(90 days)
This powdered, vinyl 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 (21CFR 880.6250).
powdered vinyl patient examination gloves, white(non-colored) that meets all of the requirements of ASTM standard D 5250-004.
The provided text is a 510(k) Premarket Notification Summary for Powdered Vinyl Patient Examination Gloves, White (Non-colored). This type of document is about demonstrating substantial equivalence to a predicate device, not necessarily proving novel clinical effectiveness or advanced AI performance. As such, the requested information regarding AI device acceptance criteria, expert adjudication, MRMC studies, and standalone algorithm performance, as well as specific details about training and test sets common for AI/ML device submissions, are not applicable to this traditional medical device submission.
The "study that proves the device meets the acceptance criteria" in this context refers to the non-clinical tests conducted to ensure the gloves meet established standards for similar devices.
Here's the relevant information based on the provided document:
1. A table of acceptance criteria and the reported device performance
| Characteristics | Acceptance Criteria (Standard) | Reported Device Performance |
|---|---|---|
| Dimension | ASTM standard D 5250-00e4 | Meets |
| Physical Properties | ASTM standard D 5250-00e4 | Meets |
| Freedom from pinholes | 21 CFR 800.20 | Meets |
| Powder Amount | ASTM standard D 5250-00e4 | Meets (<10mg/dm2) |
| Biocompatibility | Primary Skin Irritation | Passes (Not a Primary Skin Irritation) |
| Dermal Sensitization | Passes (Not a Dermal Sensitization) |
2. Sample size used for the test set and the data provenance
The document specifies that the device meets requirements per ASTM D5250-00e4, ASTM D6124-01, 21 CFR 800.20, and ISO10993-10. These are established standards for patient examination gloves and biocompatibility. The sample size for these tests is generally defined within the respective ASTM and ISO standards for statistical validity. However, the exact sample sizes used for the testing of this specific device are not explicitly stated in the provided summary.
The provenance of this data would be from laboratory testing conducted by the manufacturer or accredited testing facilities to comply with these standards. The information does not specify country of origin for the data (beyond the manufacturer being in China) or whether it was retrospective or prospective, as these terms are not typically applicable to this type of device testing.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
This question is not applicable. The "ground truth" for this device is established by objective physical and chemical testing against recognized industry standards (ASTM, ISO, and CFR regulations), not by expert human interpretation or consensus.
4. Adjudication method for the test set
This question is not applicable. As the evaluation is based on objective physical and chemical tests against predefined standards, there is no need for 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 question is not applicable. This submission is for traditional patient examination gloves, not an AI-powered device.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done
This question is not applicable. This submission is for traditional patient examination gloves, not an AI-powered device.
7. The type of ground truth used
The ground truth used is based on pre-established objective standards and specifications from ASTM International (e.g., D5250-00e4 for physical properties and dimensions), the Code of Federal Regulations (e.g., 21 CFR 800.20 for freedom from pinholes), and ISO (e.g., ISO10993-10 for biocompatibility).
8. The sample size for the training set
This question is not applicable. There is no "training set" in the context of this traditional medical device submission, as it does not involve machine learning or AI.
9. How the ground truth for the training set was established
This question is not applicable. There is no "training set" in the context of this traditional medical device submission.
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Image /page/0/Picture/2 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with its wings spread, facing to the right. The eagle is composed of three curved lines that suggest feathers. The logo is surrounded by a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in all caps.
MAR 2 3 2005
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
Shijiazhuang Manful Light Industrial Products Company Limited C/O Ms. Chen Yuhong Official Correspondent TUV Rheinland Beijing Office Rm 707, AVIC Building No. 2 Dong San Huan Nan Road, Chaoyang District, Beijing, 10002, P.R. CHINA
Re: K042120
Trade/Device Name: Powdered Vinyl Patient Examination Gloves White (Non-Colored) Regulation Number: 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LYZ Dated: August 2,2004 Received: August 6,2004
Dear Ms. Yuhong:
This letter corrects our substantially equivalent letter of November 4,2004 regarding the trade name.
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 (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 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 Ms. Yuhong
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 531-542 of the Act); 21 CFR 1000-1050.
