K Number
K092617
Device Name
ROYAL GUARD
Date Cleared
2010-05-20

(267 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
This is a disposable device intended for medical application that is worn on the examiner's hand to prevent contamination between examiner and patient and to protect examiner from the following Chemotherapy drugs tested to ASTM D 6978 with the indicated Breakthrough Detection Times : Chemotherapy Drug Permeation (Breakthrough Detection Time) in Minutes. Nitrile Powder Free Examination Glove (Blue) * CAUTION: Testing showed average breakthrough time of 40.00minutes with Carmustine. Nitrile Powder Free Examination Glove (Green) * WARNING: DO NOT USE WITH CARMUTINE. Nitrile Powder Free Examination Glove (White) * CAUTION: Testing showed average breakthrough time of 48.00minutes with Thio-Tepa. * WARNING: DO NOT USE WITH CARMUTINE.
Device Description
Non Sterile. Powder-Free. Nitrile Examination for Use with Chemotherapy Drugs
More Information

510K 051333

Not Found

No
The device description and performance studies focus on the physical properties and chemical resistance of examination gloves, with no mention of AI or ML technologies.

No.
Explanation: The device is an examination glove designed to prevent contamination and protect the examiner, not to treat a medical condition or provide a therapeutic benefit to a patient.

No

The device is a medical glove designed for protection against contamination and chemotherapy drugs, not for diagnosing medical conditions.

No

The device is a physical glove made of nitrile, intended for medical application and worn on the hand. The description focuses on material properties, physical characteristics, and performance against chemotherapy drugs, all indicative of a hardware device. There is no mention of software functionality.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, or tissue) to detect diseases, conditions, or infections. These tests are performed outside the body (in vitro).
  • Device Function: The described device is a disposable glove worn on the hand. Its purpose is to create a physical barrier to prevent contamination and protect the examiner from chemotherapy drugs. It does not perform any diagnostic test on a patient sample.
  • Intended Use: The intended use clearly states it's for "medical application that is worn on the examiner's hand to prevent contamination between examiner and patient and to protect examiner from the following Chemotherapy drugs". This is a protective barrier function, not a diagnostic one.
  • Performance Metrics: The key performance metric is "Breakthrough Detection Time for Chemotherapy Drug Permeation". This relates to the glove's ability to resist penetration by chemicals, not its ability to detect or measure something in a biological sample.

The device is a medical device, specifically a protective barrier device (an examination glove), but it does not fit the definition of an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

This is a disposable device intended for medical application that is worn on the examiner's hand to prevent contamination between examiner and patient and to protect examiner from the following Chemotherapy drugs tested to ASTM D 6978 with the indicated Breakthrough Detection Times :

Product codes (comma separated list FDA assigned to the subject device)

LZA, LZC

Device Description

Non Sterile. Powder-Free. Nitrile Examination for Use with Chemotherapy Drugs

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

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 performance test data of the non-clinical tests that support a determination of substantial equivalence is the same as mentioned above in Section 15.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

510K 051333

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

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

K092617

SHUN THAI RUBBER GLOVES INDUSTRY PUBLIC COMPANY LIMI

9 Moo-4 Kached, Muang Rayong, RAYONG 21100, THAILAÑD Tel. (+66) 3863 4072-3, (+66) 3863 4816 FAX : (+66) 3863 4001,(+66)3863 4480

E-mail address: shunthai@shunthais.com

Highly Intend To Reply Your Satisfaction .......

510(k) Summary As Required by 21 Section 807.92 (c)

MAY 2 0 2010

'ﮨﮯ''

1.Submitter Name:Shun Thai Rubber Gloves Industry Public Company Limited
2.Address:9. Moo 4. Kached Muang. Rayong. Thailand 21100
3.Phone:(+66)38 634 4072
4.Fax:(+66)38 634 4001
5.Contact Person:Mr. Hew Seng Yeap ( Marketing Director)
6.Official Correspondent:Mr. Kok-Kee Hon
7.Address:6324 Meetinghouse Way
Alexandria. VA 22312. USA
8.Phone:703-941-7656
9.Fax:703-941-2551
10.Device Trade or Proprietary Name:Royal Guard Nitrile Examination Glove Tested For Use with
Chemotherapy Drugs
11.Device Common or Usual Name:Examination Glove
12.Device Classification Name:Nitrile Patient Examination Glove (Powder-Free)
13.Description of the Device:Non Sterile. Powder-Free. Nitrile Examination for Use with Chemotherapy Drugs
14.Intended Use of the Device:This is a disposable device intended for medical application that is worn on the
examiner's hand to prevent contamination between examiner and patient and to
protect examiner from the following Chemotherapy drugs tested to ASTM D 6978
with the indicated Breakthrough Detection Times :

Chemotherapy Drug Permeation (Breakthrough Detection Time) in Minutes.

Nitrile Powder Free Examination GloveBlueGreenWhite
*Carmustine (BCNU)40.0017.009.00
Cyclophosphamide (Cytoxan)> 240> 240> 240
Doxorubicin HCl (Adriamycin)>240> 240> 240
Etoposide (Toposar)>240> 240> 240
Fluorouracil>240> 240> 240
Paclitaxel (Taxol)>240> 240> 240
*Thio-Tepa177.0063.0048.00
Cisplatin>240> 240> 240
Dacarbazine (DTIC)>240> 240> 240

1

K092617

ﻟﻲ ﺍﻟﻤﺮﺍﺟﻊ

SHUN THAI

SHUN THAI RUBBER GLOVES INDUSTRY PUBLIC COMPANY LỊM

9 Moo-4 Kached, Muang Rayong, RAYONG 21100, THAILAÑD

Tel. (+66) 3863 4072-3, (+66) 3863 4816 FAX : (+66) 3863 4001,(+66)3863 4480

E-mail address: shunthai@shunthais.com

Highly Intend To Reply Your Satisfaction .......

