K Number
K201857
Date Cleared
2021-08-20

(410 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 Nitrile Examination Glove, Black and dual color White-Blue are Class 1 Patient Examination Gloves. The dual color White-Blue is made dual color by double dipping. They are ambidextrous and come in different sizes, Extra Small, Small, Medium, Large and Extra Large, Double Extra-Large and Triple Extra-Large.

AI/ML Overview

This document describes the premarket notification (510(k)) for Powder Free Nitrile Examination Gloves (Black and Dual Color White-Blue) from Careplus (M) SDN BHD. This is for an examination glove, a Class I reserved device (21 CFR 880.6250) intended for medical purposes to prevent contamination between patient and examiner.

Here's an analysis of the acceptance criteria and study information provided:

1. Table of Acceptance Criteria and Reported Device Performance

ParameterStandard ReferenceStandard SpecificationDevice Performance (Black Glove)Device Performance (White-Blue Glove)Predicate Device Performance
Product Code-LZA, 21 CFR 880.6250LZA, 21 CFR 880.6250LZA, 21 CFR 880.6250LZA, 21 CFR 880.6250
Class-IIII
Material-NitrileNitrileNitrileNitrile
Color--BlackWhite-BlueBlue, White
White Pigment-Titanium DioxideTitanium DioxideTitanium DioxideTitanium Dioxide
SizeASTM D6319-19-XS,S,M,L,XL, XXL,XXXLXS,S,M,L,XL, XXL,XXXLXS,S,M,L,XL
Water Tight TestASTM D6319-19, ASTM D5151-06G-I, AQL 2.5Meets specificationMeets specificationMeets specification
Physical Properties (Before Aging)
Tensile StrengthASTM D6319-19Min. 14 MpaMeets specification (min. 25 Mpa)Meets specification (min. 25 Mpa)Meets specification
Ultimate ElongationASTM D6319-19Min. 500 %Meets specification (min. 605 %)Meets specification (min. 606 %)Meets specification
Physical Properties (After Aging)
Tensile StrengthASTM D6319-19Min. 14 MpaMeets specification (min. 29 Mpa)Meets specification (min. 26 Mpa)Meets specification
Ultimate ElongationASTM D6319-19Min. 500 % (should be 400 min based on table 6)Meets specification (min. 559 %)Meets specification (min. 576 %)Meets specification
Powder ContentASTM D6319-19, ASTM D6124-06Max. 2 mg/gloveMeets specification (Max. 1.02)Meets specification (Max. 0.90)Meets specification
Biocompatibility Tests
Primary Skin Irritation TestISO 10993-10-No irritant responseNo irritant responseNo irritant response
Dermal Sensitization TestISO 10993-10-No skin sensitization effectNo skin sensitization effectNo skin sensitization effect
Acute Systemic ToxicityISO 10993-11-No revelation of toxicityNo revelation of toxicityNo revelation of toxicity
In vitro Cytotoxicity TestISO 10993-5Cytotox at undiluted, 1:2 (Black); undiluted, 1:2, 1:4, 1:8 (White-Blue)Varies by dilution, non-cytotoxic at higher dilutionsVaries by dilution, non-cytotoxic at higher dilutionsVaries by dilution, non-cytotoxic at higher dilutions
Freedom from pin-holesASTM D6319-19AQL 2.51.5 and below1.5 and below1.5 and below
Dimensions
Width, mmASTM D6319-19XS - 70 ± 10, etc.Within specificationWithin specificationMeet Specification
Length, mmASTM D6319-19XS - 220 min, etc.Within specificationWithin specificationMeet Specification
Thickness Palm, mmASTM D6319-19XS - 0.05 min, etc.Within specification (e.g., min 0.13)Within specification (e.g., min 0.15)Meet Specification
Thickness Finger, mmASTM D6319-19XS - 0.05 min, etc.Within specification (e.g., min 0.18)Within specification (e.g., min 0.19)Meet Specification
Single Use-Single UseSingle UseSingle UseSingle Use
Labeling-Single UseSingle UseSingle UseSingle Use
Intended Use-As defined (medical purposes)Same as predicateSame as predicateSame as predicate

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

The document does not explicitly state the specific sample sizes used for each test. Instead, it indicates that the "performance test data from the non-clinical test met the specifications from ASTM testing methodology." ASTM standards for examination gloves (like D6319-19) typically define sampling plans for various tests (e.g., AQL for pinholes).

