K Number
K211667
Date Cleared
2021-09-23

(114 days)

Product Code
Regulation Number
862.3280
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Disposable Medical Synthetic Nitrile Examination Gloves are disposable device intended for medical purpose that is worn on the examiner's hand to prevent contamination between patient and examiner.

Device Description

The subject device in this 510(k) Notification is Disposable Medical Synthetic Nitrile Examination Gloves. Non-sterile. The subject device is a patient examination glove made from nittile and vinyl compound, blue color, powder free and non-sterile (Per 21 CFR 880.6250, Class I). The device meets the specifications in ASTM D6319-19 Standard Specification for Nitrile Examination Gloves for Medical Application.

AI/ML Overview

The provided document is a 510(k) summary for Disposable Medical Synthetic Nitrile Examination Gloves (Non-Sterile). It details the non-clinical testing performed to demonstrate substantial equivalence to a predicate device.

1. Table of Acceptance Criteria and Reported Device Performance

Test Method (Reference)Acceptance CriteriaReported Device Performance
Physical Dimensions (ASMT D6319-19)Width: 80 mm (±10mm) (for small size) 95 mm (±10mm) (for medium size) 110 mm (±10mm) (for large size) Length: 220 mm (Minimum) (for small size) 230 mm (Minimum)(for medium, large size) Thickness: (for all sizes) Finger -0.05 mm (Minimum) Palm -0.05mm (Minimum)Passed
Physical Requirements (Tensile Strength & Ultimate Elongation) (ASMT D6319-19)Before Acceleration Aging: Tensile Strength (MPa): 14 (Minimum) Ultimate Elongation (%): 500 (Minimum) After Acceleration Aging: Tensile Strength (MPa): 14 (Minimum) Ultimate Elongation (%): 400(Minimum)Passed
Freedom from Holes (Water Tight -1000 ml) (ASTM D6319-19 (ASTM D5151-11))AQL 2.5Passed
Residual Powder on Medical Gloves (ASMT D6319-19 (ASTM D6124-11))< 2.0 mg/glove0.6 mg/glove, Passed
Skin Irritation (ISO 10993-10)Under the condition of study not an irritantUnder the condition of study not an irritant
Skin Sensitization (ISO 10993-10)Under the conditions of the study not a sensitizer.Under the condition of the study not a sensitizer.
In Vitro Cytotoxicity (ISO 10993-5)No more than grade 2 cytotoxicity at 100% extract concentrationUnder the conditions of the cytotoxicity study, the extract of the test article showed mild cytotoxicity to L-929 cells and the cytotoxic level was 2. (This meets the acceptance criteria of "no more than grade 2 cytotoxicity").

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

The document does not specify the exact sample sizes used for each individual test (e.g., number of gloves tested for physical dimensions, holes, or residual powder). However, the general statement mentions that the device "meets the specifications in ASTM D6319-19 Standard Specification for Nitrile Examination Gloves for Medical Application," implying that the testing was conducted according to the sampling plans outlined in these standards.

The data provenance is not explicitly stated in terms of country of origin for the test data, nor whether it was retrospective or prospective. It is implied that these are prospective tests performed on the manufactured gloves as part of the submission process to demonstrate compliance with standards.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Their Qualifications

This information is not applicable to this document. The "ground truth" for this medical device (examination gloves) is established through adherence to recognized international standards (ASTM and ISO) for physical, chemical, and biological properties, not by expert interpretation of clinical data or images.

4. Adjudication Method for the Test Set

This information is not applicable. The tests are objective measurements against defined standards, not subjective assessments requiring adjudication.

5. If a Multi Reader Multi Case (MRMC) Comparative Effectiveness Study Was Done, and Effect Size

No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. This type of study is relevant for diagnostic devices that involve human interpretation, such as imaging AI applications. Examination gloves do not involve human diagnostic interpretation.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

This information is not applicable. This is a physical medical device (gloves), not an algorithm or AI system.

7. The Type of Ground Truth Used

The "ground truth" for this device's performance is based on objective measurement against established international standards. Specifically:

  • ASTM D6319-19: Standard Specification for Nitrile Examination Gloves for Medical Application
  • ASTM D5151-11: Standard Test Method for Detection of Holes in Medical Gloves
  • ASTM D6124-11: Standard Test Method for Residual Powder on Medical Gloves
  • ISO 10993-10: Biological evaluation of medical devices — Part 10: Tests for skin irritation and skin sensitization
  • ISO 10993-5: Biological evaluation of medical devices — Part 5: Tests for in vitro cytotoxicity

8. The Sample Size for the Training Set

This information is not applicable. This is a physical medical device, not an AI or machine learning model that requires a training set.

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

This information is not applicable for the same reason as above.

