AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
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.

AI/ML Overview

The provided text describes the acceptance criteria and study results for "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." This is a medical device, specifically examination gloves, and the acceptance criteria and studies are related to its physical properties, biocompatibility, and resistance to permeation by certain chemicals.

Here's an analysis based on your request:

1. Table of acceptance criteria and the reported device performance:

Acceptance Criteria (Standard Where Limits Test Limits Set)Reported Device Performance (Results)
Dimensions (ASTM D 6319)Meets Requirements
Length: 220 mm minimum (XS, S), 230 mm minimum (M, L, XL)All sizes comply with length dimensions
Width (mean): 70 mm minimum (XS), 80 mm minimum (S), 95 mm minimum (M), 110 mm minimum (L), 120 mm minimum (XL)All sizes comply with width dimensions
Finger Thickness: 0.05 mm minimumAll sizes comply with Finger Thickness dimensions
Palm Thickness: 0.05 mm minimumAll sizes comply with Palm Thickness dimensions
Physical Properties (ASTM D 6319)Meets Requirements
Before Aging: Tensile Strength: ≥ 14 MPa, Ultimate elongation: ≥ 500%Complies both before and after accelerated aging
After Aging: Tensile Strength: ≥ 14 MPa, Ultimate elongation: 400%Complies both before and after accelerated aging
Freedom from Pinholes (ASTM D 5151)Meets Requirements
AQL 2.5, No leakagePass (AQL 0.65) - Note: Subject device has a tighter AQL than the predicate
Powder-Free (ASTM D 6124)Meets Requirements
≤ 2 mg / glovePassed at <2mg / glove in accordance with the standard
Biocompatibility (ISO 10993)
Irritation (ISO 10993, Part 23): No irritationUnder the conditions of the study, the device is not an irritant.
Acute Systemic Toxicity (ISO 10993, Part 11): No systemic toxicityNo evidence of Acute systemic toxicity
Dermal Sensitization (ISO 10993, Part 10): No sensitizationUnder the conditions of the study, the device is not a sensitizer
Resistance to Permeation by Chemotherapy Drugs (ASTM D6978-05)
No signs of breakthrough for the subject device up to 240 minutes. Any drugs performing at less than 240 minutes are specified as such.Breakthrough was measured for up to 240 minutes for each of the 24 chemotherapy drugs and opioid drug listed. See Table 5.2 for specific breakthrough detection times. (e.g., Carmustine: 78.1 min, others >240 min)

2. Sample size used for the test set and the data provenance:

The document does not explicitly state the exact sample sizes used for each specific test (e.g., how many gloves were tested for pinholes, or how many individual permeation tests were conducted for each chemical). However, it references recognized standards like ASTM D6319 (for dimensions and physical properties, which dictates sampling plans), ASTM D5151 (for holes, which specifies AQLs), and ISO 2859-1:1999 (Sampling Procedures and Tables for Inspection by Attributes). Meeting these AQLs (Acceptable Quality Levels) implies specific sample sizes would have been drawn and tested in accordance with the standards.

The data provenance is not explicitly stated as "country of origin" or "retrospective/prospective." However, given it's an FDA 510(k) submission, the studies would have been conducted by the manufacturer (Kimberly-Clark Corporation) or their designated testing facilities, likely in a controlled, prospective manner to generate data for the submission. The testing standards are international (ASTM, ISO), suggesting globally recognized methods.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

This information is not applicable to this type of device and study. The testing described involves objective, quantitative measurements of physical and chemical resistance properties according to established engineering and material science standards (ASTM, ISO). "Ground truth" in this context is defined by the objective measurement procedures and acceptance criteria outlined in these standards, not by expert consensus or interpretation of images/clinical data.

4. Adjudication method (e.g., 2+1, 3+1, none) for the test set:

This is not applicable. Adjudication methods like 2+1 or 3+1 refer to processes for resolving disagreements among multiple human readers in diagnostic imaging or clinical studies. The studies presented here are laboratory-based, objective material property tests.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:

This is not applicable. This submission is for a physical medical device (examination gloves), not an AI-powered diagnostic tool. Therefore, MRMC studies and the concept of "human readers improving with AI assistance" are irrelevant.

