K Number
K212827
Date Cleared
2021-12-06

(94 days)

Product Code
Regulation Number
880.6250
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

JR Medic Blue Nitrile Examination Gloves Powder Free tested for use with Chemotherapy drugs is a disposable device intended for medical purpose that is worn on the examination between patient and examiner.

Additionally, the gloves were tested for use with chemotherapy drugs in accordance with ASTM D6978-05 (2019) Standard Practice for Assessment of Medical Glove to Permeation by Chemotherapy Drugs.

The tested chemotherapy drugs and their breakthrough detection times are as follows:

Tested Chemotherapy Drug Name & ConcentrationMinimum Breakthrough Detection Time
Carmustine (BCNU) (3.3 mg/ml)35.0 Minutes
Carboplatin (10 mg/ml)>240 Minutes
Cisplatin (1 mg/ml)>240 Minutes
Cyclophosphamide (Cytoxan) (20 mg/ml)>240 Minutes
Dacarbazine (10.0 mg/ml)>240 Minutes
Doxorubicin HCl (2 mg/ml)>240 Minutes
Etoposide (20 mg/ml)>240 Minutes
Fluorouracil (50 mg/ml)>240 Minutes
Ifosfamide (50 mg/ml)>240 Minutes
Methotrexate (25 mg/ml)>240 Minutes
Mitomycin C (0.5 mg/ml)>240 Minutes
Mitoxantrone (2 mg/ml)>240 Minutes
Paclitaxel (6 mg/ml)>240 Minutes
Thiotepa (10 mg/ml)64.9 Minutes
Vincristine Sulfate (1 mg/ml)>240 Minutes
Device Description

The subject device in 510(K) notification is JR Medic blue nitrile examination gloves powder free tested for use with Chemotherapy drugs.

The subject device is a patient examination glove made from acrylonitrile-butadiene copolymer dispersion, blue color, powder free and non sterile (as per 21CFR 880.6250, class I).

The subject device meets all the current specifications listed under the ASTM Specification D 6319 -2019, Standard Specification for Nitrile Examination Gloves for Medical Application. This device also complies with requirements for standard practice for assessment of resistance of medical gloves to permeation by chemotherapy drugs as per ASTM D6978- 05(2019)

AI/ML Overview

I am sorry, but the provided text does not describe a study involving an AI device or algorithm, and therefore all the requested information about acceptance criteria, study design, sample sizes, ground truth, expert involvement, and MRMC studies cannot be extracted.

The document is a 510(k) premarket notification for "JR Medic Blue Nitrile Examination Powder Free Gloves tested for use with chemotherapy drugs." It details the non-clinical testing performed on these medical gloves to demonstrate their safety and effectiveness, specifically their resistance to permeation by chemotherapy drugs, in accordance with established ASTM (American Society for Testing and Materials) standards.

The document focuses on the physical, chemical, and biocompatibility properties of the gloves, not on the performance of a software algorithm or AI.

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

December 6, 2021

JR Engineering & Medical Technologies (M) SDN.BHD. Manoj Zacharias Consultant Liberty Management Group Ltd. 75 Executive Dr. STE 114 Aurora, Illinois 60504

Re: K212827

Trade/Device Name: Jr Medic Blue Nitrile Examination Powder Free Gloves tested for use with chemotherapy drugs Regulation Number: 21 CFR 880.6250 Regulation Name: Non-Powdered Patient Examination Glove Regulatory Class: Class I, reserved Product Code: LZA, LZC, OPJ Dated: November 2, 2021 Received: November 4, 2021

Dear Manoj Zacharias:

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 Clarence W. Murray III, PhD 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) K212827

Device Name

JR Medic Blue Nitrile Examination Gloves Powder Free tested for use with Chemotherapy drugs

Indications for Use (Describe)

JR Medic Blue Nitrile Examination Gloves Powder Free tested for use with Chemotherapy drugs is a disposable device intended for medical purpose that is worn on the examination between patient and examiner.

