K Number
K072377
Date Cleared
2007-12-14

(112 days)

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

A PATIENT EXAMINATION GLOVES IS A DISPOSABLE DEVICE INTENDED FOR MEDICAL PURPOSE THAT IS WORN ON THE EXAMINER'S HAND OR FINGERS TO PREVENT CONTAMINATION BETWEEN PATIENT AND EXAMINER.

Device Description

Classified by FDA's General and Plastic Surgery Device panel as Class 1, 21 CFR 880.6250, Powder-Free Vinyl Patient Examination Glove, 80LYZ, and meets all requirements of ASTM Standard D5250-06.

AI/ML Overview

The provided text describes the regulatory clearance for a medical device: "Xuzhou Full Sun Medical Products Ltd. Disposable Powder Free Vinyl Synthetic Exam Gloves, White Color." This document is a 510(k) summary, which focuses on demonstrating substantial equivalence to a predicate device rather than comprehensive clinical studies. Therefore, much of the information typically requested for AI/algorithm-based devices (like the specifics of a study proving device meets acceptance criteria, sample sizes for training/test sets, expert involvement, and MRMC studies) is not applicable or detailed in this submission.

Here's a breakdown of the available information based on your request:

Acceptance Criteria and Device Performance

The acceptance criteria are primarily based on established ASTM standards for patient examination gloves. The device performance is reported as meeting these requirements.

Acceptance Criteria CategorySpecific Criteria/StandardReported Device Performance
Physical and DimensionsASTM D5250-06Meets all requirements of ASTM D5250-06
WatertightnessFDA 1000 ml Watertight Test (based on ASTM D-5151-06) with AQL 2.5, Inspection level IMeets requirements
Powder ResidueASTM D6124-06 (for "powder-free" claim)Contains no more than 2 mg powder per glove
BiocompatibilityPrimary Skin IrritationNo primary skin irritant reactions
Skin Sensitization (allergic contact dermatitis)No sensitization reactions
Lead Content(Implicit, due to mention)May contain 1.00 ppm of lead

Study Details

This document is a 510(k) summary for a Class 1 medical device (patient examination glove). The "study" described is a series of non-clinical tests to demonstrate conformance to established standards and substantial equivalence to a predicate device, rather than a clinical trial validating an AI algorithm.

  1. Sample size used for the test set and the data provenance:

    • Watertightness Test: Sampling of AQL 2.5, Inspection level I. (No specific number of gloves given, but AQL and inspection level define the sampling plan.)
    • Physical and Dimensions Testing: Inspection level S-2, AQL 4.0. (No specific number of gloves given.)
    • Biocompatibility Testing: Not specified, but standard toxicological testing would involve animal models.
    • Data Provenance: Not explicitly stated, but assumed to be from internal testing by Xuzhou Full Sun Medical Products Ltd. in China, as per the manufacturer's location. The tests are "non-clinical."
    • Retrospective/Prospective: Not applicable for these non-clinical tests.
  2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. These tests involve objective measurements against physical and chemical standards, not subjective expert interpretation of complex data.

  3. Adjudication method (e.g. 2+1, 3+1, none) for the test set: Not applicable. The tests are based on objective, quantifiable measurements against ASTM standards.

  4. 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 is a physical device (glove), not an AI algorithm for diagnostic imaging or similar applications.

  5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not applicable. This is a physical device.

  6. The type of ground truth used (expert consensus, pathology, outcomes data, etc): The "ground truth" for this device is defined by the objective pass/fail criteria established by the ASTM standards (e.g., tensile strength, elongation, watertightness, powder residue limit) and biocompatibility test results.

  7. The sample size for the training set: Not applicable. This is a physical device, not an AI algorithm.

  8. How the ground truth for the training set was established: Not applicable.

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K072377

DEC 1 4 2007

REVISED 510(k) SUMMARY OF SAFETY AND EFFECTIVENESS

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:

1. Submitter's Identification:

Hsun-Hui Huang

Xuzhou Full Sun Medical Products Ltd.

