K Number
K213934
Device Name
Pro Guard Nitrile Powder Free Examination Glove
Date Cleared
2022-08-06

(233 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Pro Guard ® Nitrile Powder free 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.
Device Description
Black Nitrile Examination Gloves Powder Free are Class I patient examination gloves bearing the product code Nitrile - LZA (21 CFR 880.6250). The gloves are made from acrylonitrile-butadiene copolymer dispersion. These gloves are black in color and are powder free.
More Information

Not Found

No
The 510(k) summary describes a standard examination glove and does not mention any AI or ML components or functionalities.

No
Explanation: The device is an examination glove, intended to prevent contamination between patient and examiner, not to provide therapy.

No
Explanation: The device is an examination glove, intended to prevent contamination between patient and examiner, not to diagnose a condition.

No

The device is a physical examination glove, not a software application. The description clearly states it is a disposable device worn on the hand and made from acrylonitrile-butadiene copolymer dispersion.

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

Here's why:

  • Intended Use: The intended use clearly states the device is a glove worn on the hand to prevent contamination between patient and examiner. This is a physical barrier function, not a diagnostic test performed on a sample from the body.
  • Device Description: The description confirms it's a Class I patient examination glove made of nitrile. This aligns with a physical barrier device.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing a biological sample (blood, urine, tissue, etc.)
    • Detecting or measuring a substance in a sample
    • Providing information for diagnosis, monitoring, or screening
    • Using reagents or other chemicals to perform a test

The device is a medical device, specifically a Class I examination glove, but it does not fit the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

Pro Guard Nitrile Powder free 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.

Product codes

LZA

Device Description

Black Nitrile Examination Gloves Powder Free are Class I patient examination gloves bearing the product code Nitrile - LZA (21 CFR 880.6250). The gloves are made from acrylonitrile-butadiene copolymer dispersion. These gloves are black in color and are powder free.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

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 testing was performed to determine the performance of the Pro Guard Nitrile Powder Free Examination Glove.
Tests conducted include:

  • Dimension (Length, Width, Thickness) according to ASTM D6319-19. All dimensions met the acceptance criteria and passed.
  • Watertight test (1000 ml) according to ASTM D5151-19. Sample size: 200 pcs, Acceptance Number 7. All glove sizes (Extra Small, Small, Medium, Large, Extra Large) had 0 (Zero) holes and passed.
  • Residual powder according to ASTM D6124-06 (Reapproved 2017). Acceptance criteria: 2 mg per glove or less. Results ranged from 1.24 mg/glove to 1.42 mg/glove for different sizes, meeting the criteria and passing.
  • Physical Properties (Tensile strength and Ultimate Elongation) according to ASTM D6319-19.
    • Tensile Strength: Before Ageing, all sizes were above 14 MPa min. After ageing, all sizes were 14.00 MPa or above, meeting the minimal requirement and passing.
    • Ultimate Elongation: Before Ageing, all sizes were above 500% min. After ageing, all sizes were above 400% min, meeting the minimal requirement and passing.

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

Not Found

Predicate Device(s)

K143131

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.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left, there is a seal with an abstract design. To the right of the seal, there is the FDA logo in blue, followed by the words "U.S. FOOD & DRUG" in a larger font and "ADMINISTRATION" in a smaller font. The logo is simple and professional, and it is easily recognizable.

August 6, 2022

Medical Glove Co., Ltd Teoh Choh Shee Managing Director 288, Moo 7, Tambon Lam Thap, Krabi 81190 Thailand

Re: K213934

Trade/Device Name: Pro Guard Nitrile Powder Free 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 17, 2022 Received: June 30, 2022

Dear Teoh Choh Shee:

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 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

1

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.

Bifeng Oian, M.D., 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 Quality Center for Devices and Radiological Health

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: 06/30/2023 See PRA Statement below.

510(k) Number (if known) K213934

Device Name

Pro Guard® Nitrile Powder Free Examination Glove

Indications for Use (Describe)

Pro Guard ® Nitrile Powder free 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.

