K971200 · W.A. Rubbermate Co., Ltd. · LYY · Aug 29, 1997 · General Hospital
Device Facts
Record ID
K971200
Device Name
W.A.
Applicant
W.A. Rubbermate Co., Ltd.
Product Code
LYY · General Hospital
Decision Date
Aug 29, 1997
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 880.6250
Device Class
Class 1
Intended Use
A medical gloves is worn on the hand of healthcare and similar personnel to prevent contamination between healthcare personnel and patient.
Device Story
Powder-free latex patient examination gloves; worn on hands by healthcare personnel; serves as protective barrier to prevent cross-contamination between clinician and patient; used in clinical settings; disposable; non-sterile; provides physical barrier protection.
Clinical Evidence
No clinical data; bench testing only.
Technological Characteristics
Material: Latex rubber; form factor: powder-free examination glove; non-sterile; Class I device.
Indications for Use
Indicated for use by healthcare and similar personnel as a protective barrier worn on the hands to prevent cross-contamination between the personnel and the patient.
Regulatory Classification
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.
Related Devices
K972539 — Hi Coat Powder Free Latex Patient Examination Gloves · P.T. Latexindo Tobaperkasa · Nov 18, 1997
K964819 — SHENG HO · Shang HO Industrial Corp. , Ltd. · Jan 6, 1998
K020363 — GREAT GLOVE LATEX EXAMINATION POWDERFREE GLOVES WITH PROTEIN LABELLING CLAIMS (50 MICROGRAMS OR LESS) · Great Glove Sdn Bhd · Apr 10, 2002
K973811 — POWDER-FREE LATEX EXAMINATION GLOVE, TEAL OR WHITE (NON-COLORED) · Absolute Quality Leadership, Inc. · Oct 21, 1997
Submission Summary (Full Text)
{0}
DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
Food and Drug Administration
9200 Corporate Boulevard
Rockville MD 20850
Mr. Prachai Kongwaree
President
Comp Mech, Incorporated
8186 East Del Cuarzo Drive
Scottsdale, Arizona 85258
AUG 29 1997
Re: K971200
Trade Name: Powder Free Latex Patient Examination Gloves
Regulatory Class: I
Product Code: LYY
Dated: July 29, 1997
Received: August 4, 1997
Dear Mr. Kongwaree:
We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.
If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531
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Page 2 - Mr. Kongwaree
through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.
This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4618. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".
Sincerely yours,
Timothy A. Ulatowski
Director
Division of Dental, Infection Control and General Hospital Devices
Office of Device Evaluation
Center for Devices and Radiological Health
Enclosure
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# Attachment I
## Indication For Use Statement
510k Number (if known): K971200
Device Name: Powder Free Latex Patient Examination Gloves
Indications For Use:
A medical gloves is worn on the hand of healthcare and similar personnel to prevent contamination between healthcare personnel and patient.
W.A.RUBBERMATE CO.,LTD

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
(Division Sign-Off)
Division of Dental, Infection Control, and General Hospital Devices
510(k) Number K971200
Prescription Use ☐
OR
Over-The-Counter Use ☑
(Per 21 CFR 801.109)
(Optional Format 1-2-96)
Panel 1
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