(391 days)
A patient examination glove is a disposable device intended for medical purposes that is worn on the examiners hand or finger to prevent contamination between the patient and examiner.
VitalCare Powder Free Synthetic Vinyl Examination Glove. A patient examination glove is a disposable device intended for medical purposes that is worn on the hand of healthcare professional and similar personnel to prevent contamination between the healthcare personnel and the patient's body, fluids, waste or environment.
This document details the acceptance criteria for the "VitalCare Powder Free Synthetic Vinyl Examination Glove" and the studies performed to demonstrate its compliance.
1. Table of Acceptance Criteria and Reported Device Performance
| Feature/Claim | Acceptance Criteria | Reported Device Performance |
|---|---|---|
| Physical and Dimensional Testing | Meets all requirements for ASTM Standard D-5250-00 | VitalCare Powder Free Vinyl Examination Glove meets all requirements for ASTM Standard D-5250-00 physical and dimensional testing. |
| Powder-Free Claim (Starch Content) | No more than 2mg powder per glove (ASTM D6124-01) | VitalCare Powder Free Vinyl Examination Glove meets ASTM D6124-01 for starch to determine the gloves meet the powder-free claim, no more than 2mg powder per glove. |
| Water Leak Test | FDA 1000ml Water Leak Test | VitalCare Powder Free Vinyl Examination Glove meets FDA 1000ml Water Leak Test. |
| Primary Skin Irritation | Demonstrates no skin irritation | Primary Skin Irritation tests demonstrate no skin irritation. |
| Skin Sensitization | Demonstrates no skin sensitization | Skin Sensitization tests demonstrate no skin sensitization. |
| Intended Use | A disposable device intended for medical purposes that is worn on the hand of healthcare professional and similar personnel to prevent contamination between the healthcare personnel and the patient's body, fluids, waste or environment. | The intended use is clearly stated as: "A patient examination glove is a disposable device intended for medical purposes that is worn on the examiners hand or finger to prevent contamination between the patient and examiner." This aligns with the acceptance criteria. |
| Materials | Similar to predicate device (Vinyl, Synthetic, Plastic Bag, Corrugated) | The materials used (Vinyl, Synthetic, Plastic Bag, Corrugated) are stated as similar to the predicate device. |
| Labeling | Similar to predicate device (Reorder Number, Size, Quantity, Non-Sterile, pouch and shipping case, Manufacturer Address) with the addition of "Powder Free" and absence of "Powdered". | Labeling information provided adheres to the required details, specifically mentioning "VitalCare Powder Free Synthetic Vinyl Examination Glove," and other details similar to the predicate device, excluding "Powdered." |
| Packaging | Similar to predicate device (One plastic bag, 100 pouches per case) | Packaging is stated as "One plastic bag, 100 pouches per case," which is similar to the predicate device. |
| Sterilization Information | Bulk Non-Sterile | Device is described as "Bulk Non-Sterile." |
| Comparative Claims | No comparative claims (e.g., hypoallergenic, comparison to other devices) | "No comparative claims are made for the VitalCare Powder Free Synthetic Vinyl Examination glove. The glove is not claimed as hypoallergenic. It will not be compared in labeling or advertising to other devices." |
| Unique Designs | Not unique | "The design of the VitalCare Powder Free Vinyl Examination Glove is not unique." |
2. Sample Size Used for the Test Set and the Data Provenance
The document does not explicitly state the sample sizes used for each specific test (e.g., physical, dimensional, water leak, skin irritation, skin sensitization). It only refers to the tests performed to meet the standards. The data provenance (country of origin of the data, retrospective or prospective) is not specified.
3. Number of Experts Used to Establish the Ground Truth for the Test Set and the Qualifications of Those Experts
The document does not mention the number of experts or their qualifications for establishing ground truth for any of the performance tests. The "ground truth" for these tests is defined by the objective metrics and standards themselves (e.g., ASTM D-5250-00, ASTM D-6124-01, FDA 1000ml Water Leak Test, and standard dermatological tests for irritation/sensitization).
