K Number
K240629
Date Cleared
2024-05-28

(83 days)

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

The Nitrile Disposable Examination Gloves, Tested for Use with Chemotherapy Drugs and Fentanyl, 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. The tested drugs are: Chemotherapy drug Concentration Minimum Breakthrough Detection Time Bleomycin sulfate (15.0 mg/ml 15,000 ppm) 240 min Carboplatin (10.0 mg/ml 10,000 ppm) 240 min Carmustine (BCNU) (3.3mg/mL 3,300 ppm) 26.7 Cisplatin (1.0 mg/mL 1,000 ppm) 240 min Cyclophosphamide (20.0 mg/mL 20,000 ppm) 240 min Cytarabine (Cytosine) (100.0 mg/mL 100,000 ppm) 240 min Dacarbazine (10.0 mg/mL 10,000 ppm) 240 min Doxorubicin HCL (2.0 mg/mL 2,000 ppm) 240 min Etoposide (Toposar) (20.0 mg/mL 20,000 ppm) 240 min Fluorouracil (5 Flu) (50.0 mg/mL 50,000 ppm) 240 min Idarubicin (1.0 mg/ml 1,000 ppm) 240 min Ifosfamide (50.0 mg/mL 50,000 ppm) 240 min Mechlorethamine HCL (1.0 mg/ml 1,000 ppm) 240 min Methotrexate (25.0 mg/mL 25,000 ppm) 240 min Mitomycin C (0.5 mg/mL 500 ppm) 240 min Mitoxantrone HCL (2.0 mg/mL 2,000 ppm 240 min Paclitaxel (6.0 mg/mL 6,000 ppm) 240 min Thiotepa (10.0 mg/mL 10,000 ppm) 37.6 Vincristine Sulfate (1.0 mg/mL 1,000 ppm 240 min Non Chemotherapy Drug MESNA (100.0 mg/mL 100,000 ppm) 240 min Trisenox (1.0 mg/ml 1,000 ppm) 240 min Fentanyl Citrate Injection (100 mcg/2mL) 240 min Note: Carmustine and Thiotepa have extremely low permeation times of 26.7 and 37.6 minutes respectively. Warning: Do Not Use with Carmustine, Thiotepa.

Device Description

The Nitrile Disposable Examination Gloves, Tested for Use with Chemotherapy Drugs and Fentanyl are non-sterile, single use only, disposable examination gloves intended for medical purposes to be worn by examiners to prevent contamination between the patient and the examiner. The gloves are blue color, powder free, nitrile ambidextrous gloves are offered in four sizes, small, medium and large, extra-large, packed in a paper box. The gloves are designed and manufactured in accordance with the ASTM D6319-19 standard and are tested for use with chemotherapy drugs and Fentanyl per ASTM D6978-05 (Reapproved 2019). The gloves are as same as the Nitrile disposable examination gloves (Model D5000) cleared under K212578 also produced by Xingyu Medical Tech Co., Ltd. The materials and the manufacturing process technology are the same. The proposed device is increased test of Chemotherapy Drug and Fentanyl. Testing has been conducted on the proposed device passed as per ASTM D6978-05 (Reapproved 2019).

AI/ML Overview

This document is a 510(k) Premarket Notification from the FDA regarding "Nitrile Disposable Examination Gloves, Tested for Use with Chemotherapy Drugs and Fentanyl". It does not describe an AI medical device. Therefore, I cannot provide an answer based on the prompt's request for AI-specific acceptance criteria and study details.

The document focuses on the physical and chemical properties of medical gloves, their resistance to certain drugs, and their biocompatibility, which are assessed through standard laboratory testing methods, not AI performance studies.

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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 FDA name on the right. The symbol is a stylized representation of a human figure, while the FDA name is written in blue and includes the words "U.S. Food & Drug Administration".

May 28, 2024

Xingyu Medical Tech Co., Ltd. % Amanda Sun Technical Shanghai Sungo Management Consulting Company Limited 14th Floor, 1500# Central Avenue Shanghai, Shanghai 200122 China

Re: K240629

Trade/Device Name: Nitrile Disposable Examination Gloves, 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, OPJ, QDO Dated: February 18, 2024 Received: March 6, 2024

Dear Amanda Sun:

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.

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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" (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 QS 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 mediation-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).

