K Number
K140240
Device Name
ZHAOFENG
Date Cleared
2014-06-12

(133 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Powder Free Vinyl Patient Examination Gloves, Clear (non-colored) is a non-sterile 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
Powder Free Vinyl Patient Examination Gloves, Clear (Non-colored) that meets all of the requirements of ASTM standard D 5250-06(Reaffirmation 2011).
More Information

Not Found

No
The device is a standard medical glove and the description and performance studies focus on material properties and physical integrity, with no mention of AI or ML.

No
The device is described as "a non-sterile disposable device intended for medical purposes that is worn on the examiner's hand or finger to prevent contamination between patient and examiner." This indicates a barrier function, not a therapeutic one.

No

An examination glove is a barrier device used to prevent contamination between patient and examiner, not to diagnose a condition.

No

The device is a physical product (gloves) and the description focuses on material standards and physical performance tests, not software functionality.

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

Here's why:

  • Intended Use: The intended use clearly states the device is "worn on the examiner's hand or finger to prevent contamination between patient and examiner." This is a barrier function, not a diagnostic test performed on samples taken from the body.
  • Device Description: The description focuses on the physical properties and standards met by the glove (ASTM D 5250-06). It doesn't mention any components or functionalities related to analyzing biological samples.
  • Lack of IVD Indicators: The document does not mention any of the typical characteristics of an IVD, such as:
    • 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.
  • Performance Studies: The performance studies focus on the physical integrity and safety of the glove (pinholes, powder, biocompatibility), not on the accuracy or reliability of a diagnostic test.

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

N/A

Intended Use / Indications for Use

Powder Free Vinyl Patient Examination Gloves, Clear (non-colored) is a non-sterile 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

Powder Free Vinyl Patient Examination Gloves, Clear (Non-colored) that meets all of the requirements of ASTM standard D 5250-06(Reaffirmation 2011).
-- How the device functions: PVC films form a barrier to body fluids and bloodborne Pathogens
-- Scientific concepts that form the basis for the device The PVC rubber is water tight under normal conditions of use. It's tensile properties cause it to conform to the hand, allowing movements necessary for a medical procedure.
-- Physical and performance characteristics such as design, materials and physical properties: PVC gloves are known to create a barrier to bloodborne pathogens and body fluids. ASTM conforming tensile properties create a glove that is strong and flexible. The glove is manufactured in accordance with the requirements of ASTM D5250 and ASTM D5151 requirements.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Examiner's 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)

Nonclinical tests were submitted and relied upon for determination of substantial equivalence.
Powder Free Vinyl Patient Examination Gloves, Clear (Non-colored) meet requirements per ASTM D5250-06(Reaffirmation 2011), per ASTM D6124-06(Reaffirmation 2011), per 21 CFR 800.20 and ISO 10993-10 Third Edition 2010-08-01.
The device meets the ASTM standard or equivalent standard and FDA requirements for waterleak test on pinhole AQL., meets labeling claims.
Clinical data is not needed for gloves or for most devices cleared by the 510(k) process.

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.

K120968

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

Section C

JUN 1 2 2014

510(k) Summary

"This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92."

" (applicant leave blank) "The assigned 510(k) number is: K140240

Premarket Notification [510(k)] Summary

[(a)(1)]. The summary contains on the first page, preferably on your letterhead paper, the submitter's name, address, phone and fax numbers, name of contact person, and date the summary was prepared :

Submitter's name :Zhaofeng Glove Co., Ltd.
Submitter's address :Jialinzi, Sigezhuang Town, Luannan County, Hebei
Province, 063502, China
Phone number :(86) 315-4169201
Fax number :(86) 315-4430333
Name of contact person:Zhang Liang
Date the summary was prepared:2014-05-03

{(a)(2)]. The name of the device, including the trade or proprietary name if applicable, the common or usual name, and the classification name, if known

| Device Name: | Powder Free Vinyl Patient Examination Gloves, Clear
(Non-colored) |
|-------------------------|---------------------------------------------------------------------------------|
| Proprietary/Trade name: | "Zhaofeng Powder Free Vinyl Patient Examination Gloves,
Clear (non-colored)" |
| Common Name: | Patient examination glove |
| Classification Name: | Patient examination glove |
| Device Classification: | 1 |
| Regulation Number: | 21 CFR 880.6250 |
| Panel: | General Hospital
(80) |
| Product Code: | LYZ |

((a)(3)). An identification of the legally marketed device to which your firm is claiming substantial equivalence .

Class I* Powder Free Vinyl Patient Examination Gloves, Clear (Non-colored) that meets all of the requirements of ASTM standard D 5250-06 (Reaffirmation 2011).

