K Number
K151390
Device Name
Powder Free Nitrile Examination Gloves Tested For Use With Chemotherapy Drugs
Date Cleared
2016-05-02

(342 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
A powder free 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. In addition, these gloves were tested for use with chemotherapy drugs in accordance with ASTMD6978-05 Standard Practice for Assessment of Medical Gloves to Permeation by Chemotherapy Drugs: Test Chemotherapy Drug and Concentration | Minimum Breakthrough Detection Time (Minutes) ------------------------------------------|----------------------------------------------- Cisplatin, 1.0mg/ml | >240 Cyclophosphamide (Cytoxan), 20mg/ml | >240 Carmustine (BCNU), 3.3mg/ml | 1.0 Dacarbazine (DTIC), 10.0mg/ml | >240 Doxorubicin Hydrochloride, 2.0mg/ml | >240 Etoposide (Toposar), 20.0mg/ml | >240 Fluorouracil, 50.0mg/ml | >240 Paclitaxel (Taxol), 6.0mg/ml | >240 Thiotepa, 10.0mg/ml | 31.3 Methotrexate ,25mg/ml | >240 Mitomycin C, 0.5mg/ml | >240 Vincristine Sulfate, 1.0mg/ml | >240 Ifosfamide, 50.0mg/ml | >240 Please note that the following drugs have low permeation time of less than 240 minutes: Carmustine (BCNU), 3.3mg/ml: 1.0 minute Thiotepa, 10.0mg/ml: 31.3 minutes
Device Description
These patient examination gloves are formulated using nitrile, non-sterile, powder free, meet all the requirements of ASTM D6319 and tested for use with chemotherapy drugs.
More Information

Not Found

No
The document describes a physical medical device (examination gloves) and its performance characteristics related to material properties and resistance to chemicals. There is no mention of software, algorithms, or data processing that would indicate the use of AI or ML.

No
The device is a patient examination glove, intended to prevent contamination between patient and examiner and tested for use with chemotherapy drugs, not to provide therapy.

No

Explanation: The device is a patient examination glove, described as a disposable device for preventing contamination between patient and examiner. Its purpose is protective, not diagnostic.

No

The device is a physical glove made of nitrile, not software. The description focuses on material properties and performance against chemotherapy drugs.

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

Here's why:

  • Definition of IVD: An In Vitro Diagnostic device is a medical device that is used to perform tests on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. These tests are performed outside of the body (in vitro).
  • Intended Use: The intended use of this device is clearly stated as a "disposable device intended for medical purposes that is worn on the examiner's hand or finger to prevent contamination between patient and examiner." This is a barrier device used on the body (or on the examiner's hand) during a medical procedure or examination.
  • Function: The primary function of the glove is to provide a physical barrier. While it has been tested for resistance to chemotherapy drugs, this testing relates to its barrier properties and safety for the user, not to diagnosing a condition in a patient.
  • Lack of Diagnostic Function: There is no mention of this device being used to analyze biological samples or provide diagnostic information about a patient's health.

The testing for chemotherapy drug permeation is a safety and performance characteristic of the glove as a barrier device, not an indication of its use in an in vitro diagnostic test.

N/A

Intended Use / Indications for Use

A powder free 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.

In addition, these gloves were tested for use with chemotherapy drugs in accordance with ASTMD6978-05 Standard Practice for Assessment of Medical Gloves to Permeation by Chemotherapy Drugs:

Test Chemotherapy Drug and ConcentrationMinimum Breakthrough Detection Time (Minutes)
Cisplatin, 1.0mg/ml>240
Cyclophosphamide (Cytoxan), 20mg/ml>240
Carmustine (BCNU), 3.3mg/ml1.0
Dacarbazine (DTIC), 10.0mg/ml>240
Doxorubicin Hydrochloride, 2.0mg/ml>240
Etoposide (Toposar), 20.0mg/ml>240
Fluorouracil, 50.0mg/ml>240
Paclitaxel (Taxol), 6.0mg/ml>240
Thiotepa, 10.0mg/ml31.3
Methotrexate ,25mg/ml>240
Mitomycin C, 0.5mg/ml>240
Vincristine Sulfate, 1.0mg/ml>240
Ifosfamide, 50.0mg/ml>240

Please note that the following drugs have low permeation time of less than 240 minutes: Carmustine (BCNU), 3.3mg/ml: 1.0 minute Thiotepa, 10.0mg/ml: 31.3 minutes

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

LZC, LZA

Device Description

These patient examination gloves are formulated using nitrile, non-sterile, powder free, meet all the requirements of ASTM D6319 and tested for use with chemotherapy drugs.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

hands and 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)

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 watertightness.