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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Image /page/3/Picture/0 description: The image shows the logo for "MG Medical Glove". The letters "MG" are large and bolded on the left side of the image. To the right of the letters is the text "Medical Glove".

510(k) SUMMARY (K213934) Nitrile Powder Free Examination Gloves

1.0 Submitter:

| Applicant: | Medical Glove Co., Ltd.
288, Moo 7, Tambon Lam Thap,
Amphur Lam Thap, Krabi 81190, Thailand |
|-------------------------|---------------------------------------------------------------------------------------------------|
| Phone Number: | +66 98 0166138 |
| Fax Number: | +66 75 626500 |
| Name of Contact Person: | Teoh Choh Shee (Mr.) |
| Preparation date: | July 19, 2022 |

2.0 Identification of the subjected device:

Trade/Proprietary Name(s):Pro Guard® Nitrile Powder Free Examination Glove.
Common Name:Nitrile Powder Free Examination Gloves
Classification Name:Patient Examination Gloves
Device Classification:I
Product codeLZA
Regulation Number:21 CFR 880.6250

3.0 Predicate Device:

| Device Name: | Powder Free Nitrile Patient Examination Glove, Black Colored,
Non-Sterile. |
|------------------------|-------------------------------------------------------------------------------|
| 510(k): | K143131 |
| Common Name: | Patient Examination Gloves |
| Classification Name: | Patient Examination Gloves |
| Device Classification: | I |
| Product Code: | LZA |
| Regulation Number: | 21 CFR 880.6250 |

4.0 Description of the Device:

Black Nitrile Examination Gloves Powder Free are Class I patient examination gloves bearing the product code Nitrile - LZA (21 CFR 880.6250). The gloves are made from acrylonitrile-butadiene copolymer dispersion. These gloves are black in color and are powder free.

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Image /page/4/Picture/0 description: The image shows the logo for MG Medical Glove. The letters "MG" are in large, bold, yellow font on the left side of the image. To the right of the letters, the words "MEDICAL GLOVE" are stacked on top of each other, also in yellow font.

5.0 Indication for Use:

Pro Guard® Nitrile Powder Free 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.

6.0 Summary of Technological Characteristics of the Device Compared to the Predicate Device:

CharacteristicsStandardsDevice performanceComparison
PredicateCurrent (K213934)
510(k) Number-K143131New 510(k) submissionNot Available
Manufacturer(s)-Kossan International Sdn. BhdMedical Glove Co., Ltd----
Indication for UseMedical Gloves Guidance Manual - Issued on January 22, 2008A 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 examinerPro Guard® Nitrile Powder free 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.Similar
Design MaterialASTM D6319-19NitrileNitrileSame
Color-BlackBlackSame
Design-Ambidextrous, in different sizes per ASTM D6319 dimension requirementAmbidextrous, in different sizes per ASTM D6319 dimension requirementSame
Device Classification-Class IClass ISame
Shelf life-No data is available3 yearsDifferent
SizeASTM D6319-19Extra Small
Small
Medium
Large
Extra Large
XX-LargeExtra Small
Small
Medium
Large
Extra LargeDifferent
Single UseMedical Gloves Guidance Manual - Issued on January 22, 2008Single useSingle useSame
Sterility-Non-sterileNon-sterileSame
CharacteristicsStandardsDevice performanceComparison
PredicateCurrent (K213934)
DimensionASTM D6319-19Length
$\ge$ 230 mm minimumLength
230 mm minSimilar
WidthWidth
X-Small 70-80 mmExtra Small: 70 + 10 mm
Small 80-90 mmSmall: 80 + 10 mm
Medium 90-100 mmMedium: 95 ± 10 mm
Large 101-111 mmLarge: 110± 10 mm
Extra Large: 120 ± 10 mm
X-Large 111-121 mm
XX-Large 121-131 mm
ThicknessASTM D6319-19Finger: 0.05 mm min
Palm: 0.05 mm minFinger: 0.05 mm min
Palm: 0.05 mm minSame
Physical
PropertiesASTM D6319-19Before agingBefore agingSame
Tensile Strength:Tensile Strength:
14 MPa min14 MPa min
Ultimate Elongation:
500% minUltimate Elongation:
500% min
After agingAfter aging
Tensile Strength
14 MPa minTensile Strength
14 MPa min
Ultimate Elongation:
400% minUltimate Elongation:
400% min
Watertight test
(1000 ml)ASTM D5151-19Pass AQL 1.5Pass AQL 1.5Same
Powder ResidueASTM D6124-06
(Reapproved 2017)$\le$ 2.0 mg/glove$\le$ 2.0 mg/gloveSimilar

