K Number
K191869
Device Name
Biogel(R) PI UltraTouch S Surgical Glove with a Low Dermatitis Potential Claim, Biogel(R) PI UltraTouch S Indicator Underglove with a Low Dermatitis Potential Claim
Date Cleared
2020-03-13

(245 days)

Product Code
Regulation Number
878.4460
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Biogel® PI UltraTouch S Surgical Glove with a Low Dermatitis Potential Claim is a disposable device made of polyisoprene, that is intended to be worn on the hands, usually in a surgical setting, to provide a barrier against potentially infectious material and other contaminants. The Biogel® PI UltraTouch S Indicator Underglove with a Low Dermatitis Potential Claim is a disposable device made of polyisoprene, blue in color, that is intended to be worn on the hands, usually in a surgical setting, to provide a barrier against potentially infectious material and other contaminants.
Device Description
Subject of this submission are two surgical gloves: a single-use, sterile, straw-colored overglove which is a disposable, powder-free surgical glove made from synthetic polyisoprene, and a single-use, sterile, blue underglove which is a disposable, powder-free surgical glove made from synthetic polyisoprene. The overglove, and underglove may be used independently or worn as a double-gloving pair if desired.
More Information

Not Found

No
The document describes surgical gloves and their physical and performance characteristics. There is no mention of AI or ML technology.

No
The device is described as a surgical glove intended to provide a barrier against contaminants, not to treat or cure a disease or condition.

No

Explanation: The device is described as a surgical glove intended to provide a barrier against infectious material, not to diagnose any condition.

No

The device is a physical surgical glove made of polyisoprene, not software.

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

Here's why:

  • Intended Use: The intended use is clearly stated as providing a barrier against potentially infectious material and other contaminants when worn on the hands in a surgical setting. This is a physical barrier function, not a diagnostic test performed on samples from the human body.
  • Device Description: The device is described as a surgical glove made of polyisoprene. This aligns with a physical barrier device, not an IVD.
  • Lack of IVD Characteristics: The text does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in samples
    • Providing information for diagnosis, monitoring, or treatment decisions based on sample analysis.

The device is a surgical glove, which falls under the category of medical devices used for protection and barrier purposes.

N/A

Intended Use / Indications for Use

The Biogel® PI UltraTouch S Surgical Glove with a Low Dermatitis Potential Claim is a disposable device made of polyisoprene, that is intended to be worn on the hands, usually in a surgical setting, to provide a barrier against potentially infectious material and other contaminants.

The Biogel® PI UltraTouch S Indicator Underglove with a Low Dermatitis Potential Claim is a disposable device made of polyisoprene, blue in color, that is intended to be worn on the hands, usually in a surgical setting, to provide a barrier against potentially infectious material and other contaminants.

Product codes

KGO

Device Description

Subject of this submission are two surgical gloves: a single-use, sterile, straw-colored overglove which is a disposable, powder-free surgical glove made from synthetic polyisoprene, and a single-use, sterile, blue underglove which is a disposable, powder-free surgical glove made from synthetic polyisoprene. The overglove, and underglove may be used independently or worn as a double-gloving pair if desired.

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

surgical setting

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)

Biocompatibility:

  • Primary Skin Irritation: Under the conditions of the study, not an irritant.
  • ISO Closed Patch Sensitization: Under the conditions of the study, not a sensitizer.
  • Acute Systemic Toxicity Study: Under the conditions of the study, no mortality or evidence of systemic toxicity from the extracts.

Performance Test:

  • Low Dermatitis Potential (Modified Draize-95 Test): Under the conditions of the study, the subject devices demonstrated Low dermatitis potential: reduced potential for sensitizing users to chemical additives.

Physical characteristics:

  • Dimensions: Meets ASTM D3577-09(2015) requirements for length, width, and thickness. Identical to predicate.
  • Physical Properties: Meets ASTM D3577-09(2015) requirements for tensile strength and elongation at break before and after accelerated aging. Identical to Predicate.
  • Freedom from holes: Exceeds 21 CFR 800.20 and ASTM D3577-09(2015) requirements of AQL 1.5. Identical to predicate.
  • Powder residual: Meets powder level requirements for "Powder-free" designation per ASTM D3577-09(2015). Identical to predicate.

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

Not Found

Predicate Device(s)

K190077

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).