Additionally, the gloves were tested for use with chemotherapy drugs in accordance with ASTM D6978-05 (2019) Standard Practice for Assessment of Medical Glove to Permeation by Chemotherapy Drugs.

The tested chemotherapy drugs and their breakthrough detection times are as follows:

Tested Chemotherapy Drug Name & ConcentrationMinimum Breakthrough Detection Time
Carmustine (BCNU) (3.3 mg/ml)35.0 Minutes
Carboplatin (10 mg/ml)>240 Minutes
Cisplatin (1 mg/ml)>240 Minutes
Cyclophosphamide (Cytoxan) (20 mg/ml)>240 Minutes
Dacarbazine (10.0 mg/ml)>240 Minutes
Doxorubicin HCl (2 mg/ml)>240 Minutes
Etoposide (20 mg/ml)>240 Minutes
Fluorouracil (50 mg/ml)>240 Minutes
Ifosfamide (50 mg/ml)>240 Minutes
Methotrexate (25 mg/ml)>240 Minutes
Mitomycin C (0.5 mg/ml)>240 Minutes
Mitoxantrone (2 mg/ml)>240 Minutes
Paclitaxel (6 mg/ml)>240 Minutes
Thiotepa (10 mg/ml)64.9 Minutes
Vincristine Sulfate (1 mg/ml)>240 Minutes

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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510(K) SUMMARY K212827 As required by: 21CFR§807.92(c)

A. APPLICANTINFORMATION

510(K) Owner's NameJR Engineering & Medical Technologies (M) SDN.BHD.
AddressLot 8 &10, Jalan Zurah 3 & Lot 1&3, Jalan Zurah 3A/1,Pusat Perindustrian 2, 44200 Rasa, Hulu Selangor, SelangorDarul Ehsan, Malaysia.
Phone+603-60572081
Fax+603-60572181
E-mailganeshjrmt@gmail.com
Contact PersonMr. Ganesan Subramaniam
DesignationManaging Director
Contact Number+6012 224 6677
Contact Emailganeshjrmt@gmail.com
Date Submitted02 NOV 2021

B. DEVICE IDENTIFICATION

Name of the deviceJR Medic Blue Nitrile Examination Gloves PowderFree tested for use with Chemotherapy drugs
Product proprietary or trade nameJR MEDIC
Common or usual nameExam Gloves
Classification namePatient Examination Gloves, Specialty
Device ClassificationClass I
Product CodeLZC, LZA, OPJ
Regulation Number21 CFR 880.6250
Review PanelGeneral Hospital

C. PREDICATE DEVICE

Predicate DeviceHarbour HealthPowder Free Nitrile Examination Glove, Blue (Tested foruse with Chemotherapy Drugs)
510(K) NumberK210944
Regulatory Class1
Product codeLZA, LZC, OPJ

D. DESCRIPTION OF THEDEVICE:

The subject device in 510(K) notification is JR Medic blue nitrile examination gloves powder free tested for use with Chemotherapy drugs.

The subject device is a patient examination glove made from acrylonitrile-butadiene copolymer dispersion, blue color, powder free and non sterile (as per 21CFR 880.6250, class I).

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The subject device meets all the current specifications listed under the ASTM Specification D 6319 -2019, Standard Specification for Nitrile Examination Gloves for Medical Application. This device also complies with requirements for standard practice for assessment of resistance of medical gloves to permeation by chemotherapy drugs as per ASTM D6978- 05(2019)

E. INTENDED USE OF THE DEVICE:

JR Medic Blue Nitrile Examination Gloves Powder Free tested for use with Chemotherapy drugs is a disposable device intended for medical purpose that is worn on the examiner's hand to prevent contamination between patient and examiner. Additionally, the gloves were tested for use with chemotherapy drugs in accordance with ASTM D6978-05 (2019) Standard Practice for Assessment of Medical Glove to Permeation by Chemotherapy Drugs.

