K Number
K152692
Device Name
Powder Free Vinyl Patient Examination Gloves (Green)
Date Cleared
2015-12-21

(91 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Powder Free Vinyl Patient Examination Gloves (Green) is disposable non-sterile device intended for medical purpose 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 (Green) are Patient Examination Gloves, Disposable, single use only and non-sterile. The gloves are made of vinyl materials and are powder free. The physical and performance characteristics of the devices meet all requirements of ASTM D5250-06 (Reapproved 2011)--Standard Specification For Poly (Vinyl Chloride) Gloves For Medical Application.
More Information

No
The device is a simple medical glove and the summary contains no mention of AI, ML, or related concepts.

No
The device is a glove intended to prevent contamination, not to treat or diagnose a medical condition.

No
The device, "Powder Free Vinyl Patient Examination Gloves (Green)," is described as a non-sterile device intended to prevent contamination between patient and examiner. There is no mention of it being used to diagnose conditions, diseases, or provide any diagnostic information. Its purpose is for barrier protection.

No

The device is a physical glove made of vinyl material, not software.

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 for personal protection and infection control, not a diagnostic test performed on samples taken from the body.
  • Device Description: The description focuses on the physical properties and standards met for a medical glove (ASTM D5250, etc.). It doesn't mention any components or processes related to analyzing biological samples.
  • Lack of Diagnostic Elements: There is no mention of analyzing blood, urine, tissue, or any other biological material. There are no reagents, test strips, or analytical methods described.
  • Performance Metrics: The key metrics listed (Tensile Strength, Elongation, Freedom from pinholes, Residual powder, Biocompatibility) are all related to the physical integrity and safety of the glove as a barrier, not to diagnostic accuracy.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information for diagnosis, monitoring, or screening. This device's function is purely protective.

N/A

Intended Use / Indications for Use

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

Product codes

LYZ

Device Description

Powder Free Vinyl Patient Examination Gloves (Green) are Patient Examination Gloves, Disposable, single use only and non-sterile. The gloves are made of vinyl materials and are powder free. The physical and performance characteristics of the devices meet all requirements of ASTM D5250-06 (Reapproved 2011)--Standard Specification For Poly (Vinyl Chloride) Gloves For Medical Application.

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)

Non-clinical tests were performed.

  • Powder Free Vinyl Patient Examination Gloves (Green) meet requirements per ASTM D 5250-06(2011), per ASTM D6124-06 (2011), ASTM D5151-06(2011), 21CFR 800.20 and ISO 10993-10 third edition 2010-08-01.
  • Biocompatibility: Skin irritation ISO 10993-10: Under conditions of the study, not an irritant. Sensitization ISO 10993-10: Under the conditions of the study, not a sensitizer.
  • Substantial equivalence of the subject device was supported by non-clinical testing.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K141878

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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 consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract symbol that resembles a stylized caduceus or a representation of human profiles.

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

December 21, 2015

Supermax Plastic Products Co., Ltd % Ms. Kathy Liu Project Manager Hongray USA Medical Products Inc. 3973 Schaefer Ave. Chino, California 91710

Re: K152692

Trade/Device Name: Powder Free Vinyl Patient Examination Gloves (Green) Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LYZ Dated: November 24, 2015 Received: November 27, 2015

Dear Ms. Liu:

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.

1

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 and Part 809); medical device 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.

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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Indications for Use

510(k) Number (if known) K152692

Device Name

Powder Free Vinyl Patient Examination Gloves (Green)

Indications for Use (Describe)

The Powder Free Vinyl Patient Examination Gloves (Green) is disposable non-sterile device intended for medical purpose 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 FDA USE ONLY

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

This section applies only to requirements of the Paperwork Reduction Act of 1995.

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Supermax Plastic Products Co., Ltd.

314 Dragon River East Road, Luquan, Hebei Province, CHINA 050000

510(K) SUMMARY

This summary of 510(K) safety and effectiveness information is being submitted in accordance with requirements of 21 CFR $807.92.

The assigned 510(K) number is: K152692

1. Owner's Identification :

Mr. Wu Zhigang Supermax Plastic Products Co., Ltd. 314 Dragon River East Road, Luquan, Hebei Province, CHINA 050000

Tel: 86-311-83601854 Fax: 86-311-83616934

Contact: Ms. Kathy Liu, Project Manager Address: 3973 Schaefer Ave., Chino, CA 91710 Tel: 909-590-1611 Fax: 909-590-1511 Date Summary Prepared: December 15, 2015

2. Name of the Device:

Trade Name: Powder Free Vinyl Patient Examination Gloves (Green) Common Name: Patient Examination Gloves Classification Name: Patient Examination Glove Classification Regulation: 21 CFR 880.6250 Classification Panel: 80 General Hospitals Product Code: LYZ Device Class: Class I

3. Predicate Device Information:

Tangshan Hongyun Plastic Products Company Limited Powder-Free Yellow Vinyl Patient Examination Gloves (K141878)

4. Device Description:

Powder Free Vinyl Patient Examination Gloves (Green) are Patient Examination Gloves, Disposable, single use only and non-sterile. The gloves are made of vinyl materials and are powder free. The physical and performance characteristics of the devices meet all requirements of ASTM D5250-06 (Reapproved 2011)--Standard Specification For Poly (Vinyl Chloride) Gloves For Medical Application.

5. Intended Use of the Device:

4

Supermax Plastic Products Co., Ltd.