6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done:

This is not applicable. As stated above, this is not an AI algorithm. The performance described is inherent to the physical glove material and construction.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):

The "ground truth" for this device's performance is established by objective, quantitative measurements conducted in a laboratory setting according to internationally recognized standards and test methods. For example:

  • Dimensions: Measured directly using calibrated instruments.
  • Tensile Strength & Elongation: Measured using universal testing machines as per ASTM standards.
  • Freedom from Pinholes: Determined by water leak tests following ASTM D5151.
  • Powder Content: Measured gravimetrically as per ASTM D6124.
  • Biocompatibility: Determined by laboratory animal studies (e.g., skin irritation, sensitization, systemic toxicity) following ISO 10993 guidelines, which define the biological response.
  • Permeation Resistance: Measured by quantifying breakthrough time of specific chemicals using analytical techniques (e.g., chromatography) as per ASTM D6978-05.

8. The sample size for the training set:

This is not applicable. These studies are for a physical product validation, not for training an AI or machine learning model. There is no "training set" in this context.

9. How the ground truth for the training set was established:

This is not applicable as there is no training set for this type of device validation.

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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.

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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

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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 DrugConcentrationMinimum BreakthroughDetection Time
Avastin25 mg/mL (25,000 ppm)>240 min.
Cabazitaxel60 mg/1.5mL (40,000 ppm)>240 min.
Capecitabine26 mg/mL (26,000 ppm)>240 min.
Carmustine3.3 mg/mL (3,300 ppm)78.1 min.
Cisplatin1 mg/mL (1,000 ppm)>240 min.
Cyclophosphamide20 mg/mL (20,000 ppm)>240 min.
Dacarbazine10 mg/mL (10,000 ppm)>240 min.
Doxorubicin HCL2 mg/mL (2,000 ppm)>240 min.
Eribulin Mesylate0.5 mg/mL (500 ppm)>240 min.
Etoposide20 mg/mL (20,000 ppm)>240 min.
Floxuridine100 mg/mL (100,000 ppm)>240 min.
Fluorouracil50 mg/mL (50,000 ppm)>240 min.
Ifosfamide50 mg/mL (50,000 ppm)>240 min.
Lenvatinib20 mg/mL (20,000 ppm)>240 min.
Mitoxantrone2 mg/mL (2,000 ppm)>240 min.
Oxaliplatin5 mg/mL (5,000 ppm)>240 min.
Paclitaxel6 mg/mL (6,000 ppm)>240 min.
Pemetrexed25 mg/mL (25,000 ppm)>240 min.
Sorafenib Tosylate200 mg/mL (200,000 ppm)>240 min.
Tamoxifen2 mg/mL (2,000 ppm)>240 min.
ThioTEPA10 mg/mL (10,000 ppm)>240 min.
Vinblastine Sulfate1 mg/mL (1,000 ppm)>240 min.
Vincristine Sulfate1 mg/mL (1,000 ppm)>240 min.
Vinorelbine10 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)

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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 AcidConcentrationMinimum BreakthroughDetection Time
Fentanyl Citrate100mcg/2mL>240 min.
Simulated Gastric Acid Fluid0.2% (w/v) NaCl in 0.7% (v/v) HCl acid>240 min.
Simulated Gastric Acid Fluid/FentanylCitrate Injection Mix50/50 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)

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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:<august 2023="" 28,="">
Submission Format:Traditional 510(k)
510(k) #:K231435

2. Submitter Information

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

3. Device Information

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

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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.

