AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

A 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.

These gloves were tested for use with Chemotherapy Drugs as per ASTM D6978-05 Standard Practice for Assessment of Medical Gloves to Permeation by Chemotherapy Drugs:

Chemotherapy Drug Permeation

The following chemicals have been tested with these gloves.

Chemotherapy DrugConcentrationBreakthrough Detection Time in Minutes
Flourouracil (Adrucil)50.0mg/ml> 240
Etopside (Toposar)20.0mg/ml> 240
Cyclophosphamide (Cytoxan)20.0mg/ml> 240
*Carmustine (BCNU)3.3mg/ml15.0
*Thiotepa10.0mg/ml2.0
Paclitaxel (Taxol)6.0mg/ml> 240
Doxorubicin Hydrochloride (Adriamycin)2.0mg/ml> 240
Dacarbazine10.0mg/ml> 240
Cisplatin1.0mg/ml> 240
Ifosfamide50.0mg/ml> 240
Mitoxantrone2.0mg/ml> 240
Vincristine Sulfate1.0mg/ml> 240
  • Please note that the following drugs have extremely low permeation times: Carmustine (BCNU) : 15 minutes and Thiotepa : 2 minutes
Device Description

Powder Free Blue Nitrile Patient Examination Glove, Non-Sterile meets all the requirements of ASTM standard D6319-10, D6978-05 and FDA 21 CFR 880.6250.

The powder free nitrile examination glove is manufactured from synthetic rubber latex. Inner surface of gloves undergo surface treatment process to produce a smooth surface that assists the user in donning the gloves without using any lubricant such as powder on the qlove surface. The qlove is ambidextrous, i.e. can be worn on right hand or left hand. The physical properties of glove i.e. tensile strength meets ASTM standard D6319-10.

AI/ML Overview

The provided document describes the acceptance criteria and performance of the "Dermagrip Powder Free Blue Nitrile Patient Examination Gloves, Non-Sterile, Tested for use with Chemotherapy Drugs" to demonstrate substantial equivalence to a predicate device (Kimberly-Clark STERLING Nitrile Powder-Free Exam Gloves with a Chemotherapy Drug Use Claim, K081089).

Here's an analysis of the requested information:

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria are primarily defined by adherence to various ASTM standards and performance comparable to the predicate device. The reported device performance indicates compliance with these standards.

CharacteristicStandard/Acceptance CriteriaReported Device Performance (Current Device)Predicate Device Performance
Physical PropertiesASTM D6319-10MeetsMeets
DimensionsASTM D6319-10 (Min 240mm length)Min 240mmConforms to ASTM 6319-00a
Thickness - FingerASTM D6319-10 (0.07 - 0.10mm)0.07 - 0.10mm0.07 - 0.10mm
Thickness - PalmNot explicitly stated as a separate standard, but implied by D6319-10 (0.07 – 0.09mm)0.07 – 0.09mm0.07 – 0.09mm
Thickness - CuffNot explicitly stated as a separate standard, but implied by D6319-10 (0.06 - 0.08mm)0.06 - 0.08mm0.06 - 0.08mm
Powder FreeASTM D6124-06 (≤ 2 mg/glove)MeetsMeets
Chemotherapy Drug PermeationASTM D6978-05 (Breakthrough Detection Time)See specific drug results belowSee specific drug results below
Flourouracil (Adrucil)> 240 minutes> 240 minutes> 240 minutes
Etopside (Toposar)> 240 minutes> 240 minutes> 240 minutes
Cyclophosphamide (Cytoxan)> 240 minutes> 240 minutes> 240 minutes
*Carmustine (BCNU)Not explicitly stated for current device, but predicate has no listed value. Current device reports 15 minutes.15.0 minutes-
*ThiotepaNot explicitly stated for current device, but predicate reports 54.2 minutes. Current device reports 2 minutes.2.0 minutes54.2 minutes
Paclitaxel (Taxol)> 240 minutes> 240 minutes> 240 minutes
Doxorubicin Hydrochloride> 240 minutes> 240 minutes> 240 minutes
Dacarbazine> 240 minutes> 240 minutes> 240 minutes
Cisplatin> 240 minutes> 240 minutes> 240 minutes
Ifosfamide> 240 minutes> 240 minutes> 240 minutes
Mitoxantrone> 240 minutes> 240 minutes> 240 minutes
Vincristine Sulfate> 240 minutes> 240 minutes> 240 minutes
BiocompatibilityISO 10993-10:2010(E) & Consumer Product Safety Commission, Title 16, Chapter II, Part 1500 (Primary Skin Irritation)Passes (Not a primary skin irritant)Passes
ISO 10993-10:2010(E) & Consumer Product Safety Commission, Title 16, Chapter II, Part 1500.3(c)(4) (Dermal Sensitization)Passes (Not a contact sensitizer)Passes
WatertightASTM D5151-06PassesPasses
Intended UsePrevention of contamination between patient and examinerConsistent with predicateConsistent with predicate
MaterialASTM D6319-10 (Nitrile)NitrileNitrile
ColorNot a performance criterion, but a characteristicBlueLight Gray
TextureNot a performance criterion, but a characteristicFinger texturedTextured Fingertip
SizeMedical Glove Guidance Manual - Labeling (XS, S, M, L, XL)Extra Small, Small, Medium, Large, Extra LargeExtra Small, Small, Medium, Large, Extra Large
Single UseMedical Glove Guidance Manual - LabelingSingle useSingle use
Warning Statement-Required for drugs with low permeation timesRequired for drugs with low permeation times

