AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Powder Free Nitrile Examination Gloves (Blue, Purple-Blue), Tested for Use with Chemotherapy Drugs is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

Gloves have been tested for use with chemotherapy drugs using ASTM D6978 and will be labeled with a statement of compliance and a summary of the testing results.

Device Description

Powder Free Nitrile Examination Gloves (Blue, Purple-Blue), Tested for Use with Chemotherapy Drugs Are Class I Patient Examination Gloves and Specialty Chemotherapy Gloves. They are ambidextrous and come in different sizes—Extra Small, Small, Medium, Large, Extra Large and XXL.

Gloves meet the specification of ASTM D6319-19 and have been tested for resistance to permeation by chemotherapy drugs as per ASTM D6978-05(2019).

AI/ML Overview

This is an evaluation of Powder Free Nitrile Examination Gloves (Blue, Purple-Blue), Tested for Use with Chemotherapy Drugs (K213440).

1. Acceptance Criteria and Reported Device Performance

The acceptance criteria and reported device performance are presented in the following table, derived from the "510(K) SUMMARY" (pages 11-12 of the document).

Test MethodPurposeAcceptance CriteriaReported Device Performance
ASTM D6319-19LengthMinimum 230mmAll sizes ≥ 230mm
ASTM D6319-19Palm WidthXS: 70±10mmS: 80±10mmM: 95±10mmL: 110±10mmXL: 120±10mmXXL: 130±10mmXS: 77-78mmS: 86-88mmM: 96-98mmL: 108-110mmXL: 116-117mmXXL: 126-127mm
ASTM D6319-19ThicknessFinger: 0.05mm (min)Palm: 0.05mm (min)Finger: ≥ 0.05mmPalm: ≥ 0.05mm
ASTM D6319-19, ASTM D412-16Tensile Strength, Before Aging14MPa, min≥ 14 MPa
ASTM D6319-19, ASTM D412-16Tensile Strength, After Accelerated Aging14MPa, min≥ 14 MPa
ASTM D6319-19, ASTM D412-16Ultimate Elongation, Before Aging500%, min≥ 500%
ASTM D6319-19, ASTM D412-16Ultimate Elongation, After Accelerated Aging400%, min≥ 400%
ASTM D5151-19, ASTM D6319-19Freedom from holesG-I, AQL 2.5Meet and above AQL 2.5 requirements
ASTM D6124-06 (2017), ASTM D6319-19Powder-Content≤ 2 mg per glove≤ 2 mg, meet requirements
ISO 10993-10:2010Skin Irritation StudyUnder the conditions of the study, not an irritantUnder the conditions of the study, not an irritant
ISO 10993-10:2010Maximization Sensitization StudyUnder the conditions of the study, not a sensitizerUnder the conditions of the study, not a sensitizer
ISO 10993-5:2009Cytotoxicity TestUnder the conditions of this study, the test article extract showed potential toxicity (or no cytotoxic potential from predicate)Under the conditions of this study, the test article extract showed potential toxicity
ISO 10993-11:2017Systemic toxicityUnder the conditions of this study, there was no evidence of systemic toxicity.Under the conditions of this study, there was no evidence of systemic toxicity.
ASTM D6978-05 (2019)Tested for Use with Chemotherapy Drugs(Implicitly, minimum breakthrough times (BDT) as presented in the tables for blue and purple-blue gloves)Details refer to the above 5.0 result (pages 6-7, 2-3 of the document for breakdown of BDT for each drug)

2. Sample size used for the test set and data provenance

The document does not explicitly state the sample sizes used for each of the non-clinical tests (e.g., for physical properties, biocompatibility, or chemotherapy drug permeation). It mentions that "Non-clinical tests were conducted to verify that the proposed device met all design specifications" (page 11).

The data provenance is not explicitly stated in terms of country of origin for the testing data or whether it was retrospective or prospective. However, the manufacturer is Luliang Hongruida Health Protection Technology Co., Ltd. (China), and the "510(K) Summary" indicates that the testing was performed to verify the device's compliance with established international and US standards (ASTM, ISO). This suggests the testing was performed specifically for the purpose of this submission (prospective in that sense).

