K Number
K240080
Date Cleared
2024-04-02

(82 days)

Product Code
Regulation Number
880.6250
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The glove is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. Gloves have been tested for use with chemotherapy drugs and Fentanyl Citrate using ASTM D6978-05(2019)

Device Description

Aloe Vera Nitrile Examination Gloves (Green) Tested for Use with Chemotherapy Drugs and Fentanyl Citrate are Class I Patient Examination Gloves and Specialty Chemotherapy Gloves. They are ambidextrous and come in different sizes - Extra Small, Small, Medium, Large, Extra Large and XXL. Gloves meet the specification of ASTM D6319-19 and have been tested for resistance to permeation by chemotherapy drugs and Fentanyl Citrate as per ASTM D6978-05(2019). The gloves are single use, disposable, and provided non-sterile.

AI/ML Overview

The provided document describes the acceptance criteria and study results for the "Aloe Vera Nitrile Examination Gloves (Green) Tested for Use with Chemotherapy Drugs and Fentanyl Citrate" (K240080).

Here's the breakdown:

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria for the gloves are based on various physical characteristics, chemical permeation resistance (as per ASTM D6978-05(2019)), and biocompatibility tests (as per ISO 10993 standards). The reported device performance is compared to these criteria and, in some cases, to a predicate device (K200671).

Physical and Design Characteristics (Meeting ASTM D6319-19):

CharacteristicAcceptance Criteria (Subject Device K240080)Reported Device Performance (Subject Device K240080)
Length (Minimum)XS: ≥ 220 mm, S: ≥ 220 mm, M: ≥ 230 mm, L: ≥ 230 mm, XL: ≥ 230 mm, XXL: ≥ 230 mmMeets ASTM D6319-19 requirements
Palm Width (mm)XS: 70±10, S: 80±10, M: 95±10, L: 110±10, XL: 120±10, XXL: 130±10Meets ASTM D6319-19 requirements
Thickness (mm) (Minimum)Finger: 0.05, Palm: 0.05Meets ASTM D6319-19 requirements
Tensile Strength, Before Aging, min14 MPa14 MPa
Ultimate Elongation, Before Aging, min500%500%
Tensile Strength, After Accelerated Aging, min14 MPa14 MPa
Ultimate Elongation, After Accelerated Aging, min400%400%
Freedom from holesG-I, AQL 2.5G-I, AQL 2.5
Powder residual≤ 2 mg per glove≤ 2 mg per glove

Chemotherapy Permeation Resistance (ASTM D6978-05(2019)):

Chemotherapy DrugAcceptance Criteria (Minimum Permeation Time from Predicate or Acceptable Performance)Reported Device Performance (Minimum BDT in Minutes for K240080)
Carmustine 3.3 mg/ml (3,300 ppm)Similar to predicate (23.4 minutes)21.2
Cisplatin, 1mg/ml (1000 ppm)N/A (predicate did not test this)>240
Cyclophosphamide 20mg/ml (20,000 ppm)>240>240
Dacarbazine, 10 mg/ml (10,000 ppm)N/A (predicate did not test this)>240
Doxorubicin HCL, 2 mg/ml (2,000 ppm)>240>240
Etoposide, 20 mg/ml (20,000 ppm)>240>240
Fluorouracil (5 Flu), 50mg/ml (50,000ppm)>240>240
Methotrexate, 25mg/ml (25,000ppm)>240>240
Mitomycin C, 0.5mg/ml (500 ppm)N/A (predicate did not test this)>240
Paclitaxel, 6mg/ml (6,000ppm)>240>240
Thiotepa, 10mg/ml (10,000ppm)Similar to predicate (64.9 minutes)24.9
Vincristine sulfate, 1mg/ml (1000 ppm)>240>240

Fentanyl Citrate Permeation Resistance (ASTM D6978-05(2019)):

Fentanyl CitrateAcceptance Criteria (Minimum Permeation Time)Reported Device Performance (Minimum BDT in Minutes for K240080)
Fentanyl Citrate Injection, 100mcg/2mg>240>240

Biocompatibility (ISO 10993 Standards):

TestAcceptance CriteriaReported Device Performance (K240080)
In vitro Cytotoxicity ISO 10993-5Absence of cytotoxicity or similar to predicate (cytotoxic at certain dilutions, non-cytotoxic at others)Showed potential toxicity to L929 cells (similar to predicate which was cytotoxic at higher concentrations).
Acute Systemic Toxicity Test ISO 10993-11No evidence of acute systemic toxicityNo evidence of acute systemic toxicity.
Dermal Sensitization ISO 10993-10No evidence of causing skin sensitizationNo evidence of causing skin sensitization.
Primary Skin Irritation ISO 10993-23Negligible response/not an irritantResponse categorized as negligible under the test condition.

