K Number
K152222
Date Cleared
2016-04-21

(258 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

Glove is a disposable device intended for medical purpose that is worn on the examiner's hand or finger to prevent contamination between patient and examiner.

These gloves were tested for use with Chemotherapy Drugs as per ASTM D6978-05 Standard Practice for Assessment of Medical Gloves to Permeation by Chemotherapy Drugs:

Chemotherapy Drug Permeation

  • The following chemicals have been tested with these gloves
Chemotherapy DrugConcentrationBreakthrough Detection Time in Minutes
Carmustine (BCNU)3.3mg/ml*10.1
Cisplatin1.0mg/ml>240
Cyclophosphamide (Cytoxan)20.0mg/ml>240
Dacarbazine (DTIC)10.0mg/ml>240
Doxorubicin Hydrochloride2.0mg/ml>240
Etoposide (Toposar)20.0mg/ml>240
Fluorouracil50.0mg/ml>240
Paclitaxel (Taxol)6.0mg/ml>240
Thiotepa10.0mg/ml*20.2
Amethopterin Hydrate25.0mg/ml>240
Methotrexate25.0mg/ml>240
Mitomycin C0.5mg/ml>240
Vincristine Sulfate1.0mg/ml>240
  • Please note that the following drugs have extremely low permeation times:

Carmustine (BCNU): 10.1 minutes and Thiotepa: 20.2 minutes

Device Description

Nitrile Blue Powder Free Examination Gloves Tested For Use With Chemotherapy Drugs
Glove is a disposable device intended for medical purpose that is worn on the examiner's hand or finger to prevent contamination between patient and examiner.

AI/ML Overview

This document describes the FDA's substantial equivalence determination for Nitrile Blue Powder Free Examination Gloves. It focuses on their safety and effectiveness, particularly when exposed to chemotherapy drugs, based on performance criteria.

Here's an analysis of the provided information, framed by your request for acceptance criteria and study details:

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria for permeation by chemotherapy drugs are not explicitly stated as numerical targets in the document. However, they are implied by the testing methodology and the presentation of "Breakthrough Detection Time in Minutes." The general acceptance would be to demonstrate a reasonable barrier against these drugs, with the specific times providing the performance metrics.

Chemotherapy DrugConcentrationImplied Acceptance Criteria (e.g., minimum breakthrough time)Reported Device Performance (Breakthrough Detection Time in Minutes)
Carmustine (BCNU)3.3mg/ml(Not explicitly stated, but lower is worse)*10.1
Cisplatin1.0mg/ml(Not explicitly stated)>240
Cyclophosphamide (Cytoxan)20.0mg/ml(Not explicitly stated)>240
Dacarbazine (DTIC)10.0mg/ml(Not explicitly stated)>240
Doxorubicin Hydrochloride2.0mg/ml(Not explicitly stated)>240
Etoposide (Toposar)20.0mg/ml(Not explicitly stated)>240
Fluorouracil50.0mg/ml(Not explicitly stated)>240
Paclitaxel (Taxol)6.0mg/ml(Not explicitly stated)>240
Thiotepa10.0mg/ml(Not explicitly stated, but lower is worse)*20.2
Amethopterin Hydrate25.0mg/ml(Not explicitly stated)>240
Methotrexate25.0mg/ml(Not explicitly stated)>240
Mitomycin C0.5mg/ml(Not explicitly stated)>240
Vincristine Sulfate1.0mg/ml(Not explicitly stated)>240

Note: The document highlights that Carmustine and Thiotepa had "extremely low permeation times" compared to others, indicating these might be areas of concern if specific minimum times were regulatory requirements.

2. Sample Size for the Test Set and Data Provenance

  • Sample Size: The document does not explicitly state the sample size (number of gloves or tests) used for the chemotherapy drug permeation study. The table presents drug-specific results, but not the number of replicates or individual tests contributing to those results.
  • Data Provenance: The study was conducted "as per ASTM D6978-05 Standard Practice for Assessment of Medical Gloves to Permeation by Chemotherapy Drugs." This standard is a highly detailed, globally recognized protocol for testing these products, ensuring reproducibility and reliability of the data. The country of origin of the data is not specified beyond the Malaysian company (GMP Medicare SDN. BHD.) submitting the device. It is a prospective study as tests were conducted to specific ASTM standard.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Their Qualifications

This information is not applicable and therefore not provided in the document. The "ground truth" for this device's performance is established by the results of physical and chemical testing (specifically, permeation testing against a standardized protocol), not by expert consensus or interpretation of images/data. The ASTM D6978-05 standard itself defines the methodology for determining this ground truth (breakthrough time).