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Chemotherapy DrugConcentrationMinimum BreakthroughDetection Time
Avastin25 mg/mL (25,000 ppm)>240 min.
Cabazitaxel60 mg/1.5mL (40,000 ppm)>240 min.
Capecitabine26 mg/mL (26,000 ppm)>240 min.
Carmustine3.3 mg/mL (3,300 ppm)78.1 minutes
Cisplatin1 mg/mL (1,000 ppm)>240 min.
Cyclophosphamide20 mg/mL (20,000 ppm)>240 min.
Dacarbazine10 mg/mL (10,000 ppm)>240 min.
Doxorubicin HCL2 mg/mL (2,000 ppm)>240 min.
Eribulin Mesylate0.5 mg/mL (500 ppm)>240 min.
Etoposide20 mg/mL (20,000 ppm)>240 min.
Floxuridine100 mg/mL (100,000 ppm)>240 min.
Fluorouracil50 mg/mL (50,000 ppm)>240 min.
Ifosfamide50 mg/mL (50,000 ppm)>240 min.
Lenvatinib20 mg/mL (20,000 ppm)>240 min.
Mitoxantrone2 mg/mL (2,000 ppm)>240 min.
Oxaliplatin5 mg/mL (5,000 ppm)>240 min.
Paclitaxel6 mg/mL (6,000 ppm)>240 min.
Pemetrexed25 mg/mL (25,000 ppm)>240 min.
Sorafenib Tosylate200 mg/mL (200,000 ppm)>240 min.
Tamoxifen2 mg/mL (2,000 ppm)>240 min.
ThioTEPA10 mg/mL (10,000 ppm)>240 min.
Vinblastine Sulfate1 mg/mL (1,000 ppm)>240 min.
Vincristine Sulfate1 mg/mL (1,000 ppm)>240 min.
Vinorelbine10 mg/mL (10,000 ppm)>240 min.
Fentanyl/Gastric AcidConcentrationMinimum BreakthroughDetection Time
Fentanyl Citrate100mcg/2mL>240 min.
Simulated Gastric Acid Fluid0.2% (w/v) NaCl in 0.7% (v/v) HCLacid>240 min.
Simulated Gastric AcidFluid/Fentanyl Citrate InjectionMix50/50 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.

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7. Predicate & Subject Technological Characteristics Comparison Table