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

The document does not explicitly state the specific sample sizes used for each test. However, it indicates that tests were conducted according to recognized international standards such as ASTM D6319-19 (Standard Specification for Nitrile Examination Gloves for Medical Application), ASTM D6978-05(2019) (Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs), and ISO 10993 series for biocompatibility. These standards typically specify the number of samples required for testing.

The data provenance is not explicitly stated as 'country of origin' in that format, but the applicant is "Syntex Healthcare Products Co., Ltd" from "Xinji, Hebei, China," indicating the testing likely occurred under their purview or by contracted labs. The studies appear to be prospective testing conducted specifically for this premarket notification.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

This information is not applicable as the document describes performance testing of a physical medical device (gloves) against established engineering and biocompatibility standards. It does not involve interpretation of medical images or patient data by human experts for ground truth establishment.

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

This information is not applicable for the same reason as point 3. Testing involves objective measurements against predefined standards.

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 information is not applicable as the device is a medical glove, not an AI-powered diagnostic or assistive tool.

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

This information is not applicable as the device is a medical glove, not an algorithm.

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

The "ground truth" for this device's performance is based on established international and national standards for medical gloves:

  • ASTM D6319-19: for physical dimensions and integrity (e.g., freedom from holes, tensile strength).
  • ASTM D6978-05(2019): for resistance to permeation by chemotherapy drugs and Fentanyl Citrate, where "breakthrough detection time" is the key metric.
  • ISO 10993 series (ISO 10993-5, -10, -11, -23): for biocompatibility assessments like cytotoxicity, sensitization, irritation, and systemic toxicity.

8. The sample size for the training set

This information is not applicable as the device is a physical product and does not involve machine learning or AI models with training sets.

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

This information is not applicable as the device is a physical product and does not involve machine learning or AI models.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA acronym along with the full name of the agency on the right. The FDA part of the logo is in blue, with the acronym in a square and the full name, "U.S. Food & Drug Administration," written out next to it.

April 2, 2024

Syntex Healthcare Products Co., Ltd. Zhiqiang Qiao General Manager No. 1, Fanjiazhuang Industrial Zone Xinji, Hebei 052360 China

Re: K240080

Trade/Device Name: Aloe Vera Nitrile Examination Gloves (Green) Tested for Use with Chemotherapy Drugs and Fentanyl Citrate 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: January 10, 2024 Received: January 11, 2024

Dear Zhiqiang Oiao:

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 (the 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 available 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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device"

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(https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30. Design controls; 21 CFR 820.90. Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review. the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 Part 803) for devices or postmarketing safety reporting (21 CFR Part 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 Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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.

For Bifeng Qian, M.D., Ph.D. Assistant Director DHT4B: Division of Infection Control and Plastic and Reconstructive Surgery Devices

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OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K240080

Device Name

Aloe Vera Nitrile Examination Gloves (Green) Tested for Use with Chemotherapy Drugs and Fentany) Citrate

Indications for Use (Describe)

The glove is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

Gloves have been tested for use with chemotherapy drugs and Fentany] Citrate using ASTM D6978-05(2019) The following chemicals have been tested with these gloves:

Chemotherapy DrugMinimum Breakthrough Detection Time in Minutes
Carmustine 3.3 mg/ml (3,300 ppm)21.2
Cisplatin, 1mg/ml (1000 ppm)>240
Cyclophosphamide 20mg/ml (20,000 ppm)>240
Dacarbazine, 10 mg/ml (10,000 ppm)>240
Doxorubicin HCL, 2 mg/ml (2,000 ppm)>240
Etoposide, 20 mg/ml (20,000 ppm)>240
Fluorouracil (5 Flu), 50mg/ml (50,000ppm)>240
Methotrexate, 25mg/ml (25,000ppm)>240
Mitomycin C, 0.5mg/ml (500 ppm)>240
Paclitaxel, 6mg/ml (6,000ppm)>240
Thiotepa, 10mg/ml (10,000ppm)24.9
Vincristine sulfate, 1mg/ml (1000 ppm)>240
Fentanyl CitrateMinimum Breakthrough Detection Time in Minutes
Fentanyl Citrate Injection, 100mcg/2mg>240

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

Carmustine: 21.2 minutes, Thio Tepa: 24.9minutes

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.

