K Number
K201186
Device Name
KY Grosz Jelly
Manufacturer
Date Cleared
2020-07-30

(90 days)

Product Code
Regulation Number
884.5300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
This product is intended for penile, vaginal and/or anal application to moisturize and lubricate, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is compatible with natural rubber latex and polyisoprene condoms. This product is not compatible with polyurethane condoms.
Device Description
K Y Grosz Jelly is a water-based personal lubricant intended for penile, vaginal and/or anal application to moisturize and lubricate, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is compatible with natural rubber latex and polyisoprene condoms, and is not compatible with polyurethane condoms. Its formulation consists of Water, Propylene glycol, Hydroxyethylcellulose, Benzoic acid, Carbomer, Sodium hydroxide. KY Grosz Jelly may be packaged in 2 oz (57g) and 4 oz (113g) tubes composed of high-density polyethylene (HDPE) and linear low-density polyethylene (LLDPE), sealed with foil and fitted with a polypropylene (PP) cap. The individual tubes may be packaged in an outer cardboard carton. KY Grosz Jelly is a personal lubricant for over-the-counter (OTC) use.
More Information

Not Found

No
The device description and performance studies focus on the physical and chemical properties of a personal lubricant, with no mention of AI or ML technology.

Yes.

The device is intended for moisturizing and lubricating to enhance the ease and comfort of intimate sexual activity, which is a physical benefit rather than a treatment for a disease, and it is a Class II medical device (personal lubricant).

No

This product is a personal lubricant intended to enhance the comfort of intimate sexual activity, not to diagnose a medical condition.

No

The device description clearly states it is a water-based personal lubricant with a specific chemical formulation and is packaged in physical tubes. This indicates a physical product, not software.

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

Here's why:

  • Intended Use: The intended use is for "penile, vaginal and/or anal application to moisturize and lubricate, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication." This describes a product applied to the body for physical effects (lubrication and moisturizing), not a product used to test samples in vitro (outside the body) to diagnose a condition.
  • Device Description: The description confirms it's a "water-based personal lubricant intended for penile, vaginal and/or anal application." This aligns with the intended use and further indicates it's not an IVD.
  • Lack of Diagnostic Purpose: There is no mention of the device being used to detect, measure, or analyze any biological samples (like blood, urine, tissue, etc.) for diagnostic purposes.
  • Performance Studies: The performance studies focus on shelf life, biocompatibility (how it interacts with the body), and condom compatibility, which are relevant for a personal lubricant, not an IVD.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information for the diagnosis, monitoring, or treatment of diseases or conditions. This product does not fit that description.

N/A

Intended Use / Indications for Use

This product is intended for penile, vaginal and/or anal application to moisturize and lubricate, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is compatible with natural rubber latex and polyisoprene condoms. This product is not compatible with polyurethane condoms.

Product codes (comma separated list FDA assigned to the subject device)

NUC

Device Description

K Y Grosz Jelly is a water-based personal lubricant intended for penile, vaginal and/or anal application to moisturize and lubricate, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is compatible with natural rubber latex and polyisoprene condoms, and is not compatible with polyurethane condoms. Its formulation consists of Water, Propylene glycol, Hydroxyethylcellulose, Benzoic acid, Carbomer, Sodium hydroxide. KY Grosz Jelly may be packaged in 2 oz (57g) and 4 oz (113g) tubes composed of high-density polyethylene (HDPE) and linear low-density polyethylene (LLDPE), sealed with foil and fitted with a polypropylene (PP) cap. The individual tubes may be packaged in an outer cardboard carton. KY Grosz Jelly is a personal lubricant for over-the-counter (OTC) use.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

penile, vaginal and/or anal

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Over-The-Counter Use

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)

Shelf life: KY Grosz Jelly has a shelf-life of 1.5 years (18 months) in accordance with the results of an accelerated aging stability study. Results form testing demonstrated that the device can maintain its specifications (as shown in Table 1) over the duration of its shelf-life.

Biocompatibility: Biocompatibility studies were performed in accordance with the 2016 FDA guidance document "Use of International Standard ISO 10993-1, Biological Evaluation of Medical Devices – Part 1: Evaluation and testing within a risk management process" and ISO 10993- 1:2009 as follows:

  • Cytotoxicity (ISO 10993-5: 2009): The subject device test article showed no evidence of causing cell lysis or cytotoxicity to L-929 cells and therefore is not cytotoxic.
  • Vaginal Irritation (ISO 10993-10: 2010): The Irritation Index for the subject device test article was 0. Macroscopically, the vaginal tissue was found to be normal. Therefore, the subject device was considered a non-irritant to vaginal tissue of the rabbit
  • Guinea Pig Maximization Sensitization Test (ISO 10993-10: 2010): The subject device test article solution showed no evidence of causing delayed dermal contact sensitization in the guinea pig. The test article was not considered a sensitizer in the guinea pig maximization test.
  • Acute Systemic Toxicity (ISO 10993-11: 2006): There was no mortality or evidence of systemic toxicity for the subject device.

