K Number
K220609
Device Name
Powder-Free Nitrile Examination Glove Tested for Use with Chemotherapy Drugs and Fentanyl (White, Blue, Black, Orange and Green Color)
Date Cleared
2022-05-27

(86 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
A powder-free 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 examiner. In addition, the glove was tested for chemotherapy drugs permeation.
Device Description
The proposed Powder-Free Nitrile Examination Glove (White, Blue, Black, Orange and Green Color) Tested for use with Chemotherapy Drugs and Fentanyl is a disposable device intended for over-the-counter use and is provided powder-free and non-sterile. These patient examination gloves are formulated using Nitrile. The patient examination gloves are not made with natural rubber latex.
More Information

Not Found

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

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

No
The device, a patient examination glove, is intended to prevent contamination and is tested for resistance to chemotherapy drugs and fentanyl, not to diagnose a medical condition.

No

The device described is a physical medical device (examination gloves) and does not involve any software components.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are devices intended for use in the collection, preparation, and examination of specimens taken from the human body (such as blood, urine, or tissue) to provide information for the diagnosis, treatment, or prevention of disease.
  • Device Intended Use: The intended use of this device is clearly stated as a "disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner." This is a barrier device used externally during medical procedures.
  • No Specimen Examination: The device does not involve the collection, preparation, or examination of any human specimens.
  • Testing for Permeation: While the device is tested for resistance to chemotherapy drugs and Fentanyl permeation, this testing is related to the protective barrier function of the glove, not to the diagnosis or monitoring of a patient's condition through the analysis of a specimen.

The testing for chemotherapy drug and Fentanyl permeation is a performance characteristic of the glove as a protective barrier, not an indication that it is used for in vitro diagnostic purposes.

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 to prevent contamination between patient and examiner. In addition, the glove was tested for chemotherapy drugs permeation.
The following chemotherapy drugs have been tested with the glove:
Carmustine: 3.3 mg/ml
Cisplatin: 1.0 mg/ml
Cyclophosphamide: 20.0 mg/ml
Dacarbazine: 10.0 mg/ml
Doxorubicin HCL: 2.0 mg/ml
Etoposide: 20.0 mg/ml
Fluorouracil: 50.0 mg/ml
Methotrexate: 25.0 mg/ml
Paclitaxel: 6.0 mg/ml
ThioTepa: 10.0 mg/ml
Mitomycin C: 0.5 mg/ml
Vincristine Sulfate: 1.0 mg/ml
Fentanyl Citrate: 100 mcg/2mL
Warning: Do not use with Carmustine and ThioTepa.

A Powder-Free Nitrile Examination Glove (White, Blue, Black, Orange and Green Color) Tested for use with Chemotherapy Drugs and Fentanyl is a disposable device intended for medical purposes that is worn on the examiner's hand, in order to prevent contamination between patient and examiner, and also prevent transmission of a wide variety of diseases to both patient and health care personnel. In addition, these gloves were tested for chemotherapy drug permeation test.

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

LZA, LZC

Device Description

The proposed Powder-Free Nitrile Examination Glove (White, Blue, Black, Orange and Green Color) Tested for use with Chemotherapy Drugs and Fentanyl is a disposable device intended for over-the-counter use and is provided powder-free and non-sterile. These patient examination gloves are formulated using Nitrile. The patient examination gloves are not made with natural rubber latex. General specifications of the glove are as below:

  1. Overall Length: 230 mm minimum
  2. Width: 95 ± 5 mm minimum (for medium glove)
  3. Palm Thickness: 0.05 mm minimum
  4. Finger Thickness: 0.05 mm minimum
  5. Tensile Strength:
    a. Before Aging: 14 MPa minimum
    b. After Aging: 14 MPa minimum
  6. Ultimate Elongation:
    a. Before Aging: 500 % minimum
    b. After Aging: 400 % minimum
  7. Pinhole AQL: 2.5

