K Number
K213600
Date Cleared
2022-02-19

(96 days)

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

The Medical nitrile examination gloves (Model: SH001) is intended to be worn on the hands of examiners to prevent contamination between patient and examiner. This is a single-use, powder-free, non-sterile device.

Device Description

The subject device is a powder-free nitrile examination glove, provided as a non-sterile and disposable device. The subject device is mainly made from nitrile and there are four sizes, includes small (S), medium (M), large (L), X-large (XL) for optional. The gloves are provided with blue color, the colorant is Butadiene-Acrylonitrile Copolymers (CAS No.9003-18-3) and Pigment Blue (CAS No.147-14-8). The examination glove is a smooth surface with textured fingertips and a rolled rim at the cuff edge. The Medical nitrile examination gloves meet the specifications in ASTM D6319-19 Standard Specification for Nitrile Examination Gloves for Medical Application.

AI/ML Overview

The provided text describes the acceptance criteria and performance data for "Medical nitrile examination gloves (Model: SH001)" to demonstrate substantial equivalence to a predicate device for FDA 510(k) clearance. This is a Class I medical device and the data provided is for non-clinical performance testing, primarily mechanical and biocompatibility tests, not an AI/Software-as-a-Medical-Device (SaMD) study.

Therefore, many of the requested items related to AI/SaMD studies (e.g., human-in-the-loop performance, expert ground truth, adjudication methods, multi-reader multi-case studies, training/test set sample sizes for AI, etc.) are not applicable to this submission focusing on physical product characteristics of examination gloves.

I will provide the information that is applicable from the provided text.


Acceptance Criteria and Device Performance for Medical Nitrile Examination Gloves (Model: SH001)

The device, Medical nitrile examination gloves (Model: SH001), underwent non-clinical performance testing to demonstrate its safety and effectiveness, primarily adhering to the ASTM D6319-19 standard. The study aimed to show substantial equivalence to a predicate device (K203593).

1. Table of Acceptance Criteria and Reported Device Performance

Test Method (Standard)Test PurposeAcceptance CriteriaReported Device Performance (Test Results)Conclusion
ASTM D6319-19 - Physical Dimensions TestTo determine the width, length, and thickness of the glovesWidth:S: 80±10 mmM: 95±10 mmL: 110±10 mmXL: 120±10 mmLength:S: ≥220 mmM/L/XL: ≥230 mmLot Batch 20210723C1:Width: S: 79-84mm, M: 93-97mm, L: 104-107mm, XL: 112-115mmLength: S: 231-235mm, M: 234-238mm, L: 237-240mm, XL: 238-243mmLot Batch 20210719A1:Width: S: 80-83mm, M: 93-96mm, L: 104-107mm, XL: 112-116mmLength: S: 231-235mm, M: 235-238mm, L: 237-240mm, XL: 239-243mmLot Batch 20210726A0:Width: S: 79-83mm, M: 94-97mm, L: 104-107mm, XL: 112-116mmLength: S: 232-235mm, M: 235-238mm, L: 237-240mm, XL: 238-243mmPassed (for all 3 lots)
ASTM D6319-19 - Thickness TestTo determine the thickness of the glovesFinger: ≥0.05mmPalm: ≥0.05mmFor all three lots (S/M/L/XL): Finger min: 0.13mm, Palm min: 0.13mmPassed (for all 3 lots)
ASTM D6319-19 - Physical Properties (Tensile Strength & Ultimate Elongation)To determine tensile strength and ultimate elongation before and after accelerated agingBefore Aging:Tensile Strength: ≥14MpaUltimate Elongation: ≥500%After Aging:Tensile Strength: ≥14MpaUltimate Elongation: ≥400%For all three lots:Before Aging: Tensile Strength: ≥14Mpa, Ultimate Elongation: ≥500%After Aging: Tensile Strength: ≥14Mpa, Ultimate Elongation: ≥400%Passed (for all 3 lots)
ASTM D6319-19 (ASTM D5151-11) - Freedom from Holes (Water Tight)To determine the holes in the glovesAQL 2.5For all three lots: Pass at AQL 2.5Passed (for all 3 lots)
ASTM D6319-19 (ASTM D6124-11) - Residual PowderTo determine the residual powder in the gloves< 2.0 mg/gloveLot Batch 20210723C1: 0.17 mg/gloveLot Batch 20210719A1: 0.23 mg/gloveLot Batch 20210726A0: 0.18 mg/glovePassed (for all 3 lots)
ISO 10993-10 - Skin IrritationTo evaluate potential intracutaneous reactivityUnder the conditions of the study not an irritantUnder the conditions of study not an irritantPassed
ISO 10993-10 - Skin SensitizationTo determine skin sensitization potentialUnder the conditions of study not a sensitizerUnder the conditions of the study not a sensitizerPassed
ISO 10993-11:2017 - Acute Systemic ToxicityTo evaluate for acute systemic toxicityUnder the conditions of the study no systemic toxicityUnder the condition of acute systemic toxicity test, the test article did not show acute systemic toxicity in vivo.Passed