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.

K141982

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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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of three human profiles facing right, with a flowing design beneath them.

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

May 2, 2016

Maxter Glove Manufacturing SDN. BHD. Yap Peak Geeh QA & Regulatory Affairs Manager Lot 6070. Jalan Haji Abdul Manan, 6th Miles Off Jalan Meru. Klang, Selangor 41050 MALAYSIA

Re: K151390

Trade/Device Name: Powder Free Nitrile 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: March 25, 2016 Received: March 30, 2016

Dear Yap Geeh:

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.

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

1

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 devicerelated 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 Industry and Consumer Education 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. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 Industry and Consumer Education 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

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known)

K151390

Device Name

Powder Free Nitrile Examination Gloves Tested For Use With Chemotherapy Drugs

Indications for Use (Describe)

A powder free 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.

In addition, these gloves were tested for use with chemotherapy drugs in accordance with ASTMD6978-05 Standard Practice for Assessment of Medical Gloves to Permeation by Chemotherapy Drugs:

Test Chemotherapy Drug and ConcentrationMinimum Breakthrough Detection Time (Minutes)
Cisplatin, 1.0mg/ml>240
Cyclophosphamide (Cytoxan), 20mg/ml>240
Carmustine (BCNU), 3.3mg/ml1.0
Dacarbazine (DTIC), 10.0mg/ml>240
Doxorubicin Hydrochloride, 2.0mg/ml>240
Etoposide (Toposar), 20.0mg/ml>240
Fluorouracil, 50.0mg/ml>240
Paclitaxel (Taxol), 6.0mg/ml>240
Thiotepa, 10.0mg/ml31.3
Methotrexate ,25mg/ml>240
Mitomycin C, 0.5mg/ml>240
Vincristine Sulfate, 1.0mg/ml>240
Ifosfamide, 50.0mg/ml>240

Please note that the following drugs have low permeation time of less than 240 minutes: Carmustine (BCNU), 3.3mg/ml: 1.0 minute Thiotepa, 10.0mg/ml: 31.3 minutes

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)

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Image /page/3/Picture/1 description: The image shows the logo for MAXTER Glove Manufacturing SON BHO. The logo features a black panther in front of a gray circle on the left side. To the right of the panther is the word "MAXTER" in large, bold letters, with the words "GLOVE .MANUFACTURING SON BHO" below it. The text "(22°802-H)" is located below the company name, and the text "since 1989" is located in the bottom left corner.

Lot 6070, Jalan HaJiAbo

1.0 Submitter:

NameYap Peak Geeh
AddressLot 6070 Jalan Haji Abdul Manan,
6th Miles off Jalan Meru,
41050 Klang, Selangor, Malaysia.
Phone No.: 6-03-33929888
Fax No.: 60-03-33923328
Date of Summary Prepared:8th March 2016

2.0 Name of the device:

Powder Free Nitrile Examination Gloves Tested for use with Chemotherapy Drugs Common Name : Exam Gloves Classification Name: Patient Examination Gloves Speciality ( 21 CFR 880.6250) Product Code LZC, LZA)

  • 3.0 Identification Of The Legally Marketed Devices that equivalency is claimed:
Predicate
ManufacturerWRP Asia Pacific Sdn Bhd
Device NameDermagrip Powder Free Blue Nitrile Patient
Examination Gloves Tested for Use with
Chemotherapy Drugs
510(k) NumberK141982
Regulation Number21 CFR 880.6250
Regulatory NamePatient Examination Glove
Regulatory ClassI
  • 4.0 Description of the Device:
    These patient examination gloves are formulated using nitrile, non-sterile, powder free, meet all the requirements of ASTM D6319 and tested for use with chemotherapy drugs.

