K Number
K212919

Validate with FDA (Live)

Date Cleared
2021-12-15

(92 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. In addition, these gloves were tested for use with chemotherapy drugs in accordance with ASTM D6978-05 Standard Practice for Assessment of Medical gloves to Permeation by Chemotherapy Drugs.

Device Description

The subject device is single use, disposable gloves intended for medical purposes to be worn on the examiner's hands to prevent contamination between patient and examiner. The gloves are powder-free, ambidextrous with beaded cuff, blue colored, nitrile, and tested for use with chemotherapy drugs. The gloves are offered in four sizes: small, medium, large, and extra-large. The subject device is non-sterile.

AI/ML Overview

Acceptance Criteria and Device Performance for Disposable Nitrile Examination Gloves

This document outlines the acceptance criteria and details the studies conducted to demonstrate that the "Disposable Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs)" meet these criteria.

1. Table of Acceptance Criteria and Reported Device Performance

Test MethodPurposeAcceptance CriteriaReported Device Performance
ASTM D6319Physical Dimensions TestLength (mm): S: ≥220; M/L/XL: ≥230Width (mm): S: 80±10; M: 95±10; L: 110±10; XL: 120±10Thickness (mm): Finger: ≥0.05; Palm: ≥0.05Length (mm): > 240/Pass (for all sizes)Width (mm): S: 88-89 /Pass; M: 94-97/ Pass; L: 103-107/Pass; XL: 114-116/PassThickness (mm): Finger: 0.10-0.11/Pass; Palm: 0.07-0.08/Pass
ASTM D5151Watertightness Test for Detection of HolesMeet the requirements of ASTM D5151 AQL 2.50/125/Pass
ASTM D6124Powder ContentMeet the requirements of ASTM D6124 << 2.0mg0.08mg/Pass
ASTM D412Physical properties (Tensile Strength & Elongation)Before Aging: Tensile Strength ≥14MPa; Ultimate Elongation ≥500%After Aging: Tensile Strength ≥14MPa; Ultimate Elongation ≥400%Before Aging: Tensile Strength: 21.5-29.0MPa/Pass; Ultimate Elongation: 796-983%/PassAfter Aging: Tensile Strength: 19.1-25.9MPa/Pass; Ultimate Elongation: 645-904%/Pass
ISO 10993-5CytotoxicityUnder conditions of the study, device extract is not cytotoxic.Under conditions of the study, device extract is not cytotoxic. /Pass
ISO 10993-10IrritationNon-irritatingUnder the conditions of the study, not an irritant. / Pass
ISO 10993-10SensitizationNon-sensitizingUnder conditions of the study, not a sensitizer. / Pass
ASTM D6978-05Chemotherapy Drug Permeation (Minimum Breakthrough)Carmustine (BCNU) 3.3 mg/ml: > 20 Minutes (Predicate's acceptance criteria was >20 minutes, though the predicate showed 11.8 min and 31.6 min depending on color - subject device had 1.9 min, leading to a warning for this drug).Cisplatin 1.0 mg/ml: > 20 MinutesCyclophosphamide (Cytoxan) 20.0 mg/ml: > 240 MinutesDacarbazine (DTIC) 10.0 mg/ml: > 240 MinutesDoxorubicin HCl 2.0 mg/ml: > 240 MinutesEtoposide 20.0 mg/ml: > 240 MinutesFluorouracil 50.0 mg/ml: > 240 MinutesPaclitaxel 6.0 mg/ml: > 20 Minutes (Predicate's acceptance criteria was >20 minutes, though the predicate showed >240 min).ThioTepa 10.0 mg/ml: > 20 Minutes (Predicate's acceptance criteria was >20 minutes though the subject device had 11.3 min, leading to a warning for this drug).Carmustine (BCNU) 3.3 mg/ml: 1.9 Minutes (Warning: Do not use)Cisplatin 1.0 mg/ml: > 240 MinutesCyclophosphamide (Cytoxan) 20.0 mg/ml: > 240 MinutesDacarbazine 10.0 mg/ml: > 240 MinutesDoxorubicin HCL 2.0 mg/ml: > 240 MinutesEtoposide 20.0 mg/ml: > 240 MinutesFluorouracil 50.0 mg/ml: > 240 MinutesPaclitaxel 6.0 mg/ml: > 240 MinutesThioTepa 10.0 mg/ml: 11.3 Minutes (Warning: Do not use)

Note: For Carmustine (BCNU) and ThioTepa, the device performance did not meet the implicitly accepted longer breakthrough times of the predicate device for safe use, and as such, a warning was issued for non-use with these specific drugs. For other drugs, the device demonstrated comparable or superior performance to the predicate.

2. Sample Size and Data Provenance

The document does not explicitly state the specific sample sizes used for each test. However, for the Watertightness Test (ASTM D5151), the result "0/125/Pass" indicates a sample size of 125 gloves were tested, and none failed.

