K Number
K081027
Date Cleared
2008-06-30

(81 days)

Product Code
Regulation Number
880.6250
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Kimberly-Clark* STERLING Nitrile Powder-Free Exam Glove, Sterile, is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

Based upon 21CFR§880.6250 "Patient examination glove" Use: A patient examination glove is a medical device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

Device Description

Light gray nitrile, chlorinated, powder-free, sterile, textured fingertip, ambidextrous patient examination glove

AI/ML Overview

The Kimberly-Clark* Sterile STERLING* Nitrile Powder-Free Exam Glove (K081027) is a patient examination glove. The following information details its acceptance criteria and the study that proves the device meets these criteria:

1. A table of acceptance criteria and the reported device performance

The acceptance criteria for this device are based on compliance with several ASTM and ISO standards for properties typical of patient examination gloves. The device's performance is reported as meeting these requirements based on non-clinical tests.

Acceptance CriteriaStandardReported Device Performance
DimensionsASTM D 6319-00aMeets the standard
Physical PropertiesASTM D 6319-00aMeets the standard
Freedom from pinholesASTM D 6319-00aMeets the standard AQL (Acceptable Quality Level) of 2.5 for freedom from pinholes, as defined in ASTM D 5151-06.
Powder FreeASTM D 5151-06Meets the standard. The device is distinctly labeled as "Powder-Free."
SterilityASTM D 6124-06; ISO 11137-2Meets the sterility requirements. The device is specified as "sterile" and sterilized by gamma irradiation.
ISO Skin Irritation StudyISO 10993, Part 10Meets the standard. No significant skin irritation observed.
Murine Local Lymph Node AssayISO 10993, Part 10Meets the standard. No sensitization potential observed.
ISO Systemic Toxicity StudyISO 10993, Part 11Meets the standard. No systemic toxicity observed.

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

The document does not specify the exact sample sizes for each non-clinical test. The data provenance is derived from internal non-clinical laboratory and animal-based biocompatibility tests conducted by Kimberly-Clark Corporation to confirm compliance with established standards. The data is retrospective in the sense that it pertains to the product being submitted for 510(k) clearance, reflecting the outcome of these tests.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable. The ground truth for this device is established through compliance with recognized industry standards (ASTM and ISO) for physical properties, sterility, and biocompatibility. These standards define the objective measures for performance, rather than requiring expert consensus for a "ground truth" in the diagnostic sense.

4. Adjudication method for the test set

Not applicable. As the evaluation relies on objective measurements against established standards, an adjudication method in the context of expert review is not required. The results of the non-clinical tests are directly compared to the specified limits of the standards.

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

Not applicable. This device is a sterile patient examination glove and does not involve AI assistance or human-reader interpretations.

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

Not applicable. This device is a physical medical device and does not involve an algorithm.

7. The type of ground truth used

The ground truth is established through objective measurements compared against published national and international standards (ASTM, ISO) for physical properties, sterility, and biocompatibility. For example, for "Freedom from pinholes," the ground truth is defined by the AQL (Acceptable Quality Level) of 2.5 specified in ASTM D 5151-06.

8. The sample size for the training set

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

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

Not applicable. As there is no training set, this question is not relevant.

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K081027

දිවූ Kimberly-Clark Corporation

Abbreviated 510(k) for Kimberly-Clark* Sterile STERLING* Nitrile Powder-Free Exam Glove

Section 5. 510(k) SUMMARY

JUN 3 0 2008

SUMMARY OF SAFETY AND EFFECTIVENESS INFORMATION

Submitter's Name:Kimberly-Clark Corporation
Submitter's Address:1400 Holcomb Bridge RoadRoswell, GA 30076-2199
Submitter's Phone No:770-587-8208
Submitter's Fax No.920-969-5160
Date of Preparation:April 9, 2008
Trade Name:Kimberly-Clark* Sterile STERLING* Nitrile Powder-Free Exam Glove
Common Name:Patient examination glove
Classification Name:Glove, Patient Examination, Poly - 80 LZA
Legally marketed deviceto which equivalency isclaimed:• Kimberly-Clark* STERLING* Nitrile Powder-Free Exam Glove (K051347)• Kimberly-Clark* PURPLE NITRILE* Powder-Free Exam Glove, Sterile(K992062)
Description of the device:Light gray nitrile, chlorinated, powder-free, sterile, textured fingertip,ambidextrous patient examination glove
Intended use of device:The Kimberly-Clark* STERLING Nitrile Powder-Free Exam Glove, Sterile,is a disposable device intended for medical purposes that is worn on theexaminer's hand to prevent contamination between patient and examiner.
Summary of technologicalcharacteristics comparedto predicate device:There are no different technological characteristics compared to the predicatedevices. They are all chlorinated, powder-free nitrile gloves. This specificglove is gray in color, packaged in pairs in packaging to maintain sterility andsterilized by gamma irradiation.

Page 1 of 2 - Section 5 510(k) Summary

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K081027

Image /page/1/Picture/1 description: The image shows the Kimberly-Clark Corporation logo. The logo consists of a circular symbol with a stylized "K" inside, followed by the text "Kimberly-Clark Corporation" in a bold, sans-serif font. The text is aligned horizontally to the right of the symbol.

Abbreviated 510(k) for Kimberly-Clark* Sterile STERLING* Nitrile Powder-Free Exam Glove ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Brief description of Non-Clinical Tests:Non-Clinical TestsDimensionsPhysical PropertiesFreedom from pinholesPowder FreeSterilityISO Skin Irritation StudyMurine Local Lymph Node AssayISO Systemic Toxicity StudyStandardASTM D 6319-00aASTM D 6319-00aASTM D 6319-00aASTM D 5151-06ASTM D 6124-06ASTM D 6319-00aISO 11137-2ISO 10993, Part 10ISO 10993, Part 10ISO 10993, Part 11
Brief description of Clinical Tests:No new clinical tests were required to support this 510(k) application.
Conclusions drawn from the Non-Clinical and Clinical Tests:Non-clinical laboratory and animal based biocompatibility test data confirm the Kimberly-Clark* STERLING* Nitrile Powder-Free Exam Glove, Sterile, meets all applicable performance and biocompatibility requirements.
Other Information deemed necessary by the FDA:None

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Image /page/2/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features a stylized eagle with its wings spread, symbolizing protection and service. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUN 3 0 2008

Mr. Richard V. Wolfe Associate Director, Regulatory Affairs Kimberly-Clark Corporation 1400 Holcomb Bridge Road Roswell, Georgia 30076

Re: K081027

Trade/Device Name: KIMBERLY-CLARK* Sterile STERLING* Nitrile Powder-Free Exam Glove Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LZA Dated: June 18, 2008 Received: June 20, 2008

Dear Mr. Wolfe:

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 -Mr. Wolfe

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 (OS) 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 (301) 594-4618. 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/dsma/dsmamain.html

Sincerely yours,

signature

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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K081027

3 Kimberly-Clark Corporation

INDICATIONS FOR USE

Kimberly-Clark Corporation Applicant:

510(k) Number:

Device Name:

KIMBERLY-CLARK* Sterile STERLING* Nitrile Powder-Free Exam Glove

Indications for Based upon 21CFR§880.6250 "Patient examination glove" Use:

A patient examination glove is a medical device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

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

Concurrence of CDRH Office of Device Evaluation (ODE)

Prescription UsePer 21CFR 801.109 Subpart DOROver-The-CounterPer 21CFR 801.109 Subpart C X
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(Division Sign-Off)

Division of Anesthesiology, General Hospital

Infection Control, Dental Devices

510(k) Number:K081027
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§ 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.