K Number
K220121
Device Name
Non Sterile Nitrile Powder Free Examination Gloves – Blue,Green, and Black
Date Cleared
2022-04-11

(83 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
A powder-free 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.
Device Description
The Powder Free Nitrile Examination Gloves are non sterile, single use, and disposable. These gloves are available in Blue, Green, and Black colors. This device is to protect the examiner and prevent contamination between patient and the examiner when properly worn. The sizes of the gloves are Small, Medium, Large and X-Large. Non Sterile Nitrile Powder Free Examination Gloves meet all current specifications listed under ASTM Specifications D6319.
More Information

Not Found

No
The device description and performance studies focus solely on the physical properties and performance of examination gloves, with no mention of AI or ML technology.

No
The device is a glove intended to prevent contamination, not to treat or diagnose a medical condition.

No

This device is a glove, intended to prevent contamination, not to diagnose a condition or disease.

No

The device description clearly states it is a physical glove made of nitrile, which is a hardware component. There is no mention of software.

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

Here's why:

  • Intended Use: The intended use clearly states the device is a "powder-free patient examination glove... worn on the examiner's hand or finger to prevent contamination between patient and examiner." This describes a physical barrier for protection, not a device used to examine specimens from the human body to provide information for diagnosis, monitoring, or screening.
  • Device Description: The description reinforces the function as a protective barrier.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in those samples
    • Providing diagnostic information

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

A powder-free 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.

Product codes (comma separated list FDA assigned to the subject device)

LZA

Device Description

The Powder Free Nitrile Examination Gloves are non sterile, single use, and disposable. These gloves are available in Blue, Green, and Black colors. This device is to protect the examiner and prevent contamination between patient and the examiner when properly worn. The sizes of the gloves are Small, Medium, Large and X-Large. Non Sterile Nitrile Powder Free Examination Gloves meet all current specifications listed under ASTM Specifications D6319.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Hand 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)

Nonclinical tests were performed to demonstrate substantial equivalence to the predicate device. These tests included:

  • Dimensions (Overall Length, Width, Palm Thickness, Finger thickness) meeting ASTM D6319 criteria.
  • Physical Properties (Tensile Strength before and after aging, Ultimate Elongation before and after aging) meeting ASTM D6319 criteria.
  • Freedom From Holes/Watertight meeting ASTM D5151 criteria with AQL=2.5.
  • Powder Free/Residual Powder content meeting ASTM D6319 criteria (residue limit of 2.0 mg/glove).
  • Biocompatibility testing per ISO 10993-10 (Non-irritant and Non-sensitizer) and ISO 10993-11 (Acute Systemic Toxicity; No toxic effects).

Key results showed that the subject device "Pass" for all tested parameters across Blue, Green, and Black gloves in all sizes (Small, Medium, Large, X-Large) against the specified ASTM D6319 requirements.

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

  • Tensile Strength (Before Aging): Minimum 14 MPa.
  • Tensile Strength (After Aging): Minimum 14 MPa.
  • Ultimate Elongation (Before Aging): Minimum 500%.
  • Ultimate Elongation (After Aging): Minimum 400%.
  • Freedom from Holes (Pinhole AQL): Inspection Level G-1; AQL=2.5. Acceptance criteria for 200 samples vary by size (e.g., Small: Accept on 10, Medium: Accept on 7).
  • Powder Free/Powder Content: Does not exceed 2 mg per glove.

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K143289

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

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 shows 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.

April 11, 2022

AAMedix Glove Sdn Bhd Annette Schaps Regulatory Consultant Unit 19D, Level 19, No.16, Persiaran Setia Dagang Bander Setia Alam, 40170 Shah Alam Selanger Darul Ehsan, 40170 Malaysia

Re: K220121

Trade/Device Name: Non Sterile Nitrile Powder Free Examination Gloves - Blue,Green, and Black Regulation Number: 21 CFR 880.6250 Regulation Name: Non-Powdered Patient Examination Glove Regulatory Class: Class I, reserved Product Code: LZA Dated: January 13, 2022 Received: January 18, 2022

Dear Annette Schaps:

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

1

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,

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 Quality Center for Devices and Radiological Health

Enclosure

2

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)

K220121

Device Name NON STERILE NITRILE POWDER FREE EXAMINATION GLOVES - BLUE, GREEN AND BLACK

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 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)

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."