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The assigned 510(K) numbers: K240080

Date Prepared: March 14, 2024

1. Owner's Identification:

Syntex Healthcare Products Co., Ltd No. 1, Fanjiazhuang Industrial Zone, Xinji City, Hebei Province, 052360, China Contact: Mr. Qiao Zhiqiang / General Manager Tel:86-311-66179668 Email: fdareg@hongray.com.cn or janicema(@hongrayusa.com

2. Device Identification:

Trade / Product Name: Aloe Vera Nitrile Examination Gloves (Green) Tested for Use with Chemotherapy Drugs and Fentanyl Citrate Common Name: Exam Gloves Classification Name: Non-powdered patient examination glove Classification Regulation: 21 CFR 880.6250 Product Code: LZA, LZC, ODO, OPJ Classification Panel: General Hospital Device Class: Class I

3. Predicate Device Information:

Ansell Healthcare Products LLC. Microflex® Nitrile Patient Examination Gloves with Aloe and Chamomile Pink Colored Tested for Use with Chemotherapy Drugs and Fentanyl Citrate (K200671) Regulation Number: 21 CFR 880.6250 Regulation Name: Non-Powdered Patient Examination Glove Regulatory Class: Class I. Product Code: LZA, LZC, QDO

4. Device Description:

Aloe Vera Nitrile Examination Gloves (Green) Tested for Use with Chemotherapy Drugs and Fentary) Citrate are Class I Patient Examination Gloves and Specialty Chemotherapy Gloves. They are ambidextrous and come in different sizes - Extra Small, Small, Medium, Large, Extra Large and XXL. Gloves meet the specification of ASTM D6319-19 and have been tested for resistance to permeation by chemotherapy drugs and Fentanyl Citrate as per ASTM D6978-05(2019). The gloves are single use, disposable, and provided non-sterile.

5. Indications for Use:

The glove is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

Gloves have been tested for use with chemotherapy drugs and Fentanyl Citrate using ASTM D6978-05(2019) The following chemicals have been tested with these gloves:

Chemotherapy DrugMinimum Breakthrough Detection Time in Minutes
Carmustine 3.3 mg/ml (3,300 ppm)21.2
Cisplatin, 1mg/ml (1000 ppm)>240
Cyclophosphamide 20mg/ml (20,000 ppm)>240
Dacarbazine, 10 mg/ml (10,000 ppm)>240
Doxorubicin HCL, 2 mg/ml (2,000 ppm)>240
Etoposide, 20 mg/ml (20,000 ppm)>240

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Fluorouracil (5 Flu), 50mg/ml (50,000ppm)>240
Methotrexate, 25mg/ml (25,000ppm)>240
Mitomycin C, 0.5mg/ml (500 ppm)>240
Paclitaxel, 6mg/ml (6,000ppm)>240
Thiotepa, 10mg/ml (10,000ppm)24.9
Vincristine sulfate, 1mg/ml (1000 ppm)>240
Fentanyl CitrateMinimum Breakthrough Detection Time in Minutes
Fentanyl Citrate Injection, 100mcg/2mg>240

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

Carmustine: 21.2 minutes, Thiotepa: 24.9 minutes

Warning: Do not use with Carmustine and Thiotepa.

6. Comparison of Subject Device and Predicate Device:

The following tables are summaries of the technological characteristics, biocompatibility and testing for use with chemotherapy drugs & Fentanyl Citrate of the subject and predicate devices. General Comparison Table:

Characteristics andParametersSubject DeviceK240080Predicate DeviceK200671ComparisonResult
Trade NameAloe Vera Nitrile Examination Gloves(Green) Tested for Use withChemotherapy Drugs and FentanylCitrateMicroflex® Nitrile PatientExamination Gloves with Aloe andChamomile Pink Colored Tested forUse with Chemotherapy Drugs andFentanyl CitrateDifferent*
Product CodeLZA, LZC, QDO,OPJLZA, LZC,QDODifferent**
Regulation Number21 CFR 880.625021 CFR 880.6250Same
ClassIISame
Indications for UseThe glove is a disposable deviceintended for medical purposes that isworn on the examiner's hand toprevent contamination betweenpatient and examiner.Gloves have been tested for use withchemotherapy drugs and FentanylCitrate using ASTM D6978-05(2019)The glove is a disposable deviceintended for medical purposes that isworn on the examiner's hand toprevent contamination betweenpatient and examiner.The gloves have been tested for use withchemotherapy drugs and FentanylCitrate using ASTM D6978-05(2019)Same
MaterialSynthetic nitrile rubberSynthetic nitrile rubberSame
ColorGreenPinkDifferent***
Design• Single Use• Non-sterile• Powder-Free• Ambidextrous• Beaded cuff• Single Use• Non-sterile• Powder-Free• Ambidextrous• Beaded cuffSame
Chemotherapy Drugsand Fentanyl CitrateClaimSee below comparison tableSee below comparison table/

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AloeAloe coated on the donning surfaceAloe and Chamomile coated on the donning surfaceSame
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  • The trade name will be provided on the labeling, so the different does not raise any safety concerns.