Predicate device : Powder free Vinyl Patient Examination Gloves, Clear(Non-colored), Tangshan Zhonghong Pulin Plastic Co.,Ltd.. K120968 .

1

[(a)(4)] A description of the device

Device Description : Powder Free Vinyl Patient Examination Gloves, Clear (Non-colored) that meets all of the requirements of ASTM standard D 5250-06(Reaffirmation 2011).

-- How the device functions:

PVC films form a barrier to body fluids and bloodborne Pathogens

-- Scientific concepts that form the basis for the device

The PVC rubber is water tight under normal conditions of use. It's tensile properties cause it to conform to the hand, allowing movements necessary for a medical procedure.

-- Physical and performance characteristics such as design, materials and physical properties: PVC gloves are known to create a barrier to bloodborne pathogens and body fluids. ASTM conforming tensile properties create a glove that is strong and flexible. The glove is manufactured in accordance with the requirements of ASTM D5250 and ASTM D5151 requirements.

|(a)(5)] The summary describes the intended use of the device

Device Intended Use: Powder Free Vinyl Patient Examination Gloves, Clear (Non-colored) 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)(6)] A summary of the technological characteristics of new device compared to the predicate device.

The Powder Free Vinyl Patient Examination Gloves, Clear (Non-colored) non sterile are summarized with the following technological characteristics compared to ASTM or equivalent standard.

Features & DescriptionPredicate DeviceSubject DeviceResult of Comparison
CompanyTangshan Zhonghong Pulin Plastic Co., Ltd.Zhaofeng Glove Co., Ltd.--
510(K) NumberK120968K140240
Product namePowder Free Vinyl Patient Examination Gloves, Clear (Non-colored)Powder Free Vinyl Patient Examination Gloves, Clear (Non-colored)Same
Product CodeLYZLYZSame
SizeSmall/ Medium/ Large/X largeSmall/ Medium/ Large/X largeSubstantially equivalent
Intend for usePowder free Vinyl Patient Examination Gloves, Clear(Non-colored)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.Powder free Vinyl Patient Examination Gloves, Clear (Non-colored) 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.Substantially equivalent
Device Description and SpecificationsMeets ASTM D5250-06 (Reapproved 2011)Meets ASTM D5250 -06 (Reapproved 2011)Substantially equivalent
Dimensions -- LengthMeets ASTM D5250-06 (Reapproved 2011)Meets ASTM D5250-06 (Reapproved 2011)Substantially equivalent
≥230mm min.230mm min for all sizes
Dimensions -- WidthMeets ASTM D5250-06 (Reapproved 2011)Meets ASTM D5250-06 (Reapproved 2011)Substantially equivalent
Small 80-90 mm
Medium 90-100mm
Large 100-110mm
X large 110-120 mmSmall 85-90 mm
Medium 95-97 mm
Large 105-108mm
X large 113-117 mm
Dimensions ThicknessMeets ASTM D5250-06 (Reapproved 2011)Meets ASTM D5250-06 (Reapproved 2011)
Physical PropertiesFinger 0.05mm min.
Palm 0.08mm min.
Meets ASTM D5250-06
(Reapproved 2011)
Before aging/after aging
Elongation ≥300%
Tensile Strength≥11MPaFinger 0.05mm min.
Palm 0.08mm min.
Meets ASTM D5250-06
(Reapproved 2011)
Before aging/after aging
Elongation ≥300%
Tensile Strength≥ 11MPaSubstantially equivalent
Freedom from
PinholesMeets
  • 21 CFR 800.20
  • ASTM D5250-06
    (Reapproved 2011)
  • ASTM D 5151-06
    (Reapproved 2011) | Meets ASTM
    D5151-06 (Reapproved 2011)
    Holes
    Inspection Level I
    AQL2.5 | Substantially equivalent |
    | Residual Powder | Meets ASTM
    D6124-06 (Reaffirmation 2011) | ASTM D6124-06 (Reaffirmation 2011)
    Results generated values below 2mg of residual powder | Substantially equivalent |
    | Compare all
    materials used to
    fabricate the
    devices | PVC | PVC | Substantially equivalent |
    | Dusting or
    Donning Powder: | PU | PU | Substantially equivalent |
    | Dusting or
    Donning Powder:
    name | PU | Surface Coating Agent | Substantially equivalent |
    | Compare
    performance data
    supporting
    substantial
    equivalence | Meets
    ASTM D5151-06
    (Reapproved 2011)
    ASTM D5250-06
    (Reapproved 2011)
    ASTM D6124-06
    (Reaffirmation 2011) | Meets
    ASTM D5151-06
    (Reapproved 2011)
    ASTM D5250-06
    (Reapproved 2011)
    ASTM D6124-06
    (Reaffirmation 2011) | Substantially equivalent |
    | Single Patient Use | Single Patient Use | Single Patient Use | Substantially equivalent |
    | Biocompatibility | SKIN IRRITATION DERMAL
    and SENSITIZATION
    STUDIES Meets ISO
    10993-10:2002/Amd.1:2006 | The test article was a non-
    irritant or non- sensitizer.
    SKIN IRRITATION
    DERMAL and
    SENSITIZATION STUDIES
    Meets ISO 10993-10 Third
    Edition 2010-08-01 | Substantially equivalent |
    | Labeling for the
    legally marketed
    device to which
    substantial
    equivalence is
    claimed. | -Powder Free
    -devices color:
    Clear(Non-colored)
    -Patient Examination Glove
    -Non sterile
    -Single Use Only
    -Manufactured For: | -Powder Free
    -devices color:
    Clear(Non-colored)
    -Patient Examination Glove
    -Non sterile
    -Single Use Only
    -Manufactured For: | Substantially equivalent |

