K Number
K160875
Device Name
Cardinal Health Sterile Polyisoprene Powder-Free Orthopedic Surgical Gloves with Hydrogel Coating
Date Cleared
2016-07-11

(103 days)

Product Code
Regulation Number
878.4460
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
A powder-free sterile surgeon's glove is a disposable device made of synthetic rubber intended to be worn by operating room personnel to protect a surgical wound from contamination.
Device Description
The proposed device is a disposable device. It is not made with natural rubber latex. Instead, the gloves are formulated using polyisoprene, which is a synthetic rubber latex, and is brown in color. The glove is coated with hydrogel polymer coating. The gloves are manufactured using molds that feature anti-slip finish, independent thumb and mechanically locking cuffs to help prevent cuff roll down. They are offered powder-free and sterile. This glove is for single use only. This glove is suitable for use as a specialty surgical glove intended for orthopedic procedures or other procedures where a thicker barrier may be desired such as trauma and reconstructive surgery
More Information

Not Found

No
The device description and intended use are for a surgical glove, and there is no mention of AI or ML technology in the provided text.

No
The device is a surgeon's glove intended to protect a surgical wound from contamination, which is a barrier protection, not a therapeutic action.

No
Explanation: The device is a surgeon's glove, intended to protect a surgical wound from contamination, not to diagnose a medical condition.

No

The device description clearly indicates the device is a physical glove made of synthetic rubber, not software.

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

Here's why:

  • Intended Use: The intended use is to protect a surgical wound from contamination by being worn by operating room personnel. This is a physical barrier function, not a diagnostic test performed on a sample from the human body.
  • Device Description: The description focuses on the physical properties and construction of a glove. There is no mention of reagents, calibrators, controls, or any components used to analyze a biological sample.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing a biological sample (blood, urine, tissue, etc.)
    • Detecting or measuring a substance in a sample
    • Providing information for diagnosis, monitoring, or treatment decisions based on sample analysis.

This device is clearly a surgical glove, which is a Class II medical device used as a barrier.

N/A

Intended Use / Indications for Use

A powder-free sterile surgeon's glove is a disposable device made of synthetic rubber intended to be worn by operating room personnel to protect a surgical wound from contamination.

Product codes

KGO

Device Description

The proposed device is a disposable device. It is not made with natural rubber latex. Instead, the gloves are formulated using polyisoprene, which is a synthetic rubber latex, and is brown in color. The glove is coated with hydrogel polymer coating.

The gloves are manufactured using molds that feature anti-slip finish, independent thumb and mechanically locking cuffs to help prevent cuff roll down. They are offered powder-free and sterile. This glove is for single use only.

This glove is suitable for use as a specialty surgical glove intended for orthopedic procedures or other procedures where a thicker barrier may be desired such as trauma and reconstructive surgery

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

operating room personnel

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 data demonstrates Cardinal Health™ Sterile Polyisoprene Powder-Free Orthopedic Surgical Gloves with Hydrogel Coating meet the technological characteristics of ASTM D3577 standard, and are as safe, as effective, and performs as well as the legally marketed devices identified in this summary.

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

Not Found

Predicate Device(s)

K092304, K151778

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4460 Non-powdered surgeon's glove.

(a)
Identification. A non-powdered surgeon's glove is a device intended to be worn on the hands of operating room personnel to protect a surgical wound from contamination. A non-powdered surgeon's 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).

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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, stacked on top of each other, with flowing lines representing hair or movement.

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

July 11, 2016

Cardinal Health, Inc. Ms. Megan Middaugh Manager, Regulatory Affairs 1500 Waukegan Rd Waukegan, IL 60085

Re: K160875

Trade/Device Name: Cardinal Health™ Sterile Polyisoprene Powder-Free Orthopedic Surgical Gloves with Hydrogel Coating Regulation Number: 21 CFR 878.4460 Regulation Name: Surgeon's Glove Regulatory Class: I Product Code: KGO Dated: June 9, 2016 Received: June 13, 2016

Dear Ms. Middaugh:

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 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

1

the quality systems (OS) 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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Indications for Use

510(k) Number (if known) K160875

Device Name

Cardinal Health™ Sterile Polyisoprene Powder-Free Orthopedic Surgical Gloves with Hydrogel Coating

Indications for Use (Describe)

A powder-free sterile surgeon's glove is a disposable device made of synthetic rubber intended to be worn by operating room personnel to protect a surgical wound from contamination.

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)

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Image /page/3/Picture/0 description: The image features the logo for Cardinal Health. The logo consists of a stylized red graphic above the company name. The graphic is composed of several curved lines that converge to a point, resembling a bird in flight. The text "CardinalHealth" is written in a bold, sans-serif font.

Cardinal Health 1500 Waukegan Road Waukegan, IL 60085 cardinalhealth.com

Page 1 of 5

510(k) SUMMARY

Cardinal Health™ Sterile Polyisoprene Powder-Free Orthopedic Surgical Gloves with Hydrogel Coating

| Manufacturer: | Cardinal Health 200, LLC
1500 Waukegan Road
Waukegan, IL 60085 |
|----------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Regulatory Affairs Contact: | Megan Middaugh
1500 Waukegan Road
Waukegan, IL 60085 |
| Telephone Number: | (847) 887-6812 |
| Fax Number: | (847) 887-2461 |
| Date Summary Prepared: | June 9, 2016 |
| Product Trade Name: | Cardinal Health™ Sterile Polyisoprene Powder-Free Orthopedic
Surgical Gloves with Hydrogel Coating |
| Common Name: | Orthopedic Surgeon's Gloves |
| Classification Name: | Surgeon's Gloves |
| Classification Panel: | General and Plastic Surgery |
| Regulation: | 21 CFR 878.4460 |
| Product Code: | KGO |
| Predicate Devices: | 1) Esteem Ortho Polyisoprene Powder-Free Surgical Sterile
Gloves previously cleared under K092304 on September 15,
2009

  1. Sterile Latex Powder-Free Surgical Orthopedic Gloves with
    Hydrogel Coating cleared under K151778 on March 24, 2016 |
    | Reason for 510(k)
    Submission: | New device |
    | Device Description: | The proposed device is a disposable device. It is not made with
    natural rubber latex. Instead, the gloves are formulated using
    polyisoprene, which is a synthetic rubber latex, and is brown in
    color. The glove is coated with hydrogel polymer coating.