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable. This submission is for medical gloves and involves non-clinical performance testing against established standards (e.g., ASTM, ISO), which do not typically require expert consensus for ground truth establishment in the way AI/CADe devices do. The "ground truth" is defined by the technical specifications of the standards themselves (e.g., a specific tensile strength value, acceptable limits for holes, or breakthrough time metrics).

4. Adjudication method (e.g., 2+1, 3+1, none) for the test set

Not applicable. As noted above, this device does not involve a diagnostic or interpretive task that would require human expert adjudication. The tests performed are objective measurements against defined criteria.

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 is a medical glove, a physical device, not an AI/CADe system. Therefore, MRMC studies involving human readers and AI assistance are not relevant.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

Not applicable. This is a medical glove, not an algorithm or AI system.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

For the physical and chemical properties (e.g., tensile strength, freedom from holes, powder content, biocompatibility, chemotherapy drug permeation), the "ground truth" is established by the specified test methods and their defined acceptance criteria (e.g., ASTM D6319-19, ASTM D6978-05, ISO 10993 series). These are objective, measurable standards, not subject to subjective interpretation or expert consensus in the typical sense of medical image analysis. For chemotherapy drug permeation, the "ground truth" is the measured breakthrough time for each drug using the ASTM D6978-05 standard.

8. The sample size for the training set

Not applicable. This is a physical medical device, not an algorithm that requires a training set. The performance data is derived from specific tests on samples of the manufactured gloves.

9. How the ground truth for the training set was established

Not applicable. As there is no training set for a physical device, no ground truth was established for it.

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Image /page/0/Picture/0 description: The image contains the logos of the Department of Health & Human Services and the Food and Drug Administration (FDA). The Department of Health & Human Services logo is on the left, and the FDA logo is on the right. The FDA logo includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

February 18, 2022

Luliang Hongruida Health Protection Technology Co., Ltd. % Kathy Liu Project Manager Hongray USA Medical Products Inc. 3973 Schaefer Avenue, Chino, California 91710

Re: K213440

Trade/Device Name: Powder Free Nitrile Examination Gloves (Blue, Purple-Blue), 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, LZC Dated: December 23, 2021 Received: January 10, 2022

Dear Kathy 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. 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.

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) K213440

Device Name

Powder Free Nitrile Examination Gloves (Blue, Purple-Blue), Tested for Use with Chemotherapy Drugs

Indications for Use (Describe)

Powder Free Nitrile Examination Gloves (Blue), Tested for Use with Chemotherapy Drugs is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

Gloves have been tested for use with chemotherapy drugs using ASTM D6978 and will be labeled with a statement of compliance and a summary of the testing results.

The following chemicals have been tested with these gloves:

For Blue gloves:
Chemotherapy DrugMinimum BDT (Minutes)
Bleomycin Sulfate 15mg/ml (15000 ppm)>240
Busulfan 6mg/ml (6,000 ppm)>240
Carboplatin 10mg/ml (10,000 ppm)>240
Carmustine 3.3 mg/ml (3,300 ppm)25.5
Chloroquine 50mg/ml (50,000ppm)>240
Cisplatin 1mg/ml (1,000 ppm)>240
Cyclophosphamide 20mg/ml (20,000 ppm)>240
Cyclosporin 100 mg/ml (100,000 ppm)>240
Cytarabine HCL, 100 mg/ml (100,000 ppm)>240
Dacarbazine 10 mg/ml (10,000 ppm)>240
Daunorubicin HCL, 5 mg/ml (5,000 ppm)>240
Docetaxel HCL, 10 mg/ml (10,000 ppm)>240
Doxorubicin HCL, 2 mg/ml (2,000 ppm)>240
Epirubicin HCL, 2 mg/ml (2,000 ppm)>240
Etoposide, 20 mg/ml (20,000 ppm)>240
Fludarabine, 25 mg/ml (25,000 ppm)>240
Fluorouracil, 50mg/ml (50,000ppm)>240
Gemcitabine, 38mg/ml (38,000ppm)>240
Idarubicin HCL, 1mg/ml (1,000ppm)>240
Ifosfamide, 50mg/ml (50,000ppm)>240
Irinotecan, 20mg/ml (20,000ppm)>240
Mechlorethamine HCI, 1mg/ml (1,000ppm)>240
Melphalan, 5mg/ml (5,000ppm)>240
Methotrexate, 25mg/ml (25,000ppm)>240
Mitomycin, 0.5mg/ml (500ppm)>240
Mitoxantrone HCL, 2mg/ml (2,000ppm)>240
Oxaliplatin, 5mg/ml (5,000ppm)>240
Paclitaxel, 6mg/ml (6,000ppm)>240
Paraplatin/Carboplatin, 10mg/ml (10,000ppm)>240
Retrovir, 10mg/ml (10,000ppm)>240
Rituximab, 10mg/ml (10,000ppm)>240
Thiotepa, 10mg/ml (10,000ppm)66.8
Topotecan, 1mg/ml (1,000ppm)>240
Trisenox, 1mg/ml (1,000ppm)>240
Velcade (Bortezomib), 1mg/ml (1,000ppm)>240

