K Number
K083305
Device Name
POWDER FREE NITRILE EXAMINATION GLOVES, STERILE WITH CHEMOTHERAPY CLAIM
Date Cleared
2009-06-18

(220 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The powder free chemotherapy examination glove is a specialty medical glove which is a disposable device intended for medical purposes that is worn on the examiner's hand or forefinger to prevent contamination between examiner and patient bodily fluids, waste or environment. Tested for use with chemotherapy drugs. Tested chemotherapy drugs are as follows [Cyclophosphamide, Dacarbazine, Doxorubicin Hydrochloride; 5-Fluorouracil, Cisplatin, Etoposide, Vincristine Sulfate and Paclitaxel] WARNING: DO NOT USE GLOVES WITH CARMUSTINE OR THIO-TEPA
Device Description
Powder Free Blue Nitrile Examination Gloves, Sterile with Chemotherapy Claim meet all the requirements of ASTM standard D6978-05, D5712-0562 and FDA 21 CFR 880.6250.
More Information

Not Found

No
The device is a chemotherapy examination glove, and the description focuses on its physical properties, material, and resistance to chemotherapy drugs, with no mention of AI or ML.

No.
The device is described as an examination glove intended to prevent contamination, which serves as a barrier rather than providing a therapeutic effect.

No

The device is a chemotherapy examination glove, intended to prevent contamination between the examiner and patient bodily fluids. It is a protective barrier, not a tool for diagnosing medical conditions.

No

The device is a physical glove, not software. The description clearly outlines its material (nitrile), physical properties, and performance testing related to its function as a barrier.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Definition of IVD: An In Vitro Diagnostic device is a medical device that is used to perform tests on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. These tests are performed outside of the body (in vitro).
  • Intended Use: The intended use of this device is clearly stated as a "specialty medical glove which is a disposable device intended for medical purposes that is worn on the examiner's hand or forefinger to prevent contamination between examiner and patient bodily fluids, waste or environment." This is a barrier device used on the body (or on the examiner's hand) for protection, not for testing samples.
  • Device Description: The description confirms it's a "Powder Free Blue Nitrile Examination Gloves." This is a physical barrier, not a diagnostic tool.
  • Lack of Diagnostic Function: There is no mention of the device being used to analyze samples, detect biomarkers, or provide any diagnostic information about a patient's health status. The testing mentioned is for the glove's performance as a barrier against chemotherapy drugs.

In summary, this device is a medical glove intended for protection and barrier purposes, not for performing diagnostic tests on samples.

N/A

Intended Use / Indications for Use

The powder free chemotherapy examination glove is a specialty medical glove which is a disposable device intended for medical purposes that is worn on the examiner's hand or forefinger to prevent contamination between examiner and patient bodily fluids, waste or environment. Tested for use with chemotherapy drugs. Tested chemotherapy drugs are as follows [Cyclophosphamide, Dacarbazine, Doxorubicin Hydrochloride; 5-Fluorouracil, Cisplatin, Etoposide, Vincristine Sulfate and Paclitaxel]

WARNING: DO NOT USE GLOVES WITH CARMUSTINE OR THIO-TEPA

Product codes

LZC

Device Description

Powder Free Blue Nitrile Examination Gloves, Sterile with Chemotherapy Claim meet all the requirements of ASTM standard D6978-05, D5712-0562 and FDA 21 CFR 880.6250.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

examiner’s hand or forefinger

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

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 Powder Free Blue Nitrile Examination Gloves, Sterile with Chemotherapy Claim are summarized with the following technological characteristics compared to ASTM D3578-01E1 or equivalent standards.

CHARACTERISTICS: Dimensions; STANDARDS: ASTM D6319-00a (2005) e-1; DEVICE PERFORMANCE: Meets
CHARACTERISTICS: Physical Properties; STANDARDS: ASTM D6319-00a (2005) e-1; DEVICE PERFORMANCE: Meets
CHARACTERISTICS: Thickness; STANDARDS: ASTM D6319-00a (2005) e-1; DEVICE PERFORMANCE: Meets
CHARACTERISTICS: Powder Free; STANDARDS: ASTM D6124-01; DEVICE PERFORMANCE: Meets ≤ 2 mg/glove
CHARACTERISTICS: Biocompatability: Primary Skin Irritation; STANDARDS: ASTM F-720-81; DEVICE PERFORMANCE: Passes (Not a primary skin irritant)
CHARACTERISTICS: Biocompatability: Dermal Sensitization; STANDARDS: ASTM F-720-81; DEVICE PERFORMANCE: Passes (Not a contact sensitizer)
CHARACTERISTICS: Watertight (1000ml); STANDARDS: ASTM D5151-06; DEVICE PERFORMANCE: Passes
CHARACTERISTICS: *Resistance to permeation by Chemotherapy Drugs; STANDARDS: ASTM D6978-05; DEVICE PERFORMANCE: Meets requirement
CHARACTERISTICS: Sterile; STANDARDS: Gamma Irradiated; DEVICE PERFORMANCE: Sterile (Dose Validation Report Attached)

