K Number
K110418
Device Name
POWDER FREE NITRILE EXAMINATION GLOVES
Date Cleared
2011-07-13

(149 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Powder Free Nitrile Examination Gloves is a disposable device intended for medical purposes that is intended to be worn on the hand for medical purpose to provide barrier against potentially infectious materials and other contaminants.
Device Description
Powder Free Nitrile Examination Gloves is substantially equivalent to the Class 1 patient examination glove bearing the product code 80LZA ( 21 CFR 880.6250 ). It meets all the current specifications listed under the ASTM Specification D 6319 - 10 Standard Specification for Nitrile Examination Gloves for Medical Application¹. They are made from nitrile compound(dispersion of butadiene acrylonitrile copolymer. They are powder free gloves.
More Information

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Not Found

No
The device is a standard examination glove and the summary contains no mention of AI or ML technology.

No
The device, Powder Free Nitrile Examination Gloves, is intended to provide a barrier against contaminants, not to treat or alleviate a disease or condition.

No
The device, "Powder Free Nitrile Examination Gloves," is intended to provide a barrier against infectious materials and contaminants, not to diagnose medical conditions or diseases.

No

The device is a physical product (gloves) and the description focuses on material properties and performance testing related to a physical barrier, not software functionality.

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

Here's why:

  • Intended Use: The intended use clearly states the gloves are "intended to be worn on the hand for medical purpose to provide barrier against potentially infectious materials and other contaminants." This describes a physical barrier function, not a diagnostic test performed on samples outside the body.
  • Device Description: The description focuses on the material (nitrile), the form (powder-free gloves), and compliance with standards for examination gloves. It doesn't mention any components or processes related to analyzing biological samples.
  • Lack of IVD Indicators: The document lacks any mention of:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring specific substances (analytes)
    • Providing information for diagnosis, monitoring, or treatment decisions based on sample analysis.
  • Predicate Device: The predicate device is a "Class 1 patient examination glove," which is consistent with a barrier device, not an IVD.

In summary, the device is a medical glove intended for protection, not for performing diagnostic tests on samples.

N/A

Intended Use / Indications for Use

Powder Free Nitrile Examination Gloves are intended for single use for medical purposes that is worn on the hand of health care and similar personnel to prevent contamination between the health care personnel and the patients.
Powder Free Nitrile Examination Gloves is a disposable device intended for medical purposes that is intended to be worn on the hand for medical purpose to provide barrier against potentially infectious materials and other contaminants.

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

LZA

Device Description

Powder Free Nitrile Examination Gloves is substantially equivalent to the Class 1 patient examination glove bearing the product code 80LZA ( 21 CFR 880.6250 ). It meets all the current specifications listed under the ASTM Specification D 6319 - 10 Standard Specification for Nitrile Examination Gloves for Medical Application¹. They are made from nitrile compound(dispersion of butadiene acrylonitrile copolymer. They are powder free gloves.

Mentions image processing

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Mentions AI, DNN, or ML

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Input Imaging Modality

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Anatomical Site

hand

Indicated Patient Age Range

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Intended User / Care Setting

health care and similar personnel

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)

Non-Clinical laboratory and animal based test data indicate that the powder free product meets all performance and biocompatibility requirements.

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.

Powder Free Nitrile Examination Gloves as described in this 510 K Notification is substantially equivalent to the current Class 1 Patient Examination glove bearing the product code 80LZA ( 21 CFR 880.6250 ). It meets all the current specifications listed under the ASTM Specification D 6319 - 10 Standard Specification for Nitrile Examination Gloves for Medical Application.

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.