AttributesStandard WhereLimits Test LimitsSetPurpleK200072(Predicate)Polaris(Subject Device)Comparison
DeviceRegulationNA21 CFR 880.625021 CFR 880.6250Same
ProductCodesNALZA, LZC, QDOLZA, LZC, QDO,ОРЈSame
CommonNameNAExamination gloveExaminationgloveSame
SizesNAFive sizes:XS, S, M, L, XLFive sizes:XS, S, M, L, XLSame
BaseMaterialNANitrileNitrileSame
ColorNAPurpleDark MagentaSimilar:Biocompatibility& physicalattributes testingshow that thedifference incolor does notalter glovesafety orperformance.
GloveformulationNAKC Purple Nitrile9.5 ChemoFormulationProprietaryformulaSimilar:Formulationsshare similarmaterials andphysicalcharacteristics;biocompatibilityand physicalpropertiestesting show thatthe subjectdevice'sformulation doesnot reduce glovesafety orperformance.
AttributesStandard WhereLimits Test Limits SetPurpleK200072(Predicate)Polaris(Subject Device)Comparison
Glove layersNASingle layerSingle layerSame
Sterile orNon- SterileNANon-SterileNon-SterileSame
Prescriptionor OTCNAОТСОТСSame
Single UseDisposableNAYesYesSame
Intended Use/Indications forUseNAThe device is adisposable deviceintended for medicalpurposes that isworn on theexaminer's hand orfinger to preventcontaminationbetween patientsand examiner.KIMTECH™ PurpleNitrile™ Powder freeExamination Glovesare Tested for Usewith ChemotherapyDrugs, OpioidFentanyl Citrate,Simulated GastricAcid, and Fentanyl inSimulated GastricAcid.The nitrilepowder-freepatientexaminationglove is a non-sterile disposabledevice intendedfor medicalpurposes that isworn on theexaminer's handto preventcontaminationbetween patientand examiner.In addition toroutineexaminationglove's intendeduse, the glovesare tested forUse withChemotherapyDrugs, OpioidFentanyl Citrate,SimulatedGastric Acid andFentanyl inSimulatedGastric Acid.Similar:The subjectdevice removed"or finger"because it isintended to beworn on thehand, not thefinger.
AttributesStandard WhereLimits Test LimitsSetPurpleK200072(Predicate)Polaris(Subject Device)Comparison
Indicationsfor UseClaims:Chemotherapydrugs tested forpermeation anddegradation inaccordance withASTM D6978-05(2019)ChemotherapyDrugs Tested:1. Carmustine2. Cyclophosphamide3. Doxorubicin HCL4. Etoposide5. Fluorouracil6. Mitoxantrone7. Paclitaxel8. ThioTEPA9. Dacarbazine10. Ifosfamide11. VincristineSulfate12. Bleomycin Sulfate13. Busulfan14. Cytarabine15. Dacarbazine16. Daunorubicin17. Docetaxel18. Epirubicin19. Fludarabine20. Gemcitabine21. Idarubicin22. MechlorethamineHCL23. Melphalan24. Methotrexate25. Mitomycin C26. Osplaten27. Paraplatin28. RituximabChemotherapyDrugs Tested:1. Avastin2. Cabazitaxel3. Capecitabine4. Carmustine5. Cisplatin6. Cyclophosphamide7. Dacarbazine8. DoxorubicinHCL9. EribulinMesylate10. Etoposide11. Floxuridine12. Fluorouracil13. Ifosfamide14. Lenvatinib15. Mitoxantrone16. Oxaliplatin17. Paclitaxel18. Pemetrexed19. SorafenibTosylate20. Tamoxifen21. ThioTEPA22. VinblastineSulfate23. VincristineSulfate24. VinorelbineSimilar: Bothhave beentested with acommon listofchemotherapydrugs inaccordancewith the sametest method,but thesubject glovehas beentested forsome differentchemotherapydrugs tobetter meetcurrent userandchemotherapytreatmentneeds.
AttributesStandard WhereLimits Test Limits SetPurpleK200072(Predicate)Polaris(Subject Device)Comparison
Permeation andDegradation Testsof OtherSubstancesASTM D6978-05(2019)Passed permeationtesting for:Fentanyl citrateSimulated gastric acid50/50 mix of fentanyland gastric acidPassed permeationtesting for:Fentanyl citrateSimulated gastric acid50/50 mix of fentanyland gastric acidSame
Carmustine andThioTEPAPermeation TimeASTM D6978-05(2019)Carmustine: 3.6minutesThioTEPA: 15.9minutesCarmustine: 78.1minutesThioTEPA: >240minutesDifferent: The predicatewas below minimumpermeation time of 240minutes specified in thestandard for Carmustineand ThioTEPA while thesubject device is onlybelow the minimumpermeation time of 240minutes specified in thestandard forCarmustine.
Carmustine andThioTEPACaution/ WarningStatementsNAWARNING: Not foruse with:Carmustine,ThioTEPACaution: The followingchemotherapy drug hasa low permeation time:Carmustine(3.3mg/ml): 78.1minutesDifferent: The predicatehas a warning due toextremely lowpermeation times whilethe subject device haslesser "CautionStatement" based onpermeation times >70minutes.
Dimensions:Overall LengthASTM D6319Minimum: 230 mmAll sizes comply withlength dimensionsAll sizes comply withlength dimensionsSame
Dimensions: Width(mean)ASTM D6319Minimum: 70 +10mmAll sizes comply withwidth dimensionsAll sizes comply withwidth dimensionsSame
Dimensions: Palm& Finger ThicknessASTM D6319Minimum Palm:0.05mmMinimum Finger:0.05mmAll sizes comply withPalm & FingerThickness dimensionsAll sizes comply withPalm & FingerThickness dimensionsSame
AttributesStandard WhereLimits Test LimitsSetPurpleK200072(Predicate)Polaris(Subject Device)Comparison
TensileStrength:Before & AfterAgingASTM D6319Min Before: 14MPaAfter: 14MpaComplies bothbefore and afteraccelerated aging.Complies bothbefore and afteraccelerated aging.Same
UltimateElongationBefore & AfteragingASTM D6319Minimum: Before:500%After:400%Complies both beforeand after acceleratedaging.Complies bothbefore and afteraccelerated aging.Same
Freedom fromPinholesASTM D6319 G1,AQL 2.57 Accept8 RejectPass(AQL 1.5)Pass(AQL 0.65)Same: Bothgloves passthe tests.The subjectglove AQL istighter andallows fewerpinholedefects.
Powder-FreeASTM D6319-19(2019) Maximum<2mg/glovePassed at <2mg /glove in accordancewith the standardPassed at <2mg /glove inaccordance withthe standardSame
BiocompatibilityAcute SystemicToxicityISO 10993-11:2017(E) —Biologicalevaluation ofmedical devices -Part 11: Tests forsystemic toxicityPassPassSame
BiocompatibilitySkin IrritationANSI/AAMI/ISO10993-23:2021(E) -Biologicalevaluation ofmedical devices -Part 23: Tests forirritationPassPassSame
AttributesStandard WhereLimits Test LimitsSetPurpleK200072(Predicate)Polaris(Subject Device)Comparison
BiocompatibilitySkinSensitizationISO 10993-23:2021(E) —Biologicalevaluation ofmedical devices –Part 10: Tests forskin sensitizationPassPassSame