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Vincristine Sulfate, 1mg/ml (1,000ppm) >240 * Please note that the following drugs have extremely low permeation times: Carmustine: 25.5 minutes, Thiotepa: 66.8 minutes

For Purple-Blue gloves:
Chemotherapy DrugMinimum BDT (Minutes)
Bleomycin Sulfate 15mg/ml (15000 ppm)>240
Busulfan 6mg/ml (6,000 ppm)>240
Carboplatin 10mg/ml (10,000 ppm)>240
Carmustine 3.3 mg/ml (3,300 ppm)21.2
Chloroquine 50mg/ml (50,000ppm)>240
Cisplatin 1mg/ml (1,000 ppm)>240
Cyclophosphamide 20mg/ml (20,000 ppm)>240
Cyclosporin 100 mg/ml (100,000 ppm)>240
Cytarabine HCL, 100 mg/ml (100,000 ppm)>240
Dacarbazine 10 mg/ml (10,000 ppm)>240
Daunorubicin HCL, 5 mg/ml (5,000 ppm)>240
Docetaxel HCL, 10 mg/ml (10,000 ppm)>240
Doxorubicin HCL, 2 mg/ml (2,000 ppm)>240
Epirubicin HCL, 2 mg/ml (2,000 ppm)>240
Etoposide, 20 mg/ml (20,000 ppm)>240
Fludarabine, 25 mg/ml (25,000 ppm)>240
Fluorouracil, 50mg/ml (50,000ppm)>240
Gemcitabine, 38mg/ml (38,000ppm)>240
Idarubicin HCL, 1mg/ml (1,000ppm)>240
Ifosfamide, 50mg/ml (50,000ppm)>240
Irinotecan, 20mg/ml (20,000ppm)>240
Mechlorethamine HCI, 1mg/ml (1,000ppm)>240
Melphalan, 5mg/ml (5,000ppm)>240
Methotrexate, 25mg/ml (25,000ppm)>240
Mitomycin, 0.5mg/ml (500ppm)>240
Mitoxantrone HCL, 2mg/ml (2,000ppm)>240
Oxaliplatin, 5mg/ml (5,000ppm)>240
Paclitaxel, 6mg/ml (6,000ppm)>240
Paraplatin/Carboplatin, 10mg/ml (10,000ppm)>240
Retrovir, 10mg/ml (10,000ppm)>240
Rituximab, 10mg/ml (10,000ppm)>240
Thiotepa, 10mg/ml (10,000ppm)36.3
Topotecan, 1mg/ml (1,000ppm)>240
Trisenox, 1mg/ml (1,000ppm)>240
Velcade (Bortezomib), 1mg/ml (1,000ppm)>240
Vincristine Sulfate, 1mg/ml (1,000ppm)>240
* Please note that the following drugs have extremely low permeation times:
Carmustine: 21.2 minutes, Thiotepa: 36.3 minutes

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

_ Prescription Use (Part 21 CFR 801 Subpart D)

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

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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Zhaokua Area, Luliang Industrial Zone, Qujing City, Yunnan Province, 655606 China

510(K) SUMMARY

The assigned 510(K) numbers: K213440 Date Prepared: December 23, 2021

1. Owner's Identification:

Mr. Zhang Guocai Luliang Hongruida Health Protection Technology Co., Ltd. Zhaokua Area, Luliang Industrial Zone, Quiing City, Yunnan Province, 655606 China

Tel: 86-311-66766067 Contact: Ms. Kathy Liu, Project Manager Address: 3973 Schaefer Avenue, Chino, CA 91710, USA Tel: 909-590-1611 Email: kathyliu@hongrayusa.com or fdareg@126.com

