K Number
K231740

Validate with FDA (Live)

Manufacturer
Date Cleared
2023-07-04

(20 days)

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

These Powder Free, Nitrile Examination Gloves are a disposable device intended for medical purpose that is worn on the examiner's hands 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 Resistance of Medical Gloves to Permeation by Chemotherapy Drugs.

Device Description

US Glove Supply's Powder Free, Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs) are Blue, Polymer coated, Nonsterile, Powder Free, Ambidextrous Nitrile Examination Gloves Tested for Use with Chemotherapy Drugs. These are made up of 100% synthetic Nitrile Butadiene Latex. Its surface finish is finger textured with beaded cuff.

AI/ML Overview

The provided text describes the acceptance criteria and performance data for Memorial™ Gloves, which are Powder Free, Nitrile Examination Gloves. The submission is a 510(k) premarket notification to the FDA, indicating a claim of substantial equivalence to already marketed predicate devices.

Here's an analysis of the provided information, framed by your questions:

1. Table of Acceptance Criteria and Reported Device Performance

The document presents several tables summarizing non-clinical tests. I will consolidate the key information from pages 15-17.

Testing/Standards (Parameter)Purpose of the TestAcceptance CriteriaReported Device Performance (Result)
Physical Properties
ASTM D-3767 (Dimensions: Length, Width, Thickness)To determine the length, width and thickness of the glovesUS Glove Supply's Powder Free, Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs) should meet the requirements of ASTM D6319.Pass. Powder Free, Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs) meets the requirements of ASTM D6319. (Specific values: Length Min 230mm, Width S 80, M 95, L 110, XL 120, Thickness (Cuff: 0.05 ± 0.02, Palm: 0.07 ± 0.02, Finger: 0.09 ± 0.02))
ASTM D-412/D-573 (Tensile Strength & Elongation)To determine the Tensile strength and elongation in gloves before aging and after agingBefore aging: Tensile Strength: 14MPa, min; Ultimate Elongation: 500%min. After aging: Tensile Strength: 14MPa, min; Ultimate Elongation: 400%min.Pass. Powder Free, Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs) meets the requirements of ASTM D6319. (Specific values are stated to meet these criteria, consistent with the acceptance criteria.)
ASTM D-5151 (Leakage/Detection of Holes)Testing for freedom from holes as per ASTM D-5151.The gloves should be free of holes (Meets with the requirement of ASTM D 5151, following ASTM D 6319 AQL 2.5/Inspection Level G-I).Pass. Powder Free, Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs) meets the requirements of ASTM D6319. (Stated as meeting ASTM D 5151, following ASTM D 6319 AQL 2.5/Inspection Level G-I)
ASTM D6124 (Powder Content)To Determine the powder residue using Test Method D6124.2.0 mg MaximumPass. Powder Free, Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs) meets the requirements of ASTM D6319. (Specific value stated as Max 1.38 mg/glove, which is < 2.0 mg)
Chemical Permeation
ASTM D6978-05 (2019) (Permeation Testing for Chemotherapy Drugs)To determine the Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy DrugsShould meet the requirements as per ASTM D 6978-05. (Specific minimum breakthrough detection times for listed drugs, e.g., No breakthrough for up to 240 minutes for most, Carmustine = 14.9 min, Thio-Tepa = 37.8 min).Pass. Powder Free, Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs) meets the requirements of ASTM D-6978-05. (Specific results include: Cyclophosphamide, Doxorubicin HCl, Etoposide, 5-Fluorouracil, Paclitaxel, Cisplatin, Dacarbazine, Methotrexate, Mitomycin C, Vincristine Sulfate: No breakthrough for up to 240 minutes. Carmustine (BCNU): Min minutes before breakthrough = 14.9. Thio-Tepa: Min minutes before breakthrough = 37.8. Warnings are noted for Carmustine and Thio-Tepa due to low permeation times.)
Biocompatibility
ISO 10993-23 (Primary Skin Irritation)To evaluate the local dermal irritation of a test article extract following intracutaneous injection in rabbits.Under the condition of study not an irritant.Under the conditions of the study, the test article met the requirements of the test.
ISO 10993-10 (Dermal Sensitization)To evaluate the test item, for the skin sensitization in Guinea pigs by maximization test.Under the conditions of the study, not a sensitizer.Under the conditions of the study, the test article was not considered a sensitizer.
ISO 10993-5 (In Vitro Cytotoxicity)To determine the potential of a test article to cause cytotoxicity.Under the conditions of the study, non-cytotoxic.Based on the results obtained under laboratory testing conditions, test item extracts of Nitrile Examination Gloves was found to be "cytotoxic" at 100% and 50% extract and "non-cytotoxic" at 25%, 12.5% and 6.25% test item extracts to the subconfluent monolayer of L-929 mouse fibroblast cells. (This indicates partial cytotoxicity at higher concentrations).
ISO 10993-11 (Acute Systemic Toxicity)To evaluate the acute systemic toxicity of a test article, extract following injection in mice.Under the conditions of study, the device extracts do not pose a systemic toxicity concern.Under the conditions of study, there was no mortality or evidence of acute systemic toxicity.