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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

Enclosure

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Indications for Use

510(k) Number (if known) K240629

Device Name

Nitrile Disposable Examination Gloves, Tested for Use with Chemotherapy Drugs and Fentanyl

Indications for Use (Describe)

The Nitrile Disposable Examination Gloves, Tested for Use with Chemotherapy Drugs and Fentany], 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. The tested drugs are: Chemotherapy drug Concentration Minimum Breakthrough Detection Time Bleomycin sulfate (15.0 mg/ml 15,000 ppm) 240 min

Carboplatin (10.0 mg/ml 10,000 ppm) 240 min

Carmustine (BCNU) (3.3mg/mL 3,300 ppm) 26.7

Cisplatin (1.0 mg/mL 1,000 ppm) 240 min

Cyclophosphamide (20.0 mg/mL 20,000 ppm) 240 min

Cytarabine (Cytosine) (100.0 mg/mL 100,000 ppm) 240 min

Dacarbazine (10.0 mg/mL 10,000 ppm) 240 min

Doxorubicin HCL (2.0 mg/mL 2,000 ppm) 240 min

Etoposide (Toposar) (20.0 mg/mL 20,000 ppm) 240 min

Fluorouracil (5 Flu) (50.0 mg/mL 50,000 ppm) 240 min

Idarubicin (1.0 mg/ml 1,000 ppm) 240 min

Ifosfamide (50.0 mg/mL 50,000 ppm) 240 min

Mechlorethamine HCL (1.0 mg/ml 1,000 ppm) 240 min

Methotrexate (25.0 mg/mL 25,000 ppm) 240 min

Mitomycin C (0.5 mg/mL 500 ppm) 240 min

Mitoxantrone HCL (2.0 mg/mL 2,000 ppm 240 min

Paclitaxel (6.0 mg/mL 6,000 ppm) 240 min

Thiotepa (10.0 mg/mL 10,000 ppm) 37.6

Vincristine Sulfate (1.0 mg/mL 1,000 ppm 240 min

Non Chemotherapy Drug MESNA (100.0 mg/mL 100,000 ppm) 240 min Trisenox (1.0 mg/ml 1,000 ppm) 240 min Fentanyl Citrate Injection (100 mcg/2mL) 240 min

Note: Carmustine and Thiotepa have extremely low permeation times of 26.7 and 37.6 minutes respectively. Warning: Do Not Use with Carmustine, 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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510(K) Summary

K240629

Summary Preparation Date: May 14, 2024

A. Applicant:

Name: Xingyu Medical Tech Co., Ltd. Address: No.2189 Yaoqian Road, Gaomi Economic Development Zone, Weifang City, Shandong Province, China Contact: Ms. Carrie Lee Title: QA Manager Tel: +86-0536-2588123 Email: medical@xingyugloves.com

Submission Correspondent: Primary contact: Ms. Amanda Sun Shanghai SUNGO Management Consulting Co., Ltd. Room 1401, Dongfang Building, 1500# Century Ave., Shanghai 200122, China Tel: +86-21-58817802 Email: jingyu.sun@sungoglobal.com Secondary contact: Mr. Raymond Luo Room 1401, Dongfang Building, 1500# Century Ave., Shanghai 200122, China Tel: +86-21-68828050 Email: zxfda@sungoglobal.com

B. Device:

Trade Name: Nitrile Disposable Examination Gloves, Tested for Use with Chemotherapy Drugs and Fentanyl Common Name: Nitrile Patient Examination Gloves (Powder Free) Size(s): S, M, L, XL

Regulatory Information

Classification Name: Non-Powdered Patient Examination Glove Classification: Class I Product code: LZA, LZC, OPJ, QDO Requlation Number: 21 CFR 880.6250 Review Panel: General Hospital

C. Predicate device:

Primary Predicate Device: K232266 Powder Free Nitrile Patient Examination Gloves, Blue Colored, Non Sterile, Tested for Use with Chemotherapy Drugs and Fentanyl Citrate Better Care Plastic Technology Co., Ltd.

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Reference Device K212578 Nitrile disposable examination gloves Xingyu Medical Tech Co., Ltd.

D. Indications for use of the device:

The Nitrile Disposable Examination Gloves, Tested for Use with Chemotherapy Drugs and Fentanyl,

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.

