K Number
K231435
Device Name
KIMTECH™ Polaris™ Xtra Nitrile Powder-Free Exam Gloves Tested for Use with Chemotherapy Drugs, Opioid Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid
Date Cleared
2023-08-28

(103 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The nitrile powder free patient examination glove is a non-sterile disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. In addition to routine examination glove's intended use, the gloves are Tested for Use with Chemotherapy Drugs, Opioid Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid.
Device Description
KIMTECH™ Polaris™ Xtra Nitrile Powder-Free Exam Gloves Tested for Use with Chemotherapy Drugs, Opioid Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid are dark magenta in color, and are single use only, non-sterile, disposable gloves. The powder-free gloves are made of synthetic copolymers of acrylonitrile and butadiene. The product will be sold as a disposable and non-sterile product in extrasmall, small, medium, large, and extra-large sizes.
More Information

Not Found

No
The summary describes a medical examination glove and its performance against various standards and chemical permeation. There is no mention of AI or ML technology in the intended use, device description, or performance studies.

No.
The intended use of the device is for examination purposes to prevent contamination between patient and examiner, not to treat or cure a disease or condition.

No

The device is a medical glove intended to prevent contamination between patient and examiner and protect against certain chemicals. It does not perform any diagnostic function.

No

The device description clearly states it is a physical glove made of synthetic copolymers, intended to be worn on the hand. It is a tangible hardware device, not software.

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

Here's why:

  • Intended Use: The intended use is clearly stated as a "non-sterile disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner." This describes a barrier device for personal protection and infection control.
  • IVD Definition: An IVD is a medical device used to perform tests on samples taken from the human body (like blood, urine, or tissue) to provide information about a person's health. This device does not perform any such tests.
  • Device Description: The description focuses on the physical characteristics and material of the glove, not on any diagnostic function.
  • Performance Studies: The performance studies described are related to the physical properties of the glove (strength, integrity, chemical resistance) and its biocompatibility, not to the accuracy or reliability of a diagnostic test.

The fact that the gloves are tested for use with chemotherapy drugs and fentanyl relates to their barrier properties and safety for the user when handling these substances, not to a diagnostic test performed in vitro.

N/A

Intended Use / Indications for Use

The nitrile powder free patient examination glove is a non-sterile disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

In addition to routine examination glove's intended use, the gloves are Tested for Use with Chemotherapy Drugs, Opioid Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid.

Product codes

LZA, LZC, ODO, OPJ

Device Description

KIMTECH™ Polaris™ Xtra Nitrile Powder-Free Exam Gloves Tested for Use with Chemotherapy Drugs, Opioid Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid are dark magenta in color, and are single use only, non-sterile, disposable gloves. The powder-free gloves are made of synthetic copolymers of acrylonitrile and butadiene. The product will be sold as a disposable and non-sterile product in extrasmall, small, medium, large, and extra-large sizes.

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

The subject 510(k) device has undergone a series of safety and performance tests. The test results demonstrated that the proposed device met the performance criteria as specified utilizing the following test methods, standards, and specifications:

  • ASTM D6319-19 Standard Specification for Nitrile Examination Gloves for Medical Application
  • ASTM D5151-19 Standard Test Method for Detection of Holes in Medical Gloves
  • ASTM D6124-06 (Reapproved 2017) Standard Test Method for Residual Powder on Medical Gloves
  • ASTM D6978-05 (Reapproved 2019) Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs
  • ISO 2859-1:1999 Sampling Procedures and Tables for Inspection by Attributes.
  • ASTM D412-2006a (Reapproved 2013) Standard Test Method for Vulcanized Rubber and Thermoplastic Elastomers-Tension
  • ASTM D573-2004 (Reapproved 2010) Standard Test Method for Rubber-Deterioration in an Air Oven
  • ASTM D3767-03 (2020) Standard Practice for Rubber Measurement of Dimensions
  • ASTM D7103-19 Standard guide for assessment of medical gloves
  • ANSI/AAMI/ISO 10993-23:2021(E) - Biological evaluation of medical devices -Part 23: Tests for irritation
  • ANSI/AAMI/ISO 10993-10:2021(E)- Biological evaluation of medical devices -Part 10: Tests for skin sensitization
  • ANSI/AAMI/ISO 10993-11:2017(E) – Biological evaluation of medical devices – Part 11: Tests for systemic toxicity.
  • ANSI/AAMI/ISO 10993-12:2021(E) Biological evaluation of medical devices Part 12: Sample preparation and reference material.
  • ANSI/AAMI/ISO 10993-2:2022(E) Biological evaluation of medical devices -Part 2: Animal welfare requirements