Tested Chemotherapy Drug Name &ConcentrationMinimum Breakthrough DetectionTime (Minutes)
Carmustine (BCNU) (3.3 mg/ml)35.0 Minutes
Carboplatin (10 mg/ml)>240 Minutes
Cisplatin (1 mg/ml)>240 Minutes
Cyclophosphamide (Cytoxan) (20 mg/ml)>240 Minutes
Dacarbazine (10.0 mg/ml)>240 Minutes
Doxorubicin HCl (2 mg/ml)>240 Minutes
Etoposide (20 mg/ml)>240 Minutes
Fluorouracil (50 mg/ml)>240 Minutes
Ifosfamide (50 mg/ml)>240 Minutes
Methotrexate (25 mg/ml)>240 Minutes
Mitomycin C (0.5 mg/ml)>240 Minutes
Mitoxantrone (2 mg/ml)>240 Minutes
Paclitaxel (6 mg/ml)>240 Minutes
Thiotepa (10 mg/ml)64.9 Minutes
Vincristine Sulfate (1 mg/ml)>240 Minutes

The tested chemotherapy drugs and their breakthrough detection times are as follows:

Please note that the following drugs have low permeation times: Carmustine (BCNU) (3.3 mg/ml) 35.0 Minutes Thiotepa (10 mg/ml) 64.9 Minutes

Warning: Do not use with Carmustine (BCNU) & Thiotepa

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F. SUMMARY OF THE TECHNOLOGICAL CHARACTERISTICS OF THE DEVICE COMPARED TO THE PREDICATE DEVICE

