(158 days)
A Patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hand or finger to prevent contamination between patient and examiner. (21CFR 880.6250)
Latex Patient Examination glove , Powder free coated , Non chlorinated , non sterile (White) 50 micrograms or less of total water extractable protein per gram
The provided text describes a 510(k) summary for a "Latex Patient Examination glove, Powder free coated, Non chlorinated, non sterile (White)" manufactured by Siam Sempermed Corp., Ltd. This document is a premarket notification for a medical device and does not contain detailed information about a study with acceptance criteria and device performance in the way a clinical trial report would.
However, it does outline acceptance criteria based on ASTM standards and reported device performance in relation to those standards, as well as protein content and specific biological tests.
Here's the information extracted and organized as requested:
1. Table of Acceptance Criteria and Reported Device Performance
| Acceptance Criteria (Standard / Requirement) | Reported Device Performance |
|---|---|
| Dimensions (ASTM D 3578-00) | Meets ASTM D 3578-00 |
| Physical Properties (ASTM D 3578-00) | Meets ASTM D 3578-00 |
| Protein content | 50 µg/g or less |
| Residue Powder (ASTM D 3578-00) | Meets ASTM D 3578-00 |
| Freedom from pinholes (ASTM D 3578-00) | Meets ASTM D 3578-00 |
| Freedom from pinholes (ASTM D 5151) | Meets ASTM D 5151 |
| Primary Dermal Irritation in Rabbits | Not a primary dermal irritant |
| Guinea Pig Sensitization (Buehler) | Not a sensitizer |
2. Sample size used for the test set and the data provenance
- The document does not specify the sample size used for testing against the ASTM standards (D 3578-00 and D 5151) or for the protein content.
- For the biological tests:
- Primary Dermal Irritation in Rabbits: The experiment reference number is T00-0175. The specific number of rabbits used is not stated in this summary, but generally, such tests involve a small, standardized number of animals.
- Guinea Pig Sensitization (Buehler): The experiment reference number is T01-0112. The specific number of guinea pigs used is not stated, but also involves a standardized number of animals.
- Data Provenance: The tests for biological evaluations (Primary Dermal Irritation and Guinea Pig Sensitization) were conducted by Consumer Product Testing Co. The location or country of origin for the other tests is not explicitly stated beyond the manufacturing location of Siam Sempermed Corp., Ltd. in Thailand. The data appears to be prospective as it was generated to demonstrate compliance for the 510(k) submission.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
- This document is for a latex examination glove and the "acceptance criteria" are based on established ASTM international standards and specific chemical/biological limits. The "ground truth" is therefore these agreed-upon standards, not expert consensus on interpretations of complex data like medical images.
- The document does not mention the use of experts to establish a "ground truth" for the performance tests in the way clinical studies for AI/diagnostic devices typically do. The tests adhere to objective, measurable standards. The conclusion report is signed by Dr. POONSUK CHERDKIATGUMCHAI, Chief Quality Officer, indicating an internal quality assurance role.
4. Adjudication method for the test set
- Not applicable as the "ground truth" is based on objective, standardized measurements against ASTM specifications and laboratory test results, rather than expert interpretation requiring adjudication.
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 physical medical glove, not an AI-powered diagnostic or assistive technology. Therefore, an MRMC comparative effectiveness study involving human readers and AI assistance was not performed.
6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done
- Not applicable. This device is a physical medical glove and does not involve any algorithm or AI component.
7. The type of ground truth used
- The "ground truth" for the device's performance is based on established manufacturing and material standards (ASTM D 3578-00 and ASTM D 5151), chemical specifications (protein content), and biological safety tests (primary dermal irritation and sensitization). This is a form of objective measurement-based ground truth.
8. The sample size for the training set
- Not applicable. This device is a physical medical glove and does not involve machine learning or a 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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Siam Sempermed Corp., Ltd.
