(40 days)
A patient examination glove is a disposable device intended for medical purpose that is worn on examiner's hand to prevent contamination between patient and examiner.
Powder free Latex Examination Gloves
Here's a breakdown of the acceptance criteria and study information based on the provided text:
Device Name: Powder free Latex Examination Gloves
1. Table of Acceptance Criteria and Reported Device Performance
| Characteristic | Acceptance Criteria (ASTM D 3578-05) | Reported Device Performance |
|---|---|---|
| Dimensions | ||
| Length (min.) | 240 mm for all sizes (S, M, L, XL) | 240 mm (min.) |
| Palm Width (min) | 80 mm (S), 95 mm (M), 100 mm (L), 110 mm (XL) | 80 mm (S), 95 mm (M), 100 mm (L), 110 mm (XL) |
| Thickness (min) - Cuff | 0.1 mm for all sizes | 0.1 mm |
| Thickness (min) - Palm | 0.1 mm for all sizes | 0.1 mm |
| Thickness (min) - FingerTip | 0.1 mm for all sizes | 0.1 mm |
| Physical Properties | ||
| Tensile Strength (Before ageing) | 18 MPa (min) | 18 MPa (min) |
| Ultimate Elongation (Before ageing) | 650 % (min.) | 650 % (min.) |
| Tensile Strength (After ageing at 70°C 168 hrs.) | 14 Mpa (min) | 14 Mpa (min) |
| Ultimate Elongation (After ageing at 70°C 168 hrs.) | 500 % (min.) | 500 % (min.) |
| FDA pin hole requirement | Meets requirement | Meets FDA pin hole requirement |
| Labeling claim | Meets requirement | Meets labeling claim |
2. Sample Size Used for the Test Set and Data Provenance
The document does not explicitly state the specific sample size used for the test set during the performance evaluation for the "Powder Free Latex Examination Gloves." It refers to the ASTM D 3578-05 standard, which would typically define the sampling plan for such tests.
The data provenance is not explicitly mentioned beyond the manufacturer being PT. Shamrock Manufacturing Corpora in Medan, North Sumatra, Indonesia. The testing itself would have been conducted to meet the ASTM standard.
3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts
This information is not applicable as the device is a physical product (examination gloves), not an AI/software device that requires expert-established ground truth for diagnosis/interpretation. The "ground truth" here is defined by objective physical and chemical properties measured against a standard (ASTM D 3578-05).
4. Adjudication Method for the Test Set
This information is not applicable for the same reasons as #3. Adjudication methods are relevant for subjective interpretations, not objective measurements of physical properties.
5. If a Multi Reader Multi Case (MRMC) Comparative Effectiveness Study Was Done, and Effect Size How Much Human Readers Improve with AI vs Without AI Assistance
This information is not applicable. The device is a medical device (gloves), not an AI system.
6. If a Standalone (i.e. algorithm only without human-in-the-loop performance) Was Done
This information is not applicable. The device is a medical device (gloves), not an AI system. Even if it were an AI system, "standalone" in this context refers to AI performance without human intervention, which isn't relevant for a physical product.
7. The Type of Ground Truth Used
The ground truth used for evaluating the device is based on objective physical and chemical standards as defined by ASTM D 3578-05 (Standard Specification for Rubber Examination Gloves) and FDA pinhole requirements.
8. The Sample Size for the Training Set
This information is not applicable. The device is not an AI/machine learning system, so there is no concept of a "training set" in the traditional sense for algorithm development. The manufacturing process would involve internal quality control and production monitoring, but not a "training set" like an AI model.
9. How the Ground Truth for the Training Set Was Established
This information is not applicable for the reasons stated in #8. The "ground truth" for manufacturing would be established by the specifications of the ASTM standard.