  • 5.0 Intended Use of the Device:
    A powder free patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hands and finger to prevent contamination between patient and examiner. In addition, these gloves were tested for use with chemotherapy drugs in accordance with ASTMD6978-05.

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Image /page/4/Picture/0 description: The image shows the logo for MAXTER GLOVE MANUFACTURING SDN BHD. The logo features a black panther in front of a moon-like circle on the left side. To the right of the panther is the company name in bold, black letters, and below that is the company's full name and registration number.

6.0 Summary of the Technological Characteristics of the Device:

Below is the summary of the technological characteristics of the Powder Free Nitrile Examination Gloves compare to ASTM D6319 or equivalent standards.

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

Table 1

CharacteristicsStandardsDevice Performance
PredicateCurrent
ManufacturerWRP Asia Pacific
Sdn BhdMaxter Gloves
Manufacturing Sdn Bhd
510 (K) NumberK141982K151390
DimensionsASTM D6319-10Min240mmMin270mm
Physical PropertiesASTM D6319-10MeetMeet
Thickness- Finger
-palmASTM D6319-100.07-0.10mm
0.07-0.09mmMin0.10mm
MinO.10mm
Freedom From
HolesASTM D6319-10
and ASTM D5151PassPass
Powder Free
ResidueASTM D6319-10
and ASTM D6124MeetMeet
Resistance to
Permeation by
Chemotherapy
Drugs:ASTM D6978-05
Test Chemotherapy
DrugConcentrationMinimum Breakthrough Detection Time (min)
Cisplatin1.0mg/ml>240 minutes>240 minutes
Cyclophosphamide
(Cytoxan)20mg/ml>240 minutes>240 minutes
Carmustine (BCNU)3.3mg/ml15.01.0 minute
Dacarbazine {DTIC)10.0mg/ml>240 minutes>240 minutes
I toposide (Toposar)20.0mg/ml>240 minutes>240 minutes
I oxorubicin
Hydrochloride2.0mg/ml>240 minutes>240 minutes
Fluorouracil50.0mg/ml>240 minutes>240 minutes
Paclitaxel (Taxol)6.0mg/ml>240 minutes>240 minutes
Thiotepa10.0mg/ml2.0 minutes31.3 minutes
Methotrexate25mg/ml->240 minutes
Mitomycin C0.5mg/ml->240 minutes
Vincristine Sulfate1.0mg/ml>240 minutes>240 minutes
Ifosfamide50.0 mg/ml>240 minutes>240 minutes
Warning StatementWarning: Please
note that the
following drugs have
extremely low
permeation times:
Carmustine(BCNU):
15 Minutes and
Thiotepa: 2 minutesWarning: Please note that
the following drugs have
low permeation time of
less than 240minutes:
Carmustine (BCNU): 1.0
Minute and
Thiotepa : 31.3 Minutes
BiocompatibilityPrimary Skin
Irritation-ISO
10993PassPass
Dermal
Sensitization-ISO
10993PassPass
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.A powder free patient
examination glove is a
disposable device intended
for medical purposes that
is worn on the examiner's
hands and finger to
prevent contamination
between patient and
examiner.In addition,
these gloves were tested
for use with chemotherapy
drugs in accordance with
ASTMD6978-05.
MaterialASTM D6319-10NitrileNitrile
Texture-Finger TexturedFinger Textured

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Image /page/5/Picture/0 description: The image shows a black panther in front of a moon. The panther is looking to the right, and the moon is in the background. The text "SINCE 1965" is at the bottom left of the image. The image is a black and white drawing.

MAXTER

GIOVE MANUFACTURING SON BHD

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Image /page/6/Picture/0 description: The image shows the logo for MAXTER GIOVE MANUFACTURING SON BHO (229862-H). The logo features a black panther in front of a circle on the left side. The text "MAXTER" is in large, bold letters on the right side of the logo.

lot 6070, Jaloo Hnji Abdul Manon
6tn Miles Off JalonIJ.eru
4H150 Klang, Sclongo