K Number
K014112
Device Name
SATARI LATEX PATIENT EXAMINATION POWDERED GLOVE SINGLE SIDE POLYMER COATED, NON STERILE, 200 MG OR LESS OF TOTAL WATER E
Date Cleared
2002-02-28

(76 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
THIS DEVICE IS A DISPASABLE DEVICE INTENDED for MEDICAL PURPOSES THAT IS WERN ON THE EXAMINER'S Official T AND HAND TO PREVENT CONTAMINATION SETWEEN EXAMINER
Device Description
SATARI® latex patient examination glove, is a powder glove single side polymer coated, non sterile, 200 ug or less of total water extractable protein per gram, 10 mg/dm- or less of residual powder
More Information

No
The device is a disposable latex glove for examination, and the description focuses on material properties and intended use for contamination prevention. There is no mention of AI, ML, image processing, or any computational analysis.

No
The device is described as a "latex patient examination glove" intended to "prevent contamination between examiner" which serves a protective barrier function, not a therapeutic purpose.

No
The device is a glove intended to prevent contamination between an examiner and a patient, which is a protective function, not a diagnostic one. It does not gather information about a patient's health condition.

No

The device description clearly states it is a "latex patient examination glove," which is a physical hardware device. There is no mention of software as the primary component or function.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly states the device is a disposable glove worn on the examiner's hand to prevent contamination. This is a barrier device for personal protection and hygiene.
  • Device Description: The description details the physical characteristics of a glove (latex, powder, coating, protein levels).
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens from the human body (blood, urine, tissue, etc.) to provide information for diagnosis, monitoring, or treatment. IVDs are used in vitro (outside the body) to analyze these specimens.

This device is a medical device, specifically a patient examination glove, but it falls under a different regulatory category than IVDs.

N/A

Intended Use / Indications for Use

SATARI® LATEX PATIENT EXAMINATION POWDERED GLOVE, SINGLE SIDE POLYMER COATED, NON STERILE 200µg OR LESS OF TOTAL WATER EXTRACTABLE PROTEIN PER GRAM, 10mg/dm² or LESS (white, Pink, and Blue) THIS DEVICE IS A DISPOSABLE DEVICE INTENDED for MEDICAL PURPOSES THAT IS WORN ON THE EXAMINER'S HAND TO PREVENT CONTAMINATION BETWEEN PATIENT AND EXAMINER

Product codes

LYY

Device Description

SATARI® latex patient examination glove, is a powder glove single side polymer coated, non sterile, 200 ug or less of total water extractable protein per gram, 10 mg/dm- or less of residual powder

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Examiner / Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Not Found

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K981096

Reference Device(s)

510k 970794

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc)

Not Found

§ 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.

0

K01412

510(k) Summary As Required by 21 section 807.92 ( c )

FEB 2 8 2002

1-Submitter Name: Siam Sempermed Corp., Ltd

110 Moo 8 Kanjanavanit Road. Pathong Hatyai 2-Address: Songkhla. Thailand 90230

3-Phone:(++66) 074 291 648
4-Fax:(++66) 074 291 650
5-Contact Person:Dr Poonsuk Cherdkiatgumchai (Chief Quality Officer)
6-Date summary prepared:December 7th, 2001
7- Official Correspondent:Mansour Consulting
8- Address:1308 Morningside Park Dr
Alpharetta, GA 30022 USA
9- Phone:(678) 908-8180
10- Fax:(425) 795-9341
11- Contact person:Jay Mansour, president
12-Device Trade or Proprietary Name:SATARI® latex patient

examination powdered glove single side polymer coated, non sterile, 200 µg or less of total water extractable protein per gram, 10 mg/dm2 or less of residual powder

13-Device Common or usual name: Examination glove

14-Device Classification Name: Glove, Patient Examination, Latex

15-Substantial Equivalency is claimed against the following device:

Siam Sempermed Latex Patient Examination Glove Polymer powder free, 510k #K981096 (refer to Appendix 2 for FDA website printout. This notification for the SATARI® latex examination glove is of the ABBREVIATED type as per the declaration of conformity on page 4 of this summary

11-Description of the Device:

SATARI® latex patient examination glove, is a powder glove single side polymer coated, non sterile, 200 ug or less of total water extractable protein per gram, 10 mg/dm- or less of residual powder

12-Intended use of the device: (Indications for use typed on a separate FDA form)

This device is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner

13-Safety and effectiveness of the device:

This device is safe and effective as the predicate device Siam Sempermed Latex Patient Examination Glove polymer, powder-free. Indeed, it is equivalent.

This is better expressed in the tabulated comparison (Paragraph 14 below)

14-Summary comparing technological characteristics with other predicate device:

PAGE 3.1

1

General comparison result between SATARI® latex examination glove and the predicate device (Siam Sempermed Latex Patient Examination Glove polymer, powder-free) is tabulated below.

014112

Technical comparison of specific elements is attached in the main submission

FDA file reference number510k 970794
Attachments inside notification
submission fileREFER TO APPENDIX 2
TECHNOLOGICAL
CHARACTERISTICSComparison result
REFER TO ADDITIONAL TECHNICAL
COMPARATIVE TABLE WITHIN 510K SUBMISSION
Indications for useIdentical
Target populationIdentical
DesignSimilar
MaterialsIdentical
PerformanceIdentical
SterilityIdentical
BiocompatibilityIdentical
Mechanical safetyIdentical
Chemical safetyIdentical
Anatomical sitesIdentical
Human factorsIdentical
Energy used and/or deliveredIdentical (not applicable)
Compatibility with
environment and other devicesIdentical
Where usedIdentical
Standards metIdentical
Electrical safetyIdentical (not applicable)
Thermal safetyIdentical (not applicable)
Radiation safetyIdentical (not applicable)

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the top half of the circle. Inside the circle is a stylized image of an eagle or bird with three wing-like shapes and a flowing tail.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

FEB 2 8 2002

Siam Sempermed Corporation Limited C/O Mr. Jay Mansour Mansour Consulting 1308 Morningside Park Drive Alpharetta, Georgia 30022

Re: K014112

Trade/Device Name: Satari Powdered Latex Examination Gloves with Protein Content Labeling Claim ( 200 Micrograms or Less) Polymer Coated White, Pink and Blue Regulation Number: 880.6250 Regulation Name: Patient Examination Gloves Regulatory Class: I Product Code: LYY Dated: December 10, 2001 Received: December 14, 2001

Dear Mr. Mansour:

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. 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 (PMA), 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 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

3

Page 2 - Mr. Mansour

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 a!l the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

This letter will allow you to begin marketing your device as described in your Section 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 21 CFR Part 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" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Timothy Ulatowski

Timothy Director Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health

4

510(k) Number (if known): K014112
SATART® LATEX PATIENT EXAMINATION POWDERED GLOVE,
Device Name: SINGLE SIDE POLYMER COATED, NON STERILE 200μg OR LESS
OF TOTAL WATER EXTRACTABLE PROTEIN PER GRAM, 10mg/dm² or LESS
Indications For Use: (white, Pink, and Blue)

THIS DEVICE IS A DISPASABLE DEVICE INTENDED for MEDICAL PURPOSES THAT IS WERN ON THE EXAMINER'S Official T AND HAND TO PREVENT CONTAMINATION SETWEEN EXAMINER

PLEASE DO NOT WRITE BELOW THIS LINE - CONTROLLED DOCUMENT

Commission of CSRA, Office of Dispute Resolution (ODR)

Qhin S. Lin

(Division Sign-Off) Division of Dental, Infection Control, and General Hospital Devices ! 10(k) Number

Prescription Use (Per 21 CFR 801. 109)

OR

Over-The-Counter Use X

(Optional Format 1-2-85)

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