2. Name of the Device:

Trade / Product Name: Powder Free Nitrile Examination Gloves (Blue, Purple-Blue), Tested for Use with Chemotherapy Drugs Common Name: Examination Gloves Classification Name: Patient Examination Glove Specialty Classification Regulation: 21 CFR 880.6250 Product Code: LZA LZC Classification Panel: General Hospital Device Class: Class I

3. Predicate Device Information:

Better Care Plastic Technology Co., Ltd Powder Free Nitrile Examination Gloves, Tested for Use with Chemotherapy Drugs (Blue) (K182600)

4. Device Description:

Powder Free Nitrile Examination Gloves (Blue, Purple-Blue), Tested for Use with Chemotherapy Drugs Are Class I Patient Examination Gloves and Specialty Chemotherapy Gloves. They are ambidextrous and come in different sizes—Extra Small, Small, Medium, Large, Extra Large and XXL.

Gloves meet the specification of ASTM D6319-19 and have been tested for resistance to permeation by chemotherapy drugs as per ASTM D6978-05(2019).

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Zhaokua Area, Luliang Industrial Zone, Qujing City, Yunnan Province, 655606 China

510(K) SUMMARY

5. Indications for Use:

Powder Free Nitrile Examination Gloves (Blue, Purple-Blue), Tested for Use with Chemotherapy Drugs is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

Gloves have been tested for use with chemotherapy drugs using ASTM D6978-05(2019) and will be labeled with a statement of compliance and a summary of the testing results. Chemotherapy Drug Permeation

The following chemicals have been tested with these gloves: Blue øloves

Blue gloves
Chemotherapy DrugMinimum BDT (Minutes)
Bleomycin Sulfate 15mg/ml (15000 ppm)>240
Busulfan 6mg/ml (6,000 ppm)>240
Carboplatin 10mg/ml (10,000 ppm)>240
Carmustine 3.3 mg/ml (3,300 ppm)25.5
Chloroquine 50mg/ml (50,000ppm)>240
Cisplatin 1mg/ml (1,000 ppm)>240
Cyclophosphamide 20mg/ml (20,000 ppm)>240
Cyclosporin 100 mg/ml (100,000 ppm)>240
Cytarabine HCL, 100 mg/ml (100,000 ppm)>240
Dacarbazine 10 mg/ml (10,000 ppm)>240
Daunorubicin HCL, 5 mg/ml (5,000 ppm)>240
Docetaxel HCL, 10 mg/ml (10,000 ppm)>240
Doxorubicin HCL, 2 mg/ml (2,000 ppm)>240
Epirubicin HCL, 2 mg/ml (2,000 ppm)>240
Etoposide, 20 mg/ml (20,000 ppm)>240
Fludarabine, 25 mg/ml (25,000 ppm)>240
Fluorouracil, 50mg/ml (50,000ppm)>240
Gemcitabine, 38mg/ml (38,000ppm)>240
Idarubicin HCL, 1mg/ml (1,000ppm)>240
Ifosfamide, 50mg/ml (50,000ppm)>240
Irinotecan, 20mg/ml (20,000ppm)>240
Mechlorethamine HCI, 1mg/ml (1,000ppm)>240
Melphalan, 5mg/ml (5,000ppm)>240
Methotrexate, 25mg/ml (25,000ppm)>240
Mitomycin, 0.5mg/ml (500ppm)>240
Mitoxantrone HCL, 2mg/ml (2,000ppm)>240
Oxaliplatin, 5mg/ml (5,000ppm)>240
Paclitaxel, 6mg/ml (6,000ppm)>240
Paraplatin/Carboplatin, 10mg/ml (10,000ppm)>240
Retrovir, 10mg/ml (10,000ppm)>240
Rituximab, 10mg/ml (10,000ppm)>240
Thiotepa, 10mg/ml (10,000ppm)66.8
Topotecan, 1mg/ml (1,000ppm)>240

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Zhaokua Area, Luliang Industrial Zone, Qujing City, Yunnan Province, 655606 China

510(K) SUMMARY

Trisenox, 1mg/ml (1,000ppm)>240
Velcade (Bortezomib), 1mg/ml (1,000ppm)>240
Vincristine Sulfate, 1mg/ml (1,000ppm)>240
  • Please note that the following drugs have extremely low permeation times: Carmustine: 25.5 minutes, Thiotepa: 66.8 minutes

