POWDERED (WHITE) VINYL PATIENT EXAMINATION GLOVES
K062655 · Shijiazhuang Junfei Plastic Products Co., Ltd. · LYZ · Sep 18, 2006 · General Hospital
Device Facts
| Record ID | K062655 |
| Device Name | POWDERED (WHITE) VINYL PATIENT EXAMINATION GLOVES |
| Applicant | Shijiazhuang Junfei Plastic Products Co., Ltd. |
| Product Code | LYZ · General Hospital |
| Decision Date | Sep 18, 2006 |
| Decision | SESE |
| Submission Type | Traditional |
| Regulation | 21 CFR 880.6250 |
| Device Class | Class 1 |
Intended Use
A patient examination glove is a disposable device intended for medical purposes that is worn on the hand of healthcare and similar personnel to prevent contamination between healthcare personnel and the patient's body, fluids, waste or environment.
Device Story
Disposable vinyl patient examination glove; worn by healthcare personnel on hands/fingers; acts as physical barrier to prevent contamination between patient and examiner; protects against fluids, waste, and environmental contaminants; used in clinical settings; non-sterile; powdered finish.
Clinical Evidence
No clinical data. Bench testing only: physical dimensions, water fill test (AQL 2.5), and biocompatibility (skin irritation/sensitization) performed per ASTM D-5250-00E4 and ASTM D-6124-06.
Technological Characteristics
Material: Vinyl. Standard: ASTM D-5250-00E4. Residual powder limit: <= 10mg/dm2 per ASTM D-6124-06. Inspection level: S-2, AQL 4.0. Water fill test: AQL 2.5, inspection level I.
Indications for Use
Indicated for use as a disposable medical glove worn on the examiner's hand or finger to prevent cross-contamination between patient and examiner.
Regulatory Classification
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.
Predicate Devices
- Shijiazhuang Great Eagle Plastic Products Co., Ltd Powdered (White) Vinyl Patient Examination Gloves (K000166)
Related Devices
- K070035 — POWDERED VINYL PATIENT EXAMINATION GLOVE · Super Safe Plastic Products Co., Ltd. · Jan 23, 2007
- K033723 — DISPOSABLE POWDERED VINYL PATIENT EXAMINATION GLOVES · Baoding Guanzhong Glove Co., Ltd. · Feb 24, 2004
- K070046 — POWDERED VINYL PATIENT GLOVE · Shijiazhuang Lianhe Shunda Plastic Products Co., L · Feb 7, 2007
- K102724 — POWDER-FREE VINYL PATIENT EXAMINATION GLOVES · Zibo Yuqun New Material Science and Technology CO · Dec 20, 2010
- K974120 — POWDER-FREE VINYL PATIENT EXAMINATION GLOVES · Shanghai Super Gloves Co., Ltd. · Dec 17, 1997
Submission Summary (Full Text)
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# SEP 1 8 2006
EXHIBIT #1 Page 1 of 2
### 510(K) SUMMARY
This summary of 510(K) safety and effectiveness information is being submitted in accordance with requirements of SMDA 1990 and 21 CFR §807.92.
The assigned 510(K) number is: كيف (OG2 كيج
# 1. Submitter's Identification:
Mr. Guixi Liu Shijiazhuang Junfei Plastic Products Co., Ltd. Donggao Industrial Zone Zanhuang, Hebei, China 050000
Date Summary Prepared: August 30, 2006
### 2. Name of the Device:
Shijiazhuang Junfei Plastic Products Co., Ltd. Powdered (White) Vinyl Patient Examination Gloves
#### 3. Predicate Device Information:
Shijiazhuang Great Eagle Plastic Products Co., Ltd Powdered (White) Vinyl Patient Examination Gloves (K000166)
#### 4. Device Description:
Classified by FDA's General and Plastic Surgery Device panel as Class I, 21 CFR 880.6250, Powered Vinyl Patient Examination Gloves, 80 LYZ, and meets all requirements of ASTM standard D-5250-00€4.