2. Sample Size Used for the Test Set and Data Provenance

The document does not specify the sample sizes used for each individual test (e.g., number of gloves tested for permeation, number of animals for biocompatibility). It generally states that the tests "meet the requirements of" the respective ASTM or ISO standards, which typically implies that the sample sizes specified by those standards were followed.

The data provenance is non-clinical testing, performed to meet specific international and US standards. The document doesn't specify the country of origin of the data beyond the standards themselves. The tests are prospective in the sense that they were specifically conducted for this submission.

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

This information is not applicable in the context of this device submission. This is a 510(k) for examination gloves, which relies on well-established performance standards (ASTM, ISO) for physical, chemical, and biocompatibility properties, not on expert adjudication of subjective results (like image interpretation).

4. Adjudication Method for the Test Set

This is not applicable. The tests performed are objective, quantitative measurements (e.g., tensile strength, breakthrough time, cytotoxicity levels) against predefined acceptance criteria from international standards. There is no expert adjudication process for these types of tests.

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

This device is not an AI/ML-enabled medical device. Therefore, a MRMC comparative effectiveness study is not applicable and was not performed. The device is a physical product (gloves) whose performance is evaluated against material and barrier properties.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

This is not applicable, as the device is not an algorithm or AI.

7. The Type of Ground Truth Used (Expert Consensus, Pathology, Outcomes Data, etc.)

The "ground truth" for this product is derived from established international and laboratory standards (ASTM, ISO). These standards define the scientific methods and criteria for evaluating the physical, chemical resistance, and biocompatibility of medical gloves. For example:

  • Physical properties: Measured parameters (length, width, thickness, tensile strength, elongation, freedom from holes, powder content) are compared against the numerical specifications in ASTM D6319 and D5151/D6124.
  • Chemotherapy drug permeation: Breakthrough times are objectively measured according to ASTM D6978-05.
  • Biocompatibility: In vitro and in vivo tests (irritation, sensitization, cytotoxicity, systemic toxicity) follow ISO 10993 series to assess biological responses, with predefined criteria for "irritant," "sensitizer," "cytotoxic," etc.

8. The Sample Size for the Training Set

This is not applicable. The device is not an AI/ML product and does not involve training data sets.

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.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

July 4, 2023

US Glove Supply % Prithul Bom Accredited Person, Reviewer Regulatory Technology Services, LLC 1000 Westgate Drive, Suite 510k Saint Paul, Minnesota 55114

Re: K231740

Trade/Device Name: Memorial™ Gloves Regulation Number: 21 CFR 880.6250 Regulation Name: Non-powdered patient examination glove Regulatory Class: Class I. reserved Product Code: LZA, LZC, OPJ Dated: June 14, 2023 Received: June 14, 2023

Dear Prithul Bom:

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.

Bifeng Qian -S

Bifeng Qian, M.D., Ph.D. 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

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Indications for Use

510(k) Number (if known)

K231740

Device Name

Memorialтм Gloves

Indications for Use (Describe)

These Powder Free, Nitrile Examination Gloves are a disposable device intended for medical purpose that is worn on the examiner's hands 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 Resistance of Medical Gloves to Permeation by Chemotherapy Drugs.