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Image /page/5/Picture/0 description: The image shows the words "MG MEDICAL GLOVE" in a yellow font. The letters "MG" are larger than the other words. The words "MEDICAL GLOVE" are stacked on top of each other. The background is white.

MEDICAL GLOVE CO., LTD

288 Moo 7 T. Lam Thap, A. Lam Thap, Krabi 81190 Thailand.
Cell Phone: +66 98016 6138 . Email_inquiry@medicalglove.net

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Image /page/6/Picture/0 description: The image shows the logo for MG Medical Glove. The letters "MG" are in large, bold, yellow font on the left side of the image. To the right of "MG" are the words "MEDICAL GLOVE" in a smaller, yellow font. The logo is simple and easy to read.

MEDICAL GLOVE CO., LTD

288 Moo 7 T. Lam Thap, A. Lam Thap, Krabi 81190 Thailand.
Cell Phone: +66 98016 6138 . Email_inquiry@medicalglove.net

CharacteristicsStandardsDevice performance
PredicateCurrent (K213934)Comparison
BiocompatibilityPrimary Skin
Irritation -
ISO 10993-10 Third
Edition 2010-08-01Under the conditions
of the study, not an
irritantUnder the conditions
of the study, not an
irritantSame
Dermal
Sensitization -
ISO 10993-10 Third
Edition 2010-08-01Under the conditions
of the study, not a
sensitizerUnder the conditions
of the study, not a
sensitizerSame
In vitro cytotoxicity
ISO10993-5
:2009(E)No data is availableUnder the conditions of the
study, cytotoxic for undiluted,
1:2, 1:4 and 1:8 dilutions, but
non-cytotoxic for 1:16 and
1:32 dilutions. Moreover,
under the conditions of the
study, non acute systemic
toxic.Different
Acute Systemic
Toxicity ISO10993-
11:2017(E)No data is availableUnder the conditions of the
study, did not induce any
systemic toxicity.Different

There are no significant differences between the two products and are identical in terms of intended use, materials, design, manufacturing methods. Both devices meet the ASTM standards.

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Image /page/7/Picture/0 description: The image shows the logo and contact information for Medical Glove Co., LTD. The logo features the letters "MG" in a stylized font, with the words "MEDICAL GLOVE" stacked vertically to the right of the letters. The contact information includes the company's address at 288 Moo 7 T. Lam Thap, A. Lam Thap, Krabi 81190 Thailand, as well as a cell phone number of +66 98016 6138 and an email address of inquiry@medicalglove.net.