4. Adjudication Method for the Test Set
No adjudication method is described. The performance data seems to be based on direct measurement and adherence to established standard specifications rather than subjective expert review requiring adjudication.
5. If a Multi Reader Multi Case (MRMC) Comparative Effectiveness Study was done
No, a Multi Reader Multi Case (MRMC) comparative effectiveness study was not performed. The device is an examination glove, and its performance is evaluated against physical and chemical standards, not through human reader diagnostic accuracy.
6. If a Standalone (i.e. algorithm only without human-in-the loop performance) was done
Yes, the performance tests described (ASTM standards, FDA water leak test, skin irritation/sensitization) are inherently standalone evaluations of the device's physical and biological properties. They do not involve human-in-the-loop performance in the way an AI diagnostic algorithm would.
7. The Type of Ground Truth Used
The ground truth used for performance evaluation is based on objective standards and test methods:
- ASTM Standard D-5250-00: For physical and dimensional testing.
- ASTM D-6124-01: For starch content to quantitatively determine the "powder-free" claim.
- FDA 1000ml Water Leak Test: For assessing barrier integrity.
- Primary Skin Irritation and Skin Sensitization tests: Standard toxicological/dermatological testing to assess biocompatibility.
8. The Sample Size for the Training Set
This information is not applicable. The device is a physical product (an examination glove), not an AI algorithm requiring a "training set."
9. How the Ground Truth for the Training Set Was Established
This information is not applicable for the same reason as point 8.
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MAY - 4 2005
K 0409/6
| 510(k) Summary |
|---|
| ---------------- |
| Date: | March 24, 2004 |
|---|---|
| Submitter: | VitalCare Group Inc.8935 NW 27th StreetMiami Fl. 33172 |
| Contact: | Michael McAveniaDirector of Quality Assurance(305) 620-4007Fax: (305) 620-5220Internet: michaelm@vitalcare.com |
| Establishment Number: | 1063200 |
| Address of Manufacturing Site: | VitalCare Malaysia, SDN BHD, Inc.Lot 7, Jalan 16/11Shah Alan - SelangorMalaysia |
| Name of Device: | VitalCare Powder Free Synthetic Vinyl ExaminationGlove |
| Predicate Device: | VitalCare Vinyl Powdered Examination Glove |
| Device Common and Classification Name(s): | |
|---|---|
| Common Name: Powder Free Exam GloveClassification Name: Glove, Patient Examination, Vinyl |
| Classification Information: | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Class:Class IPanel:General HospitalProduct Code:LYZCite:880.6250 | Class: | Class I | Panel: | General Hospital | Product Code: | LYZ | Cite: | 880.6250 | |
| Class: | Class I | ||||||||
| Panel: | General Hospital | ||||||||
| Product Code: | LYZ | ||||||||
| Cite: | 880.6250 |
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Intended Use of the New Device: A patient examination glove is a disposable device intended for medical purposes that is worn on the hand of healthcare professional and similar personnel to prevent contamination between the healthcare personnel and the patient's body, fluids, waste or environment
Guidance Documents: ASTM -D-5250-00, ASTM- D-6124-01, FDA 1000 ml Water Leak Test.
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| Feature\Claim | Detail | Predicate |
|---|---|---|
| Intended Use | A patient examination glove is a disposable deviceintended for medical purposes that is worn on thehand of healthcare professional and similar personnelto prevent contamination between the healthcarepersonnel and the patient's body, fluids, waste orenvironment | Similar |
| Materials | Vinyl, SyntheticPlastic BagCorrugated | SimilarSimilarSimilar |
| Labeling | VitalCare Powder Free Synthetic Vinyl ExaminationGloveReorder NumberSizeQuantityNon - Sterile, pouch and shipping caseManufacturer Address | PowderedSimilarSimilarSimilarSimilarSimilarSimilar |
| Packaging | One plastic bag, 100 pouches per case | Similar |
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Labels, Labeling: See Attachments
: !
Package labels: Copies of the labels for the Powder Free Synthetic Vinyl Exam glove pouch and shipping case are included. See Attachment 1
Promotional Materials: No promotional materials have been developed for this device.
