510(k) · Cleared
ClearedSingle-Use Surgical Mask With Ear Loop
Data to Oct 25, 2026 (FDA decisions) Oct 12, 2026 (recalls) Sep 30, 2026 (MAUDE) refreshed weekly
Qiqihar Hengxin Medical Supplies, Ltd. · FXX Mask, Surgical
Cleared on Sep 17, 2020 as substantially equivalent to K153496 (Xiantao Rayxin Medical Products Co., Ltd., 2016) after an 87-day review. Its family tree reaches back 8 generations to 1987. 3 later devices descend from it.
- Decided
- Sep 17, 2020
- Review
- 87 days
- Class
- Class II
- Product code
- FXX
- Recalls
- None
- Predicates
- 1
Its longest line of descent runs back 8 generations to K874608 (1987). 10 ancestors in all, the oldest K801036 (1980). 3 later devices descend from it, 3 citing it directly.
- Root · 8 generations backK874608 Tecnol Fluid Shield Surgical MaskTecnol New Jersey Wound Care, Inc. · 1987
- 7 generations backK955556 Fluid Resistant MaskAmerican Threshold Healthcare · 1996
- 6 generations backK082258 Crosstex Isolite and Isofluid Earloop Face Masks and Isofluid…Crosstex International · 2008
- 5 generations backK110455 Kimberly-Clark Low Barrier, Astm 2100 Face MasksKimberly-Clark Corp. · 2011
- 4 generations backK111402 KC200, Surgical Mask, KC200, Procedure Mask, KC300, Surgicalmask…Kimberly-Clark · 2011
- 3 generations backK131879 KC 300 Surgical MaskKimberly-Clark Corp. · 2013 · Recalled
- 2 generations backK133070 SURGICAL FACE MASK (Ear Loops and Tie-on)Bh Medical Products Co., Ltd. · 2015
- 1 generation backK153496 Disposable Surgical Face MaskXiantao Rayxin Medical Products Co., Ltd. · 2016
- This deviceK201691 Single-Use Surgical Mask With Ear LoopQiqihar Hengxin Medical Supplies, Ltd. · 2020
- Descendant · cites it directly · 0 of its ownK220637 3 Ply Medical Grade Single Use Procedural Disposable Face MaskKdi Med Supply · 2022
- Descendant · cites it directly · 0 of its ownK210102 Topwide Surgical Face MaskTopwide (Hubei) Medical Products Manufacturer · 2021
- Descendant · cites it directly · 0 of its ownK203455 Disposable Medical MaskFujian Kang Chen Daily Necessities Co., Ltd. · 2021
Most influential descendants
Showing 3 of 3 · See all- K2206373 Ply Medical Grade Single Use Procedural Disposable Face MaskKdi Med Supply · 2022 · cites it directly0descendants
- K210102Topwide Surgical Face MaskTopwide (Hubei) Medical Products Manufacturer · 2021 · cites it directly0descendants
- K203455Disposable Medical MaskFujian Kang Chen Daily Necessities Co., Ltd. · 2021 · cites it directly0descendants
View FIG. 1 as a table
Line of descent and top descendants
| Generation | Number | Device | Applicant | Decided | Recalls |
|---|---|---|---|---|---|
| −8 | K874608 | Tecnol Fluid Shield Surgical Mask | Tecnol New Jersey Wound Care, Inc. | 1987 | — |
| −7 | K955556 | Fluid Resistant Mask | American Threshold Healthcare | 1996 | — |
| −6 | K082258 | Crosstex Isolite and Isofluid Earloop Face Masks and Isofluid Fogfree Face… | Crosstex International | 2008 | — |
| −5 | K110455 | Kimberly-Clark Low Barrier, Astm 2100 Face Masks | Kimberly-Clark Corp. | 2011 | — |
| −4 | K111402 | KC200, Surgical Mask, KC200, Procedure Mask, KC300, Surgicalmask, Fluidshield… | Kimberly-Clark | 2011 | — |
| −3 | K131879 | KC 300 Surgical Mask | Kimberly-Clark Corp. | 2013 | 1 |
| −2 | K133070 | SURGICAL FACE MASK (Ear Loops and Tie-on) | Bh Medical Products Co., Ltd. | 2015 | — |
| −1 | K153496 | Disposable Surgical Face Mask | Xiantao Rayxin Medical Products Co., Ltd. | 2016 | — |
| 0 (this device) | K201691 | Single-Use Surgical Mask With Ear Loop | Qiqihar Hengxin Medical Supplies, Ltd. | 2020 | — |
| +1 | K220637 | 3 Ply Medical Grade Single Use Procedural Disposable Face Mask | Kdi Med Supply | 2022 | — |
| +1 | K210102 | Topwide Surgical Face Mask | Topwide (Hubei) Medical Products Manufacturer | 2021 | — |
| +1 | K203455 | Disposable Medical Mask | Fujian Kang Chen Daily Necessities Co., Ltd. | 2021 | — |
Other ancestors by year cleared
| Year cleared | Devices | With a Class I recall |
|---|---|---|
| 1980 | 1 | 0 |
| 1991 | 1 | 0 |
Descendants by year cleared
| Year cleared | Devices | With a Class I recall |
|---|---|---|
| 2021 | 2 | 0 |
| 2022 | 1 | 0 |
Sources: FDA 510(k) database (decision fields), the FDA summary (predicates and indications), FDA recall and enforcement reports, and MAUDE; processed by 510(k) Report. Verify on FDA.gov · Methodology and accuracy.
