K Number
K051662
Device Name
VINYL NITRILE CO-POLYMER POWDER FREE EXAM GLOVES (BLUE COLOR)
Date Cleared
2005-07-22

(30 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
A patient examination glove is a disposable device intended for medical purposes that is worn on the hand of healthcare and similar personnel to prevent contamination between healthcare personnel and the patient's body, fluids, waste or environment. The Vinyl Plastic Co-Polymer Powder-Free Examination Gloves (Blue Color) is a disposable device intended for medical purposes that is worn on the examiner's hands to prevent contamination between patient and examiner.
Device Description
Classified by FDA's General and Plastic Surgery Device panel as Class I, 21 CFR 880.6250, Power-Free Vinyl Patient Examination Glove, 80 LZA, and meets all requirements of ASTM standard D-6319-00a1 and ASTM D-5250.
More Information

Not Found

No
The device is a patient examination glove, and the summary describes standard testing and materials for this type of device. There is no mention of AI or ML technology.

No
The device, a patient examination glove, is intended to prevent contamination, not to treat or alleviate a disease or condition.

No

The device is an examination glove, which is intended to prevent contamination between healthcare personnel and patients. It does not perform any diagnostic function.

No

The device description clearly identifies the device as a physical examination glove, which is a hardware product, not software.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly states the device is a "patient examination glove" worn on the hand to prevent contamination between healthcare personnel and the patient's body, fluids, waste, or environment. This is a barrier function, not a diagnostic one.
  • Device Description: The device is classified under "General and Plastic Surgery Device panel" and is a "Power-Free Vinyl Patient Examination Glove." This classification is for general medical devices, not IVDs.
  • Lack of Diagnostic Function: There is no mention of the device being used to test samples (like blood, urine, or tissue) or to provide information about a patient's health status or condition.
  • Performance Studies: The performance studies focus on the physical properties of the gloves (dimensions, water fill test, skin irritation, residual powder), which are relevant to their barrier function and safety, not diagnostic accuracy.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information for diagnosis, monitoring, or screening. This glove does not perform such a function.

N/A

Intended Use / Indications for Use

A patient examination glove is a disposable device intended for medical purposes that is worn on the hand of healthcare and similar personnel to prevent contamination between healthcare personnel and the patient's body, fluids, waste or environment.

The Vinyl Nitrile Co-Polymer Powder-Free Examination Gloves (Blue Color) is a disposable device intended for medical purposes that is worn on the examiner's hands to prevent contamination between patient and examiner.

Product codes

LZA

Device Description

Classified by FDA's General and Plastic Surgery Device panel as Class I, 21 CFR 880.6250, Power-Free Vinyl Patient Examination Glove, 80 LZA, and meets all requirements of ASTM standard D-6319-00a1 and ASTM D-5250.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

hands

Indicated Patient Age Range

Not Found

Intended User / Care Setting

healthcare and similar personnel

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)

The standards used for Grand Work Plastic Products Co., Ltd.'s glove product are bassed on ASTM-D-6319-00a1 and ASTM D-5250. All testing meets requirements for physical and dimensions testing conducted on gloves. Inspection level S-2, AQL 4.0.

The FDA 1000 ml. Water Fill Test based on ASTM D-5151-99 was also conducted with samplings of AQL 2.5, inspection level G-1, meeting these requirements. Primary Skin Irritation and Skin Sensitization (allergic contact dermatitis) testing was conducted with results showing no primary skin irritant or sensitization reactions.

A Residual Powder Test that based on ASTM D-6124-01 for Starch at finished inspection is conducted to insure that our gloves meet our "powder-free" claims (contain no more than 2 mg powder per glove).

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

Not Found

Predicate Device(s)

K011882

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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

K 051662

JUL 2 2 2005

EXHIBIT #1 Page 1 of 2

510(K) SUMMARY

This summary of 510(K) safety and effectiveness information is being submitted in accordance with requirements of SMDA 1990 and 21 CFR $807.92.

The assigned 510(K) number is: _ _____________________________________________________________________________________________________________________________________________

1. Submitter's Identification:

Mr. Shuangzu Ma Grand Work Plastic Products Co., Ltd. Donggao Industrial Zone Zanhuang, Hebei, China

Date Summary Prepared: June 16, 2005

2. Name of the Device:

Grand Work Plastic Products Co., Ltd. Vinyl Nitrile Co-Polymer Powder Free Exam Gloves (Blue Color)

3. Predicate Device Information:

Shijiazhuang Eversharp Plastic Products Co., Ltd. Synthetic Powder Free (Yellow) Vinyl Examination Gloves (K011882)

4. Device Description:

Classified by FDA's General and Plastic Surgery Device panel as Class I, 21 CFR 880.6250, Power-Free Vinyl Patient Examination Glove, 80 LZA, and meets all

requirements of ASTM standard D-6319-00a1 and ASTM D-5250.