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, Health care personnel

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 tests were conducted:

  • Dimension Test: To evaluate whether the device meets the current ASTM D6319-19. Result: Meets requirement.
  • Freedom From Hole: To evaluate whether the subject meets current 21 CFR 800.20, ASTM D6319-19 and test according to ASTM D5151-19. Result: Meets requirements.
  • Physical Property Test: To evaluate whether the subjects meet current ASTM D6319-19 and test according to ASTM D412 and ASTM D573. Result: Meets requirement.
  • Residual Powder Test: To evaluate whether the subjects meet current ASTM D6319-19 and test according to ASTM D6124-06. Result: Meets requirement.
  • Biocompatibility Test (Skin Irritation): To determine whether skin irritation potential of device meets ISO 10993-10. Result: Non-irritant under the conditions of the study.
  • Biocompatibility Test (Skin Sensitization): To determine whether skin sensitization potential of device meets ISO 10993-10. Result: Non-sensitizer under the conditions of the study.
  • Biocompatibility Test (Acute Systemic Toxicity): To determine whether leachable extracted from the device would cause acute systemic toxicity and meet ISO 10993-11. Result: Not an acute systemic toxic under the condition of the study.
  • Chemotherapy drug permeation test (ASTM D6978-05) was conducted. The results for the proposed device are summarized in Table 5.1 and Table 6.3, showing breakthrough detection times for various chemotherapy drugs and Fentanyl Citrate. The predicate device's permeation results are also provided for comparison. It is noted that Carmustine and ThioTepa have extremely low permeation times, and a warning is issued not to use the gloves with these two drugs.

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

Key metrics include physical properties (tensile strength, ultimate elongation), pinhole AQL, and resistance to permeation by chemotherapy drugs, reported as Minimum Breakthrough Detection Time in minutes.

  • Tensile Strength: Before Aging (14 MPa minimum), After Aging (14 MPa minimum)
  • Ultimate Elongation: Before Aging (500 % minimum), After Aging (400 % minimum)
  • Pinhole AQL: 2.5
  • Residual Powder:

§ 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 for the U.S. Food & Drug Administration (FDA). The logo consists of two parts: a symbol on the left and the text on the right. The symbol is a stylized representation of a caduceus, a traditional symbol of medicine, with intertwined snakes and wings. To the right of the symbol is the text "FDA U.S. FOOD & DRUG ADMINISTRATION" in blue, with "FDA" in a larger font size than the rest of the text.

May 27, 2022

Encompass Industries Sdn. Bhd. Nur Muhyiddin OA Manager Lot 18256, Kawasan Perindustrian Lot Q Kertih BioPolymer Park Kemaman, Terengganu 24300 Malaysia

Re: K220609

Trade/Device Name: Powder-Free Nitrile Examination Glove (White, Blue, Black, Orange and Green Color) Tested for Use with Chemotherapy Drugs and Fentanyl Regulation Number: 21 CFR 880.6250 Regulation Name: Non-powdered patient examination glove Regulatory Class: Class I, reserved Product Code: LZA, LZC Dated: February 24, 2022 Received: March 2, 2022

Dear Nur Muhyiddin:

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.

1

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 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 Qian, M.D., Ph.D. Acting 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

Indications for Use

510(k) Number (if known) K220609

Device Name

Powder-Free Nitrile Examination Glove (White, Blue, Black, Orange and Green Color) Tested for Use with Chemotherapy Drugs and Fentanyl

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 to prevent contamination between patient and examiner. In addition, the glove was tested for chemotherapy drugs permeation.