0

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services-USA seal. To the right of the seal is the FDA logo in blue, with the words "U.S. FOOD & DRUG" stacked on top of the word "ADMINISTRATION".

March 13, 2020

Molnlycke Health Care, US LLC Leonard Stewart Regulatory Affairs Specialist 5550 Peachtree Parkway, Suite 500 Norcross, Georgia 30092

Re: K191869

Trade/Device Name: Biogel PI UltraTouch S Surgical Glove with a Low Dermatitis Potential Claim, Biogel PI UltraTouch S Indicator Underglove with a Low Dermatitis Potential Claim Regulation Number: 21 CFR 878.4460 Regulation Name: Non-Powdered Surgeon's Glove Regulatory Class: Class I, reserved Product Code: KGO Dated: February 17, 2020 Received: February 18, 2020

Dear Leonard Stewart:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

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/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely.

Elizabeth Claverie, M.S. Assistant Director DHT4B: Division of Infection Control and Plastic Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known)

K191869

Device Name

Biogel® PI UltraTouch S Surgical Glove with a Low Dermatis Potential Claim and Biogel® PI UltraTouch S Indicator Underglove with a Low Dermatitis Potential Claim

Indications for Use (Describe)

The Biogel® PI UltraTouch S Surgical Glove with a Low Dermatitis Potential Claim is a disposable device made of polyisoprene, that is intended to be worn on the hands, usually in a surgical setting, to provide a barrier against potentially infectious material and other contaminants.

The Biogel® PI UltraTouch S Indicator Underglove with a Low Dermatitis Potential Claim is a disposable device made of polyisoprene, blue in color, that is intended to be worn on the hands, usually in a surgical setting, to provide a barrier against potentially infectious material and other contaminants

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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3

510(k) SUMMARY (K191869)

for

Biogel® PI UltraTouch S Surgical Glove with Low Dermatitis Potential Claim and Biogel® PI UltraTouch S Indicator Underglove with Low Dermatitis Potential Claim

Date Prepared:March 11, 2020
Submission Sponsor:Mölnlycke Health Care US, LLC
5550 Peachtree Parkway, Suite 500
Norcross, GA 30092
Registration number: 3004763499
Owner/Operator Number: 8030877
Submission Correspondent:Leonard Stewart
Regulatory Affairs Specialist
Tel: 470-375-0178
Fax: 678-245-7746
email: leonard.stewart@molnlycke.com
Trade/Proprietary Names:Biogel® PI UltraTouch S Surgical Glove with a Low Dermatitis
Potential Claim and Biogel® PI UltraTouch S Indicator Underglove
with a Low Dermatitis Potential Claim
Regulation Name:Non-powered surgeon's glove
Common Name:Surgeon's Glove
Classification Name:Surgeon's Glove
Device Class:Class I
Regulation Number:21 CFR 878.4460
Product Code:KGO
510(k) Submission Number:
Predicate Device Name(s):Biogel® PI UltraTouch S Surgical Glove and Biogel® PI UltraTouch
S Indicator Underglove (K190077)

Subject of this submission are two surgical gloves: a single-use, sterile, straw-colored overglove which is a disposable, powder-free surgical glove made from synthetic polyisoprene, and a single-use, sterile, blue underglove which is a disposable, powder-free surgical glove made from synthetic polyisoprene. The overglove, and underglove may be used independently or worn as a double-gloving pair if desired.

Indications for Use:

The Biogel® PI UltraTouch S Surgical Glove with a Low Dermatitis Potential Claim is a disposable device made of polyisoprene, that is intended to be worn on the hands, usually in a surgical setting, to provide a barrier against potentially infectious material and other contaminants.

4

The Bioge® Pl UltraTouch S Indicator Underglove with a Low Dermatitis Potential Claim is a disposable device made of polyisoprene, blue in color, that is intended to be worn on the hands, usually in a surgical setting, to provide a barrier against potentially infectious material and othercontaminants

