K Number
K071746
Date Cleared
2007-12-13

(169 days)

Product Code
Regulation Number
878.4460
Reference & Predicate Devices
N/A
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

These gloves are intended to be worn by operating room personnel to protect a surgical wound from contamination.

Device Description

Derma Prene® PI or Isotouch® Green Sterile Powder-Free Synthetic Polyisoprene Surgical Gloves meet all of the requirements of ASTM D 3577-06, Type 2.
Derma Prene® PI or Isotouch® Green Sterile Powder-Free Synthetic Polyisoprene Surgical Gloves meet all of the current specifications of ASTM D 3577-06, Type 2.
Derma Prene® PI or Isotouch® Green Sterile Powder-Free Synthetic Polyisoprene Surgical Gloves are sterile disposable devices intended to be worn by operating room personnel to protect a surgical wound from contamination.
Derma Prene® PI or Isotouch® Green Sterile Powder-Free Synthetic Polyisoprene Surgical Gloves are summarized with the following technological characteristics compared to ASTM or equivalent standards.
Characteristics: Dimensions, Physical Properties, Freedom from Holes, Powder Free
Standard: Meets ASTM D 3577, Meets ASTM D 3577, Type 2, Meets ASTM D 3577, Meets ASTM D 5151, Meets ASTM D 6124
Powder content = 2 mg per glove

AI/ML Overview

This document describes the acceptance criteria and the study that proves the device meets those criteria for the Ansell Derma Prene® PI or Isotouch® Green Sterile Powder-Free Synthetic Polyisoprene Surgical Gloves.

1. Table of acceptance criteria and the reported device performance

CharacteristicsAcceptance Criteria (Standard)Reported Device Performance
DimensionsMeets ASTM D 3577Meets ASTM D 3577
Physical PropertiesMeets ASTM D 3577, Type 2Meets ASTM D 3577, Type 2
Freedom from HolesMeets ASTM D 3577 and ASTM D 5151Meets ASTM D 3577 and ASTM D 5151
Powder FreeMeets ASTM D 6124Powder content = ≤ 2 mg per glove (Meeting ASTM D 6124)
FHSA Skin Irritation StudyPassesPasses
ISO Maximization Sensitization StudyPassesPasses
Cytotoxicity Study using the End-Point Titration MethodNon-ToxicNon-Toxic at 24 hours

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

The document does not specify the exact sample sizes used for each test (e.g., freedom from holes, physical properties, biocompatibility). However, it indicates that the tests conform to established ASTM and ISO standards, which typically include defined sampling plans. The data provenance is not explicitly stated in terms of country of origin or whether it was retrospective or prospective. It is implied to be laboratory testing conducted by the manufacturer or a certified lab to demonstrate compliance with the specified 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. The ground truth for this device is established through adherence to physical and performance standards (ASTM, ISO, FDA hole requirements) rather than expert consensus on interpretive data (like imaging studies).

4. Adjudication method for the test set

This information is not applicable. Adjudication methods like 2+1 or 3+1 are typically used for studies involving human interpretation (e.g., medical image analysis) to resolve discrepancies among experts. For this device, objective measurements against established standards determine compliance.

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

An MRMC comparative effectiveness study was not applicable and not done. This device is a surgical glove, and its performance is evaluated based on physical properties, freedom from defects, and biocompatibility, not on human interpretive tasks or AI assistance.

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

A standalone (algorithm-only) performance evaluation was not applicable and not done. This device is a physical product (surgical glove), not an algorithm or AI-driven system.

7. The type of ground truth used

The ground truth used for this device is based on established standard specifications and laboratory testing outcomes. This includes:

  • ASTM Standards: Defined dimensional, physical property, and hole specifications provided by ASTM D 3577 and ASTM D 5151.
  • ISO Standards: Biocompatibility testing protocols from ISO.
  • FDA Hole Requirements: Specific defect rate criteria mandated by the FDA.
  • Industry Standards: Powder content standards as specified by ASTM D 6124.

8. The sample size for the training set

This information is not applicable. This device is a physical product, not a machine learning model, so there is no "training set."

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

This information is not applicable, as there is no training set for this device.