The data provenance is not specified beyond being generated by the device manufacturer, Careplus (M) SDN BHD, located in Seremban, Negeri Sembilan Darul Khusus, Malaysia. The studies are prospective in the sense that they were conducted to test the performance of the specific subject devices.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

This section is not applicable as the device is an examination glove, not an AI or diagnostic imaging device that requires expert interpretation to establish a "ground truth" for a test set. Its performance is evaluated against physical and chemical specifications and biocompatibility standards.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

This section is not applicable. The performance evaluation for examination gloves typically involves objective measurements and scientific testing against established standards, not subjective adjudication by experts on a test set as would be found in AI/diagnostic studies.

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

This section is not applicable. The device is an examination glove, not an AI-assisted diagnostic tool. Therefore, MRMC studies are irrelevant to this submission.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

This section is not applicable. The device is a physical product (an examination glove), not an algorithm or AI system.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

The "ground truth" for this device's performance is established by objective measurements and adherence to recognized international standards such as ASTM D6319-19 (Standard Specification for Nitrile Examination Gloves for Medical Application) and ISO 10993 (Biological evaluation of medical devices for biocompatibility). For example:

  • Pin-hole detection is measured against an Acceptable Quality Level (AQL).
  • Physical properties like tensile strength, elongation, and dimensions are tested against minimum/maximum values specified in the ASTM standard.
  • Biocompatibility is assessed through standardized tests (e.g., skin irritation, sensitization, acute systemic toxicity, in vitro cytotoxicity) as per ISO 10993, with predefined criteria for "no irritant response," "no skin sensitization effect," etc.

8. The sample size for the training set

This section is not applicable. The device is a physical product, not a machine learning model, so there is no "training set."

9. How the ground truth for the training set was established

This section is not applicable for the same reasons as point 8.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food & Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

August 20, 2021

Careplus (M) SDN BHD Bee Khoo Quality Manager Lot 120 & 121, Jalan Senawang 3, Senawang Industrial Estate Seremban. 70450 Mv

Re: K201857

Trade/Device Name: Powder Free Nitrile Examination Glove Black and Dual Color White-Blue Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: Class I, reserved Product Code: LZA Dated: July 8, 2021 Received: July 12, 2021

Dear Bee Khoo:

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. 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

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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,

Clarence W. Murray, III, Ph.D. 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

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Indications for Use

510(k) Number (if known) K201857

Device Name

Powder Free Nitrile Examination Glove Black and Dual Color White-Blue

Indications for Use (Describe)

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.

Prescription Use (Part 21 CFR 801 Subpart D)

X Over-The-Counter Use (21 CFR 801 Subpart C)

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K201857

510(K) SUMMARY

  • 1.0 Applicant: CAREPLUS (M) SDN BHD
    Address: Lot 120 & 121 . Jalan Senawang 3, Senawang Industrial Estate, 70450 Seremban, Negeri Sembilan Darul Khusus, Malaysia.

Phone No. 60-6-6772781 Fax No. 60-6-6772780

Contact Person Lim Kwee Shyan

  • 2.0 Date of Summary 18th June, 2021
  • 3.0 Device Information Device Name

POWDER FREE NITRILE EXAMINATION GLOVE BLACK AND DUAL COLOR WHITE-BLUE

Common Name: Exam Gloves
Classification Name: Patient Examination Gloves (21 CFR 880.6250, LZA)
Classification Panel: Non-powdered patient examination glove
Class: I

4.0 Predicate Device

Predicate device: Powder Free Nitrile Examination Glove White, 510(k) number K142858 and Powder Free Nitrile Examination Glove Blue, 510(k) number K142862, product code LZA.