Nitrile Powder Free Examination Glove (Blue)

  • CAUTION: Testing showed average breakthrough time of 40.00minutes with Carmustine.

Nitrile Powder Free Examination Glove (Green)

  • WARNING: DO NOT USE WITH CARMUTINE.

Nitrile Powder Free Examination Glove (White)

  • CAUTION: Testing showed average breakthrough time of 48.00minutes with Thio-Tepa.

  • WARNING: DO NOT USE WITH CARMUTINE.

    1. Summary of The Technological Characteristics of the Device: The following technological characteristics of the Device compared to ASTM or Equivalent Standards are summarized below
CHARACTERISTICSSTANDARDSDEVICE PREFORMANCE
DimensionsASTM D 6319-00a (2005)Meets
Physical PropertiesASTM D 6319-00a (2005)Meets
Freedom from HolesASTM D 6319-00a (2005)Meets
Powder-Free ResidueASTM D 6124-06Meets
BiocompatibilityPrimary Skin Irritation in RabbitsMeets
BiocompatibilityGuinea Pig SensitizationMeets
Chemotherapy Drug
PermationASTM D 6978-05See Breakthrough Time In
Section 14
    1. 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 above in Section 15.

17. Conclusion

It can be concluded that the Royal Guard Powder-Free Nitrile Examination Glove Tested For Use With Chemotherapy Drugs will perform to the glove performance standards referenced in Section 15 and meets the ASTM standards and FDA requirements. This device is therefore substantially equivalent to currently marketed devices. It is sale and effective as the predicate device 510K 051333 Powder-Free Nitrile Examination Glove.

I 8. Date Summary Prepared: July 10. 2009

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

Shun Thai Rubber Gloves Industry Public Company Limited C/O Mr. Kok-Kee Hon 6324 Meeting House Way Alexandria, Virginia 22312-1718

MAY 20 2010

Re: K092617

Trade/Device Name: Royal Guard Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LZA, LZC Dated: May 11, 2010 Received: May 14, 2010

Dear Mr. Hon:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

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.

3

Page 2- Mr. Kok-Kee Hon

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 (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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801). please go to

http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. 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 go to

http://www.fda.gov/MedicalDevices/Safety/ReportalProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely vours.

Anthony D. Watson, B.S., M.S., M.B.A. Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

Image /page/4/Picture/0 description: The image shows a logo with two stylized hands forming the shape of the letter 'S'. The hands are stacked on top of each other, with the fingers of each hand pointing towards the center of the 'S' shape. Below the logo, the words 'SHUN THAI' are printed in a simple, sans-serif font. The logo is black and white and appears to be a company or brand identifier.

SHUN THAI RUBBER GLOVES INDUSTRY PUBLIC COMPANY LIMITED

9 Moo-4 Kached, Muang Rayong, RAYONG 21100, THAILAND

Tel. (+66) 3863 4072-3, (+66) 3863 4816 FAX : (+66) 3863 4001,(+66)3863 4480

E-mail address: shunthai@shunthais.com Highly Intend To Reply Your Satisfaction ......

INDICATION FOR USE

Applicant: Shun Thai Rubber Gloves Industry Public Company Limited

510 (K) Number: K 092617

Device Name: Nittile, Blue, White and Green Examination Gloves, Powder Free and Tested For

Use with Chemotherapy . Drugs

Indications for Use:

This glove is disposable and intended purpose that is worn on the examiner 's hand to prevent contamination between patient and examiner, gloves use for protection against chemotherapy drugs as below.

Chemotherapy Drug Permeation (Breakthrough Detection Time) in Minutes.

Nitrile Powder Free Examination GloveBlueGreenWhite
*Carmustine (BCNU)40.0017.009.00
Cyclophosphamide (Cytoxan)> 240> 240> 240
Doxorubicin HCI (Adriamycin)>240> 240> 240
Etoposide (Toposar)>240> 240> 240
Fluorouracil>240> 240> 240
Paclitaxel (Taxol)>240> 240> 240
*Thio-Tepa177.0063.0048.00
Cisplatin>240> 240> 240
Dacarbazine (DTIC)>240> 240> 240

Nitrile Powder Frec Examination Clove(Blue)

  • CAUTION: Testing showed average breakthrough time of 40.00minutes with Carmustine.

Nitrile Powder Free Examination Glove(Green)

  • warning: do not use with Carmutine.

Nitrile Powder Free Examination Glove(White)

*CAUTION: Testing showed average breakthrough time of 48.00minutes with Thio-Tepa.

  • WARNING: DO NOT USE WITH CARMUTINE.
Prescription UseAND/OR Over the-Counter Use
(Part 21CFR 801 Subpart D)(21 CFR 801 Subpart C)X
(PLEASE DO NOT INRITE BELOW THIS LINE)
(Division Sign-Off)
Concurrence of CDRH, Office of Device Evaluation (ODE)) vision of Anesthesiology, General Hospital
nfection Control, Dental Devices
20
510(k) Number:1092617