Purple-Blue gloves

Chemotherapy DrugMinimum BDT (Minutes)
Bleomycin Sulfate 15mg/ml (15000 ppm)>240
Busulfan 6mg/ml (6,000 ppm)>240
Carboplatin 10mg/ml (10,000 ppm)>240
Carmustine 3.3 mg/ml (3,300 ppm)21.2
Chloroquine 50mg/ml (50,000ppm)>240
Cisplatin 1mg/ml (1,000 ppm)>240
Cyclophosphamide 20mg/ml (20,000 ppm)>240
Cyclosporin 100 mg/ml (100,000 ppm)>240
Cytarabine HCL, 100 mg/ml (100,000 ppm)>240
Dacarbazine 10 mg/ml (10,000 ppm)>240
Daunorubicin HCL, 5 mg/ml (5,000 ppm)>240
Docetaxel HCL, 10 mg/ml (10,000 ppm)>240
Doxorubicin HCL, 2 mg/ml (2,000 ppm)>240
Epirubicin HCL, 2 mg/ml (2,000 ppm)>240
Etoposide, 20 mg/ml (20,000 ppm)>240
Fludarabine, 25 mg/ml (25,000 ppm)>240
Fluorouracil, 50mg/ml (50,000ppm)>240
Gemcitabine, 38mg/ml (38,000ppm)>240
Idarubicin HCL, 1mg/ml (1,000ppm)>240
Ifosfamide, 50mg/ml (50,000ppm)>240
Irinotecan, 20mg/ml (20,000ppm)>240
Mechlorethamine HCI, 1mg/ml (1,000ppm)>240
Melphalan, 5mg/ml (5,000ppm)>240
Methotrexate, 25mg/ml (25,000ppm)>240
Mitomycin, 0.5mg/ml (500ppm)>240
Mitoxantrone HCL, 2mg/ml (2,000ppm)>240
Oxaliplatin, 5mg/ml (5,000ppm)>240
Paclitaxel, 6mg/ml (6,000ppm)>240
Paraplatin/Carboplatin, 10mg/ml (10,000ppm)>240
Retrovir, 10mg/ml (10,000ppm)>240
Rituximab, 10mg/ml (10,000ppm)>240
Thiotepa, 10mg/ml (10,000ppm)36.3
Topotecan, 1mg/ml (1,000ppm)>240
Trisenox, 1mg/ml (1,000ppm)>240
Velcade (Bortezomib) , 1mg/ml (1,000ppm)>240
Vincristine Sulfate, 1mg/ml (1,000ppm)>240
  • Please note that the following drugs have extremely low permeation times:

Carmustine: 21.2 minutes, Thiotepa: 36.3 minutes

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Zhaokua Area, Luliang Industrial Zone, Qujing City, Yunnan Province, 655606 China

510(K) SUMMARY

6. Comnarison of Subiect Device and Predicate Device:

The proposed device will be known as Powder Free Nitrile Examination Gloves (Blue, Purple-Blue), Tested for Use with Chemotherapy Drugs.

The following tables are summaries of the technological characteristics, biocompatibility and testing for use with chemotherapy drugs of the proposed and predicate devices.

Proposed DeviceK213440Predicate DeviceK182600Remark
Trade NamePowder Free NitrileExamination Gloves(Blue, Purple-Blue),Tested for Use withChemotherapy DrugsPowder Free NitrileExamination Gloves,Tested for Use withChemotherapy Drugs(Blue)Similar
Product CodeLZA, LZCLZA, LZCSame
Regulation Number21 CFR 880.625021 CFR 880.6250Same
ClassIISame
Indications for UsePowder Free NitrileExamination Gloves (Blue,Purple-Blue), Tested for Usewith Chemotherapy Drugs isa disposable device intendedfor medical purposes that isworn on the examiner's handto prevent contaminationbetween patient and examiner.Powder Free NitrileExamination Gloves, Tested forUse with Chemotherapy Drugs(Blue) is a disposable deviceintended for medical purposesthat is worn on the examiner'shand to prevent contaminationbetween patient and examiner.Same
Powder or PowderFreePowder FreePowder FreeSame
Design FeatureAmbidextrousAmbidextrousSame
ColorBlue, Purple-BlueBlueSimilar
LabelingInformationSingle-use, powder freeglove size, quantity,Nitrile ExaminationGloves, Non SterileSingle-use, powder free glovesize, quantity, NitrileExamination Gloves, NonSterileSame
Chemotherapy DrugPermeation ClaimSee below comparisontableSee below comparison tableSame

