ISO 15223-1:2016 Medical Devices -- Symbols to Be Used with

Medical Device Labels, Labelling, and Information to Be Supplied

-- Part 1: General Requirements."

The top image represents a non-sterile protective outer layer with an internal
sterile barrier system.
The middle image represents a double sterile barrier system.
The third image represents a sterile outer layer with a protective inner layer that
does not provide an additional sterile barrier system.
And the last image represents a single sterile barrier system.