Vinyl Examination Glove (Clear, Non-Colored)

• K Number: K180861
• Device Name: Vinyl Examination Glove (Clear, Non-Colored)
• Manufacturer: Zhicheng Trading Co., Ltd.
• Date Cleared: 2018-06-13 ( 72 days)
• Product Code: LYZ
• Regulation Number: 880.6250

Intended Use

The Vinyl Examination Glove (Clear, Non-Colored) is a disposable device intended for medical purposes that is worn on the examiner's hands to prevent contamination between patient and examiner.

Device Description

The proposed device is Powder Free Vinyl Patient Examination Gloves. The colors of proposed device is clear, non-colored. The design of proposed device is addressing the standards as ASTM D6124, ASTM D5151, and ASTM D5250. The proposed device is non-sterile.

Predicate Devices

K163168

Reference Devices

Not Found

AI/ML (Artificial Intelligence / Machine Learning)

No
The device is a simple vinyl examination glove and the summary contains no mention of AI or ML.

Therapeutic

No.
The device, a Vinyl Examination Glove, is intended to prevent contamination between patient and examiner and does not claim to treat or cure any medical condition.

Diagnostic

No

Explanation: The device, a disposable examination glove, is for preventing contamination between patient and examiner. It does not gather or process data to diagnose a condition.

SaMD (Software as a Medical Device)

No

The device is a physical examination glove, which is a hardware device, not software.

IVD (In Vitro Diagnostic)

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

• Intended Use: The intended use is clearly stated as a "disposable device intended for medical purposes that is worn on the examiner's hands to prevent contamination between patient and examiner." This describes a barrier device used for infection control, not a device used to examine specimens derived from the human body for the purpose of providing information for diagnosis, monitoring, or treatment.
• Device Description: The description focuses on the physical properties and standards related to examination gloves (tensile strength, freedom from holes, etc.). There is no mention of reagents, calibrators, controls, or any components typically associated with in vitro diagnostic tests.
• Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
  • Analyzing biological samples (blood, urine, tissue, etc.)
  • Detecting specific analytes (proteins, genes, pathogens, etc.)
  • Providing diagnostic information
  • Using laboratory equipment for analysis

The device is a medical device, specifically a Class I examination glove, but it does not fit the definition of an In Vitro Diagnostic device.

PCCP (Predetermined Change Control Plan) Authorized

N/A

Overview

Intended Use / Indications for Use

The Vinyl Examination Glove (Clear, Non-Colored) is a disposable device intended for medical purposes that is worn on the examiner's hands to prevent contamination between patient and examiner.

Product codes

LYZ

Device Description

The proposed device is Powder Free Vinyl Patient Examination Gloves. The colors of proposed device is clear, non-colored. The design of proposed device is addressing the standards as ASTM D6124, ASTM D5151, and ASTM D5250. The proposed device is non-sterile.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

hands

Indicated Patient Age Range

Not Found

Intended User / Care Setting

examiner / Not Found

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

Non clinical tests were conducted to verify that the proposed device met all design specifications or acceptance criteria of the standards. The test results demonstrated that the proposed device met the design or acceptance criteria of the following standards:

• ISO 10993-10:2010 Biological Evaluation Of Medical Devices - Part 10: Tests For Irritation And Skin Sensitization.
• ISO 10993-5:2009 Biological Evaluation Of Medical Devices - Part 5: Tests For In Vitro Cytotoxicity
• ASTM D6124-06 (Reaffirmation 2011), Standard Test Method for Residual Powder on Medical Gloves
• ASTM D5151-06 (Reapproved 2015), Standard Test Method for Detection of Holes in Medical Gloves.
• ASTM D5250-06 (Reapproved 2015), Standard Specification for Poly(vinyl chloride) Gloves for Medical Application.
• ISO 2859-1:1999, "Sampling Procedures for Inspection by Attributes - Part I: Sampling Plans Indexed by Acceptable Quality Level (AQL) for Lot-by-Lot Inspection.