Study Proving Device Meets Acceptance Criteria:

The studies cited are non-clinical performance tests conducted to demonstrate compliance with recognized industry standards. The submission explicitly states that "The performance test data of the non-clinical tests that support a determination of substantial equivalence is the same as mentioned immediately above (ASTM Requirements)." This implies specific tests were performed on the device to prove its compliance with each standard.

2. Sample size used for the test set and the data provenance

  • The document does not specify the sample sizes used for the individual tests (e.g., how many gloves were tested for permeation, physical properties, or biocompatibility).
  • The data provenance is non-clinical test data, performed by the manufacturer, WRP Asia Pacific Sdn Bhd, located in Malaysia. The tests are reported as being compliant with internationally recognized ASTM standards.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

  • This is not applicable to this type of submission. The "ground truth" for glove performance is established by adherence to standardized testing protocols (e.g., ASTM D6978-05 for chemotherapy drug permeation), not by expert consensus in a clinical setting.
  • The document does not mention any medical experts' involvement in establishing test results or ground truth. The tests are laboratory-based.

4. Adjudication method for the test set

  • Not applicable. Adjudication methods are typically associated with human interpretation of results, often in clinical or image-based studies. Here, the results are quantitative measurements against predefined standard thresholds.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

  • Not applicable. This is a submission for medical gloves, not an AI-powered diagnostic device. Therefore, no MRMC study or AI assistance is relevant.

6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done

  • Not applicable. This involves physical product performance, not an algorithm.

7. The type of ground truth used

  • The "ground truth" for the device's performance is compliance with established, quantitative, and standardized test methods (e.g., ASTM D6319-10 for physical characteristics, ASTM D6978-05 for chemotherapy drug permeation, ISO 10993-10 for biocompatibility, and ASTM D5151-06 for watertightness). The results are direct measurements against these standards.

8. The sample size for the training set

  • Not applicable. This device is a physical product (gloves) and does not involve machine learning or AI, thus there is no "training set."

9. How the ground truth for the training set was established

  • Not applicable, as there is no training set for this device.

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of a human figure in profile, with three overlapping faces suggesting community and connection. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the figure.

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

February 5, 2015

WRP Asia Pacific Sdn Bhd Ms. Sarala Devi Jayaraman Regulatory Affairs Manager Lot 1, Jalan 3, Kawasan Perusahaan Bandar Baru Salak Tinggi Sepang, Selangor Darul Ehsan Malaysia 43900

Re: K141982

Trade/Device Name: Dermagrip Powder Free Blue Nitrile Patient Examination Gloves Tested for Use with Chemotherapy Drugs Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LZC, LZA Dated: December 23, 2014 Received: December 29, 2014

Dear Ms. Jayaraman:

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 - Ms. Jayaraman

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/Resourcesfor You/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/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Tejashri Purohit-Sheth, M.D.

