K Number
K210723
Device Name
Nitrile Patient Examination Glove
Date Cleared
2021-07-12

(124 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Nitrile Patient Examination Glove is a non-sterile disposable device intended for medical purposes that is worn on the examiner's hands or finger to prevent contamination between patient and examiner.
Device Description
The subject device is powder free nitrile examination gloves. The subject device is blue. The subject device is non-sterile.
More Information

Not Found

No
The device is a simple examination glove and the summary contains no mention of AI, ML, or any related technologies.

No.
The document states its purpose is to prevent contamination between patient and examiner, not to provide therapy or treatment.

No
Explanation: The device is described as a "Nitrile Patient Examination Glove" intended for preventing contamination. Its function is to provide a barrier, not to diagnose a condition or disease.

No

The device is a physical product (nitrile gloves) and the description focuses on material properties and performance standards for a physical barrier. There is no mention of software functionality.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used to diagnose, monitor, or screen for health issues.
  • Device Description and Intended Use: The description clearly states the device is a "Nitrile Patient Examination Glove" intended to be "worn on the examiner's hands or finger to prevent contamination between patient and examiner." This is a barrier device used for protection and hygiene, not for testing samples from the body.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples.
    • Detecting specific substances or markers.
    • Providing diagnostic information.
    • Using reagents or analytical methods.

The information provided describes a medical device used for personal protection and preventing cross-contamination, which falls under a different regulatory category than IVDs.

N/A

Intended Use / Indications for Use

The Nitrile Patient Examination Glove is a non-sterile disposable device intended for medical purposes that is worn on the examiner's hands or finger to prevent contamination between patient and examiner.

Product codes

LZA

Device Description

The subject device is powder free nitrile examination gloves. The subject device is blue. The subject device is non-sterile.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

hands or finger

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

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)

Non-clinical tests were conducted to verify that the proposed device met all design specifications. The test results demonstrated that the proposed device complies with the following standards:
ISO 10993-10:2010 Biological Evaluation of Medical Devices - Part 10: Tests For Irritation And Skin Sensitization.
ISO 10993-5:2009 Biological Evaluation of Medical Devices - Part 5: Tests For In Vitro Cytotoxicity
ASTM D6124-06 (Reapproved 2017), Standard Test Method for Residual Powder on Medical Gloves
ASTM D5151-19, Standard Test Method for Detection of Holes in Medical Gloves.
ASTM D6319-19, Standard Specification for Nitrile Examination Gloves for Medical Application.

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

Not Found

Predicate Device(s)

K171422

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

0

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: 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 a symbol of the agency's mission to protect and promote public health through the regulation and supervision of food safety, tobacco, pharmaceuticals, medical devices, and other related products.

July 12, 2021

Jiangxi Zhonghong Pulin Medical Products Co.,Ltd. % Boyle Wang Shanghai Truthful Information Technology Co., Ltd. RM.608,No.738,Shangcheng Rd.,Pudong Shanghai, Shanghai 200120 China

Re: K210723

Trade/Device Name: Nitrile Patient Examination Glove Regulation Number: 21 CFR 880.6250 Regulation Name: Non-powdered patient examination glove Regulatory Class: Class I, reserved Product Code: LZA Dated: June 15, 2021 Received: June 24, 2021

Dear Boyle Wang:

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

1

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 (OS) 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,

Ryan Ortega Acting 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) K210723

Device Name Nitrile Patient Examination Glove

Indications for Use (Describe)

The Nitrile Patient Examination Glove is a non-sterile disposable device intended for medical purposes that is worn on the examiner's hands or finger to prevent contamination between patient and examiner.

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 (K210723)

This summary of 510(k) is being submitted in accordance with 21 CFR 807.92.

1.0 Submitter's Information

Name: Jiangxi Zhonghong Pulin Medical Products Co.,Ltd. Address: Yinshawan Park,High-tech Industrial Park,Hukou County, Jiujiang City,Jiangxi Province,China,332500 Phone Number: +86-19931401105 Contact: Zhou Ziyu Date of Preparation: Jun.15,2021

Designated Submission Correspondent

Mr. Boyle Wang Shanghai Truthful Information Technology Co., Ltd. Room 608, No. 738 Shangcheng Rd., Pudong,Shanghai 200120 ,China Tel: +86-21-50313932 Email: Info@truthful.com.cn

2.0 Device Information

Trade name: Nitrile Patient Examination Glove Common name: Patient Examination Gloves Classification name: Non-powdered patient examination glove Model(s): XS,S, M, L, XL

3.0 Classification

Production code: LZA Regulation number: 21CFR880.6250 Classification: Class I Panel: General Hospital

4.0 Predicate Device Information

Manufacturer: Ever Global (Vietnam) Enterprise Corp Device: Disposable Powder Free Nitrile Examination Glove, White/ Blue/ Black/ Pink Color 510(k) number: K171422

4

5.0 Indication for Use

The Nitrile Patient Examination Glove is a non-sterile disposable device intended for medical purposes that is worn on the examiner's hands or finger to prevent contamination between patient and examiner.