314 Dragon River East Road, Luquan, Hebei Province, CHINA 050000

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

6. Technological Characteristics and Substantial Equivalence:

Supermax Plastic Products Co., Ltd.'s Powder Free Vinyl Patient Examination Gloves (Green) is substantially equivalent in safety and effectiveness to the Tangshan Hongyun Plastic Products Company Limited's Powder-Free Yellow Vinyl Patient Examination Gloves (K141878). The subject device and predicate device use a similar plastic flexible barrier film to achieve a device for the intended use.

And the properties between the subject device and the predicate device are compared in the following table:

CharacteristicsStandardDevice PerformanceResult of
Predicate deviceSubject Devicecomparison
510K numberK141878K152692--
Product name1Powder-Free Yellow Vinyl
Patient Examination
GlovesPowder Free Vinyl
Patient Examination
Gloves (Green)Similar
Product CodeLYZLYZSame
Intended UsePowder-Free Yellow Vinyl
Patient Examination
Gloves 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.The Powder Free Vinyl
Patient Examination
Gloves (Green) is
disposable non-sterile
device intended for
medical purpose that is
worn on the examiner's
hand or finger to prevent
contamination between
patient and examiner.Same
SizeS/M/L/XLS/M/L/XLSame
Compare all
materials used
to fabricate the
devicesPVCPVCSame
Dusting or
Donning
powderPUPUSame
Compare
performance
data supporting
substantial
equivalenceMeets
ASTM D5151-06(2011)
ASTM D 5250-06 (2011)
ASTM D6124-06(2011)Meets
ASTM D5151-06(2011)
ASTM D 5250-06 (2011)
ASTM D6124-06(2011)Same
ColorYellowGreenSimilar
StandardDevice PerformanceResult of
CharacteristicsPredicate deviceSubject Devicecomparison
Single patient
use/Single patient useSingle patient useSimilar
Dimensions:
LengthASTM D 5250-
06 (2011)Meets
230 mm min for all sizesMeets
230 mm min for all sizesSimilar
Dimensions:
WidthASTM D 5250-
06 (2011)Meets
S: 83-86 mm
M: 94-97 mm
L: 104-107 mm
XL: 113-115 mmMeets
S: 85±5 mm
M: 95±5 mm
L: 105±5 mm
XL: 115±5 mmSimilar
Dimensions:
ThicknessASTM D 5250-
06 (2011)Meets
Palm: 0.08 mm min
Finger: 0.05 mm minMeets
Palm: 0.08 mm min
Finger: 0.05 mm minSimilar
Tensile
strength:
before
and
after agingASTM D 5250-
06 (2011)Meets
Tensile Strength≥11MPaMeets
Tensile Strength≥11MPaSimilar
Elongation
before and after
agingASTM D 5250-
06 (2011)Meets
Elongation≥300%Meets
Elongation≥300%Similar
Freedom from
pinholesASTM D 5250-
06 (2011)
ASTM D5151-
06
(Reapproved
  1. | Meets
    G-I, AQL2.5 | Meets
    G-I, AQL2.5 | Similar |
    | Residual
    powder | ASTM D 5250-
    06 (2011)
    ASTM D6124-
    06(Reaffirmati
    on 2011) | Meets
    Results below 2mg of
    residual powder | Meets
    Not more than 2mg per
    glove | Similar |
    | Biocompatibility | Skin irritation
    ISO 10993-10 | Under conditions of
    the
    study, not an irritant | Under conditions of the
    study, not an irritant | Same |
    | | Sensitization
    ISO 10993-10 | Under the conditions of the
    study, not a sensitizer | Under the conditions of
    the study, not a sensitizer | Same |
    | Labeling | / | Powder Free
    Devices color: Yellow
    Patient examination Glove
    Non Sterile
    Single use only
    Manufactured for:
    Lot | Powder Free
    Devices color: Green
    Patient examination
    Glove
    Non Sterile Single
    use only
    Manufactured for:
    Lot | Similar |

5

Supermax Plastic Products Co., Ltd.
314 Dragon River East Road, Luquan, Hebei Province, CHINA 050000

6

Supermax Plastic Products Co., Ltd.

314 Dragon River East Road, Luquan, Hebei Province, CHINA 050000

Powder Free Vinyl Patient Examination Gloves (Green) shares the same or comparable technology characteristics compared to the predicate device. The subject device performs according to the glove performance standards ASTM D5250-06(2011), biocompatibility requirement and FDA requirements and the labeling claims for the product. It performs as well as the legally marketed predicate device.

7. Discussion of Non-Clinical Tests Performed for Determination of Substantial Equivalence is as Follows:

Powder Free Vinyl Patient Examination Gloves (Green) meet requirements per ASTM D 5250-06(2011), per ASTM D6124-06 (2011), ASTM D5151-06(2011), 21CFR 800.20 and ISO 10993-10 third edition 2010-08-01

8. Discussion of Clinical Tests Performed:

Clinical data was not included in the submission. Substantial equivalence of the subject device was supported by non-clinical testing.

9. Conclusions:

Powder Free Vinyl Patient Examination Gloves (Green) conform fully to ASTM D 5250-06 (2011) standard as well as applicable 21 CFR references, and meets pinhole FDA requirements, biocompatibility requirements and labeling claims as shown by data discussed above.

Drawn from the complete list of non-clinical tests, the subject device is as safe, as effective, and performs as well as the legally marketed predicate device. The subject device is substantially equivalent to the predicate device.