Chemotherapy Drug Permeation

The following chemicals have been tested with these gloves:

Tested Chemotherapy Drug and ConcentrationMinimum Breakthrough Detection time
Cyclophosphamide (20.0 mg/ml)No breakthrough for up to 240 minutes
Doxorubicin Hydrochloride (2.0 mg/ml)No breakthrough for up to 240 minutes
Etoposide (20.0 mg/ml)No breakthrough for up to 240 minutes
5-Fluorouracil (50.0 mg/ml)No breakthrough for up to 240 minutes
Paclitaxel (Taxol) (6.0 mg/ml)No breakthrough for up to 240 minutes
Cisplatin (1.0 mg/ml)No breakthrough for up to 240 minutes
Dacarbazine (10.0 mg/ml)No breakthrough for up to 240 minutes
Methotrexate (25 mg/ml)No breakthrough for up to 240 minutes
Mitomycin C (0.5 mg/ml)No breakthrough for up to 240 minutes
Vincristine Sulfate (1.0 mg/ml)No breakthrough for up to 240 minutes
Carmustine (BCNU) (3.3 mg/ml)Min minutes before breakthrough =14.9
Thio-Tepa (10.0 mg/ml)Min minutes before breakthrough =37.8

Warning Not For use with Carmustine

Warning Not For use with Thio-Tepa

*Please note that the following drugs have low permeation times:

Carmustine (BCNU): 14.9 Minutes and Thio-Tepa: 37.8 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)
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CONTINUE ON A SEPARATE PAGE IF NEEDED.

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

510 (k) Summary - K231740

5.1 Submission Sponsor Information

US Glove Supply 300 Commerce Drive, Buffalo NY, 14218 United States Cell Phone Number: 516-456-3642 E-mail: jacomo@glovesupply.us Website: www.glovesupply.us Primary Contact: Mr Jacomo Hakim Secondary Contact: Rose Robbins E-mail: Rose@glovesupply.us Cell Phone Number:212-771-8822

5.2 Date Prepared

6/29/2023

5.3 Device Identification

Trade/Proprietary NameMemorialTM Gloves
Common NamePowder Free, Nitrile Examination Gloves (Tested for Usewith Chemotherapy Drugs)
Classification NameNon-Powdered Patient Examination Glove Specialty
Regulation Number21 CFR 880.6250
Product CodeLZC, LZA, OPJ
Device ClassClass I, reserved
Classification PanelGeneral Hospital and Personal Use Devices

Legally marketed device(s) to which equivalence is claimed 5.4

Predicate Device:

510(k)K172525
Trade/Proprietary NameBlue Non-Sterile Powder Free Nitrile Examination Gloves
Tested for Use with Chemotherapy Drugs
Common NameChemotherapy Gloves, Exam Gloves
Classification NamePatient Examination Gloves Specialty

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Regulation Number21 CFR 880.6250
Product CodeLZC, LZA
Device ClassClass I
Classification PanelGeneral Hospital and Personal Use Devices

Reference device:

510(k)K223559
Trade/Proprietary NameNephron Nitrile
Common NameNitrile Examination Gloves (Tested for Use withChemotherapy drugs)
Classification NameNon-Powdered Patient Examination Glove Specialty
Regulation Number21 CFR 880.6250
Product CodeLZC, LZA, OPJ
Device ClassClass I, reserved
Classification PanelGeneral Hospital and Personal Use Devices

ર્ રંડ Device Description

US Glove Supply's Powder Free, Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs) are Blue, Polymer coated, Nonsterile, Powder Free, Ambidextrous Nitrile Examination Gloves Tested for Use with Chemotherapy Drugs. These are made up of 100% synthetic Nitrile Butadiene Latex. Its surface finish is finger textured with beaded cuff.

The device is designed and tested as per its device specific guidance; "Medical Glove Guidance Manual".

