AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

A powder-free patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. The glove was tested for use with Chemotherapy Drugs and Fentanyl Citrate as per ASTM D6978-05 Standard Practice for Assessment for Medical Gloves to Permeation by Chemotherapy Drugs. Please note that the following drug has an extremely low permeation time: Carmustine: 47.9 minutes (Blue), 49.6 minutes (Green), 27.6 minutes (Black). Warning: Do not use with Carmustine.

Device Description

Microflex® Nitrile Patient Examination Gloves Blue Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate, Microflex® Nitrile Patient Examination Gloves Green Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate, Microflex® Nitrile Patient Examination Gloves Black Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate are non-sterile, single use only, disposable, powder free examination gloves are made of nitrile butadiene rubber. A polyacrylic polymer is applied to the inner surface of the gloves to make donning easy.

Characteristics:

  • . Ambidextrous with beaded cuff and straight fingers
  • . Finger-textured
  • Blue, green, or black colored .
  • . Four (4) sizes - small, medium, large, and extra-large
  • . Tested against chemotherapy drugs and fentanyl citrate

High levels of ozone will degrade rubber material of the gloves; therefore, the gloves should be protected from ozone in particular.

The gloves are designed to meet the specifications of ASTM D6319-10, Standard Specification for Nitrile Examination Gloves for Medical Application.

AI/ML Overview

This is an analysis of a 510(k) Premarket Notification for medical gloves, which are considered Class I devices. The submission focuses on demonstrating substantial equivalence to a predicate device, primarily through non-clinical performance testing against established standards rather than clinical studies involving human patients or complex AI algorithms.

Here's a breakdown of the requested information based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria are generally established by referring to ASTM and ISO standards for examination gloves. The reported device performance indicates that the gloves meet or exceed these standards.

Microflex Nitrile Patient Examination Gloves (Blue, Green, Black)

CharacteristicsStandard/Test/FDA GuidanceAcceptance Criteria (from Standard, implied)Reported Device Performance
Physical Characteristics:
Dimensions:ASTM D6319-10Meets ASTM D6319-10 requirementsMeets ASTM D6319-10 requirements for length, width, and thickness
LengthMinimum 230mmMinimum 240mm (Exceeds)
Palm width (S)80 ± 10 mm85 ± 5 mm (Meets)
Palm width (M)95 ± 10 mm95 ± 5 mm (Meets)
Palm width (L)110 ± 10 mm105 ± 5 mm (Meets)
Palm width (XL)120 ± 10 mm115 ± 5 mm (Meets)
Thickness (single-wall):
Fingerminimum 0.05 mmFinger - min 0.09 mm (Exceeds)
Palmminimum 0.05 mmPalm - min 0.06 mm (Exceeds)
CuffNot specified (implied to meet standard)Cuff - min 0.05 mm
Physical Properties:ASTM D6319-10Meets ASTM D6319-10 requirementsMeets ASTM D6319-10 requirements for tensile strength and ultimate elongation before and after accelerated aging
Tensile Strength (Before Aging)minimum 14 MPaminimum 16 MPa (Exceeds)
Tensile Strength (After Aging)minimum 14 MPaminimum 14 MPa (Meets)
Ultimate Elongation (Before Aging)minimum 500%minimum 500% (Meets)
Ultimate Elongation (After Aging)minimum 400%minimum 400% (Meets)
Freedom from holes:ASTM D6319-10, ASTM D5151-06AQL 2.5Meets or exceeds ASTM D6319-10 and ASTM D5151-06 requirements of AQL 2.5
Powder Residual:ASTM D6319-10, ASTM D6124-06≤ 2 mg per gloveMeets applicable requirement for powder free; ≤ 2 mg per glove
Biocompatibility:
ISO In Vitro CytotoxicityISO 10993-5:2009Non-cytotoxicUndiluted, 1:2, 1:4, 1:8, 1:16 dilution was cytotoxic. 1:32 and 1:64 are not cytotoxic. (Requires clarification on acceptable dilution for "non-cytotoxic")
ISO Skin Irritation StudyISO10993-10:2010Not an irritantUnder the conditions of the study, not an irritant
ISO Maximization Sensitization StudyISO 10993-10:2010Not a sensitizerUnder the conditions of the study, not a sensitizer
ISO Acute Systemic ToxicityISO 10993-11:2006No evidence of systemic toxicityUnder the conditions of the study, no evidence of systemic toxicity
Chemotherapy Drug Permeation (ASTM D6978-05):ASTM D6978-05No permeation within a specified time*Varies by drug and glove color. Carmustine has low permeation (27.6 to 49.6 minutes), others generally >240 minutes.