Condom Compatibility: KY Grosz Jelly was tested in accordance with ASTM D7661-10 "Standard Test Method for Determining Compatibility of Personal Lubricants with Natural Rubber Latex Condoms" and was determined to be compatible with natural rubber latex and polyisoprene condoms. It was determined not to be compatible with polyurethane condoms.

Conclusion: The results of the performance testing described above demonstrate that the KY Grosz Jelly is as safe and effective as the predicate device and supports a determination of substantial equivalence.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K183302

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 884.5300 Condom.

(a)
Identification. A condom is a sheath which completely covers the penis with a closely fitting membrane. The condom is used for contraceptive and for prophylactic purposes (preventing transmission of sexually transmitted infections). The device may also be used to collect semen to aid in the diagnosis of infertility.(b)
Classification. (1) Class II (special controls) for condoms made of materials other than natural rubber latex, including natural membrane (skin) or synthetic.(2) Class II (special controls) for natural rubber latex condoms. The guidance document entitled “Class II Special Controls Guidance Document: Labeling for Natural Rubber Latex Condoms Classified Under 21 CFR 884.5300” will serve as the special control. See § 884.1(e) for the availability of this guidance document.

0

Image /page/0/Picture/0 description: The image shows the logo for the U.S. Food & Drug Administration (FDA). The logo consists of two parts: on the left, there is a symbol representing the Department of Health & Human Services-USA, and on the right, there is the text "FDA U.S. FOOD & DRUG ADMINISTRATION" in blue. The FDA logo is commonly used on products and materials related to food and drug regulation in the United States.

July 30, 2020

RB Health (US) LLC Elizabeth Viguerie Regulatory Manager 399 Interpace Pkwy Parsippany, NJ 07054

Re: K201186 Trade/Device Name: KY Grosz Jelly Regulation Number: 21 CFR§ 884.5300 Regulation Name: Condom Regulatory Class: II Product Code: NUC Dated: May 1, 2020 Received: May 1, 2020

Dear Elizabeth Viguerie:

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.

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.

1

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-regulatoryinformation/postmarketing-safety-reporting-combination-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 mediation-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,

Monica D. Garcia, Ph.D. Acting Assistant Director DHT3B: Division of Reproductive. Gynecology and Urology Devices OHT3: Office of GastroRenal, ObGyn, General Hospital and Urology Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K201186

Device Name KY Grosz Jelly

Indications for Use (Describe)

This product is intended for penile, vaginal and/or anal application to moisturize and lubricate, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is compatible with natural rubber latex and polyisoprene condoms. This product is not compatible with polyurethane condoms.

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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510K Summary K201186 KY Grosz Jelly

| Submitted by: | RB Health (US) LLC
399 Interpace Parkway
Parsippany NJ 07054-0224
973-404-2715 |
|----------------------|-----------------------------------------------------------------------------------------|
| Contact Person: | Elizabeth Viguerie
Regulatory Manager
RB Health (US) LLC
973-404-2715 |
| Date Prepared: | July 29, 2020 |
| Trade Name: | KY Grosz Jelly |
| Common Name: | Personal Lubricant |
| Regulation Number: | 21 CFR 884.5300 |
| Regulation Name: | Condom |
| Product Code: | NUC (Lubricant, Personal) |
| Regulatory Class: | Class II |
| Predicate Device(s): | KY Banksy Aloe
RB Health (US) LLC
510(k) No.: K183302 |

The predicate device has not been subject to a design-related recall.

Description of the Device:

K Y Grosz Jelly is a water-based personal lubricant intended for penile, vaginal and/or anal application to moisturize and lubricate, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is compatible with natural rubber latex and polyisoprene condoms, and is not compatible with polyurethane condoms. Its formulation consists of Water, Propylene glycol, Hydroxyethylcellulose, Benzoic acid, Carbomer, Sodium hydroxide. KY Grosz Jelly may be packaged in 2 oz (57g) and 4 oz (113g) tubes composed of high-density polyethylene (HDPE) and linear low-density polyethylene (LLDPE), sealed with foil and fitted with a polypropylene (PP) cap. The individual tubes may be packaged in an outer cardboard carton. KY Grosz Jelly is a personal lubricant for over-the-counter (OTC) use.

Device specifications are listed in the table below.