Key Metrics

Physical Properties:

• Tensile Strength (Before Aging): 15 MPa, min
• Ultimate Elongation (Before Aging): 380 % min
• Tensile Strength (After Aging): 15 MPa, min
• Ultimate Elongation (After Aging): 380 % min
• Comply with ASTM D5250

Freedom from Holes:

• Be free from holes when tested in accordance with ASTM D5151 AQL=1.5

Powder Content:

• 0.4 mg

Biocompatibility:

• Irritation: Under the conditions of the study, not an irritant (Comply with ISO 10993-10)
• Sensitization: Under conditions of the study, not a sensitizer.
• Cytotoxicity: Under conditions of the study, did not show potential toxicity to L-929 cells. Complies with ISO 10993-5

Predicate Device(s)

K163168

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

Regulation Number and Section

§ 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.

Summary

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Image /page/0/Picture/0 description: The image contains the logos of the Department of Health and Human Services and the Food and Drug Administration (FDA). The Department of Health and Human Services logo is on the left, and the FDA logo is on the right. The FDA logo includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

June 13, 2018

Zhicheng Trading Co., Ltd. % Ray Wang General Manager Beijing Believe-Med Technology Service Co., Ltd. Rm.912, Building #15, XiYueHui, No.5, YiHe North Rd. FangShan District Beijing, 102401 Cn

Re: K180861

Trade/Device Name: Vinyl Examination Glove (Clear, Non-Colored) Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: Class I Product Code: LYZ Dated: March 30. 2018 Received: April 2, 2018

Dear Ray Wang:

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 comprehensive regulatory information about medical devices and radiation-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 ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely,

Elizabeth F. Claverie -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

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known)

K180861

Device Name Vinyl Examination Glove (Clear, Non-Colored)

Indications for Use (Describe)

The Vinyl Examination Glove (Clear, Non-Colored) is a disposable device intended for medical purposes that is worn on the examiner's hands to prevent contamination between patient and examiner.

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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Form Approved: OMB No. 0910-0120

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510(k) Summary

This 510(k) Summary is being submitted in accordance with requirements in 21 CFR 807.92.

The assigned 510(k) Number: K180861

• 1. Date of Preparation:2018/05/14
• 2. Sponsor Identification

ZHICHENG TRADING CO., LTD.

NORTH, BEIJING ROAD, ZHANGDIAN DISTRICT, ZIBO CITY, CHINA 255000 Establishment Registration Number: Not yet registered

Contact Person: Chong Zhao Position:Sales Manager Tel: [phone] Fax: [phone]

Email: [e-mail]

• 3. Designated Submission Correspondent
     Mr. Ray Wang

Beijing Believe-Med Technology Service Co., Ltd.

Tel: [phone], Fax: [phone] Email: [e-mail]

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• 4. Identification of Proposed Device
     Trade Name: Vinyl Examination Glove (Clear, Non-Colored) Common Name: Vinyl Patient Examination Gloves (Powder Free) Model(s): S M L XL

Regulatory Information Classification Name: Vinyl Patient Examination Gloves (Powder Free) Classification:I Product Code: LYZ Regulation Number: 21 CFR 880.6250 Review Panel: General Hospital

Indication for use Statement:

The Vinyl Examination Glove (Clear, Non-Colored) is a disposable device intended for medical purposes that is worn on the examiner's hands to prevent contamination between patient and examiner.

• Device Description న.
  The proposed device is Powder Free Vinyl Patient Examination Gloves. The colors of proposed device is clear, non-colored. The design of proposed device is addressing the standards as ASTM D6124, ASTM D5151, and ASTM D5250. The proposed device is non-sterile.

Identification of Predicate Device(s) 6.

Predicate Device K163168 Vinyl Patient Examination Gloves (White, Blue, Yellow) Hebei Hongtai Plastic Products Company Limited

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ITEM	Proposed Device	Predicate Device (K163168)	Remark
Product Code	LYZ	LYZ	SAME
Regulation No.	21 CFR 880.6250	21 CFR 880.6250	SAME
Class	I	I	SAME
Intended Use	The Vinyl Patient Examination Glove
(Clear, Non-Colored) is a disposable
device intended for medical purposes that
is worn on the examiner's hands to prevent
contamination between patient and
examiner.	The Vinyl Examination Glove (White,
Blue, or Yellow) is a disposable device
intended for medical purposes that is worn
on the examiner's hands to prevent
contamination between patient and
examiner.	Similiar
Powdered or
Powered free	Powdered free	Powdered free	SAME
Design Feature	ambidextrous	ambidextrous	SAME
Labeling
Information	Single-use indication, powder free, device
color, device name, glove size and quantity,
Vinyl Examination Gloves, Non-Sterile	Single-use indication, powder free, device
color, device name, glove size and quantity,
Vinyl Examination Gloves, Non-Sterile	SAME

Technological Comparison 7.