The following chemotherapy drugs have been tested with the glove:

Chemotherapy DrugsConcentrationBreakthrough Detection Time in Minutes
WhiteBlueBlackOrangeGreen
Carmustine3.3 mg/ml11.210.711.067.367.1
Cisplatin1.0 mg/ml>240>240>240>240>240
Cyclophosphamide20.0 mg/ml>240>240>240>240>240
Dacarbazine10.0 mg/ml>240>240>240>240>240
Doxorubicin HCL2.0 mg/ml>240>240>240>240>240
Etoposide20.0 mg/ml>240>240>240>240>240
Fluorouracil50.0 mg/ml>240>240>240>240>240
Methotrexate25.0 mg/ml>240>240>240>240>240
Paclitaxel6.0 mg/ml>240>240>240>240>240
ThioTepa10.0 mg/ml25.221.511.147.8169.1
Mitomycin C0.5 mg/ml>240>240>240>240>240
Vincristine Sulfate1.0 mg/ml>240>240>240>240>240
Fentanyl Citrate100 mcg/2mL>240>240>240>240>240

*Please note that the following 2 drugs have extremely low permeation times:

    1. Carmustine
    1. Thiotepa

Warning: Do not use with Carmustine and ThioTepa.

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.

3

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4

510(k) Summary

K220609

Preparation date: May 27, 2022

1. Submitter
Name:Encompass Industries Sdn. Bhd.
Address:Lot 18256, Kawasan Perindustrian Lot Q,
Kertih Bio-Polymer Park, 24300 Kemaman,
Terengganu, Malaysia.
Telephone No.:+609 831 8866
Contact Person:Nur Atikah binti Muhammad Muhyiddin
E-mail:regulatory@encompass-medical.com atikah@ems-inc.com

2. Identification of Device

| Trade/Proprietary Name(s) | : 1. Powder-Free Nitrile Examination Glove (White, Blue, Black, Orange and Green Color) Tested for use with Chemotherapy Drugs and Fentanyl
2. Other clients' trade name and private labeling |
|---------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Common Name(s) | : Powder-Free Nitrile Examination Glove |
| Classification Name: | : 1. Non-powdered Patient Examination Glove (21 CFR 880.6250)
2. Patient Examination Glove, Specialty (Product Code: LZC)
3. Polymer Patient Examination Glove (Product Code: LZA) |
| Device Classification | : Class I |

3. Identification of Legally Marketed Device as Predicate

| Predicate name | : Black Colored, Powder Free Nitrile Examination Gloves, Non-sterile,
Tested for Use with Chemotherapy Drugs and Fentanyl Citrate |
|----------------|--------------------------------------------------------------------------------------------------------------------------------------|
| 510(k) number | : K200181 |
| Company | : Comfort Rubber Glove Industries Sdn Bhd |

4. Description of Device

The proposed Powder-Free Nitrile Examination Glove (White, Blue, Black, Orange and Green Color) Tested for use with Chemotherapy Drugs and Fentanyl is a disposable device intended for over-the-counter use and is provided powder-free and non-sterile. These patient examination gloves are formulated using Nitrile. The patient examination gloves are not made with natural rubber latex. General specifications of the glove are as below:

1. Overall Length:230 mm minimum
2. Width:95 ± 5 mm minimum (for medium glove)
3. Palm Thickness:0.05 mm minimum
4. Finger Thickness:0.05 mm minimum
5. Tensile Strength
a. Before Aging:14 MPa minimum

5

b. After Aging:14 MPa minimum
6. Ultimate Elongation
a. Before Aging:500 % minimum
b. After Aging:400 % minimum
7. Pinhole AQL:2.5

5. Intended Use / Indication for Use:

A Powder-Free Nitrile Examination Glove (White, Blue, Black, Orange and Green Color) Tested for use with Chemotherapy Drugs and Fentanyl is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. In addition, these gloves were tested for chemotherapy drugs permeation test.