Key Results:

  • Dimensions (Length, Width, Finger Thickness, Palm Thickness): Meets Requirements based on ASTM D 6319.
  • Physical Properties (Tensile Strength, Ultimate elongation before and after aging): Meets Requirements based on ASTM D 6319.
  • Freedom from Pinholes: Meets Requirements based on ASTM D 5151 (AQL 0.65).
  • Powder - Free: Meets Requirements based on ASTM D 6124 (≤ 2 mg / glove).
  • ISO Irritation Study: Under the conditions of the study, the device is not an irritant (ISO 10993, Part 23).
  • ISO Acute Systemic Toxicity Study: No evidence of acute systemic toxicity (ISO 10993, Part 11).
  • ISO Dermal Sensitization: Under the conditions of the study, the device is not a sensitizer (ISO 10993, Part 10).
  • Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs: Breakthrough was measured for up to 240 minutes for each of the 24 chemotherapy drugs and opioid drug listed. No signs of breakthrough for the subject device up to 240 minutes, with the exception of Carmustine (78.1 minutes).

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

  • Minimum Breakthrough Detection Times for Chemotherapy Drugs: Most are >240 min, Carmustine is 78.1 min.
  • Minimum Breakthrough Detection Times for Fentanyl/Gastric Acid: >240 min for Fentanyl Citrate, Simulated Gastric Acid Fluid, and Simulated Gastric Acid Fluid/Fentanyl Citrate Injection Mix.
  • Freedom from Pinholes: Pass (AQL 0.65)
  • Powder-Free: Passed at

§ 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 contains the logo of the U.S. Food & Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

August 28, 2023

Kimberly-Clark Corporation % Amy Fowler Consultant Pathmaker FDA Law PLLC 1415 Lilac Drive N, Suite 270 Minneapolis, Minnesota 55422

Re: K231435

Trade/Device Name: KIMTECH™ Polaris™ Xtra Nitrile Powder-Free Exam Gloves Tested for Use with Chemotherapy Drugs, Opioid Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid Regulation Number: 21 CFR 880.6250 Regulation Name: Non-Powdered Patient Examination Glove Regulatory Class: Class I, reserved Product Code: LZA, LZC, ODO, OPJ Dated: May 17, 2023 Received: May 17, 2023

Dear Amy Fowler:

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 -S

Bifeng Qian, 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

2

Indications for Use

510(k) Number (if known)

K231435

Device Name

KIMTECH™ Polaris™ Xtra Nitrile Powder-Free Exam Gloves Tested for Use with Chemotherapy Drugs, Opioid Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid.

Indications for Use (Describe)

The nitrile powder free patient examination glove is a non-sterile disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

In addition to routine examination glove's intended use, the gloves are Tested for Use with Chemotherapy Drugs, Opioid Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid.

Table 1. Chemotherapy Drugs, Concentrations, and Minimum Breakthrough Detection Times

