K Number
K203483
Date Cleared
2021-02-01

(66 days)

Product Code
Regulation Number
878.4460
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Medispo Rubber/Polyisoprene surgical gloves are sterile and single use device intended to be worn on the hands of operating room personnel to protect a surgical wound from contamination.

Device Description

The proposed devices, surgical gloves, are sterile and disposable devices. There are two types of surgical gloves according to the raw materials in this submission:

  • Type 1-Natural rubber surgical gloves .
  • Type 2-Synthetic polyisoprene surgical gloves .
    The proposed devices are powder-free gloves with creamy white in color. There are seven sizes (6", 6.5", 7", 7.5", 8", 8.5", 9") available for the gloves whichever are smooth- or texture-surfaced, with or without a rolled rim at the cuff edge.
    The gloves are sterilized by ionizing irradiation. The shelf-life is three (3) years.
AI/ML Overview

This document is a 510(k) premarket notification for Medispo Rubber Surgical Gloves and Medispo Polyisoprene Surgical Gloves. It compares the proposed devices to legally marketed predicate devices to demonstrate substantial equivalence.

Here's a breakdown of the acceptance criteria and study information provided:

1. Table of Acceptance Criteria and Reported Device Performance

ItemAcceptance Criteria (Methodology / Standard)Reported Device Performance
Medispo Rubber Surgical Gloves (Main Material: Natural Rubber)
Product CodeKGOKGO
Regulation No.21 CFR 878.446021 CFR 878.4460
ClassificationClass IClass I
Gloves classificationType I, Surgeon's glovesType I, Surgeon's gloves
Powder freeYesYes
Indication for useTo protect a surgical wound from contaminationTo protect a surgical wound from contamination
Palm width76mm±5mm (6.0), 83mm±5mm (6.5), 89mm±5mm (7.0), 95mm±5mm (7.5), 102mm±6mm (8.0), 108mm±6mm (8.5), 114mm±6mm (9) (ASTM D3767-03(2020))Pass
Length265mm min (6.0, 6.5), 270mm min (7.0, 7.5, 8.0), 280mm min (8.5, 9) (ASTM D3767-03(2020))Pass
ThicknessCuff: min 0.10mm, Palm: min 0.13mm, Finger tip: min 0.13mm (ASTM D3767-03(2020))Pass
Freedom from holesAQL 1.5 (ASTM D5151-19)Pass
Physical Properties (before aging)Tensile Strength: ≥24 MPa, Ultimate Elongation: ≥750% (ASTM D412-16)Pass
Physical Properties (after aging)Tensile Strength: ≥18 MPa, Ultimate Elongation: ≥560% (ASTM D412-16)Pass
Powder residual≤2.0 mg/glove (ASTM D6124-06(2017))Pass
Special label claimNo protein labeling statementNo protein labeling statement
SterilitySterileSterile
Sterilization methodRadiationRadiation
For single useYesYes
Type of useOver the counter useOver the counter use
BiocompatibilityConform to ISO 10993 series standardsConform to ISO 10993 series standards
Medispo Polyisoprene Surgical Gloves (Main Material: Synthetic Polyisoprene)
Product CodeKGOKGO
Regulation No.21 CFR 878.446021 CFR 878.4460
ClassificationClass IClass I
Gloves classificationType II, Surgeon's glovesType II, Surgeon's gloves
Powder freeYesYes
Indication for useTo protect a surgical wound from contaminationTo protect a surgical wound from contamination
Palm width76mm±5mm (6.0), 83mm±5mm (6.5), 89mm±5mm (7.0), 95mm±5mm (7.5), 102mm±6mm (8.0), 108mm±6mm (8.5), 114mm±6mm (9) (ASTM D3767-03(2020))Pass
Length265mm min (6.0, 6.5), 270mm min (7.0, 7.5, 8.0), 280mm min (8.5, 9) (ASTM D3767-03(2020))Pass
ThicknessCuff: min 0.10mm, Palm: min 0.13mm, Finger tip: min 0.13mm (ASTM D3767-03(2020))Pass
Freedom from holesAQL 1.5 (ASTM D5151-19)Pass
Physical Properties (before aging)Tensile Strength: ≥24 MPa, Ultimate Elongation: ≥750% (ASTM D412-16)Pass
Physical Properties (after aging)Tensile Strength: ≥18 MPa, Ultimate Elongation: ≥560% (ASTM D412-16)Pass
Powder residual≤2.0 mg/glove (ASTM D6124-06(2017))Pass
SterilitySterileSterile
Sterilization methodRadiationRadiation
For single useYesYes
Type of useOver the counter useOver the counter use
BiocompatibilityConform to ISO 10993 series standardsConform to ISO 10993 series standards

Study that Proves the Device Meets Acceptance Criteria:

The document states: "The performance test of the subject devices were performed on the final finished device. The test results show the subject devices meet the requirements of ASTM D3577-19."