3

AAMedix Glove Sdn Bhd NON STERILE NITRILE POWDER FREE EXAMINATION GLOVES – BLUE, GREEN AND BLACK

510(K) Summary

510K SUMMARY

Date of Summary Prepared: March 23, 2022

510K Number: K220121

    1. Applicant : AAMedix Glove Sdn Bhd
Address: Unit 19D, Level 19
No. 16 Persiaran Setia Dagang
Bandar Setia Alam
40170 Shah Alam, Selanger Darul Ehsan
MALAYSIA
Tel: 03-33592650
Fax: 03-33592657
E-mails: anson@aamedix-glove.com

Official Correspondence: Annette Schaps

    1. Device Name: Non Sterile Nitrile Powder Free Examination Gloves Blue, Green And Black color.
      Trade Name: Non Sterile Nitrile Powder Free Examination Gloves – Blue, Green and Black color.

Common Name: Nitrile Examination Gloves

4

3. Regulatory Information

Classification NameNitrile Powder Free Examination Gloves
ClassificationClass I
Product CodeLZA
Regulation Number21 CFR 880.6250

4. Predicate Device

510K Number: K143289- YTY Industry (Manjung) Sdn. Bhd.
Device Name: Non Sterile, Powder Free Nitrile Examination Gloves -
Orange, Green, Blue and Violet Color.

5. Intended Use

A powder-free 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.

6. Description

The Powder Free Nitrile Examination Gloves are non sterile, single use, and disposable. These gloves are available in Blue, Green, and Black colors. This device is to protect the examiner and prevent contamination between patient and the examiner when properly worn. The sizes of the gloves are Small, Medium, Large and X-Large. Non Sterile Nitrile Powder Free Examination Gloves meet all current specifications listed under ASTM Specifications D6319.

5

Summary of Comparison and Technological Characteristic
Table 1 - General Comparison
SUBJECT DEVICE:
K220121PREDICATE DEVICE:
K143289Comparison
Company NameAAMedix Glove Sdn BhdYTY INDUSTRY
(MANJUNG) SDN. BHD
Product NameNon Sterile, Powder Free
Nitrile Examination
Gloves-BLUE, GREEN AND
BLACKNon Sterile, Powder Free
Nitrile Examination
Gloves-Orange, Green,
Blue and Violet Color
Available ColorsBlue, Green and BlackBlue, Green and OthersSimilar
Available SizesSmall, Medium, Large and
X-LargeNot specified but data
provided on MediumSimilar
Indications for UseA powder free 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 patient examination
gloves is a disposable
device intended for
medical purpose that is
worn on the examiner's
hand or finger to prevent
contamination between
patient and examiner.Similar
MATERIALSCarboxylated Butadiene
Acrylonitrile as base
materialCarboxylated Butadiene
Acrylonitrile as base
materialSame
DIMENSIONSMeets ASTM D6319
CriteriaMeets ASTM D6319
CriteriaSame
PHYSICAL
PROPERTIESMeets ASTM D6319
CriteriaMeets ASTM D6319
CriteriaSame
FREEDOM FROM
HOLES/WatertightMeets ASTM
D6319/ASTM D5151
CriteriaMeets ASTM D5151
CriteriaSame
POWDER
FREE/Residual PowderMeets ASTM D6319
CriteriaMeets ASTM D6319
CriteriaSame
BIOCOMPATABILITYPer ISO 10993-10: Non-
irritant (Response
Category is Negligible)
and Non-sensitizer (No
sensitization)

Per ISO 10993-11: Acute
Systemic Toxicity; No
toxic effects | Per ISO 10993-10: Non-
irritant and
Non-sensitizer | Same |
| Product Common
Name | Non sterile Nitrile Powder
Free Examination Gloves | Non sterile Nitrile Powder
Free Examination Gloves | Same |
| Product Code/Class | LZA | LZA | Same |
| | Class I
(21 CFR 880.6250) | Class I
(21 CFR 880.6250) | |
| Sterility/Use | Non-Sterile/Single Use | Non-Sterile/Single Use | Same |
| OTC Use | Yes | Yes | Same |