General Comparison Table:

Dimensions and Performance Comparison Table:

TechnologicalProposed DevicePredicate DeviceRemark
----------------------------------------------------------

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CharacteristicsK213440K182600
LengthMinimum 230mmMinimum 230mmSame
Palm Width (size) (mm)
XS70±1070±10Same
S80±1080±10Same
M95±1095±10Same
L110±10110±10Same
XL120±10120±10Same
XXL130±10130±10Same
Thickness(mm)
FingerMinimum 0.05Minimum 0.05Same
PalmMinimum 0.05Minimum 0.05Same
Tensile Strength,Before Aging14MPa, min14MPa, minSame
Ultimate Elongation,Before Aging500%, min500%, minSame
Tensile Strength, AfterAccelerated Aging14MPa, min14MPa, minSame
Ultimate Elongation,After AcceleratedAging400%, min400%, minSame
Freedom from holesIn accordance withASTM D 5151-19,following ASTM D6319- 19,G-I, AQL 2.5In accordance withASTM D 5151-19,following ASTM D6319- 19,G-I, AQL 2.5Same
Powder-Content≤ 2 mg per glove≤ 2 mg per gloveSame
10993-10:2010 SkinIrritation StudyUnder the conditions of thestudy, not an irritantUnder the conditions of thestudy, not an irritantSame
10993-10:2010MaximizationSensitization StudyUnder the conditions of thestudy, not a sensitizerUnder the conditions of thestudy, not a sensitizerSame
10993-5:2009Cytotoxicity TestUnder the conditions of thisstudy, the test article extractshowed potential toxicityUnder the conditions ofthis study, no cytotoxicpotentialSame
ISO 10993 Part 11Systemic toxicityUnder the conditions of thisstudy, there was no evidence ofsystemic toxicity./Different

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Zhaokua Area, Luliang Industrial Zone, Qujing City,
Yunnan Province, 655606 China

510(K) SUMMARY

Chemotherapy Permeation Comparison:
Tested Chemotherapy Drug andMinimum BDT (Minutes)
ConcentrationProposed DeviceK213440Predicate DeviceK182600Remark
BluePurple-Blue
Bleomycin Sulfate 15mg/ml (15000 ppm)>240>240>240Same
Busulfan 6mg/ml (6,000 ppm)>240>240>240Same
Carboplatin 10mg/ml (10,000 ppm)>240>240>240Same
Carmustine 3.3 mg/ml (3,300 ppm)7.025.521.2Similar
Chloroquine 50mg/ml (50,000ppm)>240>240>240Same
Cisplatin 1mg/ml (1,000 ppm)>240>240>240Same
Cyclophosphamide 20mg/ml (20,000 ppm)>240>240>240Same
Cyclosporin 100 mg/ml (100,000 ppm)>240>240>240Same
Cytarabine HCL, 100 mg/ml (100,000 ppm)>240>240>240Same
Dacarbazine 10 mg/ml (10,000 ppm)>240>240>240Same
Daunorubicin HCL, 5 mg/ml (5,000 ppm)>240>240>240Same
Docetaxel HCL, 10 mg/ml (10,000 ppm)>240>240>240Same
Doxorubicin HCL, 2 mg/ml (2,000 ppm)>240>240>240Same
Epirubicin HCL, 2 mg/ml (2,000 ppm)>240>240>240Same
Etoposide, 20 mg/ml (20,000 ppm)>240>240>240Same
Fludarabine, 25 mg/ml (25,000 ppm)>240>240>240Same
Fluorouracil, 50mg/ml (50,000ppm)>240>240>240Same
Gemcitabine, 38mg/ml (38,000ppm)>240>240>240Same
Idarubicin HCL, 1mg/ml (1,000ppm)>240>240>240Same
Ifosfamide, 50mg/ml (50,000ppm)>240>240>240Same
Irinotecan, 20mg/ml (20,000ppm)>240>240>240Same
Mechlorethamine HCI, 1mg/ml (1,000ppm)>240>240>240Same
Melphalan, 5mg/ml (5,000ppm)>240>240>240Same
Methotrexate, 25mg/ml (25,000ppm)>240>240>240Same
Mitomycin, 0.5mg/ml (500ppm)>240>240>240Same
Mitoxantrone HCL, 2mg/ml (2,000ppm)>240>240>240Same
Oxaliplatin, 5mg/ml (5,000ppm)>240>240>240Same
Paclitaxel, 6mg/ml (6,000ppm)>240>240>240Same
Paraplatin/Carboplatin, 10mg/ml (10,000ppm)>240>240>240Same
Retrovir, 10mg/ml (10,000ppm)>240>240>240Same
Rituximab, 10mg/ml (10,000ppm)>240>240>240Same
Thiotepa, 10mg/ml (10,000ppm)23.066.836.3Similar
Topotecan, 1mg/ml (1,000ppm)>240>240>240Same
Trisenox, 1mg/ml (1,000ppm)>240>240>240Same
Velcade (Bortezomib) , 1mg/ml (1,000ppm)>240>240>240Same
Vincristine Sulfate, 1mg/ml (1,000ppm)>240>240>240Same

