K Number
K081907
Device Name
NON-STERILE, POWDER FREE LATEX EXAMINATION GLOVES WITH POLYMER COATING AND PROTEIN CLAIM (50 MICROGRAMS OR LESS)
Date Cleared
2008-09-03

(62 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 examiner's hand or finger to prevent contamination between patient and examiner.
Device Description
Non-Sterile, powder-free latex examination gloves with polymer coating and protein claim (50 micrograms or less)
More Information

Not Found

No
The device is a simple examination glove and the summary contains no mention of AI, ML, or any related technologies.

No.
The device is a patient examination glove, intended to prevent contamination between patient and examiner, not to provide therapy or treatment.

No
This device is a patient examination glove, which is a barrier device used to prevent contamination, not to diagnose a condition.

No

The device is a physical examination glove, which is a hardware medical device, 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 examiner's hand or finger to prevent contamination between patient and examiner." This describes a barrier device used for protection during physical examination, not a device used to examine specimens derived from the human body for diagnostic purposes.
  • Device Description: The description focuses on the physical characteristics of the glove (latex, powder-free, polymer coating, protein claim). This aligns with a physical barrier device.
  • Lack of IVD Characteristics: There is no mention of:
    • Analyzing samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in samples
    • Providing diagnostic information about a patient's health status
    • Any form of in vitro testing

IVD devices are specifically designed to perform tests on samples taken from the body to help diagnose diseases or conditions. This glove's function is purely as a physical barrier.

N/A

Intended Use / Indications for Use

This device is a disposable device intended for medical purpose that is worn on the examiner 's hand to prevent contamination between patient and examiner.
A 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.

Product codes

LYY

Device Description

Non-Sterile, powder-free latex examination gloves with polymer coating and protein claim (50 micrograms or less)

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

hand or finger

Indicated Patient Age Range

Not Found

Intended User / Care Setting

examiner / medical purposes

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 performance test data of the non-clinical tests that support a determination of substantial equivalence is the same as mentioned immediately above.
Summary of The Technological Characteristics of The devices :
Non-Sterile, powder-free latex examination gloves with polymer coating and protein claim (50 micrograms or less) are summarized with the following technological characteristics compared to ASTM or equivalent standards.

CHARACTERISTICSSTANDARDSDEVICE PERFORMANCE
DimensionsASTM D 3578-05Meets
Physical PropertiesASTM D 3578-05Meets
Freedom from pinholesASTM D 3578-05Meets
Powder Free ResidueASTM D 3578-05Meets
Protein LevelASTM D 3578-05Meets
BiocompatabilityPrimary Skin Irritation in Rabbits
Guinea Pig SensitizationPasses
Passes

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

Not Found

Predicate Device(s)

K970794

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

SEP - 3 2008

510 (k) Summary

As Required by 21 section 807.92 ( c)

    1. Submitter Name: Siam Sempermed Corp., Ltd
  • 352 Kanjanavanit Road. Pahtong Hatyai 2. Address: Songkhla.Thailand 90230
  • (+66) 74 291 471 3. Phone:
    1. Fax: (+66) 74 471 337
    1. Contract Person: Mrs. Parawan Paiyasan (Quality System manager)
  • Date summary prepared: June 20, 2008 6.
    1. Official Correspondent: Sempermed USA Inc.
  • 13900 49th Street North 8. Address:
  • Clearwater, USA , FL 33762
  • 727 787 7250 9. Phone:
  • 727 787 7558 10. Fax:
  • Mr. William E. Harris 11. Contact person:
    1. Device Trade or Proprietary Name: Non-sterile, powder-free latex examination gloves with polymer coating and protein claim (50 micrograms or less).
    1. Device Common or usual name: Examination glove
    1. Device Classification Name: Glove , Patient Examination , Latex

15. Description of the Device:

Non-Sterile, powder-free latex examination gloves with polymer coating and protein claim (50 micrograms or less)

16. Intended use of the device:

This device is a disposable device intended for medical purpose that is worn on the examiner 's hand to prevent contamination between patient and examiner.

17. Summary of The Technological Characteristics of The devices :

Non-Sterile, powder-free latex examination gloves with polymer coating and protein claim (50 micrograms or less) are summarized with the following technological characteristics compared to ASTM or equivalent standards.

CHARACTERISTICSSTANDARDSDEVICE PERFORMANCE
DimensionsASTM D 3578-05Meets
Physical PropertiesASTM D 3578-05Meets
Freedom from pinholesASTM D 3578-05Meets
Powder Free ResidueASTM D 3578-05Meets
Protein LevelASTM D 3578-05Meets
BiocompatabilityPrimary Skin Irritation in Rabbits
Guinea Pig SensitizationPasses
Passes

1

K081907
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18. Substantial Equivalents Based on Assessment of Non-Clinical Performance Data

The performance test data of the non-clinical tests that support a determination of substantial equivalence is the same as mentioned immediately above.

19. Conclusion

It can be concluded that Non-Sterile, powder-free latex examination gloves with polymer coating and protein claim (50 micrograms or less) will perform according to the glove performance standards referenced in section 17 above and meet ASTM standards, and FDA requirements. Consequently, this device is substantially equivalent to currently marketed device is safe and effective as the predicate device Siam Sempermed Latex Examination Glove , Powder free. Indeed , it is equivalent This is better expressed in the tabulated comparison as below.

Technical comparison of specific elements is attached in the main submission.

FDA file reference number510k number: K970794
Attachments inside notification
submission fileREFER TO APPENDIX 1
TECHNOLOGICAL
CHARACTERISTICSComparison result
REFER TO ADDITIONAL TECHNICAL
COMPARATIVE TABLE WITHIN 510K
SUBMISSION
Indications for useIdentical
Target populationIdentical
DesignIdentical
MaterialsIdentical
PerformanceIdentical
SterilityNot applicable
BiocompatibilityIdentical
Mechanical safetyIdentical
Chemical safetyIdentical
Anatomical sitesIdentical
Human factorsIdentical
Energy used and/or deliveredIdentical (Not applicable)
Compatibility with environment
and other devicesIdentical
Where usedIdentical
Standards metIdentical
Electrical safetyIdentical (Not applicable)
Thermal safetyIdentical (Not applicable)
Radiation safetyIdentical (Not applicable)

2

Public Health Service

Image /page/2/Picture/2 description: The image shows the seal of the Department of Health & Human Services - USA. The seal features a stylized caduceus, a symbol often associated with medicine and healthcare, with three intertwined strands. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the symbol.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

SEP - 3 2008

Siam Sempermed Corporation, Limited C/O Mr. William E. Harris President and Chief Executive Officer Sempermed USA, Incorporated 13900 49th Street North Clearwater, Florida 33762

Re: K081907

Trade/Device Name: Non-Sterile, Powder Free Latex Examination Gloves with Polymer Coating and Protein Claim (50 Micrograms or Less) Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LYY Dated: August 26, 2008 Received: August 29, 2008

Dear Mr. Harris:

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 - Mr. Harris

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 Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. 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 (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely vours.

J.A. Schmieder, md forell

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):

KO81907

Device Name: Non-Sterile, Powder-Free Latex Examination Gloves with Polymer Coating and Protein Claim (50 micrograms or less).

Indications For Use: A 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.

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)

Shule A. Murphy, MD
(Division Sign-Off)

Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number: K081907

Image /page/4/Picture/14 description: The image shows the word "CONFIDENTIAL" in all caps, with a handwritten "C2" to the right of the word. The word confidential is in a sans-serif font. The handwritten "C2" is in a cursive style.