Note: For chemotherapy drug permeation, the acceptance criterion isn't explicitly stated as a single value (e.g., ">X minutes"), but the comparison is made against the predicate device and the standard, indicating the longer the breakthrough time, the better the performance. The warning for Carmustine suggests that its specific permeation time is deemed too low for safe use with these gloves.

2. Sample Size Used for the Test Set and Data Provenance

The document does not explicitly state the total sample size for each specific test. However, for the Chemotherapy Drug Permeation testing, it indicates "Average Minimum Breakthrough Detection Time (Sample 1,2,3) (Minutes)", implying that at least 3 samples were tested for each drug/glove combination.

The provenance of the data is not specified in terms of country of origin or whether it was retrospective or prospective. It is generally understood that such testing is conducted in a laboratory setting for regulatory submission.

3. Number of Experts and Qualifications for Ground Truth

Not applicable. This submission pertains to physical and chemical performance testing of medical gloves, not a diagnostic device that requires expert interpretation of images or patient data to establish ground truth. The "ground truth" for these tests is defined by the objective measurements according to the specified ASTM and ISO standards (e.g., direct measurement of length, tensile strength testing, chemical permeation detection).

4. Adjudication Method for the Test Set

Not applicable. As there are no human interpretations or judgments required for establishing the "ground truth" (instead, it's objective measurement against standards), no adjudication method (like 2+1 or 3+1) is mentioned or relevant.

5. Multi Reader Multi Case (MRMC) Comparative Effectiveness Study

No MRMC study was done. This is a Class I medical device (gloves) and not an AI-assisted diagnostic tool. Therefore, the concept of human readers improving with AI assistance is not applicable.

6. Standalone Performance Study (Algorithm Only)

Not applicable. This device does not involve an algorithm. The performance studies are laboratory tests of the physical, chemical, and biological properties of the gloves.

7. Type of Ground Truth Used

The ground truth for the performance claims is based on objective measurements obtained through standardized laboratory tests according to recognized national and international standards, specifically:

  • ASTM D6319-10: Standard Specification for Nitrile Examination Gloves for Medical Application (for dimensions and physical properties like tensile strength, elongation, freedom from holes).
  • ASTM D5151-06: Standard Test Method for Detection of Holes in Medical Gloves.
  • ASTM D6124-06: Standard Test Method for Residual Powder on Medical Gloves.
  • ASTM D6978-05: Standard Practice for Assessment for Medical Gloves to Permeation by Chemotherapy Drugs.
  • 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 10993-11:2006: Biological evaluation of medical devices - Part 11: Tests for systemic toxicity.

8. Sample Size for the Training Set

Not applicable. This is not a machine learning or AI device, so there is no "training set" in the computational sense. The product development likely involved iterative design and testing, but not a formally defined "training set" for an algorithm.

9. How the Ground Truth for the Training Set Was Established

Not applicable. (See point 8).

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo features the letters 'FDA' in a blue square, followed by the words 'U.S. FOOD & DRUG ADMINISTRATION' in blue text.