4. Adjudication Method for the Test Set

This information is not applicable. Adjudication methods (like 2+1, 3+1) are typically used in clinical or diagnostic studies where expert opinions or interpretations are being harmonized. For material performance testing, the results are derived directly from the test procedure according to the ASTM standard, not from human adjudication of results.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

Not applicable. This device is a medical glove, and its performance for chemotherapy drug permeation is assessed through laboratory material testing, not through human reader interpretation of cases or clinical scenarios. Therefore, an MRMC study and the concept of "improving human readers with AI" are irrelevant to this submission.

6. Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study

Not applicable. This is not an AI/algorithm-based device. Its performance is purely based on the physical barrier properties of the glove material when exposed to specific chemicals.

7. Type of Ground Truth Used

The ground truth used is based on physical and chemical testing results derived from a standardized protocol: ASTM D6978-05 Standard Practice for Assessment of Medical Gloves to Permeation by Chemotherapy Drugs. This standard uses instrumental analysis to detect when a chemotherapy drug permeates through the glove material.

8. Sample Size for the Training Set

Not applicable. This is not an AI/machine learning device; therefore, there is no "training set" in the context of developing an algorithm. The testing described is for performance validation, not for training a model.

9. How the Ground Truth for the Training Set Was Established

Not applicable, as there is no training set for an AI/ML algorithm. The "truth" for the product's performance is established through direct, standardized laboratory testing as outlined in point 7.

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Image /page/0/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo consists of a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" written around it. Inside the circle is a stylized image of three human profiles facing to the right, with flowing lines representing hair or clothing.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

April 21, 2016

GMP Medicare SDN. BHD. Ms. Eva Mustafa QA Manager Lot/PT64593. Jalan Dahlia/KU8 Kawasan Perindustrian Meru Timur 41050 Klang, Selangor D.E. MALAYSIA

Re: K15222

Trade/Device Name: Nitrile Blue Powder Free Examination Gloves Tested For Use With Chemotherapy Drugs Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: Class I Product Code: LZC, LZA Dated: March 28, 2016 Received: April 15, 2016

Dear Ms. Mustafa:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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 of the Act

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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); medical device reporting (reporting of medical devicerelated adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Tejashri Purohit-Sheth, M.D.

Tejashri Purohit-Sheth, M.D. Clinical Deputy Director DAGRID/ODE/CDRH FOR

Erin I. Keith, M.S. Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K152222

Device Name

Nitrile Blue Powder Free Examination Gloves Tested For Use With Chemotherapy Drugs

Indications for Use (Describe)

Indication Glove is a disposable device intended for medical purpose that is worn on the examiner's hand or finger to prevent contamination between patient and examiner.

These gloves were tested for use with Chemotherapy Drugs as per ASTM D6978-05 Standard Practice for Assessment of Medical Gloves to Permeation by Chemotherapy Drugs:

Chemotherapy Drug Permeation

  • The following chemicals have been tested with these gloves
Chemotherapy DrugConcentrationBreakthrough Detection Time in Minutes
Carmustine (BCNU)3.3mg/ml*10.1
Cisplatin1.0mg/ml>240
Cyclophosphamide (Cytoxan)20.0mg/ml>240
Dacarbazine (DTIC)10.0mg/ml>240
Doxorubicin Hydrochloride2.0mg/ml>240
Etoposide (Toposar)20.0mg/ml>240
Fluorouracil50.0mg/ml>240
Paclitaxel (Taxol)6.0mg/ml>240
Thiotepa10.0mg/ml*20.2
Amethopterin Hydrate25.0mg/ml>240
Methotrexate25.0mg/ml>240
Mitomycin C0.5mg/ml>240
Vincristine Sulfate1.0mg/ml>240
  • Please note that the following drugs have extremely low permeation times:

Carmustine (BCNU): 10.1 minutes and Thiotepa: 20.2 minutes

Type of Use (Select one or both, as applicable)

Prescription Use (Part 21 CFR 801 Subpart D)

X Over-The-Counter Use (21 CFR 801 Subpart C)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

§ 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.