CHARACTERSTICSSTANDARDSDEVICE PERFORMANCEREMARKS
PREDICATEPROPOSEDDEVICE
510(K) Number-K210944K212827
Name of device-Harbour HealthPowder FreeNitrileExaminationGlove, Blue(Tested for usewithChemotherapyDrugs)JR MedicBlue NitrileExamination GlovesPowder Free testedfor use withChemotherapy drugsSimilar
Product Code-LZA, LZC, OPJLZC, LZA, OPJSimilar
Intended use-Harbour HealthPowder FreeNitrileExaminationGlove, Blue(Tested for usewithChemotherapyDrugs) disposabledevice intended formedical purpose thatis worn on theexaminer's hand topreventcontaminationbetween patientand examiner.The proposeddevice was testedfor use withchemotherapydrugs as perASTM D6978-05(2019), StandardPractice forAssessment ofMedical Gloves toPermeation byChemotherapyDrugsJR Medic BlueNitrile ExaminationGloves Powder Freetested for use withChemotherapy drugsis a disposabledevice intended formedical purpose thatis worn on theexaminer's hand topreventcontaminationbetween patient andexaminer.Additionally, thegloves were testedfor use withchemotherapy drugsin accordance withASTM D6978-05(2019) StandardPractice forAssessment ofMedical Glove toPermeation byChemotherapyDrugs.Similar
CHARACTERSTICSSTANDARDSDEVICE PERFORMANCEREMARKS
PREDICATEK210944PROPOSEDDEVICEK212827
Regulation Number-21 CFR880.625021 CFR880.6250Same
Material-NitrileNitrileSame
Color-BlueBlueSame
Texture-Finger TextureFinger textureSame
SizeASTM D6319-2019Small, Medium,Large, ExtraLargeSmall, Medium,Large, ExtraLargeSame
Single UseMedical GloveGuidanceManual- LabelingSingle UseSingle UseSame
Sterile/non sterile-Non sterileNon sterileSame
DimensionsASTM D6319-2019Length: Small-Min 220 mm &Medium, Large& Extra large-Min 230 mmWidth Min95+/-10 mm(Medium Size)Length > 230mmWidth Min95+/-10 mm(formedium size)Similar
Physical PropertiesASTM D6319-2019Before AgeingTensile Strengthmin 14 MpaUltimateElongationMin 500%After AgeingTensile Strengthmin 14 MpaUltimateElongationMin 400%Before AgeingTensile Strength> 14 MpaUltimateElongation>500%After AgeingTensile Strength>14 MpaUltimateElongation> 400%Same
ThicknessASTM D6319-2019Palmmin 0.05 mmFingermin 0.05 mmPalm >0.05 mmFinger > 0.05mmSame
Powder FreeResidueASTM D6319-2019<2 mg/glove<2 mg/gloveSame
Watertight(1000 ml)ASTM D5151-2019Passes AQL-2.5Passes AQL-1.5Similar
Label and LabelingFDA LabelrequirementsMeets FDA'srequirementsMeets FDA'srequirementsSame
CHARACTERSTICSSTANDARDSDEVICE PERFORMANCEREMARKS
PREDICATEK210944PROPOSEDDEVICEK212827
Bio-compatibilityPrimary SkinIrritation-ISO 10993-10:2010(E)Under the condition ofstudy not an irritantUnder the conditionof study not anirritantSame
Dermal Sensitization-ISO 10993-10:2010(E)Under the conditions ofthe study not asensitizerUnder the conditionsof the study not asensitizerSame
In vitrocytotoxicityISO10993-5 :2009(E)Under theconditions of thestudy, potentiallycytotoxicUnder theconditions of thestudy, cytotoxicSimilar
MaterialMediatedPyrogenicityISO 10993-11:2017(E) /USP 41<151>No Data AvailableUnder theconditions of thestudy nonpyrogenic----
Acute SystemicToxicity Test ISO10993-11:2017(E)Under the conditions ofthe study, the devicedoes not elicit asystemic toxicityresponse in the modelanimalUnder the conditionof study does notinduce any systemictoxic concernSimilar
Chemotherapy Drugs Tested with Minimum Breakthrough Detection Time as tested per ASTM D6978-05 (2019)
Busulfan (6mg/ml)>240 MinutesNot TestedDifferent
Carmustine (BCNU) (3.3 mg/ml)14.5 Minutes35.0 MinutesDifferent
Carboplatin (10 mg/ml)>240 Minutes>240 MinutesSame
Cisplatin (1 mg/ml)>240 Minutes>240 MinutesSame
Cyclophosphamide (Cytoxan) (20 mg/ml)>240 Minutes>240 MinutesSame
Cytarabine (100 mg/ ml)>240 MinutesNot TestedDifferent
Dacarbazine (10.0 mg/ml)>240 Minutes>240 MinutesSame
Docetaxel (10 mg/ml)>240 MinutesNot TestedDifferent
Doxorubicin HCl (2 mg/ml)>240 Minutes>240 MinutesSame
Etoposide (20 mg/ml)>240 Minutes>240 MinutesSame
Fluorouracil (50 mg/ml)>240 Minutes>240 MinutesSame
Ifosfamide (50 mg/ml)>240 Minutes>240 MinutesSame
MechlorethamineHCL (1 mg/ml)>240 MinutesNot TestedDifferent
Methotrexate (25 mg/ml)>240 Minutes>240 MinutesSame
Mitomycin C (0.5 mg/ml)>240 Minutes>240 MinutesSame
Mitoxantrone (2 mg/ml)>240 Minutes>240 MinutesSame
Paclitaxel (6 mg/ml)>240 Minutes>240 MinutesSame
Thiotepa (10 mg/ml)47.4 Minutes64.9 MinutesDifferent
Vincristine Sulfate (1 mg/ml)>240 Minutes>240 MinutesSame

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Test MethodPurposeAcceptance CriteriaResult
ASTM D6319-2019 StandardSpecification for NitrileExamination Gloves forMedical ApplicationTo determine thelength of the glovesMin 220 mm for Size Small& Min 230 mm for allother sizesSmall:- 404 mmMedium:- 405 mmLarge:- 405 mmX-Large:- 406 mm
ASTM D6319-2019 StandardSpecification for NitrileExamination Gloves forMedical ApplicationTo determine thewidth of the glovesSmall:- 80+/-10 mmMedium:- 95+/-10mmLarge:- 110+/-10 mmX-Large:- 120+/-10 mmSmall:- 84 mmMedium:- 94 mmLarge:- 105 mmX-Large:- 115 mm

