K Number
K173228
Device Name
U-MED Powder Free Polyethylene Examination Gloves,Blue Color
Date Cleared
2018-02-20

(139 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Powder Free Polyethylene Examination Gloves,Blue Color 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
The U-MED Powder Free Polyethylene Examination Gloves,Blue Color are nonsterile disposable Patient examination glove. The gloves are made of translucent (clear), Low Density Polyethylene material and are powder free. The U-MED Powder Free Polyethylene Examination Gloves,Blue Color come in four sizes: Small, Medium, Large, X Large. The Powder Free Polyethylene Examination Gloves, Blue Color acts as a barrier to prevent contamination between patient and examiner. The physical and performance characteristics of the devices meets all requirements of ASTM D5250 and ASTM D5151.
More Information

Not Found

No
The device is a simple examination glove and the summary contains no mention of AI, ML, or any computational analysis of data.

No
The device is a non-sterile disposable examination glove used as a barrier to prevent contamination, not to treat or cure a medical condition.

No
The device is described as an examination glove intended to prevent contamination between patient and examiner, not to diagnose a condition.

No

The device description clearly states it is a physical glove made of polyethylene material, not software.

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

Here's why:

  • Intended Use: The intended use clearly states the gloves are "worn on the examiner's hand or finger to prevent contamination between patient and examiner." This describes a physical barrier function, not a diagnostic test performed on a sample from the body.
  • Device Description: The description focuses on the material, size, and physical properties of the gloves, reinforcing their role as a barrier.
  • Lack of Diagnostic Elements: There is no mention of analyzing samples (blood, urine, tissue, etc.), detecting biomarkers, or providing information for diagnosis.
  • Performance Studies: The performance studies focus on physical properties like tensile strength, elongation, powder residual, and water leak testing, which are relevant to a barrier device, not a diagnostic one.

IVD devices are used to examine specimens derived from the human body to provide information for the diagnosis, prevention, monitoring, treatment, or alleviation of disease. This description does not align with that definition.

N/A

Intended Use / Indications for Use

Powder Free Polyethylene Examination Gloves,Blue Color 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)

LZA

Device Description

The U-MED Powder Free Polyethylene Examination Gloves,Blue Color are nonsterile disposable Patient examination glove. The gloves are made of translucent (clear), Low Density Polyethylene material and are powder free. The U-MED Powder Free Polyethylene Examination Gloves,Blue Color come in four sizes: Small, Medium, Large, X Large.

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 (for 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)

Non-Clinical Performance Data: U-MED Powder Free Polyethylene Examination Gloves,Blue Color, meet requirements per ASTM D5250-06(Reapproved 2015), per ASTM D6124-06 Reaffirmation 2011), per 21 CFR 800.20 and ISO 10993-10:2010-08-01.
Those verification tests of gloves were performed by qualified test centers according to the above standards and included dimensions, Tensile strength (Before & After aging) & Elongated rate (Before & After aging), powder residual, water leak testing, a n d biocompatibility.t. The overall results of the testing demonstrated that the subject glove passed testing performed according to ASTM D5250, Tensile strength (Before & After aging) was demonstrated more than 11MPa, Elongated rate (Before & After aging) was demonstrated more than 300%, powder residual was demonstrated less than 2 mg/device. The subject glove also did not raise any biocompatibility concerns when tested according to ISO 10993-5 and ISO 10993-10.The detail information for the non-clinical testing performed was shown on section 7.0 Summary of the Technological Characteristics of the Device.

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

Tensile strength (Before & After aging) $\ge$ 11MPa
Elongated rate (Before & After aging) $\ge$ 300%
Powder Residual

§ 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/0 description: The image contains the logos of the U.S. Department of Health & Human Services and the U.S. Food & Drug Administration (FDA). The Department of Health & Human Services logo is on the left, featuring an abstract symbol. To the right is the FDA logo, with the letters 'FDA' in a blue square, followed by the words 'U.S. FOOD & DRUG ADMINISTRATION' in blue text.

February 20, 2018

Jiangsu U-MED Rubber & Plastic Products Co.,Ltd. % Chu Xiaoan Official Correspondent Beijing Easylink CO., LTD Rm. F302 Bldg., 41, Jing Cheng Ya Ju, Courtyard 6 of Southern Dou Ge Zhuang, Beijing, 100021 CN

Re: K173228

Trade/Device Name: U-MED Powder Free Polyethylene Examination Gloves,Blue Color Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: Class I Product Code: LZA Dated: September 22, 2017 Received: November 22, 2017

Dear Chu 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.

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

1

801); 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.

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.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Michael J. Ryan -S

for Tina Kiang, Ph.D. Acting Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control, and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K173228

Device Name

U-MED Powder Free Polyethylene Examination Gloves,Blue Color

Indications for Use (Describe)

Powder Free Polyethylene Examination Gloves,Blue Color 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)❍ Prescription Use (Part 21 CFR 801 Subpart D)❌ Over-The-Counter Use (21 CFR 801 Subpart C)
❍ Prescription Use (Part 21 CFR 801 Subpart D)❌ Over-The-Counter Use (21 CFR 801 Subpart C)

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3

510(K) Summary

"The assigned 510(k) number is: _________K173228

Premarket Notification [510(k)] Summary

Submitter: 1.0

| Submitter's name : | Jiangsu U-MED Rubber & Plastic Products
Co.,Ltd. |
|-------------------------|---------------------------------------------------------------------------------|
| Submitter's address : | Luzhuang Road,Suyu High-Tech Zone,Suqian
City,Jiangsu Province,223804,China. |
| Phone number : | 0086-512-81625988 |
| Fax number : | 0086-512-58455833 |
| Name of contact person: | Chen Ye |
| Date of preparation : | 2018-01-24 |