This letter will allow you to continue 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), please contact the Office 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 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/cdrhldsmaldsmamain.html
Sincerely yours,
Syditte Michie MD
Chiu 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): K042120
Device Name: POWDERED. VINYL PATIENT EXAMINATION GLOVES, WHITE JNON-COLORED)
indications For Use: This powdered, vinyl 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 (21CFR 880.6250).
Sutte Michael MD.
INFECTION CONTROL DECIENCES BANCY ACTING
(Division Sign-Off) Division of Anesthesiology. General Hospital. Infection Control. Dental Devices H 042120
510(k) Number:-
Prescription Use (Part 21 CFR 801 Subpart D) AND/OR
Over-The-Counter Use X (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)
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C Summary
"This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92."
2120" (applicant leave blank) "The assigned 510(k) number is:
Premarket Notification [510(k)] Summary
[(a)(1)]. The summary contains on the first page, preferably on your letterhead paper, the submitter's name, address, phone and fax numbers, name of contact person, and date the summary was prepared :
| Submitter's name : | SHIJIAZHUANG MANFUL LIGHT INDUSTRIALPRODUCTS CO., LTD | |
|---|---|---|
| Submitter's address : | NO.78 CANGSHI ROAD, JINZHOU CITY, HEBEI, 052260,P.R.CHINA | |
| Phone number : | (86)0311-4318269 | |
| Fax number : | (86)0311-4322592 | |
| Name of contact person: | Mr. Guo Huanqiang | |
| Date the summary was prepared: | 2 August 2004 |
[(a)(2)]. The name of the device, including the trade or proprietary name if applicable, the common or usual name, and the classification name, if known
| Device Name: | Powdered Vinyl Patient Examination Gloves,White (Non-colored) |
|---|---|
| Proprietary/Trade name: | Powdered Vinyl Patient Examination GlovesOther clients private labeling |
| Common Name: | Patient examination glove |
| Classification Name: | Patient examination glove |
| Device Classification: | I |
| Regulation Number: | 21 CFR 880.6250 |
| Panel: | General Hospital (80) |
| Product Code: | LVZ |
[(a)(3)]. An identification of the legally marketed device to which your firm is claiming substantial equivalence .
Class I* powdered vinyl patient examination gloves, white(non-colored) that meets all of the requirements of ASTM standard D 5250-00e4
Predicate device : FUGUAN (Brand) Powdered Vinyl Patient Examination Gloves, Shijiazhuang Fuguan Plastic Products Co., Ltd.. K032907.
{(a)(4)] A description of the device
Device Description : powdered vinyl patient examination gloves, white(non-colored) that meets all of the requirements of ASTM standard D 5250-004.
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[(a)(5)] The summary describes the intended use of the device
Device Intended Use: powdered vinyl patient examination glove, white(non-colored) 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)(6)] A summary of the technological characteristics of new device compared to the predicate device.
The powdered vinyl patient examination gloves, white (non-colored) non sterile are summarized with the following technological characteristics compared to ASTM or equivalent standard,
| Characteristics | Standard | Device performance |
|---|---|---|
| Dimension | ASTM standard D 5250-00e4 | Meets |
| Physical Properties | ASTM standard D 5250-00e4 | Meets |
| Freedom from pinholes | 21 CFR 800.20 | Meets |
| Powder Amount | ASTM standard D 5250-00e4 | Meets |
| Biocompatability | Primary Skin Irritation in rabbits | <10mg/dm2PassesNot a Primary Skin Irritation |
| Dermal sensitization in the guinea pig | PassesNot a Dermal sensitization |
[(b)(1)] A brief discussion of the nonclinical submitted, reference, or relied on in the premarket notification submission for a determination of substantial equivalence .
Powdered vinyl patient examination gloves , white(non-colored) meet requirements per ASTM D5250-0064, per ASTM D6124-01, per 21 CFR 800.20 and ISO10993-10.
[(b)(2)] A brief discussion of the clinical submitted, reference, or relied on in the premarket notification submission for a determination of substantial equivalence .
Clinical data is not needed for gloves or for most devices cleared by the 510(k) process.
((b)(3)] The conclusions drawn from the nonclinical and clinical tests that demonstrate that the device is as safe, as effective, and performed as well or better than the legally marketed device identified in (a)(3).
It can be concluded that the Powdered Vinyl Patient Examination Gloves, White(non-colored) meet the ASTM standard or equivalent standard and FDA requirements for waterleak test on pinhole AQL, meet labeling claims .
§ 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.