AAMedix Glove/40170 Shah Alam, Selangor Darul Ehsa, Malaysia

6

Table 2 Specifications and Performance Test Results Comparison
SUBJECT DEVICE:
K220121
AAMedix Glove
Sdn BhdPREDICATE DEVICE:
K143289
YTY INDUSTRY
(MANJUNG) SDN.
BHDComparison
Glove Color/SizeBLUE/MediumBLUE/Medium
DIMENSIONASTM D6319
Accept Criteria
Overall Length230 mm
Minimum240-246 mm240-250 mmSame
Width95 +/-10 mm95-98 mm95-99 mmSame
Palm Thickness0.05 mm
Minimum0.06-0.06 mm0.05-0.06 mmSame
Finger thickness0.05 mm
Minimum0.09-0.10 mm0.09-0.10 mmSame
PHYSICAL PROPERTIES
Tensile Strength (before aging)14 MPa,
Minimum25.9-32.0 MPa28.46-33.44 MPaSame
Tensile Strength (after aging)14 MPa,
Minimum25.4-34.0 MPa29.76-34.18 MPaSame
Ultimate Elongation (before aging)500 %
Minimum500-540 %520-580 %Same
Ultimate Elongation (after aging)400 %
Minimum480-520 %440-520 %Same
FREEDOM FROM
HOLES/WatertightPer ASTM
D5151-06
(2011)Holes Found: 0Holes found: 0
(Accept 1, Reject 7)Same
Pinhole AQLInspection
Level G-1;
AQL=2.5Inspection Level G-
1; AQL=2.5Inspection Level G-
1; AQL=2.5Same
POWDER
FREE/Residual
PowderResidue limit
of 2.0
mg/glove0.70 mg/glove0.20 mg/gloveSame
ASTM D6319
RequirementBLUE GlovesGREEN GlovesBLACK Gloves
DIMENSIONS
Overall Length
-Small220 mm minimumPass (242-253 mm)Pass (237-243 mm)Pass (239-248 mm)
-Medium230 mm minimumPass (240-246 mm)Pass (240-247 mm)Pass (244-251 mm)
-Large230 mm minimumPass (245-255 mm)Pass (240-247 mm)Pass (243-251 mm)
-X large230 mm minimumPass (243-253 mm)Pass (240-250 mm)Pass (241-277 mm)
Width
-Small80 +/-10 mmPass (85-87 mm)Pass (86-88 mm)Pass (85-86 mm)
-Medium95 +/-10 mmPass (95-98 mm)Pass (95-96 mm)Pass (95-97 mm)
-Large110 +/-10 mmPass (106-109 mm)Pass (106-106 mm)Pass (105-106 mm)
-X large120 +/-10 mmPass (113-115 mm)Pass (114-116 mm)Pass (115-115 mm)
Palm Thickness
-Small0.05 mm
minimumPass (0.06-0.07 mm)Pass (0.12-0.14 mm)Pass (0.07-0.08 mm)
-Medium0.05 mm
minimumPass (0.06-0.06 mm)Pass (0.13-0.13 mm)Pass (0.07-0.07 mm)
-Large0.05 mm
minimumPass (0.05-0.07 mm)Pass (0.11-0.13 mm)Pass (0.07-0.07 mm)
-X large0.05 mm
minimumPass (0.06-0.06 mm)Pass (0.12-0.13 mm)Pass (0.06-0.07 mm)
Finger thickness
-Small0.05 mm
minimumPass (0.09-0.11 mm)Pass (0.15-0.17 mm)Pass (0.11-0.13 mm)
-Medium0.05 mm
minimumPass (0.09-0.10 mm)Pass (0.15-0.18 mm)Pass (0.11-0.13 mm)
-Large0.05 mm
minimumPass (0.10-0.11 mm)Pass (0.15-0.16 mm)Pass (0.11-0.13 mm)
-X large0.05 mm
minimumPass (0.10-0.11 mm)Pass (0.15-0.16 mm)Pass (0.11-0.14 mm)

AAMedix Glove/40170 Shah Alam, Selangor Darul Ehsa, Malaysia

7

Summary of Nonclinical Testing:

Table 3 Summary of Device Specifications and Performance Results

8

| | ASTM D6319
Requirement | BLUE Gloves | GREEN Gloves | BLACK Gloves |
|---------------------|------------------------------------|----------------------|----------------------|----------------------|
| PHYSICAL PROPERTIES | | | | |
| | Tensile Strength (Before Aging) | | | |
| -Small | 14 MPa minimum | Pass (25.2-31.9 MPa) | Pass (24.1-34.1 MPa) | Pass (33.5-41.2 MPa) |
| -Medium | 14 MPa minimum | Pass (25.9-32.0 MPa) | Pass (25.9-32.0 MPa) | Pass (34.3-46.5 MPa) |
| -Large | 14 MPa minimum | Pass (23.9-34.3 MPa) | Pass (21.2-28.8 MPa) | Pass (31.6-42.2 MPa) |
| -X large | 14 MPa minimum | Pass (28.2-39.2 MPa) | Pass (19.6-29.9 MPa) | Pass (25.2-43.5 MPa) |
| | Tensile Strength (After Aging) | | | |
| -Small | 14 MPa minimum | Pass (25.6-34.9 MPa) | Pass (24.4-38.1 MPa) | Pass (25.7-43.5 MPa) |
| -Medium | 14 MPa minimum | Pass (25.4-34.0 MPa) | Pass (24.8-32.3 MPa) | Pass (34.7-45.8 MPa) |
| -Large | 14 MPa minimum | Pass (24.0-37.4 MPa) | Pass (20.7-33.9 MPa) | Pass (35.1-43.0 MPa) |
| -X large | 14 MPa minimum | Pass (33.2-40.2 MPa) | Pass (21.6-32.1 MPa) | Pass (24.7-44.8 MPa) |
| | Ultimate Elongation (Before Aging) | | | |
| -Small | 500% minimum | Pass (500-540%) | Pass (500-580%) | Pass (540-600%) |
| -Medium | 500% minimum | Pass (500-540%) | Pass (500-560%) | Pass (520-600%) |
| -Large | 500% minimum | Pass (500-560%) | Pass (500-580%) | Pass (520-600%) |
| -X large | 500% minimum | Pass (500-560%) | Pass (540-580%) | Pass (460-540%) |
| | Ultimate Elongation (After Aging) | | | |
| -Small | 400% minimum | Pass (480-520%) | Pass (460-540%) | Pass (540-580%) |
| -Medium | 400% minimum | Pass (480-520%) | Pass (460-540%) | Pass (520-600%) |
| -Large | 400% minimum | Pass (480-520%) | Pass (480-560%) | Pass (520-560%) |
| -X large | 400% minimum | Pass (480-520%) | Pass (500-560%) | Pass (440-520%) |

ASTM D6319 RequirementBLUE GlovesGREEN GlovesBLACK Gloves
FREEDOM FROM HOLES (Pinhole Inspection)
-SmallAQL=2.5; Accept on 10 (n=200)Pass (Found=1)Pass (Found=0)Pass (Found=2)
-MediumAQL=2.5; Accept on 7 (n=200)Pass (Found=0)Pass (Found=0)Pass (Found=0)
-LargeAQL=2.5; Accept on 10 (n=200)Pass (Found=1)Pass (Found=1)Pass (Found=0)
-X LargeAQL=2.5; Accept on 10 (n=200)Pass (Found=0)Pass (Found=6)Pass (Found=1)

| | ASTM D6319
Requirement | BLUE Gloves | GREEN Gloves | BLACK Gloves |
|----------|-----------------------------------|--------------------------------------|--------------------------------------|--------------------------------------|
| | POWDER FREE/Powder Content | | | |
| -Small | does not exceed 2
mg per glove | Pass (Average: 0.36
mg per glove) | Pass (Average: 0.18
mg per glove) | Pass (Average: 0.04
mg per glove) |
| -Medium | Does not exceed
2 mg per glove | Pass (Average: 0.70
mg per glove) | Pass (Average: 0.10
mg per glove) | Pass (Average: 0.06
mg per glove) |
| -Large | Does not exceed
2 mg per glove | Pass (Average: 0.30
mg per glove) | Pass (Average: 0.16
mg per glove) | Pass (Average: 0.04
mg per glove) |
| -X Large | Does not exceed
2 mg per glove | Pass (Average: 1.02
mg per glove) | Pass (Average: 0.24
mg per glove) | Pass (Average: 0.10
mg per glove) |

AAMedix Glove/40170 Shah Alam, Selangor Darul Ehsa, Malaysia

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7. Conclusion

The conclusions drawn from the nonclinical tests demonstrate that the device, AAMedix Glove Sdn Bhd NON STERILE NITRILE POWDER FREE EXAMINATION GLOVES – BLUE, GREEN AND BLACK , is as safe, as effective, and performs as well as or better than the legally marketed device, YTY INDUSTRY (MANJUNG) SDN. BHD Non Sterile, Powder Free Nitrile Examination Gloves- Orange, Green, Blue and Violet Color (cleared per 510(K) K143289).