June 13, 2021

Ansell Healthcare Products LLC Donald Cronk Associate Director 2301 Robb Drive Reno, Nevada 89523

Re: K210401

Trade/Device Name: Microflex Nitrile Patient Examination Gloves Blue Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate, Microflex Nitrile Patient Examination Gloves Green Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate, Microflex Nitrile Patient Examination Gloves Black Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate Regulation Number: 21 CFR 880.6250 Regulation Name: Non-Powdered Patient Examination Glove Regulatory Class: Class I, reserved Product Code: LZA, LZC, QDO Dated: February 8, 2021 Received: February 10, 2021

Dear Donald Cronk:

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 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,

For Ryan Ortega 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)

K210401

Device Name

Microflex® Nitrile Patient Examination Gloves Blue Colored Tested for Use with Chemotherapy Drugs and Fentary1 Citrate

Indications for Use (Describe)

A powder-free patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. The glove was tested for use with Chemotherapy Drugs and Fentany) Citrate as per ASTM D6978-05 Standard Practice for Assessment for Medical Gloves to Permeation by Chemotherapy Drugs. Please note that the following drug has an extremely low permeation time: Carmustine: 47.9 minutes. Warning: Do not use with Carmustine.

Tested chemotherapy drugs are as follows:

Test Chemotherapy drug & ConcentrationAverage Breakthrough Detection Time (Minutes)
Carmustine - 3.3 mg/ml47.9
Cyclophosphamide - 20.0 mg/ml>240
Doxorubicin HCl - 2.0 mg/ml>240
Etoposide - 20.0 mg/ml>240
Fentanyl Citrate Injection - 100 mcg/2 ml>240
Fluorouracil - 50.0 mg/ml>240
Methotrexate - 25.0 mg/ml>240
Paclitaxel - 6.0 mg/ml>240
Thiotepa - 10.0 mg/ml>240
Vincristine Sulfate - 1.0 mg/ml>240
Type of Use (Select one or both, as applicable)
-------------------------------------------------

Prescription Use (Part 21 CFR 801 Subpart D)

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

Form Approved: OMB No. 0910-0120

Expiration Date: 06/30/2020

See PRA Statement below.

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

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Indications for Use

510{k} Number (if known)

K210401

Device Name

Microflex® Nitrile Patient Examination Gloves Green Colored Tested for Use with Chemotherapy Drugs and Fentary| Citrate

Indications for Use (Describe)

A powder-free patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. The glove was tested for use with Chemotherapy Drugs and Fentany) Citrate as per ASTM D6978-05 Standard Practice for Assessment for Medical Gloves to Permeation by Chemotherapy Drugs. Please note that the following drug has an extremely low permeation time: Carmustine: 49.6 minutes. Warning: Do not use with Carmustine.

Tested chemotherapy drugs are as follows:

Test Chemotherapy drug & ConcentrationAverage Breakthrough Detection Time (Minutes)
Carmustine - 3.3 mg/ml49.6
Cisplatin - 1.0 mg/ml>240
Cyclophosphamide - 20.0 mg/ml>240
Dacarbazine - 10.0 mg/ml>240
Doxorubicin HCl - 2.0 mg/ml>240
Etoposide - 20.0 mg/ml>240
Fentanyl Citrate Injection - 100 mcg/2 ml>240
Fluorouracil - 50.0 mg/ml>240
Methotrexate - 25.0 mg/ml>240
Paclitaxel - 6.0 mg/ml>240
Thiotepa - 10.0 mg/ml>240
Vincristine Sulfate - 1.0 mg/ml>240

Type of Use (Select one or both, as applicable)

J Prescription Use (Part 21 CFR 801 Subpart D)

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

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

{4}------------------------------------------------

Indications for Use

510(k) Number (if known)

K210401

Device Name

Microflex® Nitrile Patient Examination Gloves Black Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate

Indications for Use (Describe)

A powder-free patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. The glove was tested for use with Chemotherapy Drugs and Fentanyl Citrate as per ASTM D6978-05 Standard Practice for Assessment for Medical Gloves to Permeation by Chemotherapy Drugs. Please note that the following drug has an extremely low permeation time; Carmustine: 27.6 minutes. Warning: Do not use with Carmustine.

