K Number
K021388
Date Cleared
2002-06-10

(39 days)

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

A patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hands or finger to prevent contamination between patient and examiner.

Device Description

Class 1 Polymer Coated Patient Examination Glove 80 LYY, powder free that meets all the requirements of ASTM Standard D3578-00a and FDA Water Leak Test.

AI/ML Overview

The provided document describes the acceptance criteria and performance data for Cashmere Powder Free Latex Examination Gloves.

1. Acceptance Criteria and Reported Device Performance

TESTAcceptance Criteria (ASTM D3578-00a)Reported Device Performance (Cashmere Powder Free Latex Exam Gloves)
Watertight (1000 ml)GI AQL=4.0%Pass GI AQL=4.0%
Length (mm)
- Size XSMin 230240 mm minimum for all sizes
- Size SMin 230
- Size MMin 230
- Size LMin 230
- Size XLMin 230
Palm width (mm)
- Size XS-75 - 78
- Size S80 +/- 1082 - 88
- Size M95 +/- 1092 - 98
- Size L111 +/- 10102 - 108
- Size XL-111 - 115
Thickness (mm)
- Finger (Single Layer)Min 0.080.10 minimum
- Palm (Single Layer)Min 0.080.10 minimum
Physical Properties
- Before Aging
- Tensile Strength (Mpa)Min 1425.1
- Ultimate Elongation (%)Min 650940
- After Aging
- Tensile Strength (Mpa)Min 1418
- Ultimate Elongation (%)Min 500950
Powder Content-Below 2 mg / glove
Protein Content-Below 50 microgram / gram
Biocompatibility- (implicitly, pass tests)Pass Primary Dermal Irritation Test and Guinea Pig Sensitization (Buehler) test

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

The document specifies "GI AQL=4.0%" for the watertight test, which refers to General Inspection Level 1 with an Acceptance Quality Limit of 4.0% according to ASTM D3578-00a. This standard typically involves sampling plans where the sample size is determined by the lot size, but the exact number of units tested is not explicitly stated in the provided text.

The data provenance is from Malaysia, specifically from SEAL POLYMER INDUSTRIES SDN. BHD. The study appears to be prospective as it involves the testing of a manufactured product against established standards.

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

This information is not applicable as the document describes performance testing of a physical product (gloves) against established engineering and material standards (ASTM D3578-00a and FDA requirements), not the establishment of ground truth by human experts for a diagnostic algorithm.

4. Adjudication method for the test set

This information is not applicable as the document describes performance testing of a physical product against established objective standards, not a process requiring expert adjudication.

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 information is not applicable as the document describes the performance of a physical medical device (examination gloves) and does not involve AI, human readers, or case studies.

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

This information is not applicable as the document pertains to the performance of a physical medical device, not an algorithm.

7. The type of ground truth used

The ground truth used consists of established industry standards and regulatory requirements:

  • ASTM D3578-00a Standard for Latex Examination Gloves
  • FDA Water Leak Test requirements (1000 ml watertight test)
  • FDA minimum powder residual content requirements
  • Biocompatibility test standards (Primary Dermal Irritation Test and Guinea Pig Sensitization (Buehler) test)

8. The sample size for the training set

This information is not applicable. The document describes the performance of a physical product, not a statistical model or algorithm that requires a training set.

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

This information is not applicable as there is no training set mentioned or implied for this physical product performance testing.

{0}------------------------------------------------

JUN 1 0 2002

K024 388

SEAL POLYMER INDUSTRIES SDN. BHD.

Lot 72706, Jalan lahat, Kawasan Perindustrian Bukit Merah, 31500 Lahat, Perak Malaysia. Tel: 605-3223 200 Fax: 605- 3222 300 E-mail: spoly@po.jaring.my

1.0SMDA 510 (K) SUMMARY
2.0SubmitterSEAL POLYMER INDUSTRIES SDN BHDLot 72706, Jalan LahatKawasan Perindustrian Bukit Merah31500 Lahat, Perak, Malaysia
Tel(60 5) 322 3200
Fax(60 5) 322 2300
Name of Contact PersonMs. CHUN CHOOI FONG
Date of Summary PreparedMarch 27, 2002
3.0Name of Device
Trade NameCashmere Powder Free Latex Examination Gloves
Common NameExam Glove
Classification NamePatient Examination Glove

4.0 Identification of The Legally Marketed Devices

Class 1 Polymer Coated Patient Examination Glove 80 LYY, powder free that meets all the requirements of ASTM Standard D3578-00a and FDA requirements.