The data provenance is implied to be prospective bench testing conducted specifically for the submission of this device, presumably within China, given the manufacturer's and correspondent's addresses. There is no information provided regarding country of origin of data beyond the manufacturer's location.

3. Number of Experts and Qualifications for Ground Truth

This section is not applicable as the studies are primarily bench testing of physical and chemical properties of a medical device (gloves). The "ground truth" for these tests is established by published ASTM and ISO standards and their specified methodologies, not by expert consensus on diagnostic images or clinical outcomes.

4. Adjudication Method for the Test Set

This is not applicable as the studies involve objective physical and chemical testing against established standards, not interpretation of data requiring adjudication.

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

This is not applicable. The device is a medical glove, and the evaluation does not involve diagnostic imaging or human-in-the-loop performance with AI.

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

This is not applicable. The device is a medical glove, not an algorithm, and its performance is assessed directly through physical and chemical testing.

7. Type of Ground Truth Used

The ground truth used for these studies is based on:

  • Established ASTM (American Society for Testing and Materials) and ISO (International Organization for Standardization) standards: These standards define the test methodologies, performance criteria (e.g., minimum tensile strength, maximum powder content, minimum breakthrough times for chemotherapy drugs, irritation/sensitization levels), and acceptable limits.
  • Objective laboratory measurements: Physical dimensions, tensile strength, elongation, watertightness, powder content, and chemical permeation breakthrough times were measured directly according to the specified standard test methods.

8. Sample Size for the Training Set

This is not applicable. The device is a physical product (medical gloves), not an AI algorithm that requires a training set. The performance is based on direct testing of the product itself.

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

This is not applicable as there is no training set for this type of device. The "ground truth" for the performance evaluation is established by the relevant ASTM and ISO standards as mentioned in point 7.

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December 15, 2021

Jiujiang Taixin Technology Co., Ltd. % Boyle Wang Official Correspondent Shanghai Truthful information Technology Co., Ltd. RM. 1801, No. 161 Lujiazui East Rd.,Pudong Shanghai. 200120 China

Re: K212919

Trade/Device Name: Disposable Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs) Regulation Number: 21 CFR 880.6250 Regulation Name: Non-Powdered Patient Examination Glove Regulatory Class: Class I. reserved Product Code: LZA Dated: September 7, 2021 Received: September 14, 2021

Dear Boyle Wang:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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.

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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); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely.

For Clarence W. Murray, III, PhD Assistant Director DHT4B: Division of Infection Control and Plastic Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K212919

Device Name

Disposable Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs)

Indications for Use (Describe)

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. In addition, these gloves were tested for use with chemotherapy drugs in accordance with ASTM D6978-05 Standard Practice for Assessment of Medical gloves to Permeation by Chemotherapy Drugs.

Chemotherapy DrugConcentrationBreakthrough Detection Time in Minutes
Carmustine (BCNU)3.3 mg/ml (3,300 ppm)1.9 Minutes
Cisplatin1.0 mg/ml(1,000 ppm)> 240 Minutes
Cyclophosphamide (Cytoxan)20.0 mg/ml(20,000 ppm)> 240 Minutes
Dacarbazine10.0 mg/ml(10,000 ppm)> 240 Minutes
Doxorubicin HCL2.0 mg/ml(2,000 ppm)> 240 Minutes
Etoposide20.0 mg/ml(20,000 ppm)> 240 Minutes
Fluorouracil50.0 mg/ml(50,000 ppm)> 240 Minutes
Paclitaxel6.0 mg/ml(6,000 ppm)> 240 Minutes
ThioTepa10.0 mg/ml(10,000 ppm)11.3 Minutes

Please note that the following drugs have low permeation times: Carmustine (BCNU) 3.3 mg/ml 1.9 Minutes ThioTepa 10.0 mg/ml 11.3 Minutes

Warning: Please do not use with Carmustine (BCNU) and ThioTepa.

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)

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510(k) Summary

This summary of 510(k) is being submitted in accordance with 21 CFR 807.92.

1.0 Submitter's Information_

Name: Jiujiang Taixin Technology Co., Ltd.

Address: Zone A, Ruichang Science and Technology Park, Ruichang City, Jiangxi Province, P.R. China.

Contact: Li Xiaojie

Date of Preparation: Sept 7, 2021

Designated Submission Correspondent

Mr. Boyle Wang Shanghai Truthful Information Technology Co., Ltd. Room 1801, No. 161 Lujiazui East Rd., Pudong Shanghai, 200120 China Tel: +86-21-50313932 Email: Info@truthful.com.cn

2.0 Device Information

  • Trade name: Disposable Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs)
  • Common name: Patient Examination Gloves

Classification name: Non-powdered patient examination glove

Model(s): S, M, L, XL

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3.0 Classification

Production code: LZA,LZC

Regulation number: 21CFR880.6250

Classification: Class I

General Hospital Panel:

4.0 Predicate Device Information

Manufacturer: Ever Growth (Vietnam) Co., Ltd.