Tejashri Purohit-Sheth, M.D. Clinical Deputy Director DAGRID/ODE/CDRH FOR

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

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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 on last page.

510(k) Number (if known) K141982

Device Name

Dermagrip Powder Free Blue Nitrile Patient Examination Gloves, Non-Sterile, Tested for use with Chemotherapy Drugs

Indications for Use (Describe)

A 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.

These gloves were tested for use with Chemotherapy Drugs as per ASTM D6978-05 Standard Practice for Assessment of Medical Gloves to Permeation by Chemotherapy Drugs:

Chemotherapy Drug Permeation

The following chemicals have been tested with these gloves.

Chemotherapy DrugConcentrationBreakthrough Detection Time in Minutes
Flourouracil (Adrucil)50.0mg/ml> 240
Etopside (Toposar)20.0mg/ml> 240
Cyclophosphamide (Cytoxan)20.0mg/ml> 240
*Carmustine (BCNU)3.3mg/ml15.0
*Thiotepa10.0mg/ml2.0
Paclitaxel (Taxol)6.0mg/ml> 240
Doxorubicin Hydrochloride (Adriamycin)2.0mg/ml> 240
Dacarbazine10.0mg/ml> 240
Cisplatin1.0mg/ml> 240
Ifosfamide50.0mg/ml> 240
Mitoxantrone2.0mg/ml> 240
Vincristine Sulfate1.0mg/ml> 240
  • Please note that the following drugs have extremely low permeation times: Carmustine (BCNU) : 15 minutes and Thiotepa : 2 minutes

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

Prescription Use (Part 21 CFR 801 Subpart D)

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

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

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

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1.0 Submitter:

Name:Sarala Devi Jayaraman
Address:WRP Asia Pacific Sdn BhdLot 1, Jalan 3, Kawasan Perusahaan Bandar Baru Salak Tinggi, 43900Sepang, Selangor Darul Ehsan, MALAYSIA
Phone No.:+60 3 8706 1486
Fax No.:+60 3 8706 1485

Date of Summary Prepared: 4 February 2015

2.0 Name of the device:

Dermagrip Powder Free Blue Nitrile Patient Examination Gloves, Non-Sterile, Tested for use with Chemotherapy Drugs Common Name: Exam Gloves Classification Name: Patient Examination Gloves Specialty (21 CFR 880.6250 product code LZC) Patient Examination Gloves (21 CFR 880.6250 product code LZA)

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

Predicate
ManufacturerKimberly-Clark Corporation
Device nameKimberly-Clark STERLING NitrilePowder-Free Exam Gloves with aChemotherapy Drug Use Claim
510(k) NumberK081089
MDL-
Regulatory ClassI
Product CodeLZC

4.0 Description of The Device:

Powder Free Blue Nitrile Patient Examination Glove, Non-Sterile meets all the requirements of ASTM standard D6319-10, D6978-05 and FDA 21 CFR 880.6250.

The powder free nitrile examination glove is manufactured from synthetic rubber latex. Inner surface of gloves undergo surface treatment process to produce a smooth surface that assists the user in donning the gloves without using any lubricant such as powder on the qlove surface. The qlove is ambidextrous, i.e. can be worn on right hand or left hand. The physical properties of glove i.e. tensile strength meets ASTM standard D6319-10.

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5.0 Intended Use of the Device:

A 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.

6.0 Summary of the Technological Characteristics of the Device:

The Powder Free Blue Nitrile Examination Gloves, Non-Sterile are summarized with the following technological characteristics compared to ASTM D6319 or equivalent standards as shown in Table 1

Chemotherapy claim is similar to Predicate, which has a glove thickness below 0.10mm and is shorter than 270mm but compliant with the ASTM standards.