### 5. Intended Use:
A patient examination glove is a disposable device intended for medical purposes that is worn on the hand of healthcare and similar personnel to prevent contamination between healthcare personnel and the patient's body, fluids, waste or environment.
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# 6. Comparison to Predicate Devices:
Shijiazhuang Junfei Plastic Products Co., Ltd.'s Powdered (White) Vinyl Patient Examination Gloves is substantially equivalent in safety and effectiveness to the Shijiazhuang Great Eagle Plastic Products Co., Ltd.'s Powdered (White) Viny) Patient Examination Gloves.
# 7. Discussion of Non-Clinical Tests Performed for Determination of Substantial Equivalence are as Follows:
The standards used for Shijiazhuang Junfei Plastic Products Co., Ltd.'s glove
production are based on ASTM-D-5250-00E4. All testing meets requirements for physical and dimensions testing conducted on gloves. Inspection level S-2, AQL 4.0,
The FDA 1000 ml. Water Fill Test was also conducted with samplings of AQL 2.5, inspection level I, meeting these requirements.
Primary Skin Irritation and Skin Sensitization (allergic contact dermatitis) testing was conducted with results showing no primary skin irritant or sensitization reactions.
A Residual Powder Test that based on ASTM D-6124-06 for Starch at finished inspection is conducted to insure that our gloves meet our "powdered" claims (contain no more than 10mg/dm2).
### 8. Labeling:
There are no special labeling claims and we do not claim our gloves as hypoallergenic on our labels.
### 9. Discussion of Clinical Tests Performed:
Not Applicable - There is no hypoallergenic Claim.
### 10. Conclusions:
Shijiazhuang Junfei Plastic Products Co., Ltd.'s Powdered (White) Vinyl Patient Examination Gloves conform fully to ASTM D-5250-00€4 standard as well as applicable 21 CFR references, and meets pinhole FDA requirements, biocompatibility requirements and labeling claims as shown by data in Section 7. There are no safety/efficacy issues or new claims from the "substantial equivalence" products cited.
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Image /page/2/Picture/0 description: The image shows the seal of the U.S. Department of Health and Human Services. The seal features a stylized eagle with its wings spread, symbolizing protection and service. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle, indicating the department's name and national affiliation. The seal is presented in black and white.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
## SEP 1 8 2006
Shijiazhuang, Junfei Plastic Products Company Limited C/O Ms. Kathy Liu Gloveco, Incorporated 3973 Schaefer Avenue Chino, California 91710
Re: K062655
Trade/Device Name: Powdered (White) Vinyl Patient Examination Gloves Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Gloves Regulatory Class: I Product Code: LYZ Dated: August 30, 2006 Received: September 8, 2006
Dear Ms. Liu:
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.
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Page 2 - Ms. Lin
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 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), please contact the Office of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.
Sincerely yours,
Chiu Lin, Ph.D.
Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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# Attachment A
# INDICATION FOR USE
KO62652 510 (k) NUMBER (IF KNOW): APPLICANT: Shijiazhuang Junfei Plastic Prodcuts Co., Ltd. DEVICE NAME: Powdered (White) Vinyl Patient Examination Gloves
INDICATIONS FOR USE: .
A patient examination glove is disposable device intended for medical purpose that is worn on the examiner's hand or finger to prevent contamination between patient and examiner.
Prescription Use (Per 21 CFR 801.109) OR
Over-The-Counter-Use
(Optional Format 1-2-96)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED.)
Concurrent of CDRH, Office of Device Evaluation (ODE)
| | K06263 |
|--|------------------|
| | Shula Murthy, MD |
| | 9/18/06 |
(Division Sign-Off)
Division of Anesthesiology, General Hospital,
Infection Control, Dental Devices
| 510(k) Number: | K062635 |
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