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 sample size used for each specific test or the data provenance (country of origin, retrospective/prospective). It only mentions that "performance tests...were performed on the final finished device" according to relevant ASTM and ISO standards.

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 information is not applicable as the device is a surgical glove, and the evaluation is based on mechanical, physical, and chemical properties, as well as biocompatibility, against established standards. There is no "ground truth" requiring expert consensus in the context of medical image analysis or similar diagnostic applications.

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

This information is not applicable for the type of device and testing performed. Adjudication methods are typically relevant for subjective evaluations or interpretations, which are not present here.

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 information is not applicable as the device is a surgical glove and does not involve human readers or AI assistance in its function.

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

This information is not applicable as the device is not an algorithm or AI system.

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

The "ground truth" for the performance evaluation of the surgical gloves is based on established industry and regulatory standards such as ASTM D3577-19, ASTM D3767-03(2020), ASTM D5151-19, ASTM D6124-06(2017), ASTM D412-16, relevant USP standards, and ISO 10993 series standards for biocompatibility. These standards define the acceptable physical, mechanical, and biological properties of the gloves.

8. The sample size for the training set

This information is not applicable as the device is a physical product (surgical gloves) and does not involve machine learning models that require training sets.

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

This information is not applicable as the device is a physical product and does not involve machine learning models that require training sets or their associated ground truth.

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Image /page/0/Picture/2 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health and Human Services logo on the left and the FDA logo on the right. The FDA logo is a blue square with the letters "FDA" in white, followed by the words "U.S. Food & Drug Administration" in blue.

February 1, 2021

Guilin HBM Health Protections, Inc. % Shelley Li Director Landlink Healthcare Technology (Shanghai) Co., Ltd. Room 703, 705, Baohua International Plaza, West Guangzhong Road 555, Jingan Shanghai, 200071 China

Re: K203483

Trade/Device Name: Medispo Rubber Surgical Gloves, Medispo Polyisoprene Surgical Gloves Regulation Number: 21 CFR 878.4460 Regulation Name: Non-Powdered Surgeon's Glove Regulatory Class: Class I, reserved Product Code: KGO Dated: November 19, 2020 Received: November 27, 2020

Dear Shelley Li:

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.

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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 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,

For: Elizabeth F. Claverie-Williams, MS 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) K203483

Device Name

  1. Medispo Rubber Surgical Gloves

  2. Medispo Polyisoprene Surgical Gloves

Indications for Use (Describe)

The Medispo Rubber/Polyisoprene surgical gloves are sterile and single use device intended to be worn on the hands of operating room personnel to protect a surgical wound from contamination.

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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510(k) Summary: K203483

l. Submitter

Guilin HBM Health Protections, Inc. No.1-2, Shuijing East Road, Economic and Technological Development Area, Guilin, China

Contact person: Pu Lei Position: QC Manager Tel.: +86-13707738532 E-mail: pulei@hbmchina.com

Preparation date: Jan. 11, 2021

II. Proposed Device

Device Trade Name1) Medispo Rubber Surgical Gloves2) Medispo Polyisoprene Surgical Gloves
Common name:Surgeon's gloves
Regulation Number:21 CFR 878.4460
Regulatory Class:Class I
Product code:KGO
Review PanelGeneral Hospital

III. Predicate Devices

a. 510(k) Number:K171047
Trade name:Sterile Polyisoprene Powder Free Surgical Gloves
Common name:Surgeon's Gloves
Classification:Class I
Product Code:KGO
ManufacturerBetter Care Plastic Technology Co., Ltd.
b. 510(k) Number:K192328
Trade name:JR Medic Latex Surgeon's Gloves Sterile Powder Free
Common name:Surgeon's Gloves
Classification:Class I
Product Code:KGO
ManufacturerJR Engineering & Medical Technologies (M) SDN.BHD.

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IV. Device description

The proposed devices, surgical gloves, are sterile and disposable devices. There are two types of surgical gloves according to the raw materials in this submission:

  • Type 1-Natural rubber surgical gloves .
  • Type 2-Synthetic polyisoprene surgical gloves .