5.0 Device Description

Powder Free Nitrile Examination Glove, Black and dual color White-Blue are Class 1 Patient Examination Gloves. The dual color White-Blue is made dual color by double dipping. They are ambidextrous and come in different sizes, Extra Small, Small, Medium, Large and Extra Large, Double Extra-Large and Triple Extra-Large. Gloves meet the ASTM D6319-19 specification below:

SizeXSSMLXLXXLXXXL
Length, min. mm220230NA
Thickness, min. mm
finger0.05NA
palm0.05
Width, ± 10 mm708095110120NA

6.0 Indications for Use Statement

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.

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K201857

7.0 Technological Characteristics

Following is a table summarized the technological characteristics compared to Predicate Device and equivalent standards:

ParameterStandardReferenceStandardSpecificationSubject Glove(Powder FreeNitrile ExaminationGlove, Black)K201857Subject Glove(Powder FreeNitrile ExaminationGlove, Dual ColorWhite-Blue)K201857Predicate Device(Nitrile Blue,K142862Nitrile White,K142858)Characteristics
Product CodeRegulation number--LZA21 CFR 880.6250LZA21 CFR 880.6250LZA21 CFR 880.6250Same
Class--IIISame
Material--NitrileNitrileNitrileSame
Color--BlackWhite-BlueBlue, WhiteSimilar
White Pigment--Titanium DioxideTitanium DioxideTitanium DioxideSame
SizeASTMD6319-19-XS,S,M,L,XL, XXL,XXXLXS,S,M,L,XL, XXL,XXXLXS,S,M,L,XLSimilar
Water Tight Test,1000mlASTMD6319-19ASTMD5151-06G-I, AQL 2.5Meets specificationMeets specificationMeets specificationSame
Physical Propertiesi) Before AgeingTensile StrengthUltimate ElongationASTMD6319-19Min. 14 MpaMin. 500 %Meets specificationMeets specificationMeets specificationSame
ii) After Ageingii)Tensile StrengthUltimate ElongationASTMD6319-19Min. 14 MpaMin. 500Meets specificationMeets specificationMeets specificationSame
Powder ContentASTMD6319-19ASTMD6124-06Max.2 mg/gloveMeets specificationMeets specificationMeets specificationSame
BiocompatabilityTesti) Primary SkinIrritation TestISO 10993-10Conclusion: Underthe conditions of thisstudy, the testmaterial did notcause and irritantresponse.Conclusion: Underthe conditions of thisstudy, the testmaterial did notcause and irritantresponse.Conclusion: Underthe conditions of thisstudy, the testmaterial did notcause and irritantresponse.Same
ii) DermalSensitization TestISO 10993-10Conclusion: Underthe conditions of thisstudy, the testmaterial did notproduce a skinsensitization effect.Conclusion: Underthe conditions of thisstudy, the testmaterial did notproduce a skinsensitization effect.Conclusion: Underthe conditions of thisstudy, the testmaterial did notproduce a skinsensitization effect.Same
iii) Acute SystemicToxicityISO 10993-11Conclusion: Underthe conditions of thisstudy, the testmaterial both innerand outer surfacedid not revealConclusion: Underthe conditions of thisstudy, the testmaterial both innerand outer surfacedid not revealConclusion: Underthe conditions of thisstudy, the testmaterial both innerand outer surfacedid not revealSame