Table 1 General Comparison

Table 2 Device Dimensions Comparison

		Size
	Designation	XS	S	M	L	XL	Tolerance
	Length, mm	230	230	235	245	245	min
Predicate Device (K163168)	Width, mm	80	85	95	105	115	$\pm 5$
	Thickness, mm:
	Finger	0.05					min
	Palm	0.08					min
		Size
	Designation	S	M	L	XL		Tolerance
	Length, mm	230	235	245	245		min
Proposed Device	Width, mm	85	95	105	115		$\pm 5$
	Thickness, mm:
	Finger	0.05					min
	Palm	0.08					min
Remark	SAME

Table 3 Performance Comparison

ITEM			Proposed Device	Predicate Device (K163168)	Remark
Colorant			Clear, Non-Colored	White, Blue, Yellow	Analysis 1
Physical
Properties	Before
Aging	Tensile
Strength	15 MPa, min	15 MPa, min	SAME

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| | | Ultimate
Elongation | 380 % min | 380 % min | |
|--------------------|----------------|------------------------|----------------------------------------------------------------------------|----------------------------------------------------------------------------|---------|
| | | Tensile
Strength | 15 MPa, min | 15 MPa, min | |
| | After
Aging | Ultimate
Elongation | 380 % min | 380 % min | |
| | | | Comply with ASTM D5250 | Comply with ASTM D5250 | SAME |
| Freedom from Holes | | | Be free from holes when tested in
accordance with ASTM D5151
AQL=1.5 | Be free from holes when tested
in accordance with ASTM
D5151 AQL=1.5 | SAME |
| | | | | | |
| Powder Content | | | 0.4 mg | Meet the requirements of ASTM 5250 | Similar |

Table 4 Safety Comparison

ITEM	Proposed Device	Predicate Device (K163168)	Remark
Material	Vinyl	Vinyl	SAME
Biocompatibility	Irritation	Under the conditions of the study,
not an irritant	Comply with ISO 10993-10	Similar
	Sensitization	Under conditions of the study, not a
sensitizer.
	Cytotoxicity	Under conditions of the study, did
not show potential toxicity to L-929
cells. Complies with ISO 10993-5	/
Label and Labeling		Meet FDA's Requirements	Meet FDA's Requirements	SAME

Analysis 1:

The proposed device has different color to the predicate device, but all proposed devices are conducted the biocompatibility test, the test results shown difference do not effect the safety of proposed device.

8. Non-Clinical Test Conclusion

Non clinical tests were conducted to verify that the proposed device met all design specifications or acceptance criteria of the standards. The test results demonstrated that the proposed device met the design or acceptance criteria of the following standards:

• ISO 10993-10:2010 Biological Evaluation Of Medical Devices - Part 10: Tests For Irritation And Skin Sensitization.

• ISO 10993-5:2009 Biological Evaluation Of Medical Devices - Part 5: Tests For In Vitro Cytotoxicity

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• ASTM D6124-06 (Reaffirmation 2011), Standard Test Method for Residual Powder on Medical Gloves

• ASTM D5151-06 (Reapproved 2015), Standard Test Method for Detection of Holes in Medical Gloves.

• ASTM D5250-06 (Reapproved 2015), Standard Specification for Poly(vinyl chloride) Gloves for Medical Application.

• ISO 2859-1:1999, "Sampling Procedures for Inspection by Attributes - Part I: Sampling Plans Indexed by Acceptable Quality Level (AQL) for Lot-by-Lot Inspection.

• Clinical Test Conclusion 9.

No clinical study is included in this submission.

• 10. Conclusion
      The conclusions drawn from the nonclinical tests demonstrate that the proposed device is as safe, as effective, and performs as well as or better than the legally marketed predicate device.