Identification

A sterilization wrap (pack, sterilization wrapper, bag, or accessories, is a device intended to be used to enclose another medical device that is to be sterilized by a health care provider. It is intended to allow sterilization of the enclosed medical device and also to maintain sterility of the enclosed device until used.

Predicate Devices

Submission Summary (Full Text)

{0} M. SAFE MEDICAL DEVICES ACT OF 1990 STATEMENT OF SAFETY AND EFFECTIVENESS. "510(k) Summary" K964256 MAY -6 1997 October 1, 1996 Contact person: Shaun Sweeney (203) 265-9550 phone (203) 265-9961 fax Trade Name : "Cygnus Instrument Protectors" Common Name: Tray liners, instrument pouches Classification Name: Sterilization wrap, pack sterilization wrapper, bag or accessories (per 21 CFR section 880.6850). Predicate device: Manufacturer Devon Industries, 14569 Titus Street, Panorama City, California 91402 9530 Desoto Drive, Chatsworth, California 91311 Product - Devon Tiprotectors, tray pads and liners 510(k) Number - K771123 General and Plastic Surgery Device Panel Classification - Class II Regulatory Citation - 21 CFR ch 1 (4-1-95) ## Product Description The "Cygnus Instrument Protectors" liners and pouches are constructed with reticulated polyurethane ester foam. The material's open cell structure allows for the free flow of air, moisture and heat and is virtually free of particulate matter. The variety of sizes and shapes allows for greater flexibility in padding the instruments. Tray liners are available in precut sheets and rolls. The pouches are available in three sizes of single pouches and two sizes of multi pouch rolls. The pouches are formed by heat sealing the edges and seams. Each product is available in individual boxes as well as bulk case packaging. The products are shipped and marked as "non sterile" and "disposable". Each box is marked with a control lot number and universal bar code. {1} 04/08/1995 14:13 2018279333 SHAUN SWEENEY PAGE 02 ## Summary: Intended Use The primary purpose of the device is to protect surgical instruments during sterilization, storage and transportation to the surgical suite. This product is intended to be used by hospital staff during the preparation of the sterile instrument kits. - The liners are first placed into the empty sterilization tray. - The instruments are then placed onto the Cygnus liner (or in the pouch) and the trays are wrapped in CSR wrap using conventional wrapping methods. - Cygnus tray liners are to be used with steam autoclave sterilization only at temperature settings ranging between -121°C to 134°C. - The sterile wrapped kit remains closed until arrival within the sterile prepped operating room. - The liners may continue to be used during the procedure as a sterile field on which to place instruments. - Upon the completion of the procedure the liners are disposed of in accordance with applicable medical waste regulations. ## Technological Characteristics The technological characteristics of the Cygnus Instrument Protectors are identical to the predicate devices, as well as a number of other manufacturers producing this type of product. The tensile strength (30 lbs. psi), elongation (200%), tear strength (4.0 lbs. psi), density (1.9 lb./cu. ft.) and porosity (50 Pore per sq. in.) all define this product as being appropriate and consistent with the intended use of the product. 20
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