2. Sample Size and Data Provenance for the Test Set

  • Sample Size: The document refers to "Lot Batch of 20210723C1," "Lot Batch of 20210719A1," and "Lot Batch of 20210726A0" for physical dimensions, tensile strength, elongation, freedom from holes, and residual powder tests. While specific numbers of gloves per batch are not provided in this summary, the testing was done on multiple production lots.
  • Data Provenance: The manufacturing company, Jiangxi SanHao Medical Instruments Co.,Ltd, is located in China. The testing data would originate from their internal testing or qualified third-party labs, likely within China, as part of their manufacturing and quality control process. The nature of the testing is retrospective from manufactured batches to demonstrate compliance.

3. Number of Experts and Qualifications for Ground Truth

  • Not Applicable: This is not an AI/SaMD study requiring expert interpretation of medical images or data. Ground truth for physical properties (e.g., dimensions, tensile strength) is established by standardized measurement methods according to ASTM and ISO standards, using calibrated equipment and trained technicians.

4. Adjudication Method for the Test Set

  • Not Applicable: As this involves physical and chemical property testing of gloves, adjudication methods typically used for expert disagreement in medical image interpretation are not relevant. Test results are objective measurements against predefined criteria.

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

  • Not Applicable: This is not an AI/SaMD study. No human readers or AI assistance for diagnostic tasks are involved.

6. Standalone Performance (AI algorithm only without human-in-the-loop performance)

  • Not Applicable: This is not an AI/SaMD device. The "device" is a physical medical glove. The performance presented is "standalone" in the sense that it is the performance of the physical product itself under various specified tests, without human decision-making assistance beyond standard testing procedures.

7. Type of Ground Truth Used

  • Objective Measurements against Standard Specifications: The ground truth for the device's performance is established by objective measurements (e.g., length in mm, tensile strength in MPa, powder content in mg/glove) that are compared against predefined numerical acceptance criteria specified in recognized industry standards (ASTM D6319-19, ASTM D5151-11, ASTM D6124-11, ISO 10993-10, ISO 10993-11). For biocompatibility, the ground truth is the biological response (e.g., "not an irritant," "not a sensitizer," "no systemic toxicity") observed in animal models, as per ISO standards.

8. Sample Size for the Training Set

  • Not Applicable: There is no "training set" in the context of device performance testing for a physical product like examination gloves. The manufacturing process is designed to consistently produce gloves meeting the specifications, and the tests are for verification/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 a physical product, this question is not relevant.

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Image /page/0/Picture/0 description: The image contains two logos. The logo on the left is the Department of Health & Human Services - USA logo. The logo on the right is the FDA U.S. Food & Drug Administration logo. The FDA logo is in blue.

February 19, 2022

Jiangxi SanHao Medical Instruments Co.,Ltd % Cassie Lee Manger Share Info (Guangzhou) Medical Consultant Ltd. No. 1919-1920, Building D3, Minjie Plaza, Shuixi Road Huangpu District, Guangzhou, Guangdong China

Re: K213600

Trade/Device Name: Medical nitrile examination gloves (Model: SH001) Regulation Number: 21 CFR 880.6250 Regulation Name: Non-Powdered Patient Examination Glove Regulatory Class: Class I, reserved Product Code: LZA Dated: January 21, 2022 Received: January 24, 2022

Dear Cassie Lee:

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 mediation-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 -S

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) K213600

Device Name

Medical nitrile examination gloves (Model: SH001)

Indications for Use (Describe)

The Medical nitrile examination gloves (Model: SH001) is intended to be worn on the hands of examiners to prevent contamination between patient and examiner. This is a single-use, powder-free, non-sterile device.

