K Number
K220229
Device Name
Powder Free Nitrile Examination Gloves, Orange
Date Cleared
2022-03-26

(58 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Powder Free Nitrile Examination Gloves, Orange 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
Powder Free Nitrile Examination Gloves, Orange are Patient Examination Gloves, Disposable, single use only and non-sterile. The gloves are made of nitrile latex and are powder free. They are ambidextrous. The physical and performance characteristics of the devices meet all requirements of ASTM D6319-19 Standard Specification for Nitrile Examination Gloves for Medical Application.
More Information

Not Found

No
The device is a disposable examination glove, and the summary focuses on material properties and performance standards, with no mention of AI or ML.

No.
The device description states it is a "disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner," indicating it is a barrier device for examination rather than a therapeutic one.

No

Explanation: The device is described as an "examination glove" intended to prevent contamination between patient and examiner. Its purpose is to act as a barrier, not to diagnose medical conditions or provide diagnostic information.

No

The device is a physical product (gloves) and the description focuses on material properties and physical performance characteristics, not software functionality.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is "to prevent contamination between patient and examiner." This is a barrier function, not a diagnostic function.
  • Device Description: The description focuses on the physical properties and standards met for examination gloves. There is no mention of analyzing samples from the human body or providing diagnostic information.
  • Lack of IVD Characteristics: IVD devices are typically used to examine specimens (like blood, urine, tissue) to diagnose diseases or conditions. This device is worn on the hand for protection.
  • Performance Studies: The performance studies focus on the physical integrity and strength of the glove, not on diagnostic accuracy or analytical performance.

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

N/A

Intended Use / Indications for Use

Powder Free Nitrile Examination Gloves, Orange 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

Powder Free Nitrile Examination Gloves, Orange are Patient Examination Gloves, Disposable, single use only and non-sterile. The gloves are made of nitrile latex and are powder free. They are ambidextrous. The physical and performance characteristics of the devices meet all requirements of ASTM D6319-19 Standard Specification for Nitrile Examination Gloves for Medical Application.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

hand

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Examiner (medical purposes)

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

Non-clinical tests were conducted to verify that the subject device met all design specifications. The test results demonstrated that the subject device complies with the following standards: ASTM D6319-19 for length, palm width, thickness, tensile strength before and after aging, ultimate elongation before and after accelerated aging; ASTM D5151-19 and ASTM D6319-19 for freedom from holes; ASTM D6124-06(2017) and ASTM D6319-19 for powder-content. All tests passed acceptance criteria. No clinical study was included.

Key Metrics

From ASTM D6319-19:
Length: Minimum 230mm
Palm Width: XS: 70±10mm, S: 80±10mm, M:95±10mm, L:110±10mm, XL: 120±10mm, XXL: 130±10mm
Thickness: Finger: 0.05mm (min), Palm: 0.05mm (min)
Tensile Strength, Before Aging: 14MPa, min
Tensile Strength, After Accelerated Aging: 14MPa, min
Ultimate Elongation, Before Aging: 500%, min
Ultimate Elongation, After Accelerated Aging: 400%, min
Freedom from holes: G-I, AQL 2.5
Powder-Content: ≤ 2 mg per glove

Predicate Device(s)

K192635

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 shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: a symbol on the left and the FDA name and title on the right. The symbol on the left is a stylized representation of a human figure, while the text on the right reads "FDA U.S. FOOD & DRUG ADMINISTRATION" in blue letters.

March 26, 2022

Shanxi Hongjin Plastic Technology Co., Ltd. % Kathy Liu Project Manager Hongray USA Medical Products Inc. 3973 Schaefer Avenue Chino, California 91710

Re: K220229

Trade/Device Name: Powder Free Nitrile Examination Gloves, Orange Regulation Number: 21 CFR 880.6250 Regulation Name: Non-Powdered Patient Examination Glove Regulatory Class: Class I, reserved Product Code: LZA Dated: January 20, 2022 Received: January 27, 2022

Dear Kathy 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

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 Ouality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K220229

Device Name

Powder Free Nitrile Examination Gloves, Orange

Indications for Use (Describe)

Powder Free Nitrile Examination Gloves, Orange is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

Prescription Use (Part 21 CFR 801 Subpart D)

X Over-The-Counter Use (21 CFR 801 Subpart C)

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3

Shanxi Hongjin Plastic Technology Co., Ltd.