** QDO and OPJ, both designated for Medical Gloves with Fentanyl Labeling Claims - Test For Use With Fentanyl, the subject device added the product code OPJ as per requirements but does not raise questions of safety and effectiveness.

*** The finished subject device has been tested with performance and Biocompatibility, all the test results meet the requirements, so the difference of color does not raise questions of safety and effectiveness.

Technological Characteristic Comparison Table:

Technological CharacteristicsSubject DeviceK240080Predicate DeviceK200671ComparisonResult
LengthMinimumXS: ≥ 220 mmS: ≥ 220 mmM: ≥ 230 mmL: ≥ 230 mmXL: ≥ 230 mmXXL: ≥ 230 mmMinimumXS: ≥ 220 mmS: ≥ 220 mmM: ≥ 230 mmL: ≥ 230 mmXL: ≥ 230 mmSimilar*
Palm Width (size) (mm)
XS70±1070±10Same
S80±1080±10Same
M95±1095±10Same
L110±10110±10Same
XL120±10120±10Same
XXL130±10/Different*
Thickness (mm) (Minimum)
Finger0.050.05Same
Palm0.050.05Same
Tensile Strength, Before Aging,min14MPa16MPaSimilar*
Ultimate Elongation,Before Aging, min500%500%Same
Tensile Strength, AfterAccelerated Aging, min14MPa14MPaSame
Ultimate Elongation, AfterAccelerated Aging, min400%400%Same
Freedom from holesMeet ASTMD6319 andsimilar
G-I, AQL 2.5G-I, AQL 2.5
Powder residualResidual Powder: ≤ 2 mg pergloveResidual Powder: ≤ 2 mg pergloveSame
In vitro CytotoxicityISO 10993-5Under the conditions of this study,the test article showed potentialtoxicity to L929 cells.Under the conditions of thestudy, undiluted, 1:2, 1:4, 1:8,1:16 dilution was cytotoxic., 1:32and 1:64 are not cytotoxicSame

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Acute Systemic Toxicity TestISO 10993-11Under the conditions of this study, there was no evidence of acute systemic toxicity from the test article.Under the conditions of the study, no evidence of acute systemic toxicitySame
Dermal SensitizationISO 10993-10Under the conditions of this study, the test article showed no evidence of causing skin sensitizationUnder the conditions of the study, not a sensitizerSame
Primary Skin IrritationISO 10993-23The test result showed that the response of the test article was categorized as negligible under the test condition.Under the conditions of the study, not an irritantSame

*The subject device has Size XXL and the predicate device has not size XXL, but the subject device has been tested according to ASTM D6319-19 for dimensions meet the requirements of ASTM D6319-19. It can demonstrate the effectiveness of the subject device.

Chemotherapy Permeation and Fentanyl Citrate Comparison Claim:

Tested Chemotherapy Drug and ConcentrationMinimum BDT (Minutes)ComparisonResult
Subject DeviceK240080Predicate DeviceK200671
Carmustine 3.3 mg/ml (3,300 ppm)21.223.4Similar *
Cisplatin, 1mg/ml (1000 ppm)>240/Different*
Cyclophosphamide 20mg/ml (20,000 ppm)>240>240Same
Dacarbazine, 10 mg/ml (10,000 ppm)>240/Different*
Doxorubicin HCL, 2 mg/ml (2,000 ppm)>240>240Same
Etoposide, 20 mg/ml (20,000 ppm)>240>240Same
Fluorouracil (5 Flu), 50mg/ml (50,000ppm)>240>240Same
Methotrexate, 25mg/ml (25,000ppm)>240>240Same
Mitomycin C, 0.5mg/ml (500 ppm)>240/Different*
Paclitaxel, 6mg/ml (6,000ppm)>240>240Same
Thiotepa, 10mg/ml (10,000ppm)24.964.9Similar*
Vincristine sulfate, 1mg/ml (1000 ppm)>240>240Same
Minimum BDT (Minutes)
Fentanyl CitrateSubject DeviceK240080Predicate DeviceK200671ComparisonResult
Fentanyl Citrate Injection (100 mcg/2ml)>240>240Same
  • Chemotherapy drugs and the minimum breakthrough time of subject device will be listed on labeling, so this difference and similar does not raise questions of safety and effectiveness of subject device.

7. Clinical Performance Data

Not applicable.

8. Conclusion:

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

§ 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.