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Image /page/0/Picture/0 description: The image contains two logos. On the left is the Department of Health & Human Services logo. On the right is the FDA logo, which includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

September 23, 2021

Changzhou Universal Medical Equipment Co. Ltd Johnson Liu Consultant CNMED Consultant 31 Archer St Upper MT Gravatt, QLD 4122 Australia

Re: K211667

Trade/Device Name: Disposable Medical Synthetic Nitrile Examination Gloves (Non-Sterile) Regulation Number: 21 CFR 880.6250 Regulation Name: Non-Powdered Patient Examination Glove Regulatory Class: Class I, reserved Product Code: LZA Dated: August 16, 2021 Received: August 24, 2021

Dear Johnson Liu:

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

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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 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 Ouality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known)

K211667

Device Name

Disposable Medical Synthetic Nitrile Examination Gloves (Non-Sterile)

Indications for Use (Describe)

Disposable Medical Synthetic Nitrile Examination Gloves are disposable device intended for medical purpose that is worn on the examiner's hand 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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Image /page/3/Picture/1 description: The image shows a logo with a circular teal border. Inside the border are five white stars evenly spaced around the top half of the circle. In the center of the circle are two Chinese characters stacked vertically. Below the characters is the text "Lian Shou" in a sans-serif font, also in teal. In the upper right corner of the image is the registered trademark symbol.

510(K) Summary K211667

DISPOSABLE MEDICAL SYNTHETIC NITRILE EXAMINATION GLOVES, NON-STERILE

Preparation Date: Aug 16th, 2021

1. SUBMITTER

Company Name: Changzhou Universal Medical Equipment Co.,Ltd Company Address: No.6,Xinxi Road, Xinbei District Changzhou, CN 213000 Contact Person: Johnson Liu Telephone Number: +614-0158-9995 Email: Johnson@cnmed.com.au

2. NAME OF THE DEVICE

Trade Name / Proprietary Name: Disposable Synthetic Nitrile Examination Gloves (Non Sterile) Device Name: Disposable Medical Synthetic Nitrile Examination Gloves (Non-Sterile) Device Classification Name: Patient Examination Gloves Device Class: Class I Device Classification Number: 21 CFR 880.6250 Product Code: LZA

3. IDENTIFICATION OF THE LEGALLY MARKETED PREDICATE DEVICE

Primary Predicate Device: K102593 Applicant: Zibo Yingbo Medical Products Co., Ltd Device Name: Synthetic Nitrile Patient Examination Gloves - Powder free, Blue Colour Device Classification Name: Patient Examination Gloves Device Classification Number: 21 CFR 880.6250 Device Class: Class I Product Code: LZA Review Panel: General Hospital

4. DEVICE DESCRIPTION

The subject device in this 510(k) Notification is Disposable Medical Synthetic Nitrile Examination Gloves. Non-sterile. The subject device is a patient examination glove made from nittile and vinyl compound, blue color, powder free and non-sterile (Per 21 CFR 880.6250, Class I). The device meets the specifications in ASTM D6319-19 Standard Specification for Nitrile Examination Gloves for Medical Application.

5. INDICATIONS FOR USE OF THE DEVICE

Disposable Medical Synthetic Nitrile Examination Gloves, Non-sterile is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

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6. TECHNOLOGICAL CHARACTERISTIC COMPARISON FOR THE PROPOSED AND PREDICATE DEVICES

CHARACTERISTICSDEVICE PERFORMANCEPRIMARY PREDICATEResult
SUBJECT
510(k) NumberK211667K102593-
Device NameDisposable Medical Synthetic Nitrile ExaminationGloves Powder Free, Non sterileSynthetic Nitrile Patient Examination Gloves -Powder free, Blue Color-
Product CodeLZALZASame
Indications for UseDisposable Nitrile Examination Gloves Non-sterile(Non sterile) is disposable devices intended formedical purpose that are worn on the examiner's handto prevent contamination between patient andexaminer. The device is for over the-counter use.A patient examination glove is a disposabledevice intended for medical purposes that isworn on the hand of healthcare and similarpersonnel to prevent contamination betweenhealthcare personal and the patient's body,fluids, waste or environmentSame
Materials of UseNitrile and Vinyl compoundSynthetic NitrileSimilar
ColorBlueBlueSame
Size(ASTM D6319-19)Small, Medium, Large,Small, Medium, Large,Extra LargeSame
SterilizationNon-sterileNon-sterileSame
UsageSingle usageSingle usageSame
DimensionsWidth:80mm ±10mm (for small size)95mm ±10mm (for medium size)110 mm ±10mm (for large size)Length:220mm (Minimum) (for small size)230 mm (Minimum)(for medium, large size)Comply with ASTM D6319-05Same
Physical PropertiesBefore AgingTensile StrengthMin 14 MpaUltimate Elongation Min 500%After AgingTensile StrengthMin 14 MpaUltimate Elongation Min 400%(ASTM D6319-19)Before AgingTensile StrengthMin 14 MpaUltimate Elongation Min 500%After AgingTensile StrengthMin 14 MpaUltimate Elongation Min 400%(ASTM D6319-05)Same
ThicknessPalm min 0.05 mmFinger min 0.05 mm(ASTM D6319-19)Palm min 0.05 mmFinger min 0.05 mm(ASTM D6319-05)Same
Powder Free<2 mg/glove (ASTM D6319-19)<2 mg/glove (ASTM D6319-05)Same
Freedom from Holes (WaterTight -1000 ml) AQL2.5PassedASTM D6319-19 (Cross Reference D5151PassedASTM D6319-05 (Cross Reference D5151)Same
Biocompatibility -SKINSENSITIZATION - ISO10993-10: 2010 (E)Under the conditions of the study not a sensitizerUnder the conditions of the study not a sensitizerSame
Biocompatibility -SKINIRRITATION - ISO10993-10: 2010 (E)Under the conditions of study not an irritantUnder the conditions of study not an irritantSame
Biocompatibility - IN VITROCYTOTOXICITY – ISO10993-5: 2009(E)Under the conditions of the cytotoxicity study, testingresults showed mild systemic toxicity and cytotoxiclevel was 2.No Testing Result availableDifferent
Manufacturer(s)Changzhou Universal Medical Equipment Co.,LtdZibo Yingbo Medical Products Co., Ltd--