The gloves are manufactured using molds that feature anti-slip
finish, independent thumb and mechanically locking cuffs to help
prevent cuff roll down. They are offered powder-free and sterile.
This glove is for single use only.

This glove is suitable for use as a specialty surgical glove intended
for orthopedic procedures or other procedures where a thicker
barrier may be desired such as trauma and reconstructive surgery |
| Intended Use: | A powder-free sterile surgeon's glove is a disposable device
made of synthetic rubber intended to be worn by operating room
personnel to protect a surgical wound from contamination. |
| Substantial Equivalence: | Cardinal Health™ Sterile Polyisoprene Powder-Free Orthopedic
Surgical Gloves with Hydrogel Coating are substantially
equivalent to Esteem Ortho Polyisoprene Powder-Free Surgical
Sterile Gloves and the Sterile Latex Powder-Free Surgical
Orthopedic Gloves with Hydrogel Coating in regards to intended
use, sizes, physical characteristics, design and product features. All
three gloves are intended for use as specialty orthopedic surgeon's
gloves |

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Image /page/4/Picture/0 description: The image shows the logo for Cardinal Health. The logo consists of a stylized red bird-like symbol above the words "CardinalHealth" in a bold, black font. The bird symbol is made up of several curved lines that resemble feathers or wings.

Page 2 of _5

510(K) SUMMARY (CONT'D)

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Page 3 of _5

Table 1: Summary of Technological Characteristics

Summary of the technological characteristics of the device compared to the predicate devices
CharacteristicNew Device
Cardinal Health™ Sterile Polyisoprene Powder-Free
Orthopedic Surgical Gloves with Hydrogel CoatingPredicate Device
Esteem Ortho Polyisoprene Powder-Free
Surgical Sterile Gloves
(K092304)Predicate Device
Sterile Latex Powder-Free Surgical
Orthopedic Gloves with Hydrogel Coating
(K151778)
Material CompositionSynthetic Polyisoprene coated with Hydrogel polymerSynthetic PolyisopreneNatural Rubber Latex coated with Hydrogel
DesignHand Specific
Independent Thumb
Beaded Cuff
Lubricated
Polymer CoatingHand Specific
Independent Thumb
Beaded Cuff
LubricatedHand Specific
Independent Thumb
Beaded Cuff
Lubricated
Polymer Coating
Intended Use /
Indication for UsePowder-Free Orthopedic Surgeon's GlovePowder-Free Orthopedic Surgeon's GlovePowder-Free Orthopedic Surgeon's Glove
Label ClaimsSterile
Powder-free
Polyisoprene Surgical Glove with Hydrogel Coating
Not made with natural rubber latex
Single Use Only
Orthopedic
AQL 0.65 (Freedom from Holes per ASTM D5151)Sterile
Powder-free
Not made with natural rubber latex
For Single Use Only
OrthopedicSterile
Powder-free
Latex Surgical Glove with Hydrogel
Coating
Single Use Only
Orthopedic
AQL 0.65 (Freedom from Holes per ASTM
D5151)
Dimensions &
Physical PropertiesMeets ASTM D3577Meets ASTM D3577Meets ASTM D3577
Freedom from HolesMeets 21CFR 800.20 & ASTM D3577 requirements
of AQL 1.5Meets 21CFR 800.20 & ASTM D3577
requirements of AQL 1.5Meets 21CFR 800.20 & ASTM D3577
requirements of AQL 1.5
Powder ResidualMeets requirements of ≤2.0 mg/glove for Powder-
Free designation per ASTM D3577Meets requirements of ≤2.0 mg/glove for
Powder-Free designation per ASTM D3577Meets requirements of ≤2.0 mg/glove for
Powder-Free designation per ASTM D3577
Biocompatibility
(Irritation, ISO
10993-0:2010;
Sensitization, ISO
10993-10: 2010)Non-Irritating, under the conditions of the study
Non-sensitizing, under the conditions of the studyNon-Irritating, under the conditions of the study
Non-sensitizing, under the conditions of the
studyNon-Irritating, under the conditions of the
study
Non-sensitizing, under the conditions of the
study

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Table 2: Summary of Non-Clinical Tests

PERFORMANCE DATA
SUMMARY OF NON-CLINICAL TESTS CONDUCTED FOR DETERMINATION
OF SUBSTANTIAL EQUIVALENCE
Performance Test Summary-New Device
CharacteristicStandard/Test/FDA
GuidanceResults Summary
Biocompatibility:
Primary Skin
IrritationISO 10993-10Non-Irritating, under the conditions of the study
Guinea Pig
MaximizationISO 10993-10Non-sensitizing, under the conditions of the study
Physical Characteristics:
DimensionsASTM D3577Meets requirements
Physical PropertiesASTM D3577Meet requirements for synthetic surgical
gloves
Freedom from Holes21 CFR 800.20 &
ASTM D3577Tested in accordance with ASTM D 5151
and meets 21CFR 800.20 & ASTM
D3577 requirements of AQL 1.5
Powder ResidualASTM D3577 tested
using ASTM
standard D6124Gloves meet powder level requirements for
"Powder-Free" designation per ASTM
D3577. Results generated values