Image /page/5/Picture/7 description: The image shows two blue nitrile gloves. The gloves are clean and appear to be new. The gloves are positioned side by side, with the fingers pointing upwards. The gloves are likely intended for medical or industrial use.

Figure 5.1: US Glove Supply's Powder Free, Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs)

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Over the counter use: Yes

Single use disposable device: Yes

Sterile: No

User Profile/Population: Adults

Use Environment:

  • Examination and Medical (Hospitals, Dental Clinics, Chemotherapy Centers, Home-care -Centers)

Indications for Use 5.6

These Powder Free, Nitrile Examination Gloves are a disposable device intended for medical purpose that is worn on the examiner's hands 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 Resistance of Medical Gloves to Permeation by Chemotherapy Drugs.

Chemotherapy Drug Permeation

The following chemicals have been tested with these gloves:

Tested Chemotherapy Drug andConcentrationMinimum Breakthrough Detection Time
Carmustine (BCNU) 3.3 mg/mlMin minutes before breakthrough =14.9
Cyclophosphamide 20.0 mg/mlNo breakthrough for up to 240 minutes
Cisplatin (1.0 mg/ml)No breakthrough for up to 240 minutes
Dacarbazine 10.0 mg/mlNo breakthrough for up to 240 minutes
Doxorubicin Hydrochloride 2.0 mg/mlNo breakthrough for up to 240 minutes
Etoposide 20.0 mg/mlNo breakthrough for up to 240 minutes
Fluorouracil 50.0 mg/mlNo breakthrough for up to 240 minutes
Methotrexate 25 mg/mlNo breakthrough for up to 240 minutes
Mitomycin C 0.5 mg/mlNo breakthrough for up to 240 minutes
Paclitaxel (Taxol) 6.0 mg/mlNo breakthrough for up to 240 minutes
Thio-Tepa 10.0 mg/mlMin minutes before breakthrough =37.8
Vincristine Sulfate 1.0 mg/mlNo breakthrough for up to 240 minutes

*Please note that the following drugs have low permeation times: Carmustine (BCNU): 14.9 Minutes and Thio-Tepa: 37.8 Minutes Warning: Not for use with Carmustine (BCNU) and Thio-Tepa.

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5.7 Comparison of the technological characteristics with the predicate device

The comparison chart below provides evidence to facilitate the substantial equivalence determination between US Glove Supply Nitrile Examination Gloves (Tested for Use with Chemotherapy Drugs) and the predicate device (K172525) & with reference device (K223559) with respect to the intended use, technological characteristics, and principles of operation.

Reference device (K223559) has been included in the 510K to support substantial equivalence with respect to the use of additionally claimed chemotherapy drugs than that of Predicate device.