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To sum up, the subject device and predicate devices are equivalent in terms of intended use, design, safety and performance.

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7. NON-CLINICAL TESTING SUMMARY

PERFORMANCE DATA

Test MethodPurposeAcceptance CriteriaResult
ASMT D6319-19Standard Specificationfor Nitrile ExaminationGloves for MedicalApplication - PhysicalDimensions TestTo determine thewidth, length, andthickness of theglovesWidth:80 mm (±10mm) (for small size)95 mm (±10mm) (for medium size)110 mm (±10mm) (for large size)Length:220 mm (Minimum)(for small size)230 mm (Minimum)(for medium, largesize)Thickness: (for all sizes)Finger -0.05 mm (Minimum)Palm -0.05mm (Minimum)Passed
ASMT D6319-19Standard Specificationfor Nitrile ExaminationGloves for MedicalApplication - PhysicalRequirements TestTo determine thetensile strength andultimate elongationbefore and afteracceleration agingBefore Acceleration Aging:Tensile Strength (MPa): 14 (Minimum)Ultimate Elongation (%): 500 (Minimum)After Acceleration Aging:Tensile Strength (MPa): 14 (Minimum)Ultimate Elongation (%): 400(Minimum)Passed
ASTM D6319-19(ASTM D5151-11)Standard Test Methodfor Detection of Holes inMedical GlovesTo determine theholes in the glovesAQL 2.5Passed
ASMT D6319-19(ASTM D6124-11)Standard Test Methodfor Residual Powder onMedical GlovesTo determine theresidual powder inthe gloves< 2.0 mg/glove0.6 mg/glove, Passed

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BIO-COMPATIBILITY DATA

Test MethodPurposeAcceptanceCriteriaResult
ISO 10993-10 Biological evaluationof medical devices — Part 10: Testsfor skin irritation and skinsensitizationTo determine the potential of thematerial under test to produce skinirritation in rabbitsUnder the condition ofstudy not an irritantUnder thecondition of studynot an irritant
ISO 10993-10 Biological evaluationof medical devices — Part 10: Testsfor skin irritation and skinsensitizationTo determine the skin sensitizationpotential of the material both interms of induction and elicitation inguinea pigs.Under the conditions ofthe study not a sensitizer.Under the conditionof the study not asensitizer.
ISO 10993-5 Biological evaluation ofmedical devices — Part 5: Tests for invitro cytotoxicityTo evaluate the in vitro cytotoxicpotential of the test item (both innerand outer surface) Extracts in L-929mouse fibroblasts cells using elutionmethodNo more than grade 2cytotoxicity at 100%extract concentrationUnder the conditionsof the cytotoxicitystudy, the extract ofthe test articleshowed mildcytotoxicity to L-929cells and thecytotoxic level was2.

8. CLINICAL TESTING SUMMARY

Not applicable - Clinical data is not needed for gloves or for most devices cleared by the 510(k) process.

9. CONCLUSION

The conclusions drawn from the non-clinical test demonstrate that the subject device in 510(k) submission, the Disposable Medical Synthetic Nitrile Examination Gloves Non sterile is as safe, as effective, and performs as well as or better than the legally marketed predicate device K102593- Synthetic Nitrile Patient Examination Gloves – Powder free, Blue.

§ 862.3280 Clinical toxicology control material.

(a)
Identification. A clinical toxicology control material is a device intended to provide an estimation of the precision of a device test system and to detect and monitor systematic deviations from accuracy resulting from reagent or instrument defects. This generic type of device includes various single, and multi-analyte control materials.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.