Tested chemotherapy drugs are as follows:

Test Chemotherapy drug & ConcentrationAverage Breakthrough Detection Time (Minutes)
Carmustine - 3.3 mg/ml27.6
Cyclophosphamide - 20.0 mg/ml>240
Doxorubicin HCl - 2.0 mg/ml>240
Etoposide - 20.0 mg/ml>240
Fentanyl Citrate Injection - 100 mcg/2 ml>240
Fluorouracil - 50.0 mg/ml>240
Methotrexate - 25.0 mg/ml>240
Paclitaxel - 6.0 mg/ml>240
Thiotepa - 10.0 mg/ml>240
Vincristine Sulfate - 1.0 mg/ml>240
Type of Use (Select one or both, as applicable)
---------------------------------------------------

Prescription Use (Part 21 CFR 801 Subpart D)

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

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

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510K Summary

Submitter:

Ansell Healthcare Products LLC. 2301 Robb Drive Reno, NV 89523

Contact Person(s):

Don Cronk Associate Director, Regulatory Affairs Phone: (775) 470-7106 Email: don.cronk@ansell.com

Jacob Ramirez Senior Coordinator, Regulatory Affairs Phone: (775) 624-8118 Email: jacob.ramirez@ansell.com

Date Prepared:

5/3/2021

Name of the Device:

Trade Names:Microflex® Nitrile Patient Examination Gloves Blue Colored Tested forUse with Chemotherapy Drugs and Fentanyl CitrateMicroflex® Nitrile Patient Examination Gloves Green Colored Tested forUse with Chemotherapy Drugs and Fentanyl CitrateMicroflex® Nitrile Patient Examination Gloves Black Colored Tested forUse with Chemotherapy Drugs and Fentanyl Citrate
Common Name:Patient Examination Glove
Classification Name:Patient Examination Glove
Classification Regulation:21 CFR 880.6250
Device Class:I
Product Code:LZA, LZC, QDO
Classification Panel:Non-powdered patient examination glove

Legally Marketed Predicate Device:

Company:Ansell Healthcare Products LLC
Trade Name:Microflex® Nitrile Patient Examination Gloves with Aloe and ChamomileBlue Colored Tested for Use with Chemotherapy DrugsMicroflex® Nitrile Patient Examination Gloves with Aloe and ChamomileGreen Colored Tested for Use with Chemotherapy DrugsMicroflex® Nitrile Patient Examination Gloves with Aloe and ChamomilePink Colored Tested for Use with Chemotherapy Drugs and FentanylCitrate
510(k) Number:K200671
Device Class:Class I
Product Code:LZA, LZC, QDO
Device Name:Patient Examination Glove (21 CFR 880.6250)

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Device Description:

Microflex® Nitrile Patient Examination Gloves Blue Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate, Microflex® Nitrile Patient Examination Gloves Green Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate, Microflex® Nitrile Patient Examination Gloves Black Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate are non-sterile, single use only, disposable, powder free examination gloves are made of nitrile butadiene rubber. A polyacrylic polymer is applied to the inner surface of the gloves to make donning easy.

Characteristics:

  • . Ambidextrous with beaded cuff and straight fingers
  • . Finger-textured
  • Blue, green, or black colored .
  • . Four (4) sizes - small, medium, large, and extra-large
  • . Tested against chemotherapy drugs and fentanyl citrate

High levels of ozone will degrade rubber material of the gloves; therefore, the gloves should be protected from ozone in particular.

The gloves are designed to meet the specifications of ASTM D6319-10, Standard Specification for Nitrile Examination Gloves for Medical Application.

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Indications for Use Statements:

Microflex® Nitrile Patient Examination Gloves Blue Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate

A powder-free patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. The glove was tested for use with Chemotherapy Drugs and Fentanyl Citrate as per ASTM D6978-05 Standard Practice for Assessment for Medical Gloves to Permeation by Chemotherapy Drugs. Please note that the following drug has an extremely low permeation time: Carmustine: 47.9 minutes. Warning: Do not use with Carmustine.