Section C (rev.01)

Page 2/4

2

[(b)(1)] A brief discussion of the nonclinical submitted, reference, or relied on in the premarket notification submission for a determination of substantial equivalence.

Powder Free Vinyl Patient Examination Gloves, Clear (Non-colored)meet requirements per ASTM D5250-06(Reaffirmation 2011), per ASTM D6124-06(Reaffirmation 2011), per 21 CFR 800.20 and ISO 10993-10 Third Edition 2010-08-01. ্

}(b)(2)] A brief discussion of the clinical submitted, reference, or relied on in the premarket notification submission for a determination of substantial equivalence.

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

Section C (rev.01)

Page 3/4

3

[(b)(3)] The conclusions drawn from the nonclinical tests that demonstrate that the device is as safe, as effective, and performed as well or better than the legally marketed device identified in (a)(3).

It can be concluded that the Powder Free Vinyl Patient Examination Gloves meet the ASTM standard or equivalent standard and FDA requirements for waterleak test on pinhole AQL., meet labeling claims and the Powder Free Vinyl Patient Examination Gloves, Clear (Non-colored) is as safe, as effective, and performs as well as the predicate device, Powder free Vinyl Patient Examination Gloves, Clear(Non-colored), Tangshan Zhonghong Pulin Plastic Co.,Ltd. K120968 .

4

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-000

June 12, 2014

Zhaofeng Glove Company, Limited C/O Mr. Chu Xiaoan Official Correspondent Room 1606 Bldg.1. Jianxiang Yuan No. 209 Bei Si Huan Zhong Road Haidian District Beijing, 100083, CHINA

Re: K140240

Trade/Device Name: Powder Free Vinyl Patient Examination Gloves, Clear (Non-colored) Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LYZ Dated: May 3, 2014 Received: May 15, 2014

Dear Mr. Xiaoan,

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.

Image /page/4/Picture/10 description: The image shows a white background with some black spots scattered around. The spots are concentrated in the upper right and lower left corners of the image. The spots are small and irregular in shape, and they appear to be randomly distributed.

Image /page/4/Picture/11 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized depiction of an abstract human figure with outstretched arms, rendered in black. The figure is positioned to the right of the text, which reads "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged in a circular fashion around the left side of the emblem.

5

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 contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. 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, Teiashri Priro Erin I. Keith, M.S.

Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

6

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use ·

Form Approved: OMB No. 0910-0120 ExpIration Date: January 31, 2017 See PRA Statement below.

510(k) Number (if known) K140240

Device Name

Powder Free Vinyl Patient Examination Gloves, Clear (non-colored)

Indications for Use (Describe)

Powder Free Vinyl Patient Examination Gloves, Clear (non-colored) is a non-sterile disposable device intended for medical purposes that is worn on the examiner's hand or finger to prevent contamination between patient and examiner.

Type of Use (Select one or both, as applicable)

Prescription Use (Part 21 CFR 801 Subpart D)

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

PLEASE DO NOT WRITE BELOW THIS LINE -- CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FOR FOR FOR FOR FOR A THE ONLY : : : Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

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c=US, o=U.S. Government, ou=HHS, ou=FDA, People, 0.9.2342.19200300.100.1.1=2000540490, Sreekanth Gutala -S 2014.06.11 15:58:35 -04'00'

Digitally signed by Sreekanth Gutala -S

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'DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW."

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

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