Table 5.1 Summary Test Results for Resistance of Powder-Free Nitrile Examination Gloves (White, Blue, Black, Orange and Green Color) to Permeation by Chemotherapy Drugs

Chemotherapy DrugConcentrationMinimum Breakthrough Detection Time (minutes)
WhiteBlueBlackOrangeGreen
Carmustine (BCNU)*3.3 mg/ml11.210.711.067.367.1
Cisplatin1.0 mg/mL>240>240>240>240>240
Cyclophosphamide20.0 mg/mL>240>240>240>240>240
Dacarbazine10.0 mg/mL>240>240>240>240>240
Doxorubicin HCL2.0 mg/mL>240>240>240>240>240
Etoposide20.0 mg/mL>240>240>240>240>240
Fluorouracil50.0 mg/mL>240>240>240>240>240
Methotrexate25.0 mg/mL>240>240>240>240>240
Paclitaxel6.0 mg/mL>240>240>240>240>240
ThioTepa*10.0 mg/mL25.221.511.147.8169.1
Mitomycin C0.5 mg/mL>240>240>240>240>240
Vincristine Sulfate1.0 mg/mL>240>240>240>240>240
Fentanyl Citrate100.0 mcg/2mL>240>240>240>240>240
*Please note that the following drugs have extremely low permeation time:
1. Carmustine (3.3 mg/mL)
  1. Thiotepa (10 mg/mL)

Warning: Do not use with Carmustine and ThioTepa.

6. Comparative Technological Characteristics & Performance Information Summary

Table 6.1 Summary of Technological Characteristics Comparison between Proposed Device and Predicate Device

Device Performance / CharacteristicComparison Analysis
Character-
isticsRequirement /
StandardPredicate Device
(K200181)Subject DeviceComparisonAny
Safety &
Effective-
ness Issue
Material-NitrileNitrileSimilarNo
Color-BlackWhite
Blue
Black
Orange
GreenMinor
Different
(Supported by
Biocompatibility Study)No
Product
CodeLZA
LZCLZA
LZCSimilarNo
Type of
Use-Single UseSingle UseSimilarNo
Material-NitrileNitrileSimilarNo
Powder-
Free-YesYesSimilarNo
Sterility-Non-sterileNon-SterileSimilarNo
Intended
Use /
Indications
for Use-The Black Colored,
Powder Free Nitrile
Examination Gloves,
Non-Sterile, and Tested
for Use with
Chemotherapy Drugs and
Fentanyl Citrate is a
specialty medical glove
which is a disposable
device intended for
medical purposes that is
worn on the examiner's
hand or finger to prevent
contamination between
examiner and patient. In
addition, these gloves are
worn to protect the
wearer against exposure
to chemotherapy drugs
and Fentanyl Citrate.Powder-Free Nitrile
Examination Glove (White,
Blue, Black, Orange and
Green Color) Tested for
Use with Chemotherapy
Drugs and Fentanyl is a
disposable device intended
for medical purposes that is
worn on the examiner's
hand, in order to prevent
contamination between
patient and examiner, and
also prevent transmission of
a wide variety of diseases to
both patient and health care
personnel. In addition,
these gloves were tested for
chemotherapy drug
permeation test.SimilarNo
DimensionASTM D6319-10Meets requirementMeets requirementSimilarNo
Physical
PropertiesASTM D6319-10Meets requirementMeets requirementSimilarNo
Freedom
from HolesASTM D6319-10
(Tested according
to ASTM D5151-
  1. | Meets requirements of
    ASTM D6319-10
    (ASTM D5151) | Meets ASTM D6319-10,
    21 CFR 800.20 (Tested in
    accordance with ASTM
    D5151-06) | Similar | No |
    | Powder
    Residual | ASTM D6124-06 | Meets requirement | Meets requirement | Similar | No |
    | Biocompati
    bility | .In Vitro
    Cytotoxicity-
    ISO 10993-5 | Under the conditions of
    the study, the device is
    non-cytotoxic | Under the condition of
    study, the device extract
    shows potential toxicity. | Different
    (Supported by
    Acute
    Systemic
    Toxicity
    Study) | No |
    | | Acute Systemic
    Toxicity - ISO
    10993-11 | - | Not an acute systemic toxic
    under the condition of the
    study. | Different
    (Device is
    proven safe to
    used) | No |
    | | Skin Sensitization
  • ISO 10993-10 | Under the condition of
    the study, the device is
    non-sensitization | Not a sensitizer under the
    conditions of the study. | Similar | No |
    | | Skin Irritation -
    ISO 10993-10 | Under the conditions of
    the study, the device is
    non irritating | Not a primary skin irritant
    under the conditions of the
    study. | Similar | No |