Coal Bed Gas Industrial Zone, Qu'e Town, Daning County, Linfen City, Shanxi Province

510(K) SUMMARY

The assigned 510(K) number: K220229 Date Prepared: January 20, 2022

1. Owner's Identification:

Mr. Wu Zhigang Shanxi Hongjin Plastic Technology Co., Ltd. Coal Bed Gas Industrial Zone, Qu'e Town, Daning County, Linfen City, Shanxi Province

Tel: 86-311-66766067 Contact: Ms. Kathy Liu, Project Manager Address: 3973 Schaefer Avenue, Chino, CA 91710, USA Tel: 909-590-1611 Email: kathyliu@hongrayusa.com or fdareg@126.com

2. Name of the Device:

Trade / Product Name: Powder Free Nitrile Examination Gloves, Orange Common Name: Patient Examination Gloves Classification Name: Patient Examination Glove Classification Regulation: 21 CFR 880.6250 Product Code: LZA Classification Panel: General Hospital Device Class: Class I

3. Predicate Device Information:

Wrp Asia Pacific Sdn Bhd Powder Free Nitrile Patient Examination Gloves, Non-Sterile (Orange) (K192635)

4. Device Description:

Powder Free Nitrile Examination Gloves, Orange are Patient Examination Gloves, Disposable, single use only and non-sterile. The gloves are made of nitrile latex and are powder free. They are ambidextrous. The physical and performance characteristics of the devices meet all requirements of ASTM D6319-19 Standard Specification for Nitrile Examination Gloves for Medical Application.

5. Indications for Use:

Powder Free Nitrile Examination Gloves, Orange is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

Comparison of Subject Device and Predicate Device: 6.

The subject device will be known as Powder Free Nitrile Examination Gloves, Orange. The following tables are summaries of the technological characteristics, biocompatibility of the subject and predicate devices.

| Characteristics | Standards | Subject Device
K220229 | Predicate Device
K192635 | Comparison
Analysis |
|-----------------|---------------|------------------------------------------------------|-----------------------------------------------------------------------------|------------------------|
| Material | ASTM D6319-19 | Nitrile | Nitrile | Same |
| Color | - | Orange | Orange | Same |
| Texture | - | Hand textured | Hand textured | Same |
| Trade Name | - | Powder Free Nitrile
Examination Gloves,
Orange | Powder Free Nitrile Patient
Examination Gloves, Non-
Sterile (Orange) | Similar |
| Product Code | - | LZA | LZA | Same |

General Comparison Table:

4

Shanxi Hongjin Plastic Technology Co., Ltd.

Coal Bed Gas Industrial Zone, Qu'e Town, Daning County, Linfen City, Shanxi Province