| Chemotherapy Drug | Concentration | Minimum Breakthrough
Detection Time |
|---------------------|--------------------------|----------------------------------------|
| Avastin | 25 mg/mL (25,000 ppm) | >240 min. |
| Cabazitaxel | 60 mg/1.5mL (40,000 ppm) | >240 min. |
| Capecitabine | 26 mg/mL (26,000 ppm) | >240 min. |
| Carmustine | 3.3 mg/mL (3,300 ppm) | 78.1 min. |
| Cisplatin | 1 mg/mL (1,000 ppm) | >240 min. |
| Cyclophosphamide | 20 mg/mL (20,000 ppm) | >240 min. |
| Dacarbazine | 10 mg/mL (10,000 ppm) | >240 min. |
| Doxorubicin HCL | 2 mg/mL (2,000 ppm) | >240 min. |
| Eribulin Mesylate | 0.5 mg/mL (500 ppm) | >240 min. |
| Etoposide | 20 mg/mL (20,000 ppm) | >240 min. |
| Floxuridine | 100 mg/mL (100,000 ppm) | >240 min. |
| Fluorouracil | 50 mg/mL (50,000 ppm) | >240 min. |
| Ifosfamide | 50 mg/mL (50,000 ppm) | >240 min. |
| Lenvatinib | 20 mg/mL (20,000 ppm) | >240 min. |
| Mitoxantrone | 2 mg/mL (2,000 ppm) | >240 min. |
| Oxaliplatin | 5 mg/mL (5,000 ppm) | >240 min. |
| Paclitaxel | 6 mg/mL (6,000 ppm) | >240 min. |
| Pemetrexed | 25 mg/mL (25,000 ppm) | >240 min. |
| Sorafenib Tosylate | 200 mg/mL (200,000 ppm) | >240 min. |
| Tamoxifen | 2 mg/mL (2,000 ppm) | >240 min. |
| ThioTEPA | 10 mg/mL (10,000 ppm) | >240 min. |
| Vinblastine Sulfate | 1 mg/mL (1,000 ppm) | >240 min. |
| Vincristine Sulfate | 1 mg/mL (1,000 ppm) | >240 min. |
| Vinorelbine | 10 mg/mL (10,000 ppm) | >240 min. |

Caution: The following chemotherapy drug has low permeation (3.3mg/ml): 78.1 minutes.

Tested in accordance to ASTM D6978-05 (2019)

3

Indications for Use

510(k) Number (if known)

K231435

Table 2. Fentanyl Citrate, Simulated Gastric Acid, and Simulated Gastric Acid with Fentanyl Citrate Mix Minimum Breakthrough Detection Times

| Fentanyl/Gastric Acid | Concentration | Minimum Breakthrough
Detection Time |
|----------------------------------------------------------------|----------------------------------------|----------------------------------------|
| Fentanyl Citrate | 100mcg/2mL | >240 min. |
| Simulated Gastric Acid Fluid | 0.2% (w/v) NaCl in 0.7% (v/v) HCl acid | >240 min. |
| Simulated Gastric Acid Fluid/Fentanyl
Citrate Injection Mix | 50/50 mix solution | >240 min. |

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 the 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."

4

510(k) Summary (K231435) (As required by 21 CFR 807.92)

1. Submission Information

KIMTECH™ Polaris™ Xtra Nitrile Powder-Free Exam Gloves Tested for Use with Chemotherapy Drugs, Opioid Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid

Date Prepared:
Submission Format:Traditional 510(k)
510(k) #:K231435

2. Submitter Information

Applicant:Kimberly-Clark Corporation
Address:1400 Holcomb Bridge Road
Roswell, Georgia 30076
Phone:+1 770 587 8000
Contact person:Kimberly Tempas
Associate Director, Regulatory Affairs
2100 Winchester Road
Neenah, WI 54956
Phone:
Email:+1 (920) 721-4084
Kimberly.Tempas@kcc.com

3. Device Information

| Trade Name: | KIMTECH™ Polaris™ Xtra Nitrile Powder-Free Exam Gloves
Tested for Use with Chemotherapy Drugs, Opioid Fentanyl
Citrate, Simulated Gastric Acid and Fentanyl in Simulated
Gastric Acid |
|----------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Common Name: | Nitrile powder-free patient exam glove for use with
chemotherapy drugs and fentanyl |
| Classification Name: | Non-powered Patient Examination Glove |
| Regulation: | 21 CFR 880.6250 |

5

Regulatory Class:Class I
Panel:General Hospital
Product Codes:LZA, LZC, QDO, OPJ
Product codes
LZAPolymer Patient Examination Glove
LZCPatient Examination Glove, Specialty
QDOFentanyl and other opioid protection gloves
OPJMedical Gloves with Chemotherapy Labeling Claims
Table 5.1. Product codes
------------------------------

4. Predicate Device Information

K200072 Powder-free Nitrile Exam Glove for use with Chemotherapy drugs and Fentanyl Product Code: LZC, LZA, QDO.