Test Chemical and Concentration: *Dacarbazine 10mg/ml; Average breakthrough Detection Time (minutes): >240
Test Chemical and Concentration: Cyclophosphamide (Cytoxan) 20mg/ml; Average breakthrough Detection Time (minutes): >240
Test Chemical and Concentration: Doxorubicin Hydrochloride 2mg/ml; Average breakthrough Detection Time (minutes): >240
Test Chemical and Concentration: *5-Flourouracil 50mg/ml; Average breakthrough Detection Time (minutes): >240
Test Chemical and Concentration: Cisplatin 1mg/ml; Average breakthrough Detection Time (minutes): >240
Test Chemical and Concentration: Etopside (Toposar) 20mg/ml; Average breakthrough Detection Time (minutes): >240
Test Chemical and Concentration: Paclitaxel (Taxol) 6mg/ml; Average breakthrough Detection Time (minutes): >240
Test Chemical and Concentration: Vincristine Sulfate 1mg/ml; Average breakthrough Detection Time (minutes): >240

Sterility:

  • Product is labeled as sterile.
  • Sterilization is achieved through gamma irradiation.
  • SAL: 10-6.
  • Method Used to validate sterilization cycle: Method 1 (ANSI/AAMI/ISO 11137) Sterilization of healthcare products ~ Radiation sterilization
  • Radiation dose: Minimum 25kGy, Maximum 45kGy.

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

Not Found

Predicate Device(s)

K993313

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.

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Submitter:

K083305

JUN 18 2009

Name: Mr. Kirk Penner Address: WRP Asia Pacific Sdn Bhd Lot 1, Jalan 3, Kawasan Perusahaan Bandar Baru Salak Tinggi, 43900 Sepang, Selangor Darul Ehsan, MALAYSIA Phone No.: +60 3 8706 1486 +60 3 8706 1485 Fax No.:

Date of Summary Prepared: Nov 2008

2.0 Name of the device:

Powder Free Blue Nitrile Examination Gloves, Sterile with Chemotherapy Claim

Common Name: Exam Gloves

Classification Name: Patient Examination Gloves, Specialty Chemotherapy (21 CFR 880.6250 product code LZC)

510(K) Number: K083305

3.0 Identification of The Legally Marketed Devices that equivalency is claimed:

Powder-Free Blue Nitrile Examination Glove, Sterile

Company: WRP ASIA PACIFIC SDN BHD 510(k): K993313

4.0 Description of The Device:

Powder Free Blue Nitrile Examination Gloves, Sterile with Chemotherapy Claim meet all the requirements of ASTM standard D6978-05, D5712-0562 and FDA 21 CFR 880.6250.

5.0 Intended Use of the Device:

The powder free chemotherapy examination glove is a specialty medical glove which is a disposable device intended for medical purposes that is worn on the examiner's hand or forefinger to prevent contamination between examiner and patient bodily fluids, waste or environment. Tested for use with chemotherapy drugs. Tested chemotherapy drugs are as follows [Cyclophosphamide, Dacarbazine, Doxorubicin Hydrochloride; 5-Fluorouracil, Cisplatin, Etoposide, Vincristine Sulfate and Paclitaxel]

WARNING: DO NOT USE GLOVES WITH CARMUSTINE OR THIO-TEPA

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510(k) SUMMARY

Summary of the Technological Characteristics of the Device: 6.0

The Powder Free Blue Nitrile Examination Gloves, Sterile with Chemotherapy Claim are summarized with the following technological characteristics compared to ASTM D3578-01E1 or equivalent standards.

| CHARACTERISTICS | STANDARDS | DEVICE PERFORMANCE
(Both Predicate and
Current) |
|----------------------------------------------------|---------------------------------------------------------------------|---------------------------------------------------------------------------------|
| Dimensions | ASTM D6319-00a
(2005) e-1 | Meets |
| Physical Properties | ASTM D6319-00a
(2005) e-1 | Meets |
| Thickness | ASTM D6319-00a
(2005) e-1 | Meets |
| Powder Free | ASTM D6124-01 | Meets
≤ 2 mg/glove |
| Biocompatability | Primary Skin
Irritation
Dermal Sensitization
ASTM F-720-81 | Passes
(Not a primary skin irritant)
Passes
(Not a contact sensitizer) |
| Watertight (1000ml) | ASTM D5151-06 | Passes |
| *Resistance to permeation
by Chemotherapy Drugs | ASTM D6978-05 | Meets requirement |
| Sterile | Gamma Irradiated | Sterile (Dose Validation Report
Attached ) |