5. Intended Use:

A patient examination glove is a disposable device intended for medical purposes that is worn on the hand of healthcare and similar personnel to prevent contamination between healthcare personnel and the patient's body, fluids, waste or environment.

1

6. Comparison to Predicate Devices:

Grand Work Plastic Products Co., Ltd.'s Vinyl Nitrile Co-Polymer Powder Free Exam Gloves (Blue Color) is substantially equivalent in safety and effectiveness to the Shijiazhuang Eversharp Plastic Products Co., Ltd.'s Synthetic Powder Free (Yellow) Vinyl Examination Glvoes.

7. Discussion of Non-Clinical Tests Performed for Determination of Substantial Equivalence are as Follows:

The standards used for Grand Work Plastic Products Co., Ltd.'s glove product are

bassed on ASTM-D-6319-00a1 and ASTM D-5250. All testing meets requirements for physical and dimensions testing conducted on gloves. Inspection level S-2, AQL 4.0.

The FDA 1000 ml. Water Fill Test based on ASTM D-5151-99 was also conducted with samplings of AQL 2.5, inspection level G-1, meeting these requirements. Primary Skin Irritation and Skin Sensitization (allergic contact dermatitis) testing was conducted with results showing no primary skin irritant or sensitization reactions.

There are no special labeling claims and we do not claim our gloves as hypoallergenic on our labels.

A Residual Powder Test that based on ASTM D-6124-01 for Starch at finished inspection is conducted to insure that our gloves meet our "powder-free" claims (contain no more than 2 mg powder per glove).

8. Discussion of Clinical Tests Performed:

Not Applicable - There is no hypoallergenic Claim.

9. Conclusions:

Grand Work Plastic Products Co., Ltd.'s Vinvl Nitrile Co-Polymer Powder Free Exam Gloves (Blue Color) conform fully to ASTM D-6319-00a1 and ASTM D-5250 standard as well as applicable 21 CFR references, and meets pinhole FDA requirements, biocompatibility requirements and labeling claims as shown by data in Section 7. There are no safety/efficacy issues or new claims from the "substantial equivalence" products cited.

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with three lines representing its body and wings. The eagle is positioned to the right of a circular border containing the text "DEPARTMENT OF HEALTH AND HUMAN SERVICES - USA".

JUL 2 2 2005

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Grand Work Plastic Products, Company, Limited c/o Mr. Micky Lin Gloveco Incorporated 3973 Schafer Avenue Chino, California 91710

Re: K051662

Trade/Device Name: Vinyl Nitrile Co-Polymer Powder Free Examination Gloves (Blue Color) Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LZA Dated: July 13, 2005 Received: July 14, 2005

Dear Mr. Lin:

We have reviewed your Section 510(k) premarket notification of intent to market the device wt nave reviewed your becamed the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for use stated in the May 28, 1976, the enactment date of the Medical Device Amendments, or to conniner co may to ria) 2011-12-11 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 I ou mayy are expressions 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 If your device to such additional controls. Existing major regulations affecting your device can may be subject to back adderal Regulations, Title 21, Parts 800 to 898. In addition, FDA may be found in the overning your device in the Federal Register.

3

Please be advised that FDA's issuance of a substantial equivalence determination does not mean Please be advised mat TDA s issualled of a business with other requirements of the Act that FDA has made a determination that Jour securities of by other Federal agencies. You must of any Federal statutes and regulations annuments, but not limited to: registration and listing (21 comply with an the Act 3 requirements, moreans, and manufacturing practice requirements as set CFR Part 807), labeling (21 CFR Part 820); and if applicable, the electronic forul in the quality systems (Sections 531-542 of the Act); 21 CFR 1000-1050. product radiation control provisions (bections over device as described in your Section 510(k) i his letter will anow you to oegin manceing your are a convalence of your device to a legally premarket nothication. The PDA inding of backantal or 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 If you desire specific advice for your do not as a loss, please note the regulation entitled, and Colliact the Office of Comphalled as (21) = 17 = 15 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = = 1 " Misbranding by Icierchec to premance no ilities under the Act from the Division of Small other general information on your responsion.com at its toll-free number (800) 638-204 or Minutaturers, International and Oct.ss http://www.fda.gov/cdrl/industry/support/index.html.

Sincerely yours,

Soutie y. Michie Omd.

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

4

Indications for Use

510(k) Number (if kn wn):_K051662

$

Device Name: Vinyl `itrile Co-Polymer Powder-Free Examination Gloves (Blue Color)

Indications For Use The Vinyl Plastic Co-Polymer Powder-Free Examination Gloves (Blues Indications For Use The Viny Flasto Co Fermer over that is worn on the examiner's hands Color) is a disposuore normination between patient and examiner.

Prescription Use (Part 21 CFR 801 Subp: D) AND/OR

Over-The-Counter Use ___ × (21 CFR 801 Subpart C)

(PLEASE DO NOT VRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Shula H. Murphry, Ph.D. 2/2/05

ivision Sign-Off) ivision of Anesthesinlogy. General Hospital, Infontion Control, Dental Devices

K051LL2