Bihe Industry Area, Yitang Town

Pizhou County, Jiangsu Province

China

Date Summary Revised: December 12, 2007

2. Name of the Device:

Xuzhou Full Sun Medical Products Ltd. Disposable Powder Free Vinyl Synthetic Exam Gloves, White Color -

3. Predicate Device Information:

MDM ENTERPRISE CORP.

Disposable Powder Free Vinyl Synthetic Examination Glove, White Color (K033835)

4. Device description:

Classified by FDA's General and Plastic Surgery Device panel as Class 1, 21 CFR 880.6250, Powder-Free Vinyl Patient Examination Glove, 80LYZ, and meets all requirements of ASTM Standard D5250-06.

5. Intended Use:

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.

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6. Comparison to Predicate Devices:

Xuzhou Full Sun Medical Products Ltd's Disposable Powder Free Vinyl Synthetic Exam Gloves, White Color is substantially equivalent to the device manufactured by MDM ENTERPRISE CORP. (K033835).

7. Discussion of Non-Clinical tests Performed for Determination of Substantial Equivalence are as follows:

The standards used for Xuzhou Full Sun Medical Products Ltd's glove production are Based on ASTM D5250-06. All testing meets requirements for Physical and Dimensions Testing conducted on gloves. Inspection level S-2. AOL 4.0.

The FDA 1000 ml Watertight Test based on ASTM D-5151-06 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.

There are no special labeling claims and we do not claim our gloves as hypoallergenic on our labels.

A residual Powder test that based on ASTM D6124-06 for Starch at finished inspection is conducted to insure that our gloves meet our "powder-free" claims (contain no more than 2 mg powder per gloves)

8. Discussion of Clinic Tests Performed:

Not applicable - There is no Hypoallergenic Claim.

9. Conclusions:

Xuzhou Full Sun Medical Products Ltd's Disposable Powder Free Vinyl Synthetic Exam Gloves, White Color conform fully to ASTM D-5250-06 standard as well as applicable 21CFR references, and, meets pinhole FDA requirements,

biocompatibility requirements and labeling claims as shown by data in Section 7. The pigment contained in the manufacture of these gloves may contain 1.00 ppm of lead.

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Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized eagle with three lines representing its wings and a wavy line representing its body. The logo is surrounded by the text "DEPARTMENT OF HEALTH AND HUMAN SERVICES - USA" in a circular arrangement.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

DEC ] 4 2007

Ms. Hsun-Hui Huang Manager Xuzhou Full Sun Medical Products, Ltd. Bihe Industry Area, Yitang Town Pizhou County, Jiangsu Province CHINA

Re: K072377

Trade/Device Name: Disposable Powder Free Vinyl Synthetic Exam Glove, White Color Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LYZ Dated: November 19, 2007 Received: November 23, 2007

Dear Ms. Huang:

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. Huang

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 (OS) 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 (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Arthur b. Nathan per
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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Indications for Use

XUZHOU FULL SUN MEDICAL PRODUCTS LTD. Applicant:

510(k) Number (if known): APPLIED

Device Name: Disposable Powder Free Vinyl Synthetic Exam Glove,

White Color

Indications for Use:

A PATIENT EXAMINATION GLOVES IS A DISPOSABLE DEVICE INTENDED FOR MEDICAL PURPOSE THAT IS WORN ON THE EXAMINER'S HAND OR FINGERS TO PREVENT CONTAMINATION BETWEEN PATIENT AND EXAMINER.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ Over-The-Counter Use X AND/OR (Part 21 CFR 801 Subpart D) (21 CFR 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER

PAGE OF NEEDED)

Concurrence of ODRH, Office of Device Evaluation (ODE)

(Division Sign-Off)
Division of Anesthesiology, General Hospital
Infection Control, Dental Devices

510(k) Number: K02377

§ 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.