{11}------------------------------------------------

Zhaokua Area, Luliang Industrial Zone, Qujing City, Yunnan Province, 655606 China

510(K) SUMMARY

7. Non-Clinical Performance Data

Non-clinical tests were conducted to verify that the proposed device met all design specifications. The test results demonstrated that the proposed device complies 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
  • ISO 10993-11:2017 Biological evaluation of medical devices Part 11: Tests for . systemic toxicity
  • 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 D6978-05 (Reapproved 2019), Assessment of Reissuance of Medical Gloves ● to Permeation by Chemotherapy Drugs.
Test methodPurposeAcceptance CriteriaResults
ASTM D6319- 19LengthMinimum 230mmAll size ≥230
ASTM D6319- 19Palm WidthXS: 70±10mm77-78mm
S: 80±10mm86-88 mm
M:95±10mm96 -98mm
L:110±10mm108-110 mm
XL: 120±10mm116-117 mm
XXL: 130±10mm126-127 mm
ASTM D6319- 19ThicknessFinger: 0.05mm (min)Palm: 0.05mm (min)≥0.05mm≥0.05mm
ASTM D6319-19ASTN D412-16Tensile Strength, BeforeAging14MPa, min≥14 MPa
ASTM D6319-19ASTN D412-16Tensile Strength, AfterAccelerated Aging14MPa, min≥14 MPa

{12}------------------------------------------------

Zhaokua Area, Luliang Industrial Zone, Qujing City, Yunnan Province, 655606 China

510(K) SUMMARY
ASTM D6319-19ASTN D412-16Ultimate Elongation,Before Aging500%, min≥500%
ASTM D6319-19ASTN D412-16Ultimate Elongation,After Accelerated Aging400%, min≥400%
ASTM D 5151-19ASTM D6319- 19Freedom from holesG-I, AQL 2.5Meet and above AQL2.5requirements
ASTM D 6124-06(2017)ASTM D6319- 19Powder-Content≤2 mg per glove≤2 mg, meet requirements
ISO 10993-10:2010Skin Irritation StudyUnder the conditions ofthe study, not an irritantUnder the conditions ofthe study, not an irritant
ISO 10993-10:2010MaximizationSensitization StudyUnder the conditions ofthe study, not a sensitizerUnder the conditions ofthe study, not a sensitizer
ISO 10993-5:2009Cytotoxicity TestUnder the conditions ofthis study, the test articleextract showed potentialtoxicityUnder the conditions of thisstudy, the test article extractshowed potential toxicity
ISO 10993-11:2017Systemic toxicityUnder the conditions ofthis study, there was noevidence of systemictoxicity.Under the conditions of thisstudy, there was no evidenceof systemic toxicity.
ASTM D6978-05 (2019)Tested for Use withChemotherapy Drugs/Details refer to the above 5.0result

510/K) SUMMARV

8. Clinical Performance Data

N/A

9. Conclusion:

The conclusions drawn from the nonclinical tests demonstrate that the proposed device is as safe, as effective, and performs as well as or better than the legally marketed predicated device.

§ 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.