| | Technological Characteristics:
Summary of technological characteristics of the subject device
compared to the predicate device
(overglove) | | | | (underglove) | | | |
|-----------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------|--|--|
| | Biogel® PI
UltraTouch S
Surgical
Glove with
Low
Dermatitis
Potential
Claim
(Subject
Device) | Biogel® PI
UltraTouch
S Surgical
Glove
(Predicate
Device) | Comment | Biogel® PI
UltraTouch S
Indicator
Underglove
with Low
Dermatitis
Potential
Claim
(Subject
Device) | Biogel® PI
UltraTouch
S Indicator
Underglove
(Predicate
Device) | Comment | | |
| 510(k)
Number | K191869 | K190077 | - | K191869 | K190077 | - | | |
| Manufacturer | Mölnlycke | Mölnlycke | Identical | Mölnlycke | Mölnlycke | Identical | | |
| Regulation
number | 21CFR
878.4460 | 21CFR
878.4460 | Identical | 21CFR
878.4460 | 21CFR
878.4460 | Identical | | |
| Regulation
name | Surgeon's
Glove | Surgeon's
Glove | Identical | Surgeon's
Glove | Surgeon's
Glove | Identical | | |
| Regulatory
class | Class 1 | Class 1 | Identical | Class 1 | Class 1 | Identical | | |
| Product code | KGO | KGO | Identical | KGO | KGO | Identical | | |
| Intended use | Powder-Free
Surgeon's
Glove | Powder-Free
Surgeon's
Glove | Identical | Powder-Free
Surgeon's
Glove | Powder-Free
Surgeon's
Glove | Identical | | |
| Indication for
use | Biogel® PI
UltraTouch S
Surgical Glove
with a low
dermatitis
potential claim
is a
disposable
device made
of
polyisoprene,
that is
intended to be
worn on the
hands, usually
in surgical
settings, to
provide a
barrier against | Biogel® PI
UltraTouch S
Surgical
Glove is a
disposable
device made
of
polyisoprene,
that is
intended to
be worn on
the hands,
usually in
surgical
settings, to
provide a
barrier
against | Same | Biogel® PI
UltraTouch S
Indicator
Underglove
with a low
dermatitis
potential claim
is a disposable
device made of
polyisoprene,
blue in color
that is intended
to be worn on
the hands,
usually in
surgical
settings, to
provide a
barrier against | Biogel® PI
UltraTouch S
Indicator
Underglove
is a
disposable
device made
of
polyisoprene,
blue in color
that is
intended to
be worn on
the hands,
usually in
surgical
settings, to
provide a
barrier | Same | | |

Technological Characteristics:

5

Summary of technological characteristics of the subject device compared to the predicate device
potentially
infectious
material and
other
contaminantspotentially
infectious
material and
other
contaminantspotentially
infectious
material and
other
contaminantspotentially
infectious
material and
other
contaminants
Low
Dermatitis
Potential
ClaimLow
dermatitis
potential:
reduced
potential for
sensitizing
users to
chemical
additivesLow
dermatitis
potential:
reduced
potential for
sensitizing
users to
chemical
additives
MaterialSynthetic
PolyisopreneSynthetic
PolyisopreneIdenticalSynthetic
PolyisopreneSynthetic
PolyisopreneIdentical
DesignSingle useSingle useIdenticalSingle useSingle useIdentical
SterileSterileIdenticalSterileSterileIdentical
Powder-freePowder-freeIdenticalPowder-freePowder-freeIdentical
Hand specificHand specificIdenticalHand specificHand specificIdentical
Beaded CuffBeaded cuffIdenticalBeaded cuffBeaded cuffIdentical
CoatingYesYesIdenticalYesYesIdentical
ColorStraw
(Natural)Straw
(Natural)IdenticalBlueBlueIdentical
Sterilization
methodRadiationRadiationIdenticalRadiationRadiationIdentical
Sterility
Assurance
Level (SAL)10-6 SAL10-6 SALIdentical10-6 SAL10-6 SALIdentical
Dimensions
& physical
propertiesMeets ASTM
D3577-
09(2015)Meets ASTM
D3577-
09(2015)IdenticalMeets ASTM
D3577-
09(2015)Meets ASTM
D3577-
09(2015)Identical
Freedom
from holesAQL meets 21
CFR 800.20
and ASTM
D3577-
09(2015)
requirementsAQL meets
21 CFR
800.20 and
ASTM
D3577-
09(2015)
requirementsIdenticalAQL meets 21
CFR 800.20
and ASTM
D3577-
09(2015)
requirementsAQL meets
21 CFR
800.20 and
ASTM
D3577-
09(2015)
requirementsIdentical
Powder
residualMeets
requirements
of ≤ 2.0
mg/glove for
Powder-free
designation
per ASTM
D3577-
09(2015)Meets
requirements
of ≤ 2.0
mg/glove for
Powder-free
designation
per ASTM
D3577-
09(2015)IdenticalMeets
requirements of
≤ 2.0 mg/glove
for Powder-free
designation per
ASTM D3577-
09(2015)Meets
requirements
of ≤ 2.0
mg/glove for
Powder-free
designation
per ASTM
D3577-
09(2015)Identical

