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510(k) Data Aggregation

    K Number
    K051987

    Validate with FDA (Live)

    Date Cleared
    2005-10-06

    (76 days)

    Product Code
    Regulation Number
    880.6250
    Reference & Predicate Devices
    N/A
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    Polymer Coated Latex Examination Glove, Powder Free, Non Sterile is a disposable device and made of Natural Rubber Latex Coated with Polymer Intended for Medical purpose that is worn on the Examiner's hand or finger to prevent contamination between patient and examiner

    Device Description

    The Polymer Coated Latex Examination Gloves, Powder Free, Non Sterile meets all the requirements of ASTM standard D 3578-01 a22 and FDA 1000 ml Water Leak Test.

    AI/ML Overview

    The document describes the Polymer Coated Latex Examination Gloves, Powder Free, Non Sterile, manufactured by PT Mandiri Inti Buana. The device is a disposable glove intended for medical purposes to prevent contamination between patient and examiner.

    Here's an analysis of the acceptance criteria and the study that proves the device meets them:

    1. A table of acceptance criteria and the reported device performance

    CHARACTERISTICSSTANDARDSACCEPTANCE CRITERIA (Implied by "Meets" or specified values)DEVICE PERFORMANCE
    DimensionD 3587 -01 ae²Conformance to ASTM D 3587 -01 ae²Meets (Conforms to ASTM D 3587 -01 ae²)
    Physical PropertiesD 3587 -01 ae²Conformance to ASTM D 3587 -01 ae²Meets (Conforms to ASTM D 3587 -01 ae²)
    Freedom from PinholesD 3587 -01 ae² & FDA 21 CFR 800.20Conformance to ASTM D 3587 -01 ae² & FDA 21 CFR 800.20Meets (Conforms to ASTM D 3587 -01 ae² & FDA test)
    Powder Free ResidueD 3587 -01 ae² & D6124 - 01< 2 mg/glove< 2 mg/glove
    Water Soluble Protein ContentD 3587 -01 ae² & D 5712 - 99< 50 µg/g< 50 µg/g
    Biocompatibility:
    Primary Skin IrritationPrimary Skin Irritation in RabbitsNo Primary Skin IrritationPasses (No Primary Skin Irritation)
    Dermal SensitizationDermal SensitizationNo contact sensitizerPasses (No contact sensitizer)

    2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

    The document does not explicitly state the sample sizes used for each specific test (e.g., for dimension, pinholes, etc.). It only indicates that the device "Meets" the specified standards.

    • Data Provenance: The manufacturing company is PT Mandiri Inti Buana, located in Tanjung Morawa, SUMUT - INDONESIA. It is implied that the testing was conducted by or for this manufacturer, although the specific testing location is not mentioned. The document does not specify whether the data is retrospective or prospective.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

    This is not applicable as the device is a medical glove, and its performance is evaluated against engineering and biological standards, not through expert consensus on diagnostic images or clinical outcomes. The "ground truth" is established by the defined ASTM and FDA test methods and their acceptance criteria.

    4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

    Not applicable. The performance is determined by direct measurement against quantitative and qualitative standards using defined test methods, not by expert adjudication of subjective assessments.

    5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

    Not applicable. This device is a medical glove, not an AI-assisted diagnostic tool. Therefore, an MRMC comparative effectiveness study involving human readers and AI assistance is not relevant.

    6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

    Not applicable. This device is a physical product (medical glove), not an algorithm.

    7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

    The "ground truth" for the device's performance is based on established industry standards and regulatory requirements:

    • ASTM standard D 3578-01 ae²: This is a standard specification for rubber examination gloves.
    • FDA 21 CFR 800.20 (for Freedom from Pinholes) and FDA 1000 ml Water Leak Test: These are regulatory requirements for pinhole detection in medical gloves.
    • D6124 - 01: Standard test method for residual powder on medical gloves.
    • D 5712 - 99: Standard test method for analysis of protein in natural rubber latex products.
    • Primary Skin Irritation in Rabbits and Dermal Sensitization tests: These are standard biological evaluation tests to assess biocompatibility.

    8. The sample size for the training set

    Not applicable. This device is a physical product and does not involve AI or machine learning, thus there is no "training set."

    9. How the ground truth for the training set was established

    Not applicable, as there is no training set for this type of device.

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