Table 5.3. Comparison between Subject and Predicate Devices

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9. Summary of Non-Clinical Performance Tests:

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 (FDA Recognition number 6-446)
  • . ASTM D5151-19 Standard Test Method for Detection of Holes in Medical Gloves (FDA Recognition number 6-424)
  • . ASTM D6124-06 (Reapproved 2017) Standard Test Method for Residual Powder on Medical Gloves (FDA Recognition number 6-178)
  • . ASTM D6978-05 (Reapproved 2019) Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs (FDA Recognition number 6-147)
  • . ISO 2859-1:1999 Sampling Procedures and Tables for Inspection by Attributes. (FDA Recognition number 5-88)
  • . ASTM D412-2006a (Reapproved 2013) Standard Test Method for Vulcanized Rubber and Thermoplastic Elastomers-Tension (FDA Recognition number 8-596)
  • . ASTM D573-2004 (Reapproved 2010) Standard Test Method for Rubber-Deterioration in an Air Oven (No FDA Recognition number)
  • ASTM D3767-03 (2020) Standard Practice for Rubber Measurement of Dimensions (No FDA Recognition number)
  • . ASTM D7103-19 Standard guide for assessment of medical gloves (FDA Recognition number 6-444)
  • . ANSI/AAMI/ISO 10993-23:2021(E) - Biological evaluation of medical devices -Part 23: Tests for irritation (FDA Recognition number 2-291)
  • . ANSI/AAMI/ISO 10993-10:2021(E)- Biological evaluation of medical devices -Part 10: Tests for skin sensitization (FDA Recognition number 2-296)
  • . ANSI/AAMI/ISO 10993-11:2017(E) – Biological evaluation of medical devices – Part 11: Tests for systemic toxicity. (FDA Recognition number 2-255)

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  • ANSI/AAMI/ISO 10993-12:2021(E) Biological evaluation of medical devices Part 12: Sample preparation and reference material. (FDA Recognition number 2-289)
  • ANSI/AAMI/ISO 10993-2:2022(E) Biological evaluation of medical devices -Part 2: Animal welfare requirements (FDA Recognition number 2-222)

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Brief descriptionof non-clinicaltests:TestStandardAcceptance CriteriaResults
DimensionsASTM D 6319MeetsRequirements
Length220 mm minimum(XS, S)230 mm minimum(M, L, XL)
Width (mean)70 mm minimum (XS)80 mm minimum (S)95 mm minimum (M)110 mm minimum (L)120 mm minimum(XL)
Finger ThicknessPalm Thickness0.05 mm minimum0.05 mm minimum
Physical PropertiesASTM D 6319AQL 4MeetsRequirements
BeforeTensile Strength: $\geq$ 14 MPaUltimate elongation: $\geq$ 500%AfterTensile Strength: $\geq$ 14 MPaUltimate elongation:400%
Freedom fromPinholesASTM D 5151AQL 2.5No leakageMeetsRequirements
Power - FreeASTM D 6124$\leq$ 2 mg / gloveMeetsRequirements
ISOIrritationStudyISO 10993, Part 23No irritationUnder theconditions ofthe study thedevice is not anirritant.
ISO Acute SystemicISO 10993, Part 11No systemic toxicityNo evidence of
ToxicityStudyAcute systemictoxicity
ISO DermalSensitizationISO 10993, Part 10No sensitizationUnder theconditionsof the study thedevice is not asensitizer
Standard PracticeforAssessment ofResistance ofMedicalGloves toPermeationby ChemotherapyDrugsASTM D6978-05No signs ofbreakthrough for thesubject device up to240 minutes. Anydrugs performing atless than 240 minutesare specified as such.Refer to Table 5.2 forMinimumbreakthroughdetection timesBreakthrough wasmeasuredfor up to 240minutes for eachof the 24chemotherapydrugs and opioiddrug listed above.Refer to Table 5.2for minimumbreakthroughdetection times.

Table 5.4 Description of Non-Clinical Tests

{15}------------------------------------------------

  1. Summary of Clinical Performance Testing: Not applicable.

11. Conclusion:

The conclusions drawn from the nonclinical tests demonstrate that, the 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, is as safe, as effective, and performs as well as or better than the predicate device, the KIMTECH™ Purple Nitrile Powder-Free Exam Glove cleared in K200072.

§ 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.