5. Device Description

KIMTECH™ Polaris™ Xtra Nitrile Powder-Free Exam Gloves Tested for Use with Chemotherapy Drugs, Opioid Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid are dark magenta in color, and are single use only, non-sterile, disposable gloves. The powder-free gloves are made of synthetic copolymers of acrylonitrile and butadiene. The product will be sold as a disposable and non-sterile product in extrasmall, small, medium, large, and extra-large sizes.

6. Indications for Use

The nitrile powder-free patient examination glove is a non-sterile disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. In addition to routine examination glove's intended use, the gloves are Tested for Use with Chemotherapy Drugs, Opioid Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid.

6

| Chemotherapy Drug | Concentration | Minimum Breakthrough
Detection Time |
|-------------------------------------------------------------------|-------------------------------------------|----------------------------------------|
| Avastin | 25 mg/mL (25,000 ppm) | >240 min. |
| Cabazitaxel | 60 mg/1.5mL (40,000 ppm) | >240 min. |
| Capecitabine | 26 mg/mL (26,000 ppm) | >240 min. |
| Carmustine | 3.3 mg/mL (3,300 ppm) | 78.1 minutes |
| Cisplatin | 1 mg/mL (1,000 ppm) | >240 min. |
| Cyclophosphamide | 20 mg/mL (20,000 ppm) | >240 min. |
| Dacarbazine | 10 mg/mL (10,000 ppm) | >240 min. |
| Doxorubicin HCL | 2 mg/mL (2,000 ppm) | >240 min. |
| Eribulin Mesylate | 0.5 mg/mL (500 ppm) | >240 min. |
| Etoposide | 20 mg/mL (20,000 ppm) | >240 min. |
| Floxuridine | 100 mg/mL (100,000 ppm) | >240 min. |
| Fluorouracil | 50 mg/mL (50,000 ppm) | >240 min. |
| Ifosfamide | 50 mg/mL (50,000 ppm) | >240 min. |
| Lenvatinib | 20 mg/mL (20,000 ppm) | >240 min. |
| Mitoxantrone | 2 mg/mL (2,000 ppm) | >240 min. |
| Oxaliplatin | 5 mg/mL (5,000 ppm) | >240 min. |
| Paclitaxel | 6 mg/mL (6,000 ppm) | >240 min. |
| Pemetrexed | 25 mg/mL (25,000 ppm) | >240 min. |
| Sorafenib Tosylate | 200 mg/mL (200,000 ppm) | >240 min. |
| Tamoxifen | 2 mg/mL (2,000 ppm) | >240 min. |
| ThioTEPA | 10 mg/mL (10,000 ppm) | >240 min. |
| Vinblastine Sulfate | 1 mg/mL (1,000 ppm) | >240 min. |
| Vincristine Sulfate | 1 mg/mL (1,000 ppm) | >240 min. |
| Vinorelbine | 10 mg/mL (10,000 ppm) | >240 min. |
| Fentanyl/Gastric Acid | Concentration | Minimum Breakthrough
Detection Time |
| Fentanyl Citrate | 100mcg/2mL | >240 min. |
| Simulated Gastric Acid Fluid | 0.2% (w/v) NaCl in 0.7% (v/v) HCL
acid | >240 min. |
| Simulated Gastric Acid
Fluid/Fentanyl Citrate Injection
Mix | 50/50 mix solution | >240 min. |

Table 5.2. Permeation Times for Chemotherapy Drugs

Caution: The following chemotherapy drug has a low permeation time: Carmustine (3.3mg/ml): 78.1 minutes.

