K Number
K201428
Date Cleared
2021-06-24

(391 days)

Product Code
Regulation Number
880.6250
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

A 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.

Device Description

Powder Free Black Nitrile Examination Glove meets all the current specifications listed under the ASTM Specification D6319-10, Standard Specification for Nitrile Examination Gloves for Medical Application. The principle operation and mechanism of this device is to prevent contamination between patient and examiner and this principle is achieved through testing of barrier, physical properties and other testing stated in the performance data. This device is for over-the counter single use.

AI/ML Overview

This document is a 510(k) Pre-Market Notification for a Powder Free Black Nitrile Examination Glove (K201428) and does not describe a study involving an AI/ML powered device. Instead, it details the substantial equivalence of the new nitrile glove to a predicate device (K153562) based on non-clinical performance and biological safety testing.

Therefore, I cannot provide the requested information about acceptance criteria for an AI/ML device, sample sizes for test/training sets, expert qualifications, or MRMC studies.

However, I can extract the acceptance criteria and reported performance for the nitrile examination glove based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance (for the Nitrile Examination Glove):

Characteristic/ParameterAcceptance Criteria (Predicate or Standard)Reported Performance (Proposed Device K201428)Discussion / Outcome
Product CodeLZALZASame
Intended UseTo prevent contamination between patient and examinerTo prevent contamination between patient and examinerSame
ClassificationClass 1Class 1Same
Raw Rubber MaterialNitrile (Acrylonitrile-butadiene)Nitrile (Acrylonitrile-butadiene)Same
Surface AppearanceBlue, Ambidextrous, Finger Textured (Predicate)Black, Ambidextrous, Finger TexturedDifferent color; same design/texture
Freedom of HolesMeet AQL 1.5 at G1 (Predicate) / AQL 2.5 at G1 (ASTM)Meet AQL 1.5 with G1Similar
Overall LengthMinimum 230mmAverage: 242mmSimilar
Width (S, M, L)S: 75-95mm, M: 85-105mm, L: 100-120mmS: 85mm, M: 95mm, L: 104mm (Average)Similar (Meeting specification)
Palm ThicknessMinimum 0.05mmAverage: 0.06mmSimilar
Finger ThicknessMinimum 0.05mmAverage: 0.11mmSimilar
Tensile Strength (before age)Minimum 14 MPaAverage: 17.44 MPaSimilar
Tensile Strength (after age)Minimum 14 MPaAverage: 16.37 MPaSimilar
Ultimate Elongation (before age)Minimum 500%Average: 559%Similar
Ultimate Elongation (after age)Minimum 400%Average: 508%Similar
Residual Powder TestLess than 2mg/gloveS: 0.43 mg/glove, M: 0.31 mg/glove, L: 0.47 mg/glove (Average)Similar (Contained less than 2mg/glove)
Primary Skin IrritationNot an irritantUnder the conditions of study, not an irritantSimilar
Dermal SensitizationNot a sensitizerUnder the conditions of study, not a sensitizerSimilar
CytotoxicityN/A (Predicate)Not CytotoxicDifferent (Pred. info N/A)
Acute Systemic ToxicityN/A (Predicate)Not induce systemic toxicityMeeting requirements per ISO 10993-11

As there is no AI/ML component to the device described in this document, the following points are not applicable:

2. Sample size used for the test set and the data provenance: Not applicable. (Performance claims are based on physical and biological tests of the glove material, not a data-driven test set.)
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. (Ground truth not established in the context of an AI/ML test set.)
4. Adjudication method for the test set: Not applicable.
5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance: Not applicable.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not applicable.
7. The type of ground truth used: Not applicable in the context of AI/ML. For the glove, the "ground truth" or reference for performance is established by ASTM standards and ISO biological evaluation guidelines.
8. The sample size for the training set: Not applicable.
9. How the ground truth for the training set was established: Not applicable.

§ 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.