The proposed devices are powder-free gloves with creamy white in color. There are seven sizes (6", 6.5", 7", 7.5", 8", 8.5", 9") available for the gloves whichever are smooth- or texture-surfaced, with or without a rolled rim at the cuff edge.

The gloves are sterilized by ionizing irradiation. The shelf-life is three (3) years.

V. Indication for use

The surgical gloves are sterile and single use device intended to be worn on the hands of operating room personnel to protect a surgical wound from contamination.

ItemProposed device(K203483)Predicate device(K192328)Discussion
Product nameMedispo Rubber SurgicalGlovesJR Medic Latex Surgeon'sGloves Sterile Powder Free-
Product CodeKGOKGOSame
Regulation No.21 CFR 878.446021 CFR 878.4460Same
ClassificationClass IClass ISame
GlovesclassificationType I, Surgeon's glovesType I, Surgeon's glovesSame
Powder freeYesYesSame
Indication foruseThe surgical gloves aresterile and single use deviceintended to be worn on thehands of operating roompersonnel to protect asurgical wound fromcontamination.A latex surgeon's glove is adevice made of naturalrubber intended to be wornby operating room personnelto protect a surgical woundfrom contamination.Same
Main MaterialNatural rubberNatural rubberSame
ColorCreamy whiteCreamy whiteSame
Palm width6.0 (76mm±5mm)6.5 (83mm±5mm)7.0 (89mm±5mm)6.0 (78mm)6.5 (85mm)7.0 (88mm)Similar
7.5 (95mm±5mm)7.5 (97mm)
8.0 (102mm±6mm)8.0 (103mm)
8.5 (108 mm±6mm)8.5 (110mm)
9 (114mm±6mm)9(116mm)
Length6.0 (265mm min)6.5 (265mm min)7.0 (270mm min)7.5 (270mm min)8.0 (270mm min)8.5 (280mm min)9 (280mm min)300 mmDifferent
ThicknessCuff: min 0.10mmPalm: min 0.13mmFinger tip: min 0.13mmCuff: 0.11mmPalm: 0.18mmFinger tip: 0.21mmSimilar
Freedom fromholesMeets requirements of theASTM D3577-19Meets requirements of theASTM D3577-09(2015)Similar
PhysicalProperties(before aging)Meets requirements of theASTM D3577-19Meets requirements of theASTM D3577-09(2015)Similar
PhysicalProperties(after aging)Meets requirements of theASTM D3577-19Meets requirements of theASTM D3577-09(2015)Similar
Powderresidual≤2.0 mg/glove≤2.0 mg/gloveSame
Special labelclaimNo protein labeling statementProtein content label claim of50µg/dm² or lessDifferent
SterilitySterileSterileSame
SterilizationmethodRadiationRadiationSame
For single useYesYesSame
Type of useOver the counter useOver the counter useSame
BiocompatibilityConform to the requirementsof ISO 10993 seriesstandardsConform to the requirementsof ISO 10993 seriesstandardsSame
Table 2 Comparison of Polyisoprene Surgical Gloves
ItemProposed device(K203483)Predicate device(K171047)Discussion
Product nameMedispo PolyisopreneSurgical GlovesSterile Polyisoprene PowderFree Surgical Gloves-
Product CodeKGOKGOSame
Regulation No.21 CFR 878.446021 CFR 878.4460Same
ClassificationClass IClass ISame
GlovesclassificationType II, Surgeon's glovesType II, Surgeon's glovesSame
Powder freeYesYesSame
Indication foruseThe surgical gloves aresterile and single use deviceintended to be worn on thehands of operating roompersonnel to protect asurgical wound fromcontamination.A latex surgeon's glove is adevice made of naturalrubber intended to be wornby operating room personnelto protect a surgical woundfrom contamination.Same
Main MaterialSynthetic PolyisopreneSynthetic PolyisopreneSame
ColorCreamy whiteCreamy whiteSame
Palm width6.0 (76mm±5mm)6.5 (83mm±5mm)7.0 (89mm±5mm)7.5 (95mm±5mm)8.0 (102mm±6mm)8.5 (108 mm±6mm9 (114mm±6mm)5.5 (70mm)6.0 (76mm)6.5 (83mm)7.0 (89mm)7.5 (95mm)8.0 (102mm)8.5 (108mm)9 (114mm)Similar
Length6.0 (265mm min)6.5 (265mm min)7.0 (270mm min)7.5 (270mm min)8.0 (270mm min)8.5 (280mm min)9 (280mm min)Minimum 265Average 305 mmSimilar
ThicknessCuff: 0.10mm minPalm: 0.13mm minFinger tip: 0.13mm minCuff: 0.10mm minPalm: 0.10mm minFinger tip : 0.10mm minSimilar
Freedom fromMeets requirements of theMeets requirements of theSimilar
holesASTM D3577-19ASTM D3577-09(2015)
PhysicalProperties(before aging)Meets requirements of theASTM D3577-19Meets requirements of theASTM D3577-09(2015)Similar
PhysicalProperties(after aging)Meets requirements of theASTM D3577-19Meets requirements of theASTM D3577-09(2015)Similar
Powderresidual≤2.0 mg/glove≤2.0 mg/gloveSame
SterilitySterileSterileSame
SterilizationmethodRadiationRadiationSame
For single useYesYesSame
Type of useOver the counter useOver the counter useSame
BiocompatibilityConform to the requirementsof ISO 10993 seriesstandardsConform to the requirementsof ISO 10993 seriesstandardsSame