Details and discussions of tests can be found in performance section

| *Test Chemical and Concentration | Average
breakthrough
Detection Time
(minutes) |
|------------------------------------|--------------------------------------------------------|
| *Dacarbazine 10mg/ml | >240 |
| Cyclophosphamide (Cytoxan) 20mg/ml | >240 |
| Doxorubicin Hydrochloride 2mg/ml | >240 |
| *5-Flourouracil 50mg/ml | >240 |
| Cisplatin 1mg/ml | >240 |
| Etopside (Toposar) 20mg/ml | >240 |
| Paclitaxel (Taxol) 6mg/ml | >240 |
| Vincristine Sulfate 1mg/ml | >240 |

WARNING: DO NOT USE GLOVES WITH CARMUSTINE OR THIO-TEPA

2

510(k) SUMMARY

Sterility:

  • Product is labeled as sterile. .
  • . Sterilization is achieved through gamma irradiation.
  • SAL: 10-6 .
  • Method Used to validate sterilization cycle: Method 1 (ANSI/AAMI/ISO 11137) . Sterilization of healthcare products ~ Radiation sterilization
  • Radiation dose: Minimum 25kGy, Maximum 45kGy .

Sterilizer: Sterilgamma (M) Sdn Bhd Lot 42, Rawang Integrated Industrial Park 48000 Rawang, Selangor . Malaysia

7.0 Substantial Equivalent 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.

8.0 Substantial Equivalent Based on Assessment of Clinical Performance Data

Clinical data is not needed for gloves or for most devices cleared by the 510(k) process.

9.0 Conclusion

. .

Powder Free Blue Nitrile Examination Gloves, Sterile with Chemotherapy Claim will perform according to the gloves performance standards referenced in section 6,0 above and meet ASTM standards, and FDA requirements for water leak test on pinhole AQL. Consequently, the device is substantially equivalent to currently marketed devices.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized caduceus symbol, which is a staff with two snakes coiled around it, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES.USA" arranged in a circular fashion around the symbol. The text is in all caps and appears to be in a sans-serif font.

Public Health Service

JUN 18 2009

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Kirk Penner Head of Department, Regulatory Affairs WRP Asia Pacific Sdn. Bhd. Lot 1, Jalan 3, Kawasan Perusahaan Bandar Baru Salak Tinggi, Sepang Selangor MALAYSIA 43900

  • Re: K083305
    Trade/Device Name: Powder Free Blue Nitrile Examination Gloves, Sterile with

Chemotherapy Claim Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LZC Dated: June 12, 2009 Received: June 16, 2009

Dear Mr. Penner:

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 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. Penner

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for vour 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 the reporting of adverse events under the MDR regulation (21 CFR Part 803), please contact the CDRH/Office of Surveillance and Biometrics/Division of Postmarket Surveillance at 240-276-3464. For more information regarding the reporting of adverse events, please go to http://www.fda.gov/cdrh/mdr/.

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 yours,

Anthony D. antonber

Susan Runner, D.D.S., M.A. Acting 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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Image /page/5/Picture/0 description: The image shows a logo with the letters "WRP" in bold, sans-serif font. To the left of the letters is a stylized graphic that resembles a "W" formed by three curved, ribbon-like shapes. The logo is black and white, with the graphic having a textured appearance due to the black and white contrast.

Appendix G

WRP Asia Pacific Sdn Bhd

Lot 1, Jalan 3, Kawasan Perusahaan Bandar Baru Salak Tinggi, 43900 Sepang. Selangor Darul Ehsan, MALAYSIA

Office +60-3-8706 1486 Facsimile +60-3-8706 1557 Email customer_wrp@wrpworld.com Website www.wrpworld.com

Indications for Use

510(k) Number (if known): K083305

Applicant Name: WRP ASIA PACIFIC SDN BHD

Device Name:

Powder Free Blue Nitrile Examination Gloves, Sterile with Chemotherapy Claim

Indications for Use:

The powder free chemotherapy examination glove is a specialty medical glove which is a disposable device intended for medical purposes that is worn on the examiner's hand or forefinger to prevent contamination between examiner and patient bodily fluids, waste or environment. Tested for use with chemotherapy drugs. Tested chemotherapy drugs are as follows [Cyclophosphamide, Dacarbazine, Doxorubicin Hydrochloride; 5-Fluorouracil, Cisplatin, Etoposide, Vincristine Sulfate and Paclitaxel]

WARNING: DO NOT USE GLOVES WITH CARMUSTINE OR THIO-TEPA

Prescription Use NO (Part 21 CFR 801 Subpart D)

AND/OR

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Shula A. Murphy
(Division Sign-Off)

Division of Anesthesiology, General Hospital Infection Control, Dental Devices

Page 1

510(k) Number: K083305

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