6

7

| Characteristic | Predicate Device
(K200181) | Proposed Device | Comparison Analysis | Justification |
|--------------------------------------------------|----------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Color | Black | White
Blue
Black
Orange
Green | Minor Different
(Supported by
Biocompatibility
Study) | Device in different color has
the same non-sensitization,
non-irritating and non-toxic
characteristics. |
| Biocompatibility
(In Vitro
Cytotoxicity) | Meets ISO 10993:5
Under the
conditions of the
study, the device is
non-cytotoxic | ISO 10993:5
Under the condition of
the study, the
device extract shows potential
cytotoxicity. | Different
(Supported by
Acute Systemic
Toxicity Study) | Device has potential cytotoxic
effect. Therefore, Acute
Systemic Toxicity test is
conducted to prove that
device does not have potential
toxicity. |
| Biocompatibility
(Acute Systemic
Toxicity) | - | Meets ISO 10993-11
Not an acute systemic
toxic under the
condition of the study. | Different
(Device is proven
safe to use) | Device is does not have
potential toxicity effect.
Therefore, similar with the
predicate. |

Table 6.2 Summary of Difference in Technological Characteristics

Table 6.3: Test Results for Resistance of Medical Gloves to Permeation by Chemotherapy Drugs (ASTM D6978-05)

| Chemotherapy

DrugConcentrationMinimum Breakthrough Detection Time (minutes)
Predicate Device
(K200181)Proposed Device
WhiteBlueBlackOrangeGreen
Carmustine (BCNU)*3.3 mg/ml54.111.210.711.067.367.1
Cisplatin1.0 mg/mL>240>240>240>240>240>240
Cyclophosphamide20.0 mg/mL>240>240>240>240>240>240
Dacarbazine10.0 mg/mL>240>240>240>240>240>240
Doxorubicin HCL2.0 mg/mL>240>240>240>240>240>240
Etoposide20.0 mg/mL>240>240>240>240>240>240
Fluorouracil50.0 mg/mL>240>240>240>240>240>240
Methotrexate25.0 mg/mL->240>240>240>240>240
Paclitaxel6.0 mg/mL>240>240>240>240>240>240
ThioTepa*10.0 mg/mL1.325.221.511.147.8169.1
Mitomycin C0.5 mg/mL->240>240>240>240>240
Vincristine Sulfate1.0 mg/mL->240>240>240>240>240
Fentanyl Citrate100.0 mcg/2mL>240>240>240>240>240>240
*Warning Statement:The maximum testing time is 240 minutes. Please note that the following drugs have extremely low permeation time:
  1. Carmustine (3.3 mg/mL)
  2. Thiotepa (10 mg/mL) | | | | | |

8

7. Summary of Non-Clinical Test:

Below are the non-clinical tests that was conducted and the purposes:

TestPurpose
Dimension TestTo evaluate whether the device meets the current ASTM D6319-19
Freedom From HoleTo evaluate whether the subject meets current 21 CFR 800.20, ASTM
D6319-19 and test according to ASTM D5151-19
Physical Property TestTo evaluate whether the subjects meet current ASTM D6319-19 and test
according to ASTM D412 and ASTM D573
Residual Powder TestTo evaluate whether the subjects meet current ASTM D6319-19 and test
according to ASTM D6124-06
Biocompatibility Test
(Skin Irritation)To determine whether skin irritation potential of device meets ISO 10993-
  1.                                   |
    

| Biocompatibility Test
(Skin Sensitization) | To determine whether skin sensitization potential of device meets ISO
10993-10. |
| Biocompatibility Test
(Acute Systemic
Toxicity) | To determine whether leachable extracted from the device would cause
acute systemic toxicity and meet ISO 10993-11. |