5.0 Description of The Device

Class 1 Polymer Coated Patient Examination Glove 80 LYY, powder free that meets all the requirements of ASTM Standard D3578-00a and FDA Water Leak Test.

6.0 The Intended Use of Glove

A patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hands or finger to prevent contamination between patient and examiner.

Page 1 of 3 ATTACHMENT M

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SEAL POLYMER INDUSTRIES SDN. BHD.

Lot 72706, Jalan lahat, Kawasan Perindustrian Bukit Merah, 31500 Lahat, Perak Malaysia. Tel: 605-3223 200 Fax: 605- 3222 300 E-mail: spoly@po.jaring.my

Summary of Performance Data : 7.

Performance data of gloves based on ASTM D3578-00a and FDA 1000 ml watertight test.

TESTASTM D3578-00aCASHMERE POWDERFREE LATEX EXAMGLOVES
1. Watertight (1000 ml)GIAQL=4.0%Pass GIAQL=4.0%
2. Length (mm)Size XSMin 230240 mm minimum forall sizes
SMin 230
MMin 230
LMin 230
XLMin 230
3. Palm width (mm)Size XS-75 - 78
S80 +/- 1082 - 88
M95 +/- 1092 - 98
L111 +/- 10102 - 108
XL-111 - 115
4. Thickness (mm)(Single Layer)
FingerMin 0.080.10 minimum
PalmMin 0.080.10 minimum
5. Physical Properties
Before AgingTensile Strength (Mpa)Min 1425.1
Ultimate Elongation (%)Min 650940
After AgingTensile Strength (Mpa)Min 1418
Ultimate Elongation (%)Min 500950
6. Powder Content-Below 2 mg / glove
7. Protein Content-Below 50 microgram / gram

Page 2 of 3 ATTACHMENT M

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SEAL POLYMER INDUSTRIES SDN, BHD.

Lot 72706, Jalan lahat, Kawasan Perindustrian Bukit Merah, 31500 Lahat, Perak Malaysia. Tel: 605-3223 200 Fax: 605-3222 300 E-mail: spoly@po.jaring.my

    1. The performance data of the glove as showed above meet the ASTM D3578-00a Standard and FDA's requirement. Powder content is below 2 mg per glove that meets the FDA Requirements.
  • The Biocompatibility Test consists of Primary Dermal Irritation Test and Guinea 9. Pig Sensitization (Buehler) test. The gloves pass the Biocompatibility Tests.
    1. Conclusion

We concluded that the Cashmere Powder Free Latex Examination Gloves meet:

  • -ASTM D3578-00a Standard
  • FDA pinhole requirements r
  • FDA minimum powder residual content -

Page 3 of 3 ATTACHMENT M

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which is often associated with medicine and healthcare. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" are arranged in a circular pattern around the caduceus.

Public Health Service

JUN 1 0 2002

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Chun Chooi Fong Quality Assurance Manager Seal Polymer Industrial Sdn. Bhd. Lot 72706. Jalan Lahat, Kawasan Perindustrian Bukit Merah Lahat, Perak, MALAYSIA 31500

Re: K021388

Trade/Device Name: Cashmere Non-Sterile, Polymer Coated Powder Free Latex Examination Gloves, Contains 50 Micrograms or Less of Total Water Extractable Protein Per Gram Regulation Number: 880.6250 Regulation Name: Examination Gloves Regulatory Class: I Product Code: LYY Dated: May 30, 2002 Received: June 5, 2002

Dear Mr. Fong:

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.

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Page 2 - Mr. Fong

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); 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.qov/cdrh/dsma/dsmamain.html

Sincerely yours,

Timot A. Ulatowski Director Division of Dental. Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health

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INDICATIONS FOR USE STATEMENT

Applicant : Seal Polymer Industries Sdn. Bhd.

510(K) Number: K021388

  • Device Name : Cashmere Powder Free Latex Examination Gloves With Protein Labeling Claim (50 micrograms or less) & Total Unter Extress & Later & Claim
    Indication For Use:

A patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hands or finger to prevent contamination between patient and examiner.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Concurrence of CDRH Office of Device Evaluation (ODC)

Prescription Use: ... ... ... ... ... .................. Per 21 CFR 80.109

OR

Over-The-Counter ... ....................

Qia S. Lin

(Division Sign-Off) Division of Dental, Infection Control, and General Hospital Devic 510(k) Number _

§ 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.