CHARACTERISTICSSTANDARDSDEVICE PERFORMANCE
PredicateCurrent
Manufacturer(s)Kimberly-ClarkCorporationWRP Asia Pacific SdnBhd
510(k) NumberK081089K141982
DimensionsASTM D6319-10Conforms to ASTM6319-00aMin 240mm
Physical PropertiesASTM D6319-10MeetsMeets
Thickness - FingerASTM D6319-100.07 - 0.10mm0.07 - 0.10mm
- Palm0.07 – 0.09mm0.07 – 0.09mm
- Cuff0.06 - 0.08mm0.06 - 0.08mm
Powder FreeASTM D6124-06(≤ 2 mg/glove)MeetsMeets

Table 1

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CHARACTERISTICSSTANDARDSDEVICE PERFORMANCE
PredicateCurrent
Chemotherapy DrugPermeation TestASTM D6978-05
Test Chemotherapy DrugConcentrationMinimum Breakthrough DetectionTime (min)
Flourouracil (Adrucil)50.0mg/ml> 240> 240
Etopside (Toposar)20.0mg/ml> 240> 240
Cyclophosphamide (Cytoxan)20.0mg/ml> 240> 240
*Carmustine (BCNU)3.3mg/ml-15.0
*Thiotepa10.0mg/ml54.22.0
Paclitaxel (Taxol)6.0mg/ml> 240> 240
Doxorubicin Hydrochloride(Adriamycin)2.0mg/ml> 240> 240
Dacarbazine10.0mg/ml> 240> 240
Cisplatin1.0mg/ml> 240> 240
Ifosfamide50.0mg/ml> 240> 240
Mitoxantrone2.0mg/ml> 240> 240
Vincristine Sulfate1.0mg/ml> 240> 240
Warning Statement-* WARNING:Please note thatthe followingdrugs haveextremely lowpermeation times:Carmustine(BCNU) : 15minutes andThiotepa : 2minutes.
CHARACTERISTICSSTANDARDSDEVICE PERFORMANCE
PredicateCurrent
BiocompatibilityPrimary Skin Irritation-ISO 10993-10:2010(E) &Consumer ProductSafety Commission,Tittle 16, Chapter II,Part 1500PassesPassesNot a primary skin irritantunder the conditions ofthe study.
Dermal Sensitization -ISO 10993-10:2010(E) &Consumer ProductSafety Commission,Tittle 16, Chapter II,Part 1500.3(c)(4)PassesPassesNot a contact sensitizerunder the conditions ofthe study.
Watertight (1000ml)ASTM D5151-06PassesPasses
Intended use-A patientexaminationglove is amedical deviceintended formedical purposesthat is worn onthe examiner'shand to preventcontaminationbetween patientand examiner.A patient examinationglove is a disposabledevice intended formedical purposes thatis worn on theexaminer's hand orfinger to preventcontamination betweenpatient and examiner.
MaterialASTM D6319-10NitrileNitrile
Color-Light GrayBlue
Texture-Textured FingertipFinger textured
SizeMedical GloveGuidance Manual -LabelingExtra SmallSmallMediumLargeExtra LargeExtra SmallSmallMediumLargeExtra Large
Single UseMedical GloveGuidance Manual -LabelingSingle useSingle use

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Substantial Equivalent Based on Assessment of Non-Clinical Performance 7.0 Data

The performance test data of the non-clinical tests that support a determination of substantial equivalence is the same as mentioned immediately above (ASTM Requirements).

The device and the predicate share the same intended use, same material, same specifications for thickness and length, similar permeation rates for chemotherapy drugs, similar labeling according to the glove guidance, and same compliance with standards for physical properties, powder free, biocompatibility and water tightness. Thus, the device is substantial equivalent to the predicate.

8.0 Substantial Equivalent Based on Assessment of Clinical Performance Data

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

9.0 Conclusion

Based on intended uses, technological characteristics and non-clinical performance data, the subject device K141982 is substantially equivalent to the predicate device K081089.

§ 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.