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PT. Shamrock Manufacturing Corpora
Jalan Pemuda No. 11, Medan-20151, N. Sumatra – Indonesia Ph. (+62-61) 455 8888 Fax. (+62-61) 452 0588 Email. smc@shamrock-id.com =============================================================================================================================================================================
September 30, 2005 K052709
Page Numbers 1 of 2
"510 (K)" SUMMARY
| (1) Name of applicant | : RUDI SALIM |
|---|---|
| Address | : PT. SHAMROCK Manufacturing CorporaJl. Pemuda No. 11 Medan 20151North Sumatra - Indonesia |
| Phone No. | : 62-61-4558888 |
| Fax No. | : 62-61-4520588 |
| Contact person in U.S.A | : Emmy Tjoeng |
| Phone No. | : 909-591-855 |
| Fax No. | : 909-628-6283 |
| (2) Device details | |
| Trade Name | : Powder free Latex Examination Gloves |
| Classification Name | : Powder free Latex Examination Gloves |
| (3) Product Code | : 80 LYY |
| (4) Equivalent device legally marketed | : Class I Powder Free Latex Examination Gloves 80 LYY meeting ASTM D 3578-05 |
| (5) Intended use | : Powder free Latex Examination gloves is a disposable device intended for medical purpose that is worn on examiner's hand to prevent contamination between patient and examiner. |
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PT. Shamrock Manufacturing Corpora
Jalan Pemuda No. 11, Medan-20151, N. Sumatra – Indonesia Ph. (+62-61) 455 8888 Fax. (+62-61) 452 0588 Email. smc@shamrock-id.com 글쓰레드드르드르드르드스크스트드르드르드로드로드로드로드로드드로드드로드드로드드로드드로드드로드드드드드드드드드드드드
Page Numbers 2 of 2
- (6) Technological characteristic of the gloves.
| a. DimensionsSizes | Small | Medium | Large | X-Large | |
|---|---|---|---|---|---|
| Length mm (min.) | 240 | 240 | 240 | 240 | $\pm$ 5 |
| Palm Width mm (min) | 80 | 95 | 100 | 110 | $\pm$ 1 |
| Thickness | |||||
| 1. Cuff mm (min) | 0.1 | 0.1 | 0.1 | 0.1 | |
| 2. Palm mm(min) | 0.1 | 0.1 | 0.1 | 0.1 | |
| 3. FingerTip mm (min) | 0.1 | 0.1 | 0.1 | 0.1 |
b. Physical Properties
2012-02-04
| Before ageing | After ageingat 70°C 168 hrs. | |
|---|---|---|
| Tensile Strength | : 18 MPa (min) | 14 Mpa (min) |
| Ultimate Elongation | : 650 % (min.) | 500 % (min.) |
- (7) Performance data is the same as mentioned immediately above.
- (8) Clinical data is not needed for gloves or for most devices cleared by the 510 (K) process.
- (9) Non-clinical data
We certify that our final finished powder free latex examination gloves meet or exceed the ASTM D 3578-05 Standard.
Meets FDA pin hole requirement. Meets labeling claim.
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Image /page/2/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS). The seal features an eagle-like emblem with three stylized lines representing the agency's mission. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the emblem.
Public Health Service
NOV - 8 2005
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
PT. Shamrock Manufacturing Corporation C/O Ms. Emmy Tjoeng Official Correspondent Shamrock Marketing Company, Incorporated 5445 Daniels Street Chino, California 91710
Re: K052709
Trade/Device Name: Powder Free Latex Examination Gloves Regulation Number: 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LLY Dated: November 2, 2005 Received: November 2, 2005
Dear Ms. Tjoeng:
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 - Ms. Tjoeng
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 vour 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/cdrh/industry/support/index.html.
Sincerely yours,
C. Lin, Ph.D.
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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INDICATION FOR USE
: PT. Shamrock Manufacturing Corpora Applicant
510(k) Number (if known):
: Powder Free Latex Examination Gloves Device Name
:
Indication for use
A patient examination glove is a disposable device intended for medical purpose that is worn on examiner's hand to prevent contamination between 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)
Shuley M. Humphrey D. "0/05
n Sim-Cff) of Anasthesiology, General Hospital, on Control, Dental Devices
Number. K252709
§ 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.