6

Summary of Non-Clinical/Clinical Testing:

Summary of Non-Clinical Testing
Standard/Test/FDA GuidanceBiogel® PI UltraTouch S Surgical Glove with Low Dermatitis Potential Claim (Subject Device)Biogel® PI UltraTouch S Indicator Underglove with Low Dermatitis Potential Claim (Subject Device)
Biocompatibility:
Primary Skin IrritationISO 10993-10:2010 Biological evaluation of medical devices — Part 10: Tests for irritation and skin sensitizationUnder the conditions of the study, not an irritant.Under the conditions of the study, not an irritant.
ISO Closed Patch SensitizationISO 10993-10:2010 Biological evaluation of medical devices — Part 10: Tests for irritation and skin sensitizationUnder the conditions of the study, not a sensitizer.Under the conditions of the study, not a sensitizer.
Acute Systemic Toxicity StudyISO 10993-11:2010 Biological evaluation of medical devices — Part 11: Tests for systemic toxicityUnder the conditions of the study, no mortality or evidence of systemic toxicity from the extracts.Under the conditions of the study, no mortality or evidence of systemic toxicity from the extracts.
Performance Test:
Low Dermatitis PotentialModified Draize-95 TestUnder the conditions of the study, the subject devices demonstrated Low dermatitis potential: reduced potential for sensitizing users to chemical additivesUnder the conditions of the study, the subject devices demonstrated Low dermatitis potential: reduced potential for sensitizing users to chemical additives
Physical characteristics:
DimensionsASTM D3577-09(2015) Standard Specification for Rubber Surgical GlovesMeets ASTM D3577-09(2015) requirements for length, width, and thickness. Identical to predicate.Meets ASTM D3577-09(2015) requirements for length, width, and thickness. Identical to predicate.
Physical PropertiesASTM D3577-09(2015) Standard Specification for Rubber Surgical GlovesMeets ASTM D3577-09(2015) requirements for tensile strength and elongation at break before and after accelerated aging. Identical to Predicate.Meets ASTM D3577-09(2015) requirements for tensile strength and elongation at break before and after accelerated aging. Identical to Predicate.
Freedom from holesASTM D5151-06(2015) Standard Test Method for Detection of Holes in Medical Gloves
ASTM D3577-09(2015) Standard Specification for Rubber Surgical GlovesExceeds 21 CFR 800.20 and ASTM D3577-09(2015) requirements of AQL 1.5. Identical to predicate.Exceeds 21 CFR 800.20 and ASTM D3577-09(2015) requirements of AQL 1.5. Identical to predicate.
Powder residualASTM D6124-06(2017) Standard Test Method for Residual Powder on Medical Gloves
ASTM D3577-09(2015) Standard Specification for Rubber Surgical GlovesMeets powder level requirements for "Powder-free" designation per ASTM D3577-09(2015). Identical to predicate.Meets powder level requirements for "Powder-free" designation per ASTM D3577-09(2015). Identical to predicate.

7

Clinical Data Summary
Biogel® PI UltraTouch S
Surgical Glove with Low
Dermatitis Potential Claim
(Subject Device), Biogel® PI
UltraTouch S Indicator
Underglove with Low
Dermatitis Potential
Claim (Subject Device)Biogel® PI UltraTouch S
Surgical Glove (Predicate
Device), Biogel® PI
UltraTouch S Indicator
Underglove (Predicate
Device)Comment
Clinical testingClinical data was not requiredClinical data was not
requiredIdentical

Conclusion:

The conclusions drawn from the nonclinical test for Biogel® Pl UltraTouch S Surgical Glove with a low dermatitis potential claim and Biogel® Pl UltraTouch S Indicator Underglove with a low dermatitis potential claim demonstrates that these subject devices are as safe, as effective, and perform as well or better than the legally marketed predicate devices Biogel® Pl UltraTouch S Surgical Glove and Biogel® PI UltraTouch S Indicator Underglove (K190077).