6.0 Device Description

The subject device is powder free nitrile examination gloves. The subject device is blue. The subject device is non-sterile.

7.0 Technological Characteristic Comparison Table

| Item | Subject Device
(K210723) | Predicated Device
(K171422) | Remark |
|-----------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------|
| Product Code | LZA | LZA | Same |
| Regulation No. | 21CFR880.6250 | 21CFR880.6250 | Same |
| Class | I | I | Same |
| Intended Use | The Nitrile Patient
Examination Glove
is a non-sterile
disposable device
intended for
medical purposes
that is worn on the
examiner's hands
or finger to prevent
contamination
between patient
and examiner. | The Nitrile Powder
Free patient
examination glove
is a non-sterile
disposable device
intended for
medical purposes
that is worn on the
examiner's hands
or finger to prevent
contamination
between patient
and examiner. | Same |
| Powdered or
Powered free | Powdered free | Powdered free | Same |
| Design Feature | Ambidextrous | Ambidextrous | Same |
| Labeling Information | Single-use
indication, powder
free, device color,
device name,
glove size and
quantity, Nitrile
Glove Powder | Single-use
indication, powder
free, device color,
device name, glove
size and quantity,
Disposable Powder
Free Nitrile | Same |

Table1-General Comparison

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Free Blue, Non-SterileExamination Glove, Non-Sterile
----------------------------------------------------------

| Predicate

Device(K171422)DesignationSizeTolerance
Length, mmXSSMLXLmin
Width, mm758595105115±5
Thickness, mm:
Finger0.05min
Palm0.05min
Subject Device
(K210723)DesignationSizeTolerance
Length, mmXSSMLXLmin
Width, mm708095110120±10
Thickness, mm:
Finger0.05min
Palm0.05min
RemarkSIMILAR

Table2 Device Dimensions Comparison

Analysis: The physical dimensions are little different with that of the predicate, but they all meet the requirements of ASTM D6319-19,so the differences do not raise any new safety or performance questions.

Table3 Performance Comparison

| Item | | Subject device
(K210723) | Predicated device
(K171422) | Remark |
|------------------------|--------------|-----------------------------------|-----------------------------------|--------|
| Colorant | | Blue | White/ Blue/ Black/ Pink | Same |
| Physical
Properties | Before Aging | Tensile Strength
14MPa, min | 14MPa, min | Same |
| | | Ultimate Elongation
500% min | 500% min | Same |
| | After Aging | Tensile Strength
14MPa, min | 14MPa, min | Same |
| | | Ultimate Elongation
400%min | 400%min | Same |
| | | Comply with ASTM D6319 | Comply with ASTM D6319 | Same |
| Freedom from Holes | | Be free from holes when tested in | Be free from holes when tested in | Same |

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| | accordance
with
ASTMD5151
AQL=2.5 | accordance
with
ASTMD5151
AQL=2.5 | |
|----------------|----------------------------------------------|----------------------------------------------|------|
| Powder Content | Meet the
requirements
of ASTM
D6124 | Meet the
requirements
of ASTM
D6124 | Same |

Table4 Safety Comparison

| Item | | Subject
device
(K210723) | Predicated
device
(K171422) | Remark |
|------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------|-----------------------------------|---------|
| Material | | Nitrile | Nitrile | Same |
| Biocompatibility | Irritation (ISO
10993-10:2010
Biological
Evaluation of
Medical Devices -
Part 10: Tests For
Irritation And Skin
Sensitization) | Under the
conditions of
the study, not
an irritant | | |
| | Sensitization
(ISO 10993-
10:2010
Biological
Evaluation of
Medical Devices -
Part 10: Tests For
Irritation And Skin
Sensitization) | Under
conditions of
the study, not
a sensitizer. | Comply with
ISO10993-
10 | Same |
| | Cytotoxicity (ISO
10993-5:2009
Biological
Evaluation of
Medical Devices -
Part 5: Tests For
In Vitro
Cytotoxicity) | Under
conditions of
the study,
device
extract is not
cytotoxic | / | Similar |

8.0 Discussion of Non-clinical and Performance Testing

Non-clinical tests were conducted to verify that the proposed device met all design specifications. The test results demonstrated that the proposed device

7

complies with the following standards:

ISO 10993-10:2010 Biological Evaluation of Medical Devices - Part 10: Tests For Irritation And Skin Sensitization.

ISO 10993-5:2009 Biological Evaluation of Medical Devices - Part 5: Tests For In Vitro Cytotoxicity

ASTM D6124-06 (Reapproved 2017), Standard Test Method for Residual Powder on Medical Gloves

ASTM D5151-19, Standard Test Method for Detection of Holes in Medical Gloves.

ASTM D6319-19, Standard Specification for Nitrile Examination Gloves for Medical Application.

9.0 Discussion of Clinical and Performance Testing

Clinical testing is not needed for this device.

10.0 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 predicated device.