Planning a device in FXX? A 510(k) Report weighs predicate choices, recall history and review times for a new device like this one.
Top candidate predicates for a new FXX device
- #1 K201479 DemeMASKscore 40.2 · 6 generations · no Class I recall
- #2 Held for the reportin the report
- #3 Held for the reportin the report
What was it cleared against? (1)
Devices the submitter claimed this one is substantially equivalent to (*), and reference devices cited for a specific test or feature (†), as written in the FDA summary.
| Type | Number | Device | Decided |
|---|---|---|---|
| * | K153496 | Disposable Surgical Face MaskSummary page 5…instruction for use, material used, and structure. The only difference is the dimension. 5. Identification of Predicate Device(s) Predicate Device K153496 Disposable Surgical Face Mask Xiantao Rayxin Medical Products Co., ltd.… | 2016 |
What descends from it? (3)
3 later devices cite it directly; ranked here by how many devices descend from each in turn.
Has anything in its family been recalled? (0 Class I)
No FDA recall names this device.
No ancestor or descendant has a Class I recall.
What does this lineage say?
- The line of descent spans 33 years and passes through 8 companies; a new generation was cleared every 2.5 years on median.
- 2 of the 10 ancestors have a recall of any class.
- Of its descendants, K220637 (Kdi Med Supply, 2022) has gone furthest, with 0 descendants of its own.
- 39 other devices also cite its predicate K153496.
How does its category compare?
All FXX devicesFXX Mask, Surgical: FDA decisions, review times, recalls and adverse event reports over 20 years. 2020, this device’s year, is highlighted.
FDA decisions per year · FXX
6in 2025
2026 to Oct 25, outlined.
Median 510(k) review, days · FXX
123in 2025
Receipt to decision; years with fewer than 3 clearances left blank.
Recalls per year · FXX
2in 2024
Class I (0 since 2007) Class II/III not classified
Adverse event reports per year · FXX
11in 2025
MAUDE reports naming product code FXX, not matched to any one device; reports are not rates.
View these four charts as a table
| Year | Decisions | Median 510(k) review, days | Recalls (Class I) | MAUDE reports |
|---|---|---|---|---|
| 2007 | 2 | — | 0 | 11 |
| 2008 | 2 | — | 0 | 10 |
| 2009 | 1 | — | 0 | 3 |
| 2010 | 7 | 144 | 0 | 9 |
| 2011 | 6 | 137 | 0 | 8 |
| 2012 | 1 | — | 0 | 22 |
| 2013 | 3 | 219 | 0 | 9 |
| 2014 | 1 | — | 0 | 5 |
| 2015 | 5 | 298 | 0 | 14 |
| 2016 | 5 | 268 | 0 | 16 |
| 2017 | 1 | — | 0 | 45 |
| 2018 | 3 | 119 | 0 | 21 |
| 2019 | 4 | 124 | 2 | 23 |
| 2020 | 27 | 113 | 0 | 60 |
| 2021 | 218 | 162 | 0 | 67 |
| 2022 | 91 | 113 | 0 | 21 |
| 2023 | 22 | 139 | 1 | 21 |
| 2024 | 15 | 263 | 2 | 21 |
| 2025 | 6 | 123 | 0 | 11 |
| 2026 | 5 | 142 | 0 | — |
What is it indicated for?
The Single-Use Surgical Mask with Ear Loop is intended to be worn to protect both the patient and healthcare personnel from the transfer of microorganisms, body fluids, and particulate material. The Single-Use Surgical Mask with Ear Loop intended for use in infection control practices to reduce the potential exposure to blood and body fluids. This is a single-use, disposable device(s), provided non-sterile.
Model: M and L, blue color, and Level 2 barrier level as ASTM F2100.
Indications for use as stated in the FDA summary.
https://510kreport.com/device/K201691 · printed Nov 3, 2026
Cite this page
510(k) Report. “K201691: Single-Use Surgical Mask With Ear Loop.” Lineage record from FDA 510(k) data and the FDA summary. Updated Nov 3, 2026. Accessed Nov 3, 2026. https://510kreport.com/device/K201691
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Record history
- FDA decision record loaded May 2, 2026
- Summary read Oct 13, 2026 (extraction version 9eaa42aa01ed)
- Lineage and recalls computed Nov 3, 2026
- Page last updated Nov 3, 2026