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 of K213600

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

1. Date of the summary prepared: January 29, 2022

2. Submitter's Information

Sponsor Name: Jiangxi SanHao Medical Instruments Co.,Ltd Address: Chengxi Industrial Park, Jishui County, Ji'an City, Jiangxi Province. China Post Code: 331699 Contact name: Wanqfenfanq (General Manager) Tel: +86 0796-3256750 Phone: +86-151 7966 0192 E-mail: 1218060588@qq.com

Application Correspondent:

Contact Person: Ms. Cassie Lee Company: Share Info (Guangzhou) Medical Consultant Ltd. Address: No. 1919-1920, Building D3, Minije Plaza, Shuixi Road, Huangpu District, Guangzhou, China Tel: +86 20 8200 6973 Email: regulatory@share-info.com

3. Subject Device Information

Type of 510(k): Traditional Common Name: Polymer Patient Examination Glove Classification Name: Non-Powdered Patient Examination Glove Trade Name: Medical nitrile examination qloves Model Name: SH001 Review Panel: General Hospital Product Code: LZA Requlation Number: 21 CFR 880.6250 Regulatory Class: Class I

4. Predicate Device Information

Sponsor: Guang Dong Kingfa SCI. & TECH.CO., LTD.

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Common Name: Polymer Patient Examination Glove Classification Name: Non-Powdered Patient Examination Glove Trade Name: Patient Examination Gloves 510(k) Number: K203593 Review Panel: General Hospital Product Code: LZA Regulation Number: 21 CFR 880.6250 Regulatory Class: Class I

5. Device Description

The subject device is a powder-free nitrile examination glove, provided as a non-sterile and disposable device. The subject device is mainly made from nitrile and there are four sizes, includes small (S), medium (M), large (L), X-large (XL) for optional. The gloves are provided with blue color, the colorant is Butadiene-Acrylonitrile Copolymers (CAS No.9003-18-3) and Pigment Blue (CAS No.147-14-8). The examination glove is a smooth surface with textured fingertips and a rolled rim at the cuff edge. The Medical nitrile examination gloves meet the specifications in ASTM D6319-19 Standard Specification for Nitrile Examination Gloves for Medical Application.

6. Intended Use / Indications for Use

The Medical nitrile examination gloves (Model: SH001) is intended to be worn on the hands of examiners to prevent contamination between patient and examiner. This is a single-use, powderfree, non-sterile device.

Elements ofComparisonSubject DevicePredicate DeviceResult
CompanyJiangxi SanHao MedicalInstruments Co.,LtdGuang Dong Kingfa SCI. &TECH.CO., LTD.--
510 (k) NumberK213600K203593--
Trade NameMedical nitrile examination glovesPatient Examination Gloves--
Product CodeLZALZA--
Classification NameNon-Powdered PatientExamination GloveNon-Powdered PatientExamination GloveSame
ClassificationClass IClass ISame
Regulation No.21 CFR 880.625021 CFR 880.6250Same
Indications For UseThe Medical nitrile examinationGloves (Model: SH001) is intendedto be worn onThe nitrile examination glove isintended to be worn on the handsSimilar
Elements ofComparisonSubject DevicePredicate DeviceResult
the hands of examiners to preventcontamination between patient andexaminer. This is a single-use,powder-free, non-sterile device.of examiners to preventcontamination between patientand examiner. This is a single-use, powder-free, non-steriledevice.
Material of UseNitrile rubberNitrile rubberSame
ColorBlueBlueSame
TextureFinger TexturedFinger TexturedSame
Size(ASTM D6319-19)Small, Medium, Large, X LargeSmall, Medium, Large, X LargeSame
SterilizationNon-sterileNon-sterileSame
UsageSingle usageSingle usageSame
Dimensions(ASTM D6319-19)Length:For S: ≥220 mmFor M/L/XL: ≥230 mmLength:S (220mm min)M (230mm min)L (230mm min)XL (230mm min)Same
Width:For S: 80±10mmFor M: 95±10 mmFor L: 110±10 mmFor XL: 120±10 mmPalm widthSmall (80±10mm)Medium (95±10mm)Large (110±10mm)X large (120±10mm)
Physical Properties(ASTM D6319-19)Meets requirements of the ASTMD6319-19Meets requirements of the ASTMD6319-19Same
After Aging:Tensile Strength: ≥14MpaUltimate Elongation: ≥400%After Aging:Tensile Strength: Min 14MpaUltimate Elongation: Min 400%Same
Thickness(ASTM D6319-19)Palm min. 0.05 mmFinger min. 0.05 mmPalm min. 0.05 mmFinger min. 0.05 mm
Elements ofComparisonSubject DevicePredicate DeviceResult
Powder Free(ASTM D6319-19)≤2 mg/glove≤2 mg/gloveSame
Freedom from Holes(Water Tight -1000ml)-ASTM D6319-19(Cross ReferenceD5151)Meets requirements of the ASTMD6319-19Meets requirements of the ASTMD6319-19Same
Biocompatibility -Skin Sensitization(ISO 10993-10:2010)Under the conditions of the studynot a sensitizerUnder the conditions of the studynot a sensitizerSame
Biocompatibility -Skin Irritation (ISO10993-10:2010)Under the conditions of study notan irritantUnder the conditions of study notan irritantSame
Biocompatibility -Acute SystemicToxicity (ISO 10993-11: 2017)Cytotoxicity is assessed viarationale. Under the condition ofacute systemic toxicity test,the test article did not show acutesystemic toxicity in vivo.Cytotoxicity is assessed viarationale. Under the condition ofacute systemic toxicity test,the test article did not show acutesystemic toxicity in vivo.Same