2.0 Name of the Device

| Device Name: | U-MED Powder Free Polyethylene
Examination Gloves,Blue Color |
|------------------------|-----------------------------------------------------------------|
| Common Name: | Exam gloves |
| Classification Name: | Patient examination glove |
| Device Classification: | I |
| Regulation Number: | 21 CFR 880.6250 |
| Panel: | General Hospital |
| Product Code: | LZA |

3.0 Predicate device

C2 Powder Free Polyethylene Examination Glove
AmerCare Inc.
K113639
-
21 CFR 880.6250
LZA

4.0 Device Description:

The U-MED Powder Free Polyethylene Examination Gloves,Blue Color are nonsterile disposable Patient examination glove. The gloves are made of translucent (clear), Low Density Polyethylene material and are powder free. The U-MED Powder Free Polyethylene Examination Gloves,Blue Color come in four sizes: Small, Medium, Large, X Large.

4

The Powder Free Polyethylene Examination Gloves, Blue Color acts as a barrier to prevent contamination between patient and examiner. The physical and performance characteristics of the devices meets all requirements of ASTM D5250 and ASTM D5151.

5.0 Indication for use:

Powder Free Polyethylene Examination Gloves, Blue Color 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.

6.0 Comparison table:

| Features & Description | Predicate Device | Subject Device | Result of
Comparison |
|------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------|
| Company | AmerCare Inc. | Jiangsu U-MED Rubber & Plastic Products Co.,Ltd. | -- |
| 510(K) Number | K113639 | K173228 | -- |
| Product name | Powder Free Polyethylene Examination Glove | U-MED Powder Free Polyethylene Examination Gloves,Blue Color | Similar |
| Product Code | LZA | LZA | Same |
| Size | Small/ Medium/ Large/X large | Small/ Medium/ Large/X large | Same |
| Indication for use | A powder-free ,no-sterile patient examination gloves is disposable device intended for ,medical purposes to be worn on the examiner's hand or finger to prevent contamination between patient and examiner. | Powder Free Polyethylene Examination Gloves,Blue Color 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. | Similar |
| Device Description and Specifications | Meets ASTM D5250-06 (Reapproved 2011) | Meets ASTM D5250-06 (Reapproved 2015) | Same |
| Dimensions:
Overall length, Width, Palm and Finger thickness | Meets ASTM D5250-06 (Reapproved 2011) | Meets ASTM D5250-06 (Reapproved 2015) | Same |
| Physical Properties
Tensile Strength before aging/after aging | Meets ASTM D5250-06 (Reapproved 2011) | Meets ASTM D5250-06 (Reapproved 2015) | Same |
| Ultimate Elongation before aging/after aging | Meets ASTM D5250-06 (Reapproved 2011) | Meets ASTM D5250-06 (Reapproved 2015) | Same |
| Freedom from Pinholes
Holes | Holes at Inspection Level I AQL2.5 | Holes at Inspection Level I AQL2.5 | Same |
| Residual Powder | Meets ASTM D5250-06 (Reapproved 2011) | Meets ASTM D5250-06 (Reapproved 2015) | Same |
| Materials used to fabricate the devices | Polyethylene | Polyethylene | Same |

5

ColorTranslucent [clear]Blue colorDifferent
Compare performance
data supporting
substantial equivalenceMeets
ASTM D5151-06
(Reapproved 2011)
ASTM D5250-06
(Reapproved 2011)
ASTM D6124-06
(Reaffirmation 2011)Meets
ASTM D5151-06
(Reapproved 2015)
ASTM D5250-06
(Reapproved 2015)
ASTM D6124-06
(Reaffirmation 2011)Same
Single Patient UseSingle Patient UseSingle Patient UseSame
BiocompatibilityUnder the conditions of
this study, not an irritant
and Under the conditions
of this study, not a
sensitizer.
SKIN IRRITATION
DERMAL and
SENSITIZATION
STUDIES Meets ISO
10993-10:2002/Amd.1:20
06Under the conditions of
this study, not an irritant
and Under the conditions
of this study, not a
sensitizer.
SKIN IRRITATION
DERMAL and
SENSITIZATION
STUDIES Meets ISO
10993-10 Third Edition
2010-08-01Same
Labeling for the legally
marketed device to
which substantial
equivalence is claimed.There are no special
labeling claims and we do
not claim our gloves as
hypoallergenic on our
labels.
-Powder Free
-Patient Examination
Glove
-Single Use Only
  • Manufactured For:
  • Lot | There are no special
    labeling claims and we do
    not claim our gloves as
    hypoallergenic on our
    labels.
    -Powder Free
    -Patient Examination
    Glove
    -Single Use Only
  • Manufactured For:
  • Lot | Same |

7.0 Summary of the Technological Characteristics of the Device:

Powder Free Polyethylene Examination Gloves, Blue Color are summarized with the following technological characteristics compared to ASTM or equivalent standard.

CharacteristicsStandard
ASTM D 5250-06(Reapproved 2015).
DimensionLength
$\ge$ 230mm
Width
Small 80-90 mm
Medium 90-100mm
Large 100-110mm
X large 110-120 mm
Thickness Fingertip $\ge$ 0.05mm
Palm $\ge$ 0.08mm
Physical
PropertiesASTM D 5250-06(Reapproved 2015).
Tensile strength (Before & After aging) $\ge$ 11MPa
Elongated rate (Before & After aging) $\ge$ 300%
Freedom from
pinholes21 CFR 800.20 Passed Standard Acceptance Criteria
ASTM D5250-06(Reapproved 2015)
ASTM D5151-06(Reapproved 2015)
Powder
ResidualASTM standard D 5250-06(Reapproved 2015).and D6124-06(Reaffirmation 2011) Meets