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

ComparisonparametersSTANDARDS(Proposed Device)(Predicate Device)(Reference device)Comparison
510(K)Number--K231740K172525K223559Different
ManufacturerName--US Glove SupplyCentral Medicare SDN. BHDNephron PharmaceuticalsCorporationDifferent
Name of device--Powder Free, NitrileExamination Gloves (Testedfor Use with ChemotherapyDrugs)Blue Non-Sterile Powder FreeNitrile Examination Gloves Testedfor Use with Chemotherapy DrugsNephron Nitrile Powder-FreeNitrile Examination Gloves(Tested for Use withChemotherapy Drugs)Different
Product Code--LZC, LZA, OPJLZA, LZCLZA, LZC, OPJSame withPredicateDevice
Indication foruse--These Powder Free, NitrileExamination Gloves are adisposable device intended formedical purpose that is wornon the examiner's hands toprevent contaminationbetween patient and examiner.These gloves were tested foruse with chemotherapy drugsas per ASTM D6978-05Standard Practice forAssessment of Resistance ofMedical Gloves to Permeationby Chemotherapy Drugs.Blue Non-Sterile Powder FreeNitrile Examination Gloves Testedfor Use with Chemotherapy Drugsis a disposable device intended formedical purposes that is worn onthe examiner's hand to preventcontamination between patient andexaminer.Gloves have been tested for usewith chemotherapy drugs usingASTM D6978-05 and will belabelled with a statement ofcompliance and a summary of thetesting resultsNephron Nitrile Powder-FreeNitrile Examination Gloves(Tested for Use withChemotherapy Drugs) is adisposable device intended formedical purpose that is worn onthe examiner's hand to preventcontamination between patientand examiner. In addition, thesegloves were tested for use withchemotherapy drugs inaccordance with ASTMD6978-05 (2019) StandardPractice for Assessment ofResistance of Medical Glovesto Permeation byChemotherapy Drugs.Similar;difference interminology
RegulationNumber--21 CFR 880.625021 CFR 880.625021 CFR 880.6250Same
Material--NitrileNitrileNitrileSame
Colour--BlueBlueBlueSame
Size--Small, Medium, Large, X LargeExtra Small, Small, Medium, Large, Extra LargeM, L, XL, XXLSimilar; predicate device has additional sizes
Single use--Single useSingle useSingle useSame
Sterile/non sterile--Non-sterileNon-sterileNon-sterileSame
Rx Only or OTC--OTCOTCOTCSame
Dimensions - LengthASTM D6319-2019Minimum 230Minimum 230Minimum 230Same
Dimensions - WidthASTM D6319-2019S 80M 95L 110XL 120XS 70S 80M 95L 110XL 120M 95L 113XL 121XXL 129Same
Physical PropertiesTensile StrengthASTM D6319-2019Before aging: 14MPa, minAfter aging: 14MPa, minBefore aging: 14MPa, minAfter aging: 14MPa, minSame
Physical PropertiesUltimate ElongationASTM D6319-2019Before aging: 500%, minAfter aging: 400%, minBefore aging: 500%, minAfter aging: 400%, minSame
Thickness (mm)ASTM D6319-19Cuff: 0.05 ± 0.02Palm: 0.07 ± 0.02Finger: 0.09 ± 0.02Cuff: 0.06 ± 0.03Palm: 0.08 ± 0.03Finger: 0.10 ± 0.03Similar; meets ASTM D6319 -19 requirements
Powder FreeResidueASTMD6319-19Max 1.38 mg/gloveMax. 0.52 mg per glove< 2 mg per glove Averagevalue = 0.3516 mg/glove(Medium)Similar,meets thestandardASTMD6124requirementof maximum2.0 mg
Freedom fromholesASTM D5151-2019Meets with the requirement ofASTM D 5151, followingASTM D 6319 AQL2.5/Inspection Level G-IMeets with the requirement ofASTM D 5151, followingASTM D 6319 AQL2.5/Inspection Level G-IIn accordance withASTM D 5151-19,following ASTMD6319- 19,G-I, AQL 2.5Same
ChemotherapyDrugsTested withMinimumBreakthroughDetection TimeASTM D6978-05 (2019)Carmustine (3.3mg/ml)Min minutesbefore breakthrough =14.9Carmustine (3.3mg/ml)Min minutes before breakthrough=12.4Carmustine (3.3mg/ml)Min minutesbefore breakthrough =33.8Similar
Cisplatin (1.0 mg/ml)No breakthrough for up to240minutesCisplatin (1.0 mg/ml)No breakthrough for up to240minutesCisplatin (1.0 mg/ml)No breakthrough for up to240minutesSame
Cyclophosphamide (20mg/ml)No breakthrough for up to240minutesCyclophosphamide (20mg/ml)No breakthrough for up to240minutesCyclophosphamide (20mg/ml)No breakthrough for up to240minutesSame
Dacarbazine (10.0 mg/ml)No breakthrough for up to240minutesDacarbazine (10.0 mg/ml)No breakthrough for up to240minutesDacarbazine (10.0 mg/ml)No breakthrough for up to240minutesSame
Doxorubicin HCI (2.0mg/ml)No breakthrough for up to240minutesDoxorubicin HCI (2.0mg/ml)No breakthrough for up to240minutesDoxorubicin HCI (2.0mg/ml)No breakthrough for up to240minutesSame
Etoposide (20.0 mg/ml)No breakthrough for up to240minutesEtoposide (20.0 mg/ml)No breakthrough for up to240minutesEtoposide (20.0 mg/ml)No breakthrough for up to240minutesSame