TEST CHEMOTHERAPY DRUG ANDCONCENTRATIONAVERAGE MINIMUM BREAKTHROUGH DETECTIONTIME(Sample 1,2,3) (Minutes)
Carmustine (3.3 mg/ml)47.9
Cyclophosphamide (20.0 mg/ml)>240
Doxorubicin HCl (2.0 mg/ml)>240
Etoposide (20.0 mg/ml)>240
Fentanyl Citrate Injection (100 mcg/2 ml)>240
Fluorouracil (50.0 mg/ml)>240
Methotrexate (25.0 mg/ml)>240
Paclitaxel (6.0 mg/ml)>240
Thieptepa (10.0 mg/ml)>240
Vincristine Sulfate (1.0 mg/ml)>240

Tested chemotherapy drugs are as follows:

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Microflex® Nitrile Patient Examination Gloves Green Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate

A powder-free patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. The glove was tested for use with Chemotherapy Drugs and Fentanyl Citrate as per ASTM D6978-05 Standard Practice for Assessment for Medical Gloves to Permeation by Chemotherapy Drugs. Please note that the following drug has an extremely low permeation time: Carmustine: 49.6 minutes. Warning: Do not use with Carmustine.

TEST CHEMOTHERAPY DRUG ANDCONCENTRATIONAVERAGE MINIMUM BREAKTHROUGH DETECTIONTIME(Sample 1,2,3) (Minutes)
Carmustine (3.3 mg/ml)49.6
Cisplatin (1.0 mg/ml)>240
Cyclophosphamide (20.0 mg/ml)>240
Dacarbazine (10.0 mg/ml)>240
Doxorubicin HCl (2.0 mg/ml)>240
Etoposide (20.0 mg/ml)>240
Fentanyl Citrate Injection (100 mcg/2 ml)>240
Fluorouracil (50.0 mg/ml)>240
Methotrexate (25.0 mg/ml)>240
Paclitaxel (6.0 mg/ml)>240
Thieptepa (10.0 mg/ml)>240
Vincristine Sulfate (1.0 mg/ml)>240

Tested chemotherapy drugs are as follows:

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Microflex® Nitrile Patient Examination Gloves Black Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate

A powder-free patient examination glove is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. The glove was tested for use with Chemotherapy Drugs and Fentanyl Citrate as per ASTM D6978-05 Standard Practice for Assessment for Medical Gloves to Permeation by Chemotherapy Drugs. Please note that the following drug has an extremely low permeation time: Carmustine: 27.6 minutes. Warning: Do not use with Carmustine.

TEST CHEMOTHERAPY DRUG ANDCONCENTRATIONAVERAGE MINIMUM BREAKTHROUGH DETECTIONTIME(Sample 1,2,3) (Minutes)
Carmustine (3.3 mg/ml)27.6
Cyclophosphamide (20.0 mg/ml)>240
Doxorubicin HCl (2.0 mg/ml)>240
Etoposide (20.0 mg/ml)>240
Fentanyl Citrate Injection (100 mcg/2 ml)>240
Fluorouracil (50.0 mg/ml)>240
Methotrexate (25.0 mg/ml)>240
Paclitaxel (6.0 mg/ml)>240
Thieptepa (10.0 mg/ml)>240
Vincristine Sulfate (1.0 mg/ml)>240

Tested chemotherapy drugs are as follows:

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Technological Characteristics:

Microflex® Nitrile Patient Examination Gloves Blue Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate, Microflex® Nitrile Patient Examination Gloves Green Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate, Microflex® Nitrile Patient Examination Gloves Black Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate have the following technological characteristics as compared to ASTM or equivalent standards:

CharacteristicsStandard/Test/FDA GuidanceResult Summary
Physical Characteristics:
Dimensions:ASTM D6319-10Meets ASTM D6319-10 requirements forlength, width and thickness
LengthMinimum 230mmMinimum 240mm
Palm width (mm)
Size - S$80 \pm 10$$85 \pm 5$
Size - M$95 \pm 10$$95 \pm 5$
Size - L$110\pm 10$$105 \pm 5$
Size - XL$120 \pm 10$$115 \pm 5$
Thickness (mm) - single-wall
Fingerminimum 0.05Finger - min 0.09
Palmminimum 0.05Palm - min 0.06
Cuff-Cuff - min 0.05
Physical Properties:ASTM D6319-10Meets ASTM D6319-10 requirements for tensilestrength and ultimate elongation before andafter accelerated aging:
Tensile Strength
Before Agingminimum 14 MPaminimum 16 MPa
After Agingminimum 14 MPaminimum 14 MPa
Ultimate Elongation
Before Agingminimum 500%minimum 500%
After Agingminimum 400%minimum 400%
Freedom from holesASTM D6319-10ASTM D5151-06Meets or exceeds ASTM D6319-10 and ASTMD5151-06 requirements of AQL 2.5
Powder ResidualASTM D6319-10ASTM D6124-06Meets applicable requirement for powder free;≤ 2 mg per glove
Biocompatibility:
ISO In Vitro CytotoxicityISO 10993-5:2009Under the conditions of the study, undiluted,1:2, 1:4, 1:8, 1:16 dilution was cytotoxic., 1:32and 1:64 are not cytotoxic
ISO Skin Irritation StudyISO10993-10:2010Under the conditions of the study, not anirritant
ISO MaximizationSensitization StudyISO 10993-10:2010Under the conditions of the study, not asensitizer
ISO acute systemic toxicityISO 10993-11: 2006Under the conditions of the study, no evidenceof systemic toxicity