7.0 Non-clinical testing summary

Performance Data

Test MethodStandardPurpose of testingAcceptance CriteriaResultStatus
ASTM D6319-19
Standard Specification for Nitrile
Examination Gloves for Medical
ApplicationTo determine the length
of the glovesMin 230 mm for all sizesExtra Small: min 240 mm
Small: min 243 mm
Medium: min 241 mm
Large: min 240 mm
Extra Large: min 240 mmPass
DimensionASTM D6319-19
Standard Specification for Nitrile
Examination Gloves for Medical
ApplicationTo determine the width
of the glovesExtra Small: $70 \pm 10$ mm
Small: $80 \pm 10$ mm
Medium: $95 \pm 10$ mm
Large: $110 \pm 10$ mm
Extra Large: $120 \pm 10$ mmExtra Small: 75 mm
Small: 85 mm
Medium: 95 mm
Large: 105 mm
Extra Large: 115 mmPass
ASTM D6319-19
Standard Specification for Nitrile
Examination Gloves for Medical
ApplicationTo determine the
thickness of the glovesPalm 0.05 mm min
Finger 0.05 mm min for all sizesExtra Small: Palm 0.09 mm, Finger: 0.12
mm
Small: Palm 0.09 mm, Finger: 0.13 mm
Medium: Palm: 0.09 mm, Finger: 0.12
mm
Large: Palm 0.09 mm, Finger: 0.12 mm
Extra Large: Palm 0.09 mm, Finger: 0.12
mmPass
Watertight testASTM D5151-19
Standard Test Method for Detection
of Holes in Medical
GlovesTo determine the holes in
the glovesSample size: 200 pcs
Inspection level : GI
AQL 1.5
Acceptance Number 7
Rejection Number 8The batch size for this sampling is
35,001-150,000. Hence, according to the
single sampling plan GI, the sample to be
drawn is under code L equivalent to 200
pcs with accept 7 and reject 8 to be
accept under AQL 1.5.
Extra Small: 0 (Zero)
Small: 0 (Zero)
Medium: 0 (Zero)
Large:0 (Zero)
Extra Large:0 (Zero)Pass
Test MethodStandardPurpose of testingAcceptance CriteriaResultStatus
Residual
powderASTM D6124-06 (Reapproved 2017)
Standard Test Method for Residual
Powder on Medical GlovesTo determine the residual
powder in the gloves2 mg per glove or lessSample size : 5 pcs
Requirement: 2 mg per glove or less
Result
:
Extra Small: 1.35 mg/glove
Small:1.42 mg/glove
Medium: 1.24 mg/glove
Large: 1.34 mg/glove
Extra Large:1.36 mg/glovePass
Physical
PropertiesASTM D6319-19
Standard Specification for Nitrile
Examination Gloves for Medical
ApplicationTo Determine the
physical properties-
Tensile strengthBefore Ageing
Tensile Strength 14Mpa
Minimal for all sizes
After Ageing Tensile
Strength 14Mpa
Minimal for all sizesBefore Ageing
Extra Small: 18.08 MPa
Small: 18.37 MPa
Medium: 24.56 MPa
Large: 18.30 MPa
Extra Large: 18.20 MPa
After ageing:
Extra Small: 14.01 MPa
Small: 14.08 MPa
Medium: 20.41 MPa
Large: 14.00 MPa
Extra Large: 14.00 MPaPass
To Determine the
physical properties-
Ultimate ElongationBefore Ageing
Ultimate Elongation
500% Min for all sizes
After Ageing Ultimate
Elongation 400% Min
for all sizesBefore Ageing
Extra Small: 611 %
Small: 612%
Medium: 645 %
Large:620%
Extra Large:587%
After ageing:
Extra Small: 412 %
Small:408%
Medium: 584%
Large:403%
Extra Large:416%Pass

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Image /page/8/Picture/0 description: The image shows the logo for MG Medical Glove. The letters "MG" are in large, bold, yellow font on the left side of the image. To the right of "MG" are the words "MEDICAL GLOVE" stacked on top of each other, also in yellow font. The logo appears to be for a medical glove company.

MEDICAL GLOVE CO., LTD

288 Moo 7 T. Lam Thap, A. Lam Thap, Krabi 81190 Thailand.
Cell Phone: +66 98016 6138 . Email: inquiry@medicalglove.net

9

Image /page/9/Picture/0 description: The image shows the logo for MG Medical Glove. The letters "MG" are in large, bold, yellow font on the left side of the image. To the right of the letters "MG" is the text "MEDICAL GLOVE" in a smaller, yellow font.

MEDICAL GLOVE CO., LTD 288 Moo 7 T. Lam Thap, A. Lam Thap, Krabi 81190 Thailand.
Cell Phone: +66 98016 6138 . Email:inquiry@medicalglove.net

8.0 Clinical Testing Summary

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

9.0 Conclusion:

The conclusions drawn from the non-clinical test demonstrate that the subject device Nitrile Powder Free Examination Glove is as safe, as effective, and performs as well as or better than the legally marketed predicate device K143131

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