VI. Comparison of technological characteristics with the predicate devices Table 1 Comparison of Natural Rubber Surgical Gloves

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The performance test of the subject devices were performed on the final finished device. The test results show the subject devices meet the requirements of ASTM D3577-19.

VII. Summary of Non-Clinical Testing

Non-clinical performance tests were conducted in accordance with relevant standards to verify that the proposed device met all design specifications.

ItemsMethodology /StandardAcceptance CriteriaResults
Palm widthASTM D3767-03(2020)6.0 (76mm±5mm)6.5 (83mm±5mm)7.0 (89mm±5mm)7.5 (95mm±5mm)8.0 (102mm±6mm)8.5 (108 mm±6mm)9 (114mm±6mm)Pass

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LengthASTM D3767-03(2020)6.0 (265mm min)6.5 (265mm min)7.0 (270mm min)7.5 (270mm min)8.0 (270mm min)8.5 (280mm min)9 (280mm min)Pass
ThicknessASTM D3767-03(2020)Cuff: min 0.10mmPalm: min 0.13mmFinger tip: min 0.13mmPass
Freedomfrom holesASTM D5151-19Freedom free hole AQL1.5Pass
Physical Properties(before aging)
TensileStrengthASTM D412-16≥24 MPaPass
UltimateElongationASTM D412-16≥750%Pass
Physical Properties(after aging)
TensileStrengthASTM D412-16≥18 MPaPass
UltimateElongationASTM D412-16≥560%Pass
PowderresidualASTM D6124-06(2017)2mg per glovePass

The relevant standards used in the submission are listed as below:

  • ASTM D3577-19, Standard Specification for Rubber Surgical Gloves .
  • ASTM D3767-03(2020), Practice for rubber-Measurement of Dimensions .
  • ASTM D5151-19, Standard Test Method for Detection of Holes in Medical Gloves ●
  • ASTM D6124-06(2017), Standard Test Method for Residual Powder on Medical . Gloves
  • . ASTM D5712-15, Standard Test Method for The Analysis of Aqueous Extractable Protein in Natural Rubber and Its Products Using the Modified Lowry Method
  • ASTM D573-04(2019), Standard Test Method for Rubber—Deterioration in an Air . Oven
  • ASTM D412-16, Standard Test Methods for Vulcanized Rubber and . Thermoplastic Elastomers-Tension

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  • USP 42/NF37 <151> Pyrogen Test ●
  • USP 36_NF 31<71>Sterility Test ●
  • ISO 11137-1:2006, Sterilization of health care products Radiation Part 1: ● Requirements for development, validation and routine control of a sterilization process for medical devices
  • ISO 11137-2:2013, Sterilization of health care products -- Radiation -- Part 2: . Establishing the sterilization dose
  • ISO 10993-5: 2009 Biological Evaluation Of Medical Devices -- Part 5: Tests For . In Vitro Cytotoxicity
  • . ISO 10993-10: 2010 Biological Evaluation Of Medical Devices - Part 10: Tests For Irritation And Skin Sensitization.
  • ISO 10993-11:2017, Biocompatibility Evaluation of Medical Device Part 11: Tests . for systemic toxicity
  • ISO 10993-4:2017. Biological evaluation of medical devices-Part 4: Selection of . tests for interactions with blood
  • ASTM F756-17 Standard Practice for assessments of hemolytic properties of ● material

VIII. Clinical Testing

No clinical study is included in this submission.

IX. Conclusion

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

§ 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).