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Substantial Equivalence:

Predicate DeviceProposed Subject DeviceSubstantialEquivalence toPredicate
Trade nameMicroflex® Nitrile PatientExamination Gloves with Aloeand Chamomile Blue ColoredTested for Use withChemotherapy DrugsMicroflex® Nitrile PatientExamination Gloves with Aloeand Chamomile Green ColoredTested for Use withChemotherapy DrugsMicroflex® Nitrile PatientExamination Gloves with Aloeand Chamomile Pink ColoredTested for Use withChemotherapy Drugs andFentanyl CitrateMicroflex® Nitrile PatientExamination Gloves Blue ColoredTested for Use with ChemotherapyDrugs and Fentanyl CitrateMicroflex® Nitrile PatientExamination Gloves Green ColoredTested for Use with ChemotherapyDrugs and Fentanyl CitrateMicroflex® Nitrile PatientExamination Gloves Black ColoredTested for Use with ChemotherapyDrugs and Fentanyl CitrateNot applicable
510k NumberK200671K210401Not Applicable
Product OwnerAnsell HealthcareAnsell HealthcareYes
Product CodeLZA, LZC, QDOLZA, LZC, QDOYes
Regulation Number21 CFR 880.625021 CFR 880.6250Yes
Regulatory ClassIIYes
Regulation NamePatient Examination GlovePatient Examination GloveYes
Indications for useA powder-free patientexamination glove is a disposabledevice intended for medicalpurposes that is worn on theexaminer's hand to preventcontamination between patientand examinerA powder-free patientexamination glove is a disposabledevice intended for medicalpurposes that is worn on theexaminer's hand to preventcontamination between patientand examinerYes
MaterialCompositionSynthetic nitrile rubberSynthetic nitrile rubberYes
CoatingPolyacrylic polymer inner coatingto aid donningPolyacrylic polymer inner coatingto aid donningYes
Aloe andChamomileAloe and Chamomile coated onthe donning surfaceN/AAs noted
DesignNon-sterileNon-sterileYes
Single useSingle useYes
Powder-freePowder-freeYes
AmbidextrousAmbidextrousYes
Beaded cuffBeaded cuffYes
ColorBlue, Green, and PinkBlue, Green, and BlackAs noted
PerformanceMeets ASTM D6319-10requirementsMeets ASTM D6319-10requirementsYes
a. Dimensions
b. PhysicalPropertiesMeets ASTM D6319-10requirementsMeets ASTM D6319-10requirementsYes
c. Freedom fromholesMeets ASTM D6319-10requirements of GI, AQL 2.5Meets ASTM D6319-10requirements of GI, AQL 2.5Yes
d. Powder ResidualMeets ASTM D6319-10requirements; Not more than2.0mg/gloveMeets ASTM D6319-10requirements; Not more than2.0mg/gloveYes
e. SterilityNon-sterileNon-sterileYes
BiocompatibilityPasses Primary Skin Irritation Testand Dermal Sensitization Testand Acute Systemic Toxicity TestPasses Primary Skin Irritation Testand Dermal Sensitization Test andAcute Systemic Toxicity TestYes