G. NON-CLINICAL TESTING SUMMARY PERFORMANCE DATA

Test MethodPurposeAcceptance CriteriaResult
ASTM D6319-2019 StandardSpecification for NitrileExamination Gloves forMedical ApplicationTo determine thethickness of theglovesPalm 0.05 mm minFinger 0.05 mm minfor all sizesSize       Palm       FingerSmall     0.19mm     0.21mmMedium  0.19mm     0.21mmLarge     0.19mm     0.21mmX-Large  0.19mm     0.21mm
ASTM D6319-2019 StandardSpecification for NitrileExamination Gloves forMedical ApplicationTo Determine thephysical properties-Tensile strengthBefore AgeingTensile Strength14Mpa Min for allsizesAfter Ageing TensileStrength 14Mpa Minfor all sizesSize Beforeageing AfterageingSmall     22.77Mpa     20.50MpaMedium  24.46Mpa     21.81MpaLarge     24.51Mpa     21.95MpaX-Large  24.59Mpa     22.05Mpa
Before AgeingUltimate Elongation500% Min for allsizesAfter AgeingUltimate Elongation400% Min for allsizesSize Beforeageing AfterageingSmall     885%           868%Medium  888%           870%Large     891%           872%X-Large  892%           875%

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Test MethodPurposeAcceptance CriteriaResult
ASTM D5151-2019 StandardTest Method for Detection ofHoles in Medical GlovesTo determine theholes in the glovesAQL 2.5Gloves Passes AQL 1.5
ASTM D6124-06 (Reapproved2017) Standard Test Methodfor Residual Powder onMedical GlovesTo determine theresidual powder inthe gloves2 Mg/Glove MaxSizeSmall 0.16 mg/gloveMedium 0.16 mg/gloveLarge 0.16 mg/gloveX-Large 0.16mg/glove

H. BIO-COMPATIBILITY DATA

Test MethodPurposeAcceptance CriteriaResult
ISO 10993-10 BiologicalEvaluation of Medical DevicesTest for Irritation and SkinSensitization. Test done forirritation.To determine the potential ofthe material under test toproduce dermal irritation inRabbitsUnder the conditionof study not anirritantUnder the condition ofstudy not an irritant
ISO 10993-10 BiologicalEvaluation of Medical DevicesTest for Irritation and SkinSensitization. Test done Skinsensitization.To determine the skinsensitization potential of thematerial both in terms ofinduction and elicitation inGuinea Pig.Under theconditions of thestudy not asensitizerUnder the conditions ofthe study not asensitizer
ISO 10993-5:2009 biologicalevaluation of medical devices -part 5, tests for in vitrocytotoxicity.To evaluate the in vitrocytotoxic potential of the testitem (both inner and outersurface) Extracts in L-929mouse fibroblasts cells usingelution method.Under theconditions of studynon cytotoxicUnder the conditions ofthe study cytotoxic.
ISO 10993-11:2017 biologicalevaluation of medical devices -part 11, tests for systemictoxicity.To determine the acutesystemic toxicity potential ofthe test item extracts (bothinside and outer surfaces) inSwiss Albino mice.Under theconditions of studythe device extractsdo not pose asystemic toxicityconcernUnder the conditionsof study the deviceextracts do not pose asystemic toxicityconcern
Material MediatedPyrogenicity ISO 10993-11:2017(E) / USP 41<151>To determine the pyrogenicpotential of the test itemextract following intravenousinjection in New Zealandwhite Rabbits.Under theconditions of thestudy, the devicedid notdemonstrate amaterial mediatedpyrogenicityresponse.Under the conditions ofthe study, the device didnot demonstrate amaterial mediatedpyrogenicity response.

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I. Clinical Testing Summary

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

J. CONCLUSION

The conclusions drawn from the non clinical test demonstrate that the subject device in 510(K) submission, JR Medic Blue Nitrile Examination Gloves Powder Free tested for use with Chemotherapy drugs is as safe, as effective, and performs as well as the legally marketed predicate device Harbour Health Powder Free Nitrile Examination Glove, Blue (Tested for use with Chemotherapy Drugs) K210944.

§ 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.