510(K) SUMMARY

Regulation Number-21 CFR 880.625021 CFR 880.6250Same
ClassIISame
Physical Properties
Before Aging
Tensile Strength:
Ultimate Elongation:
After Aging
Tensile Strength:
Ultimate Elongation :ASTM D6319-1914MPa min
500% min
14MPa min
400% min14MPa min
500% min
14MPa min
400% minSame
Thickness
  • Finger
  • Palm | ASTM D6319-19 | 0.16-0.22mm
    0.15-0.18mm | 0.21-0.23mm
    0.19-0.22mm | Different |
    | Powder Free | ASTM D6124–
    06(2017) | ≤ 2 mg/glove | ≤ 2 mg/glove | Same |
    | Biocompatibility
    Primary Skin Irritation
    Test | ISO 10993-10:2010 | Under conditions of the study,
    not an irritant | Not a primary skin irritant | Same |
    | Biocompatibility
    Dermal Sensitization
    Study | ISO 10993-10:2010 | Under conditions of the study,
    not a sensitizer | Not a contact sensitizer | Same |
    | Biocompatibility
    Cytotoxicity | ISO 10993-5:2009 | Under the conditions of this
    study, the test article extract
    showed potential toxicity to
    L929 cells.
    Cytotoxicity concern was
    addressed by acute systematic
    toxicity testing. | Exhibit severe cytotoxicity
    reactivity at 100%, 66%, and
    44% extract concentration.
    Moderate cytotoxicity
    reactivity at 30%, mild
    cytotoxicity reactivity at
    20% and slight cytotoxicity
    reactivity at 15% extract
    concentrations.
    Cytotoxicity concern was
    addressed by acute systematic
    toxicity testing. | Same |
    | Biocompatibility Acute
    Systemic Toxicity | ISO 10993-11:2017 | It is concluded that the extracts
    (polar and non-polar) of the
    product did not show any
    systemic toxicity | It is concluded that the extracts
    (polar and non -polar) of the
    product did not show any
    systemic toxicity | Same |
    | Watertight (1000ml) | ASTM D5151-19 | Inspection Level 1, AQL 2.5 | Inspection Level 1, AQL 1.5 | Similar |
    | Indications for Use | - | A 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 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. | Same |
    | Size | Medical Glove
    Guidance Manual
    – Labeling | XS, S, M, L, XL, XXL | XS, S, M, L, XL | Similar |
    | Single use | Medical Glove
    Guidance Manual
    – Labeling | Single use | Single use | Same |

There are no significant differences between the two products and are identical in terms of intended use, materials, design, manufacturing methods except for size and thickness. The subject device is one more extra size XXL and thinner than predicate device.

5

Shanxi Hongjin Plastic Technology Co., Ltd.

Coal Bed Gas Industrial Zone, Qu'e Town, Daning County,

Linfen City, Shanxi Province

510(K) SUMMARY

7. Summary of Non-Clinical Testing

Non-clinical tests were conducted to verify that the subject device met all design specifications. The test results demonstrated that the subject device complies with the following standards: The performance test data of the non-clinical tests for this powder free nitrile examination glove is summarized as per below.

Test methodPurposeAcceptance CriteriaResultsStatus
ASTM D6319-19LengthMinimum 230mmAll size ≥230Pass
ASTM D6319-19Palm WidthXS: 70±10mm76-78mmPass
S: 80±10mm86-88 mmPass
M:95±10mm96 -98mmPass
L:110±10mm106-108 mmPass
XL: 120±10mm116-118 mmPass
XXL: 130±10mm126-128 mmPass
ASTM D6319-19ThicknessFinger: 0.05mm (min)0.15-0.18mmPass
Palm: 0.05mm (min)0.16-0.22mmPass
ASTM D6319-19
ASTN D412-16Tensile Strength, Before
Aging14MPa, min15.8-19.9MpaPass
ASTM D6319-19
ASTN D412-16Tensile Strength, After
Accelerated Aging14MPa, min15.2-18.8MpaPass
ASTM D6319-19
ASTN D412-16Ultimate Elongation, Before
Aging500%, min500-550%Pass
ASTM D6319-19
ASTN D412-16Ultimate Elongation, After
Accelerated Aging400%, min430-500%Pass
ASTM D 5151-19
ASTM D6319-19Freedom from holesG-I, AQL 2.5Meet and above AQL2.5
requirementsPass
ASTM D 6124-06(2017)
ASTM D6319-19Powder-Content≤ 2 mg per glove0.55-0.78 mgPass

8. Summary of Clinical Testing

No Clinical study is included in this submission.

Conclusion: 9.

The conclusions drawn from the non-clinical tests demonstrate that the subject device is as safe, as effective, and performs as well as or better than the legally marketed predicated device, K192635.