110 Moo 8 Kanjanavanit Rd., Hat Yai, Songkhla, Thailand 90230 Tel: 66 074 291 648 to 9 Fax: 66 074 291 650
MAR 8 2002
510 (k) SUMMARY
1.0 APPLICANT:
Dr. POONSUK CHERDKIATGUMCHAI SIAM SEMPERMED CORPORATION., Ltd. 110 MOO 8 KANJANAVANIT ROAD PATHONG HATYAI SONGKHLA THAILAND 90230 TEL: 66 074 291 648 OR 291 649 FAX: 66 074 291 650
2.0 CONTACT PERSON
Dr. POONSUK CHERDKIATGUMCHAI SIAM SEMPERMED CORPORATION., Ltd. 110 MOO 8 KANJANAVANIT ROAD PATHONG HATYAI SONGKHLA THAILAND 90230 TEL: 66 074 291 648 OR 291 649 FAX: 66 074 291 650
Mrs. KATIE LEVINSON SEMPERMED USA Inc. 30798 US Hwy. 19 N Palm Harbor, USA FL 34684 TEL: 727 787 7250 FAX: 727 787 7558
Page 1 (2)
3.0 Device Class: I Product code: 80LYY
4.0 Specification: Latex patient examination glove , Powder free coated , Non chilorinated -Class I 80LYY meets all of the requirements of ASTM standard D3578-00
5.0 Device Description: Latex Patient Examination glove , Powder free coated , Non chlorinated , non sterile (White)
50 micrograms or less of total water extractable protein per gram
6.0 Intended use: A patient examination glove is a disposable device intended for medical purposes that is worn on the examiners hand or finger to prevent contamination between patient and examiner.
7.0 Surface treatment: polymer coated
8.0 Primary Dermal Irritation in Rabbits Guinea Pig Sensitization (Buehler) : Consumer Product Testing Co. Experiment reference number : T00-0175 , T01-0112
Conclusion : According to Federal Hazardous Substances Act Regulation , (16 CFR 1500.41), and under the conditions of this test . This test article is not a primary dermal irritant
: This test article is not a sensitizer in guinea pigs, under condition of this test.
This document and its contents are confidential. Do not discuss with or give access to people not designated.
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KO 3261
Siam Sempermed Corp., Ltd.
510 (k) SUMMARY
Page 2 (2)
CONFIDENTIAL
9.0 QUALITY CHARACTERISTICS
| Dimensions | Meet ASTM D 3578-00 |
|---|---|
| Physical Properties | Meet ASTM D 3578-00 |
| Protein content | 50 ug/g or less |
| Residue Powder | Meet ASTM D 3578-00 |
| Freedom from pinholes | Meet ASTM D 3578-00 |
| Meet ASTM D 5151 |
Glove , Non chlorinated 10. Conclusion: Siam Sempermed Latex Patient Examination Glove ,Powder free coated (White)
meet the ASTM standard or equivalent standard meet pinhole FDA requirements meet labeling claims (see 5.0 and 6.0 above)
P. Oberndörfer
Dr. POONSUK CHERDKIATGUMCHAI Chief Quality Officer August 22 ,2001
This document and its contents are confidential. Do not discuss with or give access to people not designated.
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Public Health Service
Image /page/2/Picture/2 description: The image is a black and white seal for the U.S. Department of Health & Human Services. The seal is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is a stylized image of an eagle with its wings spread.
8 2002 MAR
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
Siam Sempermed Corporated, Limited C/O Ms. Katie Levinson Sempermed USA, Incorporated 30798 US Highway 19 North Palm Harbor, Florida 34684
Re: K013267
Trade/Device Name: Powder Free (polymer Coated) Non-Chlorinated White Latex Examination Gloves with Protein Content Labeling Claim ( 50 Micrograms or Less) Regulation Number: 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LYY Dated: February 14, 2002 Received: February 25, 2002
Dear Ms. Levinson :
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate 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) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, 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 device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements
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Page 2 - Ms. Levinson
of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4618. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.
Sincerely yours,
Timothy A. Ulatowski Director Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health
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INDICATION FOR USE
Siam Sempermed Corp., Ltd. Applicant:
510(k) Number: 013267
Device Name: Latex Examination Glove, Powder-Free, Coated, Non-Chlorinated, White with a Protein Content of 50 Micrograms or Less of Total Water Extractable Protein per Gram
Indications For Use:
A Patient examination glove is a disposable device intended for medical A r adom examiner's hands or finger to prevent contamination between patient and examiner. (21CFR 880.6250)
Olin S. Lin
(Division Sign-Off) Division of Dental, Infection Control, and General Hospital Devi 510(k) Number _
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
§ 880.6250 Non-powdered patient examination glove.
(a)
Identification. A non-powdered patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hand or finger to prevent contamination between patient and examiner. A non-powdered patient examination glove does not incorporate powder for purposes other than manufacturing. The final finished glove includes only residual powder from manufacturing.(b)
Classification. Class I (general controls). The device, when it is a finger cot, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 880.9.