7

7. Predicate & Subject Technological Characteristics Comparison Table

| Attributes | Standard Where
Limits Test Limits
Set | Purple
K200072
(Predicate) | Polaris
(Subject Device) | Comparison |
|---------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Device
Regulation | NA | 21 CFR 880.6250 | 21 CFR 880.6250 | Same |
| Product
Codes | NA | LZA, LZC, QDO | LZA, LZC, QDO,
ОРЈ | Same |
| Common
Name | NA | Examination glove | Examination
glove | Same |
| Sizes | NA | Five sizes:
XS, S, M, L, XL | Five sizes:
XS, S, M, L, XL | Same |
| Base
Material | NA | Nitrile | Nitrile | Same |
| Color | NA | Purple | Dark Magenta | Similar:
Biocompatibility
& physical
attributes testing
show that the
difference in
color does not
alter glove
safety or
performance. |
| Glove
formulation | NA | KC Purple Nitrile
9.5 Chemo
Formulation | Proprietary
formula | Similar:
Formulations
share similar
materials and
physical
characteristics;
biocompatibility
and physical
properties
testing show that
the subject
device's
formulation does
not reduce glove
safety or
performance. |
| Attributes | Standard Where
Limits Test Limits Set | Purple
K200072
(Predicate) | Polaris
(Subject Device) | Comparison |
| Glove layers | NA | Single layer | Single layer | Same |
| Sterile or
Non- Sterile | NA | Non-Sterile | Non-Sterile | Same |
| Prescription
or OTC | NA | ОТС | ОТС | Same |
| Single Use
Disposable | NA | Yes | Yes | Same |
| Intended Use/
Indications for
Use | NA | The device is a
disposable device
intended for medical
purposes that is
worn on the
examiner's hand or
finger to prevent
contamination
between patients
and examiner.
KIMTECH™ Purple
Nitrile™ Powder free
Examination Gloves
are Tested for Use
with Chemotherapy
Drugs, Opioid
Fentanyl Citrate,
Simulated Gastric
Acid, and Fentanyl in
Simulated Gastric
Acid. | The nitrile
powder-free
patient
examination
glove is a non-
sterile disposable
device intended
for medical
purposes that is
worn on the
examiner's hand
to prevent
contamination
between patient
and examiner.
In addition to
routine
examination
glove's intended
use, the gloves
are tested for
Use with
Chemotherapy
Drugs, Opioid
Fentanyl Citrate,
Simulated
Gastric Acid and
Fentanyl in
Simulated
Gastric Acid. | Similar:
The subject
device removed
"or finger"
because it is
intended to be
worn on the
hand, not the
finger. |
| Attributes | Standard Where
Limits Test Limits
Set | Purple
K200072
(Predicate) | Polaris
(Subject Device) | Comparison |
| Indications
for Use
Claims: | Chemotherapy
drugs tested for
permeation and
degradation in
accordance with
ASTM D6978-05
(2019) | Chemotherapy
Drugs Tested:

