K Number
K110621
Device Name
SHENGKUN CHEMICAL
Date Cleared
2011-08-24

(174 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Synthetic Vinyl Examination Glove, Powder Free 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
Synthetic Vinyl Examination Gloves, Powder-Free
More Information

Not Found

Not Found

No
The 510(k) summary describes a standard medical glove and contains no mention of AI, ML, or related concepts like image processing or performance studies related to algorithmic analysis.

No
The device, Synthetic Vinyl Examination Glove, Powder Free, is intended to prevent contamination between the patient and examiner, not to treat or cure a disease or condition.

No
The device is described as an examination glove intended to prevent contamination, not to diagnose a condition.

No

The device is a physical glove, not software. The description clearly states it is a "disposable device intended for medical purposes that is worn on the examiner's hand or finger".

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is to prevent contamination between patient and examiner by being worn on the hand or finger. This is a barrier function, not a diagnostic test performed on samples taken from the body.
  • Device Description: It's a glove, a physical barrier.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in samples
    • Providing information for diagnosis, monitoring, or screening

IVDs are used to perform tests in vitro (outside the body) on samples to gain information about a patient's health. This device is a physical barrier used in vivo (on the body) for protection.

N/A

Intended Use / Indications for Use

Synthetic Vinyl Examination Glove, Powder Free 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 (comma separated list FDA assigned to the subject device)

LYZ

Device Description

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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

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)

Not Found

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.

Not Found

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

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the department's name around the perimeter. In the center is an abstract symbol consisting of three curved lines, which is meant to represent the human form.

Food and Drug Administration 1 0903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

Mr. Jason Liu Factory Manager Zibo Shengkun Chemical Industrial Company, Limited Fine Chemical Park, Chemical Industry Park Zibo, Shandong Zibo, Shandong China 255400

AUG 2 4 2511

Re: K110621

K 110021
Trade/Device Name: Synthetic Vinyl Examination Gloves, Powder-Free Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LYZ Dated: August 11, 2011 --Received: August 18, 2011

Dear Mr. Liu:

We have reviewed your Section 510(k) premarket notification of intent to market the device We have reviewed your Section 710(t) promainte is substantially equivalent (for the referenced above and nave decembine the concessed predicated predicate devices marketed in
indications for use stated in the enclosure , a notested of the Medical Device indications for use stated in the encrysis the enactment date of the Medical Device interstate commerce proof to May 20, 1970, the sideed in accordance with the provisions of
Amendments, or to devices that have been receives approval of a premarket Amendments, or to devices that have been results approval of a prematice approval of a premarket
the Federal Food, Drug, and Cosmetic Act (Act) that do subject to the general the Federal Food, Drug, and Cosment Act (roc) market the device, subject to the general
approval application (PMA). You may, therefore, market the devices subject to the gen approval application (FMFA). Tou may, includes provisions of the Act include controls provisions of the Act. The genting of devices, good manufacturing practice, requirements for annual registration, fishing and adulteration. Please note: CDRH does
labeling, and prohibitions against misbranding and adulteration. Novever, labeling, and promotions against inisoftanting alle assessmites. 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 If your device is classined (see above) into entrely (sp) regulations affecting your
(PMA), it may be subject to additional controls. Exist (Sparts 800 to 898 In (PMA), it may be subject to adultional controller and governments on the Peders device can be found in the Code of I cacra. Regulations, one of the Federal Register.

1

Page 2 - Mr. Liu

Please be advised that FDA's issuance of a substantial equivalence determination does not Please be advised that FDA's issuance of a substantial examples with other requirements
mean that FDA has made a determination that your device with other Federal agencies. mean that FDA has made a determinations administered by other Federal agencies.
of the Act or any Federal statutes and regulations and including, by not imited to: registrati of the Act or any Federal statutes and regulations annualing, but not limited to: registration
You must comply with all the Act of a con Re- 801): medical device reporting You must comply with all the Act Siequitements, and 801); medical device reporting
and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting and listing (2) CFR Part 807); labeling (21 CFR 803); good manufacturing
(reporting of medical device-related adverse events) (21 CFR 803); good manufacturing (reporting of medical device-related adverse events) (2) egulation (21 CFR Part 820);
practice requirements as set forth in the quality systems (QS) regulation (21 -542 of practice requirements as set forth in the quality systems (2) 1988.
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), a If you desire specific advice for your actives on on and fices/CDRHOffices please go to http://www.ida.gov/Aboution.com/Radiological Health's (CDRH's) Office of
/ucm I 15809.htm for the Center for Devices and Radiological Health and /ucm] 15809.htm for the Center for Devices not titled, "Misbranding by reference to Compliance. Also, please note the regulations regarding the reporting of
premarket notification" (21CFR Part 807.97). For questions regarding the reporting of premarket notification (21CFR r at 807.97) PCFR Part 803), please go to
adverse events under the MDR regulation (21 CFR Part 803), please go to adverse events under the MDK regulation (27 erreral voor)/default.htm for the CDRH's
http://www.fda.gov/MedicalDevices/SSS:tty/ReportsProblem/def Surveillance. http://www.fda.gov/MedicalDevices/Division of Postmarket Surveillance.
Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the You may obtain other general mionnational on "Openone" Assistance at its toll-free
Division of Small Manufacturers, International and Consumer Assistance at its toll-free Division of Sinan Manufactarers) - 100 or at its Internet address
number (800) 638-2041 or (301) 796-7100 or asferYou/Industry/def number (800) 038-2041 of (501) 770 7700 er urns - 100 er and - 1000 er - 1000 er - 1000 en - 1

Sincerely yours,

Cathony O. m

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

2

Indications for Use

510(k) Number (if known):_____________________________________________________________________________________________________________________________________________________

Device Name: Synthetic Vinyl Examination Gloves, Powder-Free

Indications For Use: Synthetic Vinyl Examination Glove, Powder Free 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 (Parl 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)

Sree Rumore

Kilolat

(Division Sign-Off) Division of Anesthesiology, @meratelospital RH, Office of Device Evaluation (ODE) Infection Control, Dental Devices

510(k) Number:

Tel:+86-533-7524868