Engineering Drawings: Engineering drawings, with dimensions and tolerances, are included in Attachment 2
Performance Data: VitalCare Powder Free Vinyl Examination Glove meets all requirements for ASTM Standard D-5250-00 physical and dimensional testing, ASTM D6124-01 for starch to determine the gloves meet the powder free claim, no more than 2mg powder per glove. FDA 1000ml Water Leak Test. Primary Skin Irritation and Skin Sensitization tests demonstrate no skin irritation or sensitization.
Comparative Claims: No comparative claims are made for the VitalCare Powder Free Synthetic Vinyl Examination glove. The glove is not claimed as hypoallergenic. It will not be compared in labeling or advertising to other devices.
Unique Designs: The design of the VitalCare Powder Free Vinyl Examination Glove is not unique.
Sterilization Information: Bulk Non - Sterile
Description of the Marketed Equivalent Device: Classified by FDA's General Hospital Panel as Class I, 21 CFR 880.6250, Powdered Vinyl Examination Glove, 880 LYZ meets all the requirements of ASTM Standard D5250-00
Device Trade or Proprietary Name: VitalCare Powdered Vinyl Examination Glove
Device Common and Classification Name(s):
Common Name: Powdered Exam Glove Classification Name: Glove, Patient Examination, Vinyl
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Classification Information:
Class I Panel: General Hospital Product Code: LYZ Cite: 880.6250
Document Control Number: K 992289
Type of Device: Patient Examination Glove
Use with other devices: N\A
Intended Use of the Marketed Equivalent Device: A patient examination glove is a disposable device intended for medical purposes that is worn on the hand of healthcare professional and similar personnel to prevent contamination between the healthcare personnel and the patient's body, fluids, waste or environment.
Labels and Labeling: See Attachment 3
Summary of technological characteristics of new device compared to predicate device: The proposed device has the same technological characteristics and is substantially equivalent to the predicate device, however, the glove is not powdered.
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Image /page/5/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized depiction of an eagle or bird-like figure with three heads, suggesting a sense of unity or collaboration. The text "DEPARTMENT OF HEALTH AND HUMAN SERVICES - USA" is arranged in a circular pattern around the central emblem.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
MAY - 4 2005
Mr. Michael McAvenia Director, Quality Assurance VitalCare Group, Incorporated 15800 NW 13th Avenue Miami, Florida 33169
Re: K040916
Trade/Device Name: VitalCare Powder Free Synthetic\Vinyl Examination Glove Regulation Number: 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LYZ Dated: February 1, 2005 Received: April 20, 2005
Dear Mr. McAvenia:
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 mendments, 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 approvisions of the Act. The general controls provisions of the Act include controls providents or 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 If your de roe is onabitional controls. Existing major regulations affecting (1 Writ), it may be backed in the Code of Federal Regulations, Title 21, Parts 800 to 898. In your device to real rot 10 loasish further announcements concerning your device in the Federal Register.
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Page 2 - Mr. McAvenia
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 modi that I Dr mas made statutes and regulations administered by other Federal agencies. of the Act of ally I ouchar time Act's requirements, including, but not limited to: registration r od listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice und noting (21 et read in the quality systems (QS) regulation (21 CFR Part 820); and if requirements as bettronic 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 premiurner notified 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), 11 you dosite specific across of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the maj vours 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/industry/support/index.html.
Sincerely yours,
Spute Y. Michai O ms.
Chíu Lin, Ph.D. Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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Indications for Use
510(k) Number (if known): K040916
Device Name: VitalCare Powder Free Synthetic\Viry| Examination Glove
Indications for Use: A patient examination glove is a disposable device intended for medical purposes that is worn on the examiners hand or finger to prevent contamination between the patient and examiner.
Prescription Use (Part 21 CFR 801 Subpart D) AND/OR
Over-The-Counter Use (21 CFR 801 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Shade P. Murphy S. 305
Page 1 of
(Division Sign-Off)
Division of Anesthesiology, General Hospital,
Infection Control, Dental Devices
510(k) Number:
11:3
§ 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.