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

K071746

Ansell

[1] 510(k) SUMMARY

  • [2] Ansell Healthcare Products LLC 1635 Industrial Road Dothan, AL 36303

DEC 1 3 2007

Contact:Lon D. McIlvainVice President, Regulatory and Quality Affairs, Global
Telephone:(334) 615-2562
Fax:(334) 615-2568

June 25, 2007

  • Derma Prene® PI or Isotouch® Green Sterile Powder-Free . [3] Trade Name: Synthetic Polyisoprene Surgical Gloves
    Common Name: Surgical Gloves

Classification Name: Surgeon's Gloves, powder-free (21 CFR §878.4461 proposed)

  • [4] Derma Prene® PI or Isotouch® Green Sterile Powder-Free Synthetic Polyisoprene Surgical Gloves meet all of the requirements of ASTM D 3577-06, Type 2.
  • [5] Derma Prene® PI or Isotouch® Green Sterile Powder-Free Synthetic Polyisoprene Surgical Gloves meet all of the current specifications of ASTM D 3577-06, Type 2.
  • Derma Prene® PI or Isotouch® Green Sterile Powder-Free Synthetic Polyisoprene [6] Surgical Gloves are sterile disposable devices intended to be worn by operating room personnel to protect a surgical wound from contamination.
  • [7] Derma Prene® PI or Isotouch® Green Sterile Powder-Free Synthetic Polyisoprene Surgical Gloves are summarized with the following technological characteristics compared to ASTM or equivalent standards.
CharacteristicsStandard
DimensionsPhysical PropertiesMeets ASTM D 3577Meets ASTM D 3577, Type 2
Freedom from HolesMeets ASTM D 3577Meets ASTM D 5151
Powder FreeMeets ASTM D 6124

IS AS I M D 0 Powder content = 2 mg per glove

{1}------------------------------------------------

Biocompatibility:

[8]

FHSA Skin Irritation Study ISO Maximization Sensitization Study Cytotoxicity Study using the End-Point Titration Method

Passes Passes

Non-Toxic at 24 hours

The performance test data of the non-clinical tests are the same as mentioned immediately above.

  • Clinical data is not needed for medical gloves or for most devices cleared by the [9] 510(k) process.
    It is concluded that Derma Prene® PI or Isotouch® Green Sterile Powder-Free (10) Synthetic Polyisoprene Surgical Gloves are as safe, as effective, and perform as well as the glove performance standards referenced in Section 7 above and therefore meet:

ASTM listed standards, FDA hole requirements, and labeling claims for the product.

  • This summary will include any other information reasonably deemed necessary by the [1] FDA.

{2}------------------------------------------------

Image /page/2/Picture/2 description: The image shows the seal of the Department of Health and Human Services. The seal features an eagle-like symbol with three curved lines representing its body and wings. The text "DEPARTMENT OF HEALTH AND HUMAN SERVICES, USA" is arranged in a circular pattern around the symbol.

DEC 1 3 2007

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Ansell Healthcare Products, LLC Ms. Cynthia A. Ingram Regulatory Affairs Manager, Americas 1635 Industrial Road Dothan, Alabama 36303

Re: K071746

Trade/Device Name: Derma Prene® PI or Isotouch® Green Sterile Powder-Free Synthetic Polyisoprene Surgical Gloves Regulation Number: 21 CFR 878.4460 Regulation Name: Surgeon's Glove Regulatory Class: I Product Code: KGO Dated: November 29, 2007 Received: November 30, 2007

Dear Ms. Ingram:

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.

{3}------------------------------------------------

Page 2 - Ms. Ingram

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), 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,

Chris Liu, 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

{4}------------------------------------------------

INDICATIONS FOR USE

510(K) Number (if known):

Device Name:

Derma Prene® PI or Isotouch® Green Sterile Powder-Free Synthetic Polyisoprene Surgical Gloves

Indications For Use:

These gloves are intended to be worn by operating room personnel to protect a surgical wound from contamination.

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)

Stele H. Murphy, MD
(Division Sign-Off)

Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number:

-10-

§ 878.4460 Non-powdered surgeon's glove.

(a)
Identification. A non-powdered surgeon's glove is a device intended to be worn on the hands of operating room personnel to protect a surgical wound from contamination. A non-powdered surgeon's 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).