7. Comparison to predicate device and conclusion

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8. Test Summary

8.1 Summary of Non-Clinical Performance Testing

Performance Testing Summary: 1)

Test MethodTest PurposeAcceptanceCriteriaTest ResultsConclusion
ASMT D6319-19StandardSpecification forNitrile ExaminationGloves for MedicalApplication -PhysicalDimensions TestTo determine thewidth, length,and thickness ofthe glovesWidth:For S: $80\pm10$ mmFor M: $95\pm10$ mmFor L: $110\pm10$ mmFor XL: $120\pm10$ mmLength:For S: $\geq220$ mmFor M: $\geq230$ mmFor L: $\geq230$ mmFor XL: $\geq230$ mmLot Batch of20210723C1:Width:For S: 7984mmFor M: 9397mmFor L: 104-107mmFor XL: 112-115mmLength:For S: 231235mmFor M: 234238mmPassed

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For L: 237240mmFor XL: 238243mm
Lot Batch of20210719A1:Width:For S: 8083mmFor M: 9396mmFor L: 104107mmFor XL: 112116mmLength:For S: 231235mmFor M: 235238mmFor L: 237240mmFor XL: 239243mm
Lot Batch of20210726A0:Width:For S: 7983mmFor M: 9497mmFor L: 104107mmFor XL: 112116mmLength:For S: 232235mmFor M: 235238mmFor L: 237240mmFor XL: 238243mm
Thickness:Finger: ≥0.05mmPalm: ≥0.05mmFor all three lots:For S/M/L/XL:Finger min: 0.13mm

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ASMT D6319-19StandardSpecification forNitrile ExaminationGloves for MedicalApplication -PhysicalDimensions TestTo determine thetensile strengthand ultimateelongationbefore and afteraccelerationagingBefore Aging:Tensile Strength:$\geq$ 14MpaUltimate Elongation:$\geq$ 500%After Aging:Tensile Strength:$\geq$ 14MpaUltimate Elongation:$\geq$ 400%For all three lots:Before Aging:Tensile Strength:$\geq$ 14MpaUltimate Elongation:$\geq$ 500%After Aging:Tensile Strength:$\geq$ 14Mpa UltimateElongation: $\geq$ 400%Passed
ASTM D6319-19(ASTM D5151-11)Standard TestMethod forDetection of Holesin Medical GlovesTo determine theholes in theglovesAQL 2.5For all three lots:Pass at AQL 2.5Passed
ASMT D6319-19(ASTM D6124-11)Standard TestMethod forResidual Powderon Medical GlovesTo determine theresidual powderin the gloves< 2.0 mg/gloveLot Batch of20210723C1:For S/M/L/XL: Pass at0.17 mg/gloveLot Batch of20210719A1:For S/M/L/XL: Pass at0.23 mg/gloveLot Batch of20210726A0:For S/M/L/XL: Pass at0.18 mg/glovePassed

2) Biocompatibility Testing Summary:

Test MethodTest PurposeAcceptance CriteriaTest ResultsConclusion
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ISO 10993-10Biological evaluationof medical devices -Part 10: Tests for skinirritation and skinsensitizationTo evaluate thepotentialintracutaneousreactivity caused byintracutaneously injectthe extract to rabbitsUnder theconditions of thestudy not anirritantUnder theconditions ofstudy not anirritantPassed
ISO 10993-10Biological evaluationof medical devices -Part 10: Tests for skinirritation and skinsensitizationTo determine the skinsensitization potentialin guinea pigs.Under theconditions of studynot a sensitizerUnder theconditions of thestudy not asensitizerPassed
ISO 10993-11:2017Biological evaluationof medical devices -Part 11: Tests foracute systemic toxicityThe test item wasevaluated for acutesystemic toxicity inICR mouseUnder theconditions of thestudy no systemictoxicityUnder thecondition ofacute systemictoxicity test,the test articledid not showacute systemictoxicity in vivo.Passed

8.2 Summary of Clinical Performance Test

No clinical study is included in this submission.

9. Final Conclusion:

The conclusions drawn from the non-clinical testing demonstrate that the Medical nitrile examination gloves (Model: SH001) are as safe, as effective, and perform as well as or better than the legally marketed predicate (K203593).

§ 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.