  1. Carmustine
  2. Cyclophosphami
    de
  3. Doxorubicin HCL
  4. Etoposide
  5. Fluorouracil
  6. Mitoxantrone
  7. Paclitaxel
  8. ThioTEPA
  9. Dacarbazine
  10. Ifosfamide
  11. Vincristine
    Sulfate
  12. Bleomycin Sulfate
  13. Busulfan
  14. Cytarabine
  15. Dacarbazine
  16. Daunorubicin
  17. Docetaxel
  18. Epirubicin
  19. Fludarabine
  20. Gemcitabine
  21. Idarubicin
  22. Mechlorethamine
    HCL
  23. Melphalan
  24. Methotrexate
  25. Mitomycin C
  26. Osplaten
  27. Paraplatin
  28. Rituximab | Chemotherapy
    Drugs Tested:
  29. Avastin
  30. Cabazitaxel
  31. Capecitabine
  32. Carmustine
  33. Cisplatin
  34. Cyclophospha
    mide
  35. Dacarbazine
  36. Doxorubicin
    HCL
  37. Eribulin
    Mesylate
  38. Etoposide
  39. Floxuridine
  40. Fluorouracil
  41. Ifosfamide
  42. Lenvatinib
  43. Mitoxantrone
  44. Oxaliplatin
  45. Paclitaxel
  46. Pemetrexed
  47. Sorafenib
    Tosylate
  48. Tamoxifen
  49. ThioTEPA
  50. Vinblastine
    Sulfate
  51. Vincristine
    Sulfate
  52. Vinorelbine | Similar: Both
    have been
    tested with a
    common list
    of
    chemotherapy
    drugs in
    accordance
    with the same
    test method,
    but the
    subject glove
    has been
    tested for
    some different
    chemotherapy
    drugs to
    better meet
    current user
    and
    chemotherapy
    treatment
    needs. |
    | Attributes | Standard Where
    Limits Test Limits Set | Purple
    K200072(Predicate) | Polaris
    (Subject Device) | Comparison |
    | Permeation and
    Degradation Tests
    of Other
    Substances | ASTM D6978-05
    (2019) | Passed permeation
    testing for:
    Fentanyl citrate
    Simulated gastric acid
    50/50 mix of fentanyl
    and gastric acid | Passed permeation
    testing for:
    Fentanyl citrate
    Simulated gastric acid
    50/50 mix of fentanyl
    and gastric acid | Same |
    | Carmustine and
    ThioTEPA
    Permeation Time | ASTM D6978-05
    (2019) | Carmustine: 3.6
    minutes
    ThioTEPA: 15.9
    minutes | Carmustine: 78.1
    minutes
    ThioTEPA: >240
    minutes | Different: The predicate
    was below minimum
    permeation time of 240
    minutes specified in the
    standard for Carmustine
    and ThioTEPA while the
    subject device is only
    below the minimum
    permeation time of 240
    minutes specified in the
    standard for
    Carmustine. |
    | Carmustine and
    ThioTEPA
    Caution/ Warning
    Statements | NA | WARNING: Not for
    use with:
    Carmustine,
    ThioTEPA | Caution: The following
    chemotherapy drug has
    a low permeation time:
    Carmustine
    (3.3mg/ml): 78.1
    minutes | Different: The predicate
    has a warning due to
    extremely low
    permeation times while
    the subject device has
    lesser "Caution
    Statement" based on
    permeation times >70
    minutes. |
    | Dimensions:
    Overall Length | ASTM D6319
    Minimum: 230 mm | All sizes comply with
    length dimensions | All sizes comply with
    length dimensions | Same |
    | Dimensions: Width
    (mean) | ASTM D6319
    Minimum: 70 +10mm | All sizes comply with
    width dimensions | All sizes comply with
    width dimensions | Same |
    | Dimensions: Palm
    & Finger Thickness | ASTM D6319
    Minimum Palm:
    0.05mm
    Minimum Finger:
    0.05mm | All sizes comply with
    Palm & Finger
    Thickness dimensions | All sizes comply with
    Palm & Finger
    Thickness dimensions | Same |
    | Attributes | Standard Where
    Limits Test Limits
    Set | Purple
    K200072(Predicate) | Polaris
    (Subject Device) | Comparison |
    | Tensile
    Strength:
    Before & After
    Aging | ASTM D6319
    Min Before: 14MPa
    After: 14Mpa | Complies both
    before and after
    accelerated aging. | Complies both
    before and after
    accelerated aging. | Same |
    | Ultimate
    Elongation
    Before & After
    aging | ASTM D6319
    Minimum: Before:
    500%
    After:400% | Complies both before
    and after accelerated
    aging. | Complies both
    before and after
    accelerated aging. | Same |
    | Freedom from
    Pinholes | ASTM D6319 G1,
    AQL 2.5
    7 Accept
    8 Reject | Pass
    (AQL 1.5) | Pass
    (AQL 0.65) | Same: Both
    gloves pass
    the tests.
    The subject
    glove AQL is
    tighter and
    allows fewer
    pinhole
    defects. |
    | Powder-Free | ASTM D6319-19
    (2019) Maximum