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K201857

iv) In vitro CytotoxicityTestISO 10993-5Conclusions: Underthe conditions of thisstudy, the testmaterial isCytotox(grade >2) atundiluted, 1:2, andNon-cyctotoxic,grade ≤2 at dilutions1:4, 1:8;1:16,1:32and 1:64Conclusions: Underthe conditions of thisstudy, the testmaterial isCytotox(grade >2) atundiluted, 1:2, 1:4,1:8 and Non-cyctotoxic, grade ≤2at dilutions;1:16,1:32and 1:64White Nitrile:Conclusions: Underthe conditions of thisstudy, the testmaterial isCytotox(grade >2) atundiluted, 1:2, 1:4and Non-cyctotoxic,grade ≤2 atdilutions, 1:8 ,1:16,1:32 and 1:64Blue Nitrile:Conclusions: Underthe conditions of thisstudy, the testmaterial isCytotox(grade >2) atundiluted, 1:2, 1:4,1:8, 1:16 and Non-cyctotoxic, grade ≤2at dilutions;1:32 and1:64Similar
Single Use-Single UseSingle UseSingle UseSame
Labeling-Single UseSingle UseSingle UseSame
Intended Use-A patientexamination glovesis a disposal deviceintended for medicalpurposes that isworn on theexaminer's hand orfinger to preventcontaminationbetween patient andexaminer.A patientexamination glovesis a disposal deviceintended for medicalpurposes that isworn on theexaminer's hand orfinger to preventcontaminationbetween patient andexaminer.A patientexamination glovesis a disposal deviceintended for medicalpurposes that isworn on theexaminer's hand orfinger to preventcontaminationbetween patient andexaminer.Same

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ParameterStandard ReferencesStandard SpecificationDevice PerformanceBlackDevice PerformanceWhite-BluePredicate Device
Freedom from pin-holesASTM D6319-19AQL 2.51.5 and below1.5 and below1.5 and below
Width, mmASTM D6319-19XS - 70 ± 10S - 80 ± 10M - 95 ± 10L - 110 ± 10XL- 120 ± 10XXL- NAXXXL- NA78- 8086- 8896- 98106- 108116- 118120- 125126- 12978- 8086- 8895- 98107- 108115- 117122- 123129- 132Meet Specification
Length, mmASTM D6319-19XS - 220 minS - 220 minM - 230 minL - 230 minXL- 230 minXXL- NAXXXL- NAmin. 293min. 285min. 287min. 281min. 282min. 292min. 290min. 297min. 285min. 285min. 286min. 301min. 289min. 300Meet Specification
Thickness Palm, mmASTM D6319-19XS – 0.05 minS - 0.05 minM - 0.05 minL - 0.05 minXL- 0.05 minXXL- NAXXXL- NAmin. 0.13min. 0.15min. 0.15min. 0.16min. 0.15min. 0.12min. 0.13min. 0.15min. 0.16min. 0.15min. 0.15min. 0.14min. 0.16min. 0.14Meet Specification
Thickness Finger, mmASTM D6319-19XS – 0.05 minS - 0.05 minM - 0.05 minL - 0.05 minXL- 0.05 minXXL- NAXXXL- NAmin. 0.18min. 0.21min. 0.21min. 0.18min. 0.21min. 0.16min. 0.20min. 0.19min. 0.20min. 0.19min. 0.20min. 0.20min. 0.20min. 0.19Meet Specification
Tensile Strength Before aging, MpaASTM D6319-1914 minmin. 25min. 25Meet Specification
Tensile Strength After aging, MpaASTM D6319-1914 minmin. 29min. 26Meet Specification
Ultimate Elongation Before aging,%ASTM D6319-19500 minmin. 605min. 606Meet Specification
Ultimate Elongation After aging,%ASTM D6319-19400 minmin. 559min. 576Meet Specification
Powder FreeASTM D6319-19Max. 2Max. 1.02Max. 0.90Meet Specification

Summary of Non-Clinical Testing 8.0

The performance test data from the non-clinical test met the specifications from ASTM testing methodology.

Summary of Clinical Testing 9.0

Clinical data is not needed for medical gloves or of most devices cleared by the 510(k) process.

10.0 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 devices.

§ 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.