  • Device: Disposable Powder Free Nitrile Examination Glove, Tested For Use With Chemotherapy Drugs, Disposable Powder Free Nitrile Examination Glove, Tested For Use With Chemotherapy Drugs, Orange Color
    510(k) number: K190860

5.0 Device Description

The subject device is single use, disposable gloves intended for medical purposes to be worn on the examiner's hands to prevent contamination between patient and examiner. The gloves are powder-free, ambidextrous with beaded cuff, blue colored, nitrile, and tested for use with chemotherapy drugs. The gloves are offered in four sizes: small, medium, large, and extra-large.

The subject device is non-sterile.

6.0 Indication 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. In addition, these gloves were

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tested for use with chemotherapy drugs in accordance with ASTM D6978-05 Standard Practice for Assessment of Medical gloves to Permeation by Chemotherapy Drugs

Chemotherapy DrugConcentrationBreakthrough DetectionTime in Minutes
Carmustine (BCNU)3.3 mg/ml (3,300 ppm)1.9
Cisplatin1.0 mg/ml(1,000 ppm)> 240
Cyclophosphamide(Cytoxan)20.0 mg/ml(20,000 ppm)> 240
Dacarbazine (DTIC)10.0 mg/ml(10,000 ppm)> 240
Doxorubicin HCI2.0 mg/ml(2,000 ppm)> 240
Etoposide20.0 mg/ml(20,000 ppm)> 240
Fluorouracil50.0 mg/ml(50,000 ppm)> 240
Paclitaxel6.0 mg/ml(6,000 ppm)> 240
ThioTepa10.0 mg/ml(10,000 ppm)11.3

Please note that the following drugs have low permeation times:

Carmustine (BCNU) 3.3 mg/ml 1.9 Minutes;

Thio Tepa 10.0 mg/ml 11.3 Minutes.

Warning: Please do not use with Carmustine (BCNU) and ThioTepa.

7.0 Technological Characteristic Comparison Table

ltemSubject Device(K212919)Predicate Device(K190860)Comparison
Product CodeLZA,LZCLZA,LZCSame

Table1-General Comparison

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Regulation No.21CFR880.625021CFR880.6250Same
ClassIISame
Intended UseA patient examinationgloves is a disposabledevice intended for medicalpurpose that is worn on theexaminer's hand orfingers to preventcontamination betweenpatient and examiner. Inaddition, these gloves weretested for use withchemotherapy drugs inaccordance with ASTMD6978-05 StandardPractice for Assessment ofMedical gloves toPermeation byChemotherapy Drugs.A patient examinationgloves is a disposabledevice intended for medicalpurpose that is worn on theexaminer's hand orfingers to preventcontamination betweenpatient and examiner. Inaddition, these gloves weretested for use withchemotherapy drugs inaccordance with ASTMD6978-05 StandardPractice for Assessment ofMedical gloves toPermeation byChemotherapy Drugs.Same
Powdered or PoweredfreePowdered freePowdered freeSame
Design FeatureAmbidextrousAmbidextrousSame
SterilityNon-SterileNon-SterileSame
Labeling InformationSingle-use indication,powder free, device color,device name, glove size andquantity,Non-Sterile,a statement of standardASTM D6978-05compliance and asummary of the testingresults.Single-use indication,powder free, device color,device name, glove sizeand quantity, Non-Sterile, astatement of standardASTM D6978-05compliance and asummary of the testingresults.Same
Dimensions(mm)Length:S: ≥220;Length:XS/S/M/L/XL: ≥230;Similar
M/L/XL: ≥230;Width:S: 80±10;M: 95±10;L: 110±10;XL: 120±10Width:XS:70±10;S: 80±10;M: 95±10;L: 110±10;XL: 120±10
Thickness(mm)Finger: ≥0.05;Palm: ≥0.05Finger: ≥0.05;Palm: ≥0.05Same
ColorantBlueWhite, OrangeDifferent
PhysicalPropertiesBeforeAgingTensileStrength 14MPa, minUltimateeElongation 500% minTensileStrength 14MPa, minUltimateElongation 500% minSame
AfterAgingTensileStrength 14MPa, minUltimateeElongation 400%minTensileStrength 14MPa, minUltimateElongation 400%minSame
Freedom from HolesBe free from holes whentested in accordance withASTMD5151 AQL=2.5Same
Powder Content0.15 mg per glove, Meetthe requirements ofASTM D6124Similar
BiocompatibilityISO 10993-10;Under the conditions ofthe study, not an irritantSame
or a sensitizeror a sensitizer
ISO 10993-5ISO 10993-5
Under conditions of thestudy, device extract isnot cytotoxicUnder conditions of thestudy, device extract isnot cytotoxicSame
Carmustine (BCNU) 3.3mg/ml: 1.9 MinutesCarmustine (BCNU) 3.3mg/ml:White: 11.8 Minutes;Orange: 31.6MinutesSimilar
Cisplatin 1.0 mg/ml: > 20MinutesCisplatin 1.0 mg/ml: >20MinutesSame
Chemotherapy DrugsTested with MinimumBreakthroughCyclophosphamide(Cytoxan) 20.0 mg/ml: >240 MinutesCyclophosphamide(Cytoxan)20.0 mg/ml: >240 MinutesSame
Dacarbazine (DTIC) 10.0mg/ml: > 240 MinutesDacarbazine (DTIC) 10.0mg/ml:>240 MinutesSame
Doxorubicin HCl 2.0 mg/ml:> 240 MinutesDoxorubicin Hydrochloride2.0mg/ml: >240 MinutesSame
Etoposide 20.0 mg/ml: >240 MinutesEtoposide (Toposar) 20.0mg/ml: >240 MinutesSame
Fluorouracil 50.0 mg/ml: >240 MinutesFluorouracil 50.0mg/ml: >240MinutesSame
Paclitaxel 6.0 mg/ml: >20MinutesPaclitaxel (Taxol) 6.0mg/ml:>240 MinutesSame