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ChemotherapyClaimMicroflex® Nitrile Patient ExaminationGloves with Aloe and Chamomile BlueColored Tested for Use withChemotherapy DrugsMicroflex® Nitrile Patient ExaminationGloves Blue Colored Tested for Use withChemotherapy Drugs and Fentanyl CitrateAs Noted(Fentanyl Citrate)
The Nitrile Patient Examination Glovewith Aloe and Chamomile Blue Colored isintended to be worn by operating roompersonnel to protect a surgical woundfrom contamination. The glove was testedfor use with Chemotherapy Drugs as perASTM D6978-05 Standard Practice forAssessment for Medical Gloves toPermeation by Chemotherapy Drugs.Please note that the following drugs haveextremely low permeation times:Carmustine (BCNU): 17.4 minutes andThiotepa: 67.1 minutes. Warning: Do notuse with Carmustine.Tested chemotherapy drugs are asfollows:A powder-free patient examination glove isa disposable device intended for medicalpurposes that is worn on the examiner'shand to prevent contamination betweenpatient and examiner. The glove was testedfor use with Chemotherapy Drugs andFentanyl Citrate as per ASTM D6978-05Standard Practice for Assessment forMedical Gloves to Permeation byChemotherapy Drugs. Please note that thefollowing drug has an extremely lowpermeation time: Carmustine: 47.9minutes. Warning; Do not use withCarmustine.Tested chemotherapy drugs are as follows:
TestChemotherapyDrug andConcentration AverageMinimumBreakthroughDetection Time(Minutes) Carmustine (3.3mg/ml) 17.4 Cyclophosphamide(20.0 mg/ml) >240 Doxorubicin HCl(2.0 mg/ml) >240 Etoposide (20.0mg/ml) >240 Fluorouracil (50.0mg/ml) >240 Methotrexate(25.0 mg/ml) >240 Paclitaxel (6.0mg/ml) >240 Thiotepa (10.0mg/ml) 67.1 Vincristine Sulfate(1.0 mg/ml) >240TestChemotherapyDrug andConcentration AverageMinimumBreakthroughDetection Time(Minutes) Carmustine (3.3mg/ml) 47.9 Cyclophosphamide(20.0 mg/ml) >240 Doxorubicin HCl(2.0 mg/ml) >240 Etoposide (20.0mg/ml) >240 Fentanyl CitrateInjection (100mcg/2 ml) >240 Fluorouracil (50.0mg/ml) >240 Methotrexate(25.0 mg/ml) >240 Paclitaxel (6.0mg/ml) >240 Thiotepa (10.0mg/ml) >240 Vincristine Sulfate(1.0 mg/ml) >240
ChemotherapyClaimMicroflex® Nitrile Patient ExaminationGloves with Aloe and Chamomile GreenColored Tested for Use withChemotherapy DrugsMicroflex® Nitrile Patient ExaminationGloves Green Colored Tested for Use withChemotherapy Drugs and Fentanyl CitrateAs Noted(Fentanyl Citrate)
The Nitrile Patient Examination Glovewith Aloe and Chamomile Green Coloredis intended to be worn by operating roompersonnel to protect a surgical woundfrom contamination. The glove was testedfor use with Chemotherapy Drugs as perASTM D6978-05 Standard Practice forAssessment for Medical Gloves toPermeation by Chemotherapy Drugs.Please note that the following drugs haveextremely low permeation times:Carmustine (BCNU): 27.9 minutes andThiotepa: 48.6 minutes. Warning: Do notuse with Carmustine.A powder-free patient examination glove isa disposable device intended for medicalpurposes that is worn on the examiner'shand to prevent contamination betweenpatient and examiner. The glove was testedfor use with Chemotherapy Drugs andFentanyl Citrate as per ASTM D6978-05Standard Practice for Assessment forMedical Gloves to Permeation byChemotherapy Drugs. Please note that thefollowing drug has an extremely lowpermeation time: Carmustine: 49.6minutes. Warning: Do not use withCarmustine.