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

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Fluorouracil (50.0 mg/ml)No breakthrough for up to240minutesFluorouracil (50.0 mg/ml)No breakthrough for up to240minutesFluorouracil (50.0 mg/ml)No breakthrough for up to240minutesSame
Methotrexate (25.0 mg/ml)No breakthrough for up to240minutesNot testedMethotrexate (25.0 mg/ml)No breakthrough for up to240minutes*Same asReferencePredicateDevice
Mitomycin C (0.5 mg/ml)No breakthrough for up to240minutesNot testedMitomycin C (0.5 mg/ml)No breakthrough for up to240minutes*Same asReferencePredicateDevice
Paclitaxel (6.0 mg/ml)No breakthrough for up to240minutesPaclitaxel (6.0 mg/ml)No breakthrough for up to240minutesPaclitaxel (6.0 mg/ml)No breakthrough for up to240minutesSame
Thiotepa (10.0 mg/ml)Min minutes beforebreakthrough =37.8Thiotepa (10.0 mg/ml)Min minutes beforebreakthrough =4.4Thiotepa (10.0 mg/ml)Min minutes beforebreakthrough =128.1Similar
Vincristine Sulfate (1.0mg/ml)No breakthrough for up to240minutesVincristine Sulfate (1.0mg/ml)No breakthrough for up to240minutesVincristine Sulfate (1.0mg/ml)No breakthrough for up to240minutesSame
Ifosfamide (50.0 mg/ml)Not testedIfosfamide (50.0 mg/ml)No breakthrough for up to240minutesIfosfamide (50.0 mg/ml)No breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Mitoxantrone (2.0 mg/ml)Not testedMitoxantrone (2.0 mg/ml)No breakthrough for up to240minutesMitoxantrone (2.0 mg/ml)No breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Mechlorethamine HCL(1.0mg/ml)Not testedMechlorethamine HCL(1.0mg/ml)Not testedMechlorethamine HCL(1.0 mg/ml)Not tested*Will not beclaimed byUS Gloves
Irinotecan (20.0 mg/ml)Not testedIrinotecan (20.0 mg/ml)Not testedIrinotecan (20.0 mg/ml)No breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Carboplatin (10.0 mg/ml)Not testedCarboplatin (10.0 mg/ml)Not testedCarboplatin (10.0 mg/ml)No breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Docetaxel (10.0 mg/ml)Not testedDocetaxel (10.0 mg/ml)Not testedDocetaxel (10.0 mg/ml)Not tested*Will not beclaimed byUS Gloves
Bleomycin Sulfate(15 mg/ml)Not TestedBleomycin Sulfate(15 mg/ml)Not TestedBleomycin Sulfate(15 mg/ml)No breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Busulfan (6 mg/ml)Not testedBusulfan (6 mg/ml)Not testedBusulfan (6 mg/ml)No breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Chloroquine 50mg/mlNot testedChloroquine50mg/mlNot testedChloroquine50mg/mlNot tested*Will not beclaimed byUS Gloves
Cyclosporin 100 mg/mlNot testedCyclosporin 100 mg/mlNot testedCyclosporin 100 mg/mlNot tested*Will not beclaimed byUS Gloves
Cytarabine HCL 100 mg/mlNot testedCytarabine HCL 100 mg/mlNot testedCytarabine HCL 100 mg/mlNot tested*Will not beclaimed byUS Gloves
Cytarabine 100 mg/mlNot testedCytarabine 100 mg/mlNot testedCytarabine 100 mg/mlNo breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Daunorubicin HCl5 mg/mlNot testedDaunorubicin HCl5 mg/mlNot testedDaunorubicin HCl5 mg/mlNo breakthrough for up to240minutes*Will not beclaimed byUS Gloves