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Detection Time asTested per ASTM D6978
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8.0 Summarv of Non-Clinical Testing

Biocompatibility Testing

The biocompatibility evaluation for Medical Examination Gloves (Tested for Use with Chemotherapy) was conducted in accordance with the following standards:

ISO 10993-10:2010 Biological Evaluation of Medical Devices - Part 10: Tests for Irritation And Skin Sensitization.

ISO 10993-5:2009 Biological Evaluation of Medical Devices - Part 5: Tests For In Vitro Cytotoxicity

Performance Testing (Bench)

Physical performance qualities of the proposed device were evaluated per ASTM D6319-10, Standard Specification for Nitrile Examination Gloves for Medical Application.

Permeation testing was conducted to support the addition of the labeling claim: Tested for use with chemotherapy drugs. In addition, the proposed device was tested according to ASTM D6978-05 (Reapproved 2019), Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs, in which minimum breakthrough times were determined for a wide range of chemotherapy drugs.

In summary, the performance testing of the subject device was conducted to adequately demonstrate the effectiveness of the device in accordance with the relevant test methods cited below:

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  • ASTM D6124-06 (Reapproved 2017), Standard Test Method for । Residual Powder on Medical Gloves
  • ASTM D5151-19, Standard Test Method for Detection of Holes in -Medical Gloves.
  • ASTM D6319-19, Standard Specification for Nitrile Examination Gloves for Medical Application.
  • ASTM D 6978-05 (Reapproved 2019), Standard Practice for । Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs.
TestMethodPurposeAcceptance CriteriaResults
ASTMD6319PhysicalDimensionsTestLength(mm):S:≥220;M/L/XL:≥230;Length(mm):> 240/Pass;
Width(mm):S: 80±10;M: 95±10;L: 110±10;XL: 120±10Width(mm):S: 88-89 /PassM: 94-97/ PassL: 103-107/PassXL:114-116/Pass
Thickness (mm):Finger: ≥0.05Palm: ≥0.05Thickness (mm):Finger: 0.10-0.11/PassPalm: 0.07-0.08/Pass
ASTMD5151WatertightnessTestforDetectionofHolesMeet the requirements of ASTM D5151AQL 2.50/125/Pass
ASTMD6124PowderContentMeet the requirements of ASTM D6124 <2.0mg0.08mg/Pass;
ASTMPhysicalBefore Tensile ≥14MPa21.5-29.0MPa/Pass;

Table 2 - Summary of non-clinical performance testing

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D412propertiesAgingStrength
UltimateElongation≥500%796-983%/Pass;
AfterAgingTensileStrength≥14MPa19.1-25.9MPa/Pass;
UltimateElongation≥400%645-904%/Pass;
ISO10993-5CytotoxicityNon- In Vitro CytotoxicityUnder conditions ofthe study, deviceextract is notcytotoxic. /Pass
ISO10993-10IrritationNon-irritatingUnder the conditionsof the study, not anirritant. / Pass
ISO10993-10SensitizationNon-sensitizingUnder conditions ofthe study, not asensitizer. / Pass

9.0 Summary of Clinical Testing

Clinical testing is not needed for this device.

10.0 Conclusion

The conclusions drawn from the nonclinical tests demonstrate that the subject device, Disposable Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs) is as safe, as effective, and performs as well as or better than the legally marketed predicated device under K190860.

§ 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.