Table 7.1 Summary of Dimension Test

StandardMinimumDevice Performance (Minimum)
CharacteristicsSizeRequirementWhiteBlueBlackOrangeGreen
LengthASTM
D6319-
19XS220 mm239 mm235 mm242 mm243 mm244 mm
S220 mm236 mm237 mm242 mm244 mm241 mm
M230 mm230 mm230 mm240 mm245 mm245 mm
L230 mm234 mm237 mm255 mm243 mm242 mm
XL230 mm232 mm246 mm240 mm240 mm245 mm
XXL230 mm238 mm238 mm242 mm240 mm245 mm
WidthASTM
D6319-
19XS$70 \pm 10$ mm75 mm77 mm77 mm77 mm77 mm
S$80 \pm 10$ mm85 mm87 mm86 mm87 mm85 mm
M$95 \pm 10$ mm93 mm86 mm92 mm97 mm97 mm
L$110 \pm 10$ mm104 mm107 mm104 mm108 mm107 mm
XL$120 \pm 10$ mm112 mm111 mm114 mm118 mm117 mm
XXL$130 \pm 10$ mm128 mm128 mm127 mm124 mm126 mm
Thickness
(Finger)ASTM
D6319-
19XS0.05 mm0.08 mm0.08 mm0.09 mm0.27 mm0.25 mm
S0.08 mm0.09 mm0.05 mm0.27 mm0.27 mm
M0.10 mm0.11 mm0.10 mm0.28 mm0.27 mm
L0.09 mm0.08 mm0.10 mm0.27 mm0.27 mm
XL0.07 mm0.06 mm0.10 mm0.28 mm0.27 mm
XXL0.07 mm0.08 mm0.07 mm0.28 mm0.26 mm
Thickness
(Palm)ASTM
D6319-
19XS0.05 mm0.05 mm0.05 mm0.06 mm0.19 mm0.19 mm
S0.05 mm0.05 mm0.06 mm0.19 mm0.19 mm
M0.06 mm0.06 mm0.05 mm0.19 mm0.18 mm
L0.05 mm0.05 mm0.06 mm0.22 mm0.20 mm
XL0.05 mm0.05 mm0.06 mm0.22 mm0.18 mm
XXL0.05 mm0.05 mm0.06 mm0.20 mm0.19 mm

9

| Characteristics | Standard | Size | Minimum
Requirement | Device Performance (Minimum) | | | | |
|-----------------------|-------------------------------------------------------------------------------------|------|------------------------|------------------------------|--------|--------|--------|--------|
| | | | | White | Blue | Black | Orange | Green |
| Freedom from
Holes | A;STM
D6319-19
21 CFR
800.20
(Tested
as per
ASTM
D5151-
19) | XS | AQL 2.5 | Passed | Passed | Passed | Passed | Passed |
| | | S | | Passed | Passed | Passed | Passed | Passed |
| | | M | | Passed | Passed | Passed | Passed | Passed |
| | | L | | Passed | Passed | Passed | Passed | Passed |
| | | XL | | Passed | Passed | Passed | Passed | Passed |
| | | XXL | | Passed | Passed | Passed | Passed | Passed |