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Docetaxel HCL 10 mg/mlNot testedDocetaxel HCL 10 mg/mlNot testedDocetaxel HCL 10 mg/mlNot tested*Will not beclaimed byUS Gloves
Docetaxel 10 mg/mlNot testedDocetaxel 10 mg/mlNot testedDocetaxel 10 mg/mlNo breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Epirubicin HCl 2 mg/mlNot testedEpirubicin HCl 2 mg/mlNot testedEpirubicin HCl 2 mg/mlNo breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Fludarabine 25 mg/mlNot testedFludarabine 25 mg/mlNot testedFludarabine 25 mg/mlNo breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Gemcitabine 38 mg/mlNot testedGemcitabine 38 mg/mlNot testedGemcitabine 38 mg/mlNo breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Idarubicin HCl 1 mg/mlNot testedIdarubicin HCl 1 mg/mlNot testedIdarubicin HCl 1 mg/mlNo breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Melphalan 5 mg/mlNot testedMelphalan 5 mg/mlNot testedMelphalan 5 mg/mlNo breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Rituximab 10 mg/mlNot testedRituximab 10 mg/mlNot testedRituximab 10 mg/mlNo breakthrough for up to240minutes*Will not beclaimed byUS Gloves
Trisenox 1 mg/mlNot testedTrisenox 1 mg/mlNot testedTrisenox 1 mg/mlNo breakthrough for up to240minutes*Will not beclaimed byUS Gloves
BiocompatibilityPrimary skinirritation- ISO10993 Part23:2021Under the conditions of thestudy, not an irritantUnder the conditions of the study,not an irritantUnder the conditions of thestudy, not an irritantSame
DermalSensitization-Under the conditions of thestudy, not a sensitizerUnder the conditions of the study,not a sensitizerUnder the conditions of thestudy, not a sensitizerSame
ISO 10993-10:2021---
In vitroCytotoxicity-ISO 10993-5:2009Based on the results obtainedunder laboratory testingconditions, test item extracts ofNitrile Examination Gloves wasfound to be "cytotoxic" at 100%and 50% extract and "non-cytotoxic" at 25%, 12.5% and6.25% test item extracts to thesubconfluent monolayer of L-929 mouse fibroblast cells.---Under the conditions of thestudy, the undiluted test articleextract and 50% test articleextract dilution did not meetthe requirements of the testand the 25%, 12.5%, 6.25%,and 3.13% test article extractdilutions met the requirementsof the testSame as theReferencePredicateDevice
AcuteSystemicToxicity- ISO10993-11:2017Under the conditions of thisstudy, there was no evidence ofacute systemic toxicity---Under the conditions of thestudy, there was no mortalityor evidence of acute systemictoxicitySame as theReferencePredicateDevice

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*Predicate device/reference device perform additional chemotherapy drug test.

*Reference device has been included in the 510K to support substantial equivalence for the subject device with respect to the use of chemotherapy drugs Mitomycin C (0.5 mg/ml) and Methotrexate (25.0 mg/ml) which was not tested in case of the predicate device.

There are no significant differences between the products and are identical in terms of intended use, materials, design and manufacturing methods. The devices meet the ASTM standard D6319 and D6978-05 (2019).

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5.8 Performance Data: Summary of non-clinical tests conducted for determination of substantial equivalence

The proposed device and its predicate devices share the same intended use, are made of the same material, are within the same minimum specifications of thickness and length by meeting ASTM D6319-19, similar permeation rates for chemotherapy drugs as per ASTM D6978-05, similar labelling, physical properties, freedom from powder, biocompatibility and water tightness.

Permeation rates for additionally claimed chemotherapy drugs Mitomycin C (0.5 mg/ml) and Methotrexate (25.0 mg/ml) which was not tested in case of the predicate device are similar to Reference device as per ASTM D6978-05. It supports substantial equivalence for the subject device with respect to the use of additionally claimed chemotherapy drugs than that of Predicate device.

Biocompatibility studies were performed on the proposed device. Under the conditions of the study, the proposed device is not a sensitizer, or an irritant.