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KI 10418

Powder Free Nitrile Examination Gloves

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Attachment 13

510(k) SUMMARY

JUL 13 2011

POWDER FREE NITRILE EXAMINATION GLOVES

Submitter's NameW.A RUBBERMATE CO., LTD
Submitter's Address67/1 Bypass Road, Moo 4,
Nongmaidaeng, A. Maung,
Chonburi 20000, Tailand
Submitter's Phone Number+662-3189442
Submitter's Fax Number+662-3183268
Name of Contact PersonTerence Lim Sin Kooi
Date of Preparation08 February 2011
Name of Device
Trade Name: POWDER FREE NITRILE EXAMINATION
GLOVES
Common Name: Nitrile Examination Gloves
Classification Name: Patient Examination Gloves
Legally Marketed Device to which Equivalency is
Being ClaimedPowder Free Nitrile Examination Gloves as
described in this 510 K Notification is
substantially equivalent to the current Class 1
Patient Examination glove bearing the product
code 80LZA ( 21 CFR 880.6250 ). It meets all the
current specifications listed under the ASTM
Specification D 6319 - 10 Standard Specification
for Nitrile Examination Gloves for Medical
Application.
Description of the DevicePowder Free Nitrile Examination Gloves is
substantially equivalent to the Class 1 patient
examination glove bearing the product code
80LZA ( 21 CFR 880.6250 ). It meets all the
current specifications listed under the ASTM
Specification D 6319 - 10 Standard Specification
for Nitrile Examination Gloves for Medical
Application¹. They are made from nitrile
compound(dispersion of butadiene acrylonitrile
copolymer. They are powder free gloves.
Intended Use of the DevicePowder Free Nitrile Examination Gloves are
intended for single use for medical purposes that
is worn on the hand of health care and similar
personnel to prevent contamination between the
health care personnel and the patients.
Summary of Technological Characteristic
Compared to the Predicate DeviceThere is no different technological characteristic.
Gloves are made from nitrile compound
(dispersion of butadiene acrylonitrile copolymer)
and the initial products are powder free nitrile
examination gloves.
Brief Description of Non-Clinical TestsTesting performed per ASTM D 6319 - 10
Standard Specification for Nitrile Examination
Gloves for Medical Application and 21 CFR
800.20. Gloves meet all the current ASTM D
6319-10.
Primary skin irritation testing in the rabbit and
delayed dermal contact sensitization study in the
guinea pigs indicate no irritation or sensitization.
Brief description of Clinical TestsNo new clinical tests were conducted under this
510(k).
Conclusions Drawn from the Non-Clinical and
Clinical TestsNon-Clinical laboratory and animal based test
data indicate that the powder free product meets
all performance and biocompatibility
requirements.
Other Information Deemed Necessary by FDANot Applicable

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1

K110418

Powder Free Nitrile Examination Gloves

Attachment 13

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and features the department's name around the perimeter. In the center is a stylized image of an eagle or bird-like figure, composed of three curved lines.

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

Mr. Terence Lim Sin Kooi Head of Regulatory Affairs W.A Rubbermate Company, Limited 67/1 Bypass Road, Moo 4 Nongmaidaeng A. Maung Chonburi, THAILAND 20000

JUL 13 2011

Re: K110418

Trade/Device Name: Powder Free Nitrile Examination Gloves (Blue) Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LZA Dated: June 29, 2011 Received: July 6, 2011

Dear Mr. Lim Sin Kooi:

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.

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Page 2- Mr. Lim Sin Kooi

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 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/ReportaProblem/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 yours.

Anthony D. anton

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

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Powder Free Nitrile Examination Gloves

Attachment 2

INDICATIONS FOR USE

Applicant

W.A RUBBER MATE CO., LTD. 4 Ramkhamhaeng 19 (Chareonploy), Ramkhamhaeng Road, Huamark, Bangkapi, Bangkok 10240, Thailand

510(k) Number (if known)

K110418 *

Device Name

POWDER FREE NITRILE EXAMINATION GLOVES ( BLUE

Indications For Use

Powder Free Nitrile Examination Gloves is a disposable device intended for medical purposes that is intended to be worn on the hand for medical purpose to provide barrier against potentially infectious materials and other contaminants.

Concurrence of CDRH Office of Device Evaluation (ODE )

Prescription Use Per 21 CFR 801.109

× OR Over-The-Counter_

Rosie Pangulung

Vivision of Anesthesiology, General Hospital nfection Control, Dental Devices

510(k) Number: K110418