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PropertySpecification
AppearanceClear to translucent jelly
OdorNo objectionable odor
Viscosity40,000-100,000 cPs
Osmolality780-1180 mOsm/kg
pH3.5 - 4.5
Total Yeast and Mold Count (TYMC, per EP 8.0 Section: 2.6.12)*Pseudomonas aeruginosa
Staphylococcus aureusAbsent
Candida albicansAbsent
Escherichia coliAbsent
Preservative Effectiveness Testing
(PET, per EP 8.0 Section: 5.1.3)*1
Escherichia coli, Pseudomonas
aeruginosa, Staphylococcus aureusNLT 3.0 log reduction from the initial count at 7 days, and no
increase from the 7 days' count at 28 days
Candida albicans, Aspergillus niger
(A. brasiliensis)2.0 log reduction from the initiation count at 14 days, and no
increase from the 14 days' count at 28 days

Subject Device Specifications

  • European Pharmacopoeia (EP) standards EP 8.0 Sections 2.6.12, 2.6.13, and 5.1.3 have harmonized with or have comparable specifications to USP standards USP , , and , respectively.

Indications of Use Statement: This product is intended for penile, vaginal and/or anal application to moisturize and lubricate, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is compatible with natural rubber latex and polyisoprene condoms. This product is not compatible with polyurethane condoms.

5

Summary of Intended Use and Technological Characteristics of New Device in Comparison to Predicate:

Comparison of the intended use and technological features of the subject and predicate devices is provided in the table below:

K201186K183302
510(k)Subject DevicePredicate Device
Device NameKY Grosz JellyKY Banksy Aloe
Indications for
UseThis product is intended for penile, vaginal
and/or anal application to moisturize and
lubricate, to enhance the ease and comfort of
intimate sexual activity and supplement the
body's natural lubrication. This product is
compatible with natural rubber latex and
polyisoprene condoms. This product is not
compatible with polyurethane condoms.This product is intended for penile, vaginal
and/or anal application to moisturize and
lubricate, to enhance the ease and comfort of
intimate sexual activity and supplement the
body's natural lubrication. This product is
compatible with natural rubber latex and
polyisoprene condoms. This product is not
compatible with polyurethane condoms.
Rx/OTCOTCOTC
Physical FeaturesClear to translucent jelly/ no objectionable
odorHomogeneous Clear Gel / Odorless
Base TypeWaterWater
SterileNoNo
Primary
IngredientsWater, Propylene glycol,
Hydroxyethylcellulose, Benzoic acid,
Carbomer, Sodium hydroxideWater, Propanediol, Xanthan Gum, Benzoic
Acid, Aloe Barbadensis Leaf Juice,
Potassium Lactate, Lactic Acid
Biocompatibility
TestedYesYes
Antimicrobial
TestedYesYes
Condom
CompatibilityCompatible with natural rubber latex and
polyisoprene condoms. Not compatible with
polyurethane condoms.Compatible with natural rubber latex and
polyisoprene condoms. Not compatible with
polyurethane condoms.
Shelf Life1.5 years2 years

Intended Use and Technological Characteristics of Subject Device Compared to Predicate

The subject and predicate device have identical indications for use statements and have the same intended use.

The subject device and predicate device have different technological characteristics, including a different formulation and different shelf life. The differences in technological characteristics between the subject and predicate devices do not raise different questions of safety and effectiveness.

6

Summary of Performance Testing:

Shelf life: KY Grosz Jelly has a shelf-life of 1.5 years (18 months) in accordance with the results of an accelerated aging stability study. Results form testing demonstrated that the device can maintain its specifications (as shown in Table 1) over the duration of its shelf-life.

Biocompatibility: Biocompatibility studies were performed in accordance with the 2016 FDA guidance document "Use of International Standard ISO 10993-1, Biological Evaluation of Medical Devices – Part 1: Evaluation and testing within a risk management process" and ISO 10993- 1:2009 as follows:

  • . Cytotoxicity (ISO 10993-5: 2009): The subject device test article showed no evidence of causing cell lysis or cytotoxicity to L-929 cells and therefore is not cytotoxic.
  • . Vaginal Irritation (ISO 10993-10: 2010): The Irritation Index for the subject device test article was 0. Macroscopically, the vaginal tissue was found to be normal. Therefore, the subject device was considered a non-irritant to vaginal tissue of the rabbit
  • . Guinea Pig Maximization Sensitization Test (ISO 10993-10: 2010): The subject device test article solution showed no evidence of causing delayed dermal contact sensitization in the guinea pig. The test article was not considered a sensitizer in the guinea pig maximization test.
  • Acute Systemic Toxicity (ISO 10993-11: 2006): There was no mortality or evidence of systemic toxicity for the subject device.

Condom Compatibility: KY Grosz Jelly was tested in accordance with ASTM D7661-10 "Standard Test Method for Determining Compatibility of Personal Lubricants with Natural Rubber Latex Condoms" and was determined to be compatible with natural rubber latex and polyisoprene condoms. It was determined not to be compatible with polyurethane condoms.

Conclusion: The results of the performance testing described above demonstrate that the KY Grosz Jelly is as safe and effective as the predicate device and supports a determination of substantial equivalence.