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Tested chemotherapy drugs are asTested chemotherapy drugs are as follows:
follows:
TestMinimum
TestAverageChemotherapyBreakthrough
ChemotherapyMinimumDrug andDetection Time
Drug andBreakthroughConcentration
ConcentrationDetection Time
(Minutes)Carmustine (3.349.6
Carmustine (3.327.9mg/ml)
mg/ml)Cisplatin (1.0>240
Cyclophosphamide>240mg/ml)
(20.0 mg/ml)Cyclophosphamide>240
Doxorubicin HCl>240(20.0 mg/ml)
(2.0 mg/ml)Dacarbazine (10.0>240
Etoposide (20.0>240mg/ml)
mg/ml)Doxorubicin HCl>240
Fluorouracil (50.0>240(2.0 mg/ml)
mg/ml)Etoposide (20.0>240
Methotrexate>240mg/ml)
(25.0 mg/ml)Paclitaxel (6.0Fentanyl CitrateInjection (100>240
mg/ml)>240mcg/2 ml)
Thiotepa (10.048.6Fluorouracil (50.0>240
mg/ml)mg/ml)
Vincristine Sulfate>240Methotrexate>240
(1.0 mg/ml)(25.0 mg/ml)
Paclitaxel (6.0>240
mg/ml)
Thiotepa (10.0>240
mg/ml)
Vincristine Sulfate>240
(1.0 mg/ml)
Microflex® Nitrile Patient ExaminationMicroflex® Nitrile Patient Examination
ChemotherapyGloves with Aloe and Chamomile PinkGloves Black Colored Tested for Use withYes
ClaimColored Tested for Use withChemotherapy Drugs and Fentanyl Citrate
Chemotherapy Drugs and Fentanyl Citrate
A powder-free patient examination glove is
The Nitrile Patient Examination Glovea disposable device intended for medical
with Aloe and Chamomile Pink Colored ispurposes that is worn on the examiner's
intended to be worn by operating roomhand to prevent contamination between
personnel to protect a surgical woundfrom contamination. The glove was testedpatient and examiner. The glove was tested
for use with Chemotherapy Drugs andfor use with Chemotherapy Drugs andFentanyl Citrate as per ASTM D6978-05
Fentanyl Citrate as per ASTM D6978-05Standard Practice for Assessment for
Standard Practice for Assessment forMedical Gloves to Permeation by
Medical Gloves to Permeation byChemotherapy Drugs. Please note that the
Chemotherapy Drugs. Please note thatfollowing drug has an extremely low
the following drugs have extremely lowpermeation time: Carmustine: 27.6
permeation times: Carmustine (BCNU):minutes. Warning: Do not use with
23.4 minutes and Thiotepa: 64.9 minutes.Carmustine.
Warning: Do not use with Carmustine.
Tested chemotherapy drugs are asTested chemotherapy drugs are as follows:
follows:
TestChemotherapyMinimumBreakthrough
TestAverageDrug andDetection Time
ChemotherapyMinimumConcentration
Drug andBreakthrough
ConcentrationDetection TimeCarmustine (3.327.6
(Minutes)mg/ml)
Carmustine (3.323.4Cyclophosphamide>240
mg/ml)(20.0 mg/ml)
Cyclophosphamide(20.0 mg/ml)>240Doxorubicin HCl(2.0 mg/ml)>240

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Doxorubicin HCl(2.0 mg/ml)>240
Etoposide (20.0 mg/ml)>240
Fentanyl CitrateInjection (100 mcg/2 ml)>240
Fluorouracil (50.0 mg/ml)>240
Methotrexate(25.0 mg/ml)>240
Paclitaxel (6.0 mg/ml)>240
Thiotepa (10.0 mg/ml)64.9
Vincristine Sulfate(1.0 mg/ml)>240

The subject devices meet the applicable requirements for patient examination gloves regarding dimensions and sizes, physical properties, freedom from holes, and powder residues as found in the following standards: ASTM D6319, ASTM D5151 and ASTM D6124. The subject devices pass biological reactivity testing for dermal sensitization and acute systemic toxicity, in accordance with the ISO 10993 series of standards.

A clinical study was not required for the subject or predicate devices.

Conclusion

The conclusions drawn from the nonclinical tests demonstrate that the subject devices are as safe, as effective, and performs as well as the legally marketed device.

§ 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.