Table 7.2 Summary of Freedom of Hole Test

Table 7.3 Summary of Physical Property Test

| Characteristics | Standard | Size | Minimum
Requirement | Device Performance (Minimum) | | | | |
|-------------------------------------|---------------------------------------|------|------------------------|------------------------------|------|-------|--------|-------|
| | | | | White | Blue | Black | Orange | Green |
| Before Aging
(Tensile [MPa]) | | XS | 14 MPa | 23.2 | 21.0 | 21.3 | 20.7 | 21.1 |
| | | S | | 21.2 | 24.5 | 23.6 | 20.0 | 20.1 |
| | | M | | 22.8 | 21.6 | 22.3 | 21.0 | 28.8 |
| | | L | | 20.7 | 23.7 | 21.6 | 21.4 | 20.9 |
| | | XL | | 20.5 | 20.2 | 24.3 | 20.9 | 22.0 |
| | | XXL | | 22.8 | 23.6 | 22.2 | 23.0 | 22.1 |
| Before Aging
(Elongation
[%]) | ASTM
D6319-
19 | XS | 500 % | 528 | 520 | 515 | 527 | 533 |
| | | S | | 527 | 549 | 518 | 515 | 556 |
| | | M | | 520 | 522 | 530 | 549 | 548 |
| | | L | | 528 | 521 | 527 | 531 | 523 |
| | | XL | | 536 | 521 | 528 | 533 | 524 |
| | | XXL | | 526 | 524 | 528 | 525 | 525 |
| After Aging
(Tensile [MPa]) | (Tested
as per
ASTM
D412-16) | XS | 14 MPa | 23.0 | 20.2 | 23.0 | 24.5 | 21.4 |
| | | S | | 20.2 | 24.6 | 26.6 | 22.7 | 20.4 |
| | | M | | 26.8 | 19.8 | 22.7 | 22.2 | 26.4 |
| | | L | | 24.9 | 26.1 | 21.4 | 25.2 | 21.7 |
| | | XL | | 26.3 | 23.1 | 28.8 | 22.2 | 24.6 |
| | | XXL | | 23.3 | 21.0 | 20.0 | 27.4 | 20.1 |
| After Aging
(Elongation
[%]) | | XS | 400 % | 432 | 461 | 414 | 430 | 465 |
| | | S | | 427 | 466 | 421 | 412 | 446 |
| | | M | | 444 | 457 | 425 | 466 | 440 |
| | | L | | 488 | 423 | 436 | 447 | 455 |
| | | XL | | 458 | 424 | 434 | 432 | 431 |
| | | XXL | | 437 | 435 | 433 | 425 | 425 |

10

| Characteristics | Standard | Size | Minimum
Requirement | Device Performance (Minimum) | | | | |
|----------------------------|--------------------------------------------------------------------|------|------------------------------------------------|------------------------------|------|-------|--------|-------|
| | | | | White | Blue | Black | Orange | Green |
| Residual
Powder
(mg) | ASTM
D6319-
19
(Tested
as per
ASTM
D6124-
06) | XS | ≤ 2.0 mg of
residual
powder per
glove | 0.98 | 0.68 | 0.80 | 0.82 | 0.96 |
| | | S | | 0.86 | 0.72 | 0.86 | 0.98 | 0.82 |
| | | M | | 0.92 | 0.88 | 0.94 | 0.92 | 0.92 |
| | | L | | 0.78 | 0.76 | 0.92 | 0.78 | 0.90 |
| | | XL | | 0.84 | 0.98 | 0.84 | 0.68 | 0.86 |
| | | XXL | | 0.74 | 0.82 | 0.92 | 0.84 | 0.98 |

Table 7.4 Summary of Residual Powder Test

Table 7.5 Summary of Biocompatibility Test

| Characteristics | Standard | Minimum
Requirement | Device Performance | | | | |
|----------------------------|--------------|------------------------|------------------------------------------------------------------|------|-------|--------|-------|
| | | | White | Blue | Black | Orange | Green |
| Skin Irritation | ISO 10993-10 | N/A | Non-irritant under the conditions of the study. | | | | |
| Skin
Sensitization | ISO 10993-10 | N/A | Non-sensitizer under the conditions of the study. | | | | |
| Acute Systemic
Toxicity | ISO 10993-11 | N/A | Not an acute systemic toxic under the condition of
the study. | | | | |

8. Summary of Clinical Test:

Clinical data is not required.

9. Conclusion:

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