The above test results demonstrated that the proposed device complies with the following standards: ASTM D6319-19

The results of the performance testing demonstrate fulfilment of requirements as per device specific guidance "Medical Glove Guidance Manual" as well as substantial equivalence with predicate. The minor differences in the product does not affect the products safety and efficacy.

Testing/StandardsPurpose of the TestAcceptance CriteriaResult
ASTM D-3767Dimensions(Length, Width &thickness)To determine thelength, width andthickness of theglovesUS Glove Supply's PowderFree, Nitrile ExaminationGloves (Tested for Use withChemotherapy Drugs) shouldmeet the requirements ofASTM D6319.Pass. Powder Free, NitrileExamination Gloves(Tested for Use withChemotherapy Drugs)meets the requirements ofASTM D6319
ASTM D-412/D-573Tensile Strength &ElongationTo determine theTensile strength andelongation in glovesbefore aging andafter agingBefore agingTensile Strength: 14MPa,minUltimate Elongation:500%minAfter agingTensile Strength: 14MPa,minPass. Powder Free, NitrileExamination Gloves(Tested for Use withChemotherapy Drugs)meets the requirements ofASTM D6319.

Table 5.2. Non-Clinical Performance Tests

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

Ultimate Elongation:400%min
ASTM D-5151Leakage/Detectionof HolesTesting for freedomfrom holes as perASTM D-5151.The gloves should be free ofholesPass. Powder Free, NitrileExamination Gloves(Tested for Use withChemotherapy Drugs)meets the requirements ofASTM D6319
ASTM D6124Powder ContentTo Determine thepowder residue usingTest Method D6124.2.0 mg MaximumPass. Powder Free, NitrileExamination Gloves(Tested for Use withChemotherapy Drugs)meets the requirements ofASTM D6319
Permeation Testingper ASTM D6978-05 (2019)To determine theAssessment ofResistance ofMedical Gloves toPermeation byChemotherapy DrugsShould meet the requirementsas per ASTM D 6978-05Pass. Powder Free, NitrileExamination Gloves(Tested for Use withChemotherapy Drugs)meets the requirements ofASTM D-6978-05.

BIOCOMPATIBILTIY DATA

TEST DATAPURPOSEACCEPTANCECRITERIARESULT
ISO 10993-23 Firstedition2021-01 BiologicalEvaluation of MedicalDevices - Part 23, TestsforIrritation.To evaluate the localdermal irritation of a testarticle extract followingintracutaneous injectionin rabbits.Under the condition ofstudy not an irritantUnder the conditionsof the study, the testarticle met therequirements of thetest
10993-10 Fourthedition 2021-11Biological Evaluationof Medical Devices -Part 10, Tests for SkinSensitization.To evaluate the testitem, for the skinsensitization in Guineapigs by maximizationtest.Under the conditions ofthe study, not a sensitizerUnder the conditionsof the study, the testarticle was notconsidered asensitizer
ISO 10993-5 Thirdedition2009-06-01 BiologicalEvaluation of MedicalDevices - Part 5, TestsforTo determine thepotentialof a test article to causecytotoxicityUnder the conditions ofthe study, non-cytotoxicBased on the resultsobtained underlaboratory testingconditions, test itemextracts of NitrileExamination Gloves

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In Vitro Cytotoxicity.was found to be"cytotoxic" at 100%and 50% extract and"non-cytotoxic" at25%, 12.5% and6.25% test itemextracts to thesubconfluentmonolayer of L-929mouse fibroblastcells.
ISO 10993-11 Thirdedition 2017-09BiologicalEvaluation of MedicalDevices - Part 11, Testsfor Systemic Toxicity.To evaluate the acutesystemic toxicity of atest article, extractfollowing injection inmice.Under the conditions ofstudy, the device extractsdo not pose a systemictoxicity concern.Under the conditionsof study, there wasno mortality orevidence of acutesystemic toxicity.

5.9 Summary of clinical tests conducted for determination of substantial equivalence or of clinical information

No clinical testing is required for this device.

5.10 Conclusions

The conclusions drawn from the non-clinical tests demonstrate that the subject device, US Glove Supply's Powder Free, 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 Predicate device (K172525).

§ 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.