The tested drugs are:

DrugsConcentrationMinimum BreakthroughDetection Time
The tested chemotherapy drugs are:
Bleomycin sulfate(15.0 mg/ml 15,000 ppm)>240 min
Carboplatin(10.0 mg/ml 10,000 ppm)>240 min
Carmustine (BCNU)(3.3mg/mL 3,300 ppm)26.7
Cisplatin(1.0 mg/mL 1,000 ppm)>240 min
Cyclophosphamide(20.0 mg/mL 20,000 ppm)>240 min
Cytarabine (Cytosine)(100.0 mg/mL 100,000 ppm)>240 min
Dacarbazine(10.0 mg/mL 10,000 ppm)>240 min
Doxorubicin HCL(2.0 mg/mL 2,000 ppm)>240 min
Etoposide (Toposar)(20.0 mg/mL 20,000 ppm)>240 min
Fluorouracil (5 Flu)(50.0 mg/mL 50,000 ppm)>240 min
Idarubicin(1.0 mg/ml 1,000 ppm)>240 min
Ifosfamide(50.0 mg/mL 50,000 ppm)>240 min
Mechlorethamine HCL(1.0 mg/ml 1,000 ppm)>240 min
Methotrexate(25.0 mg/mL 25,000 ppm)>240 min
Mitomycin C(0.5 mg/mL 500 ppm)>240 min
Mitoxantrone HCL(2.0 mg/mL 2,000 ppm)>240 min
Paclitaxel(6.0 mg/mL 6,000 ppm)>240 min

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Thiotepa(10.0 mg/mL 10,000 ppm)37.6
Vincristine Sulfate(1.0 mg/mL 1,000 ppm)>240 min
The tested non-chemotherapy drugs are:
MESNA(100.0 mg/mL 100,000 ppm)>240 min
Trisenox (Arsenic Trioxide)(1.0 mg/ml 1,000 ppm)>240 min
Fentanyl Citrate Injection(100 mcg/2mL)>240 min

Note: Carmustine and Thiotepa have extremely low permeation times of 26.7 and 37.6 minutes respectively.

Warning: Do Not Use with Carmustine, Thiotepa

E. Device Description:

The Nitrile Disposable Examination Gloves, Tested for Use with Chemotherapy Drugs and Fentanyl are non-sterile, single use only, disposable examination gloves intended for medical purposes to be worn by examiners to prevent contamination between the patient and the examiner. The gloves are blue color, powder free, nitrile ambidextrous gloves are offered in four sizes, small, medium and large, extra-large, packed in a paper box.

The gloves are designed and manufactured in accordance with the ASTM D6319-19 standard and are tested for use with chemotherapy drugs and Fentanyl per ASTM D6978-05 (Reapproved 2019). The gloves are as same as the Nitrile disposable examination gloves (Model D5000) cleared under K212578 also produced by Xingyu Medical Tech Co., Ltd. The materials and the manufacturing process technology are the same. The proposed device is increased test of Chemotherapy Drug and Fentanyl. Testing has been conducted on the proposed device passed as per ASTM D6978-05 (Reapproved 2019).

F. Summary of Technological Characteristics

Table 2 Comparison of Proposed, Predicate Devices and Reference Device

DeviceProposed DevicePredicate DeviceReference DeviceResult
510K #K240629K232266K212578N/A
ManufacturerXINGYU MEDICAL TECHCO.,LTDBetter Care PlasticTechnology Co., Ltd.XINGYU MEDICAL TECHCO.,LTDDifferent fromPredicateSame as Reference

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Product NameNitrile Examination Disposable Gloves, Tested for Use with Chemotherapy Drugs and FentanylPowder Free Nitrile Patient Examination Gloves, Blue Colored, Non Sterile, Tested for Use with Chemotherapy Drugs and Fentanyl CitrateNitrile disposable examination gloves-
Product CodeLZA (primary), LZC, OPJ, QDOLZA (primary), LZC, OPJ, QDOLZASame
Regulation Number21 CFR 880.625021 CFR 880.625021 CFR 880.6250Same
Indications for useThe Nitrile Disposable Examination Gloves, Tested for Use with Chemotherapy Drugs and Fentanyl, 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.The tested chemotherapy drugs are:The device 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.The following Chemotherapy Drugs have been tested with these gloves:Nitrile Disposable Examination Gloves are non-sterile disposable device intended for medical purposes that is worn on the examiner's hand or finger to prevent contamination between patient and examiner.① Similar as K232266
DrugsThe tested chemotherapy drugs are:Bleomycin sulfate (15.0 mg/ml 15,000 ppm)Carboplatin (10.0 mg/ml 10,000 ppm)Carmustine (BCNU) (3.3mg/mL 3,300 ppm)Cisplatin (1.0 mg/ml 1,000 ppm)-Cyclophosphamide (20.0 mg/ml. 20,000 ppm)Cytarabine (Cytosine) (100.0 mg/ml 100,000 ppm)Dacarbazine (10.0 mg/ml 10,000 ppm)Doxorubicin HCL (2.0 mg/mL 2.000 ppm)Etoposide (Toposar) (20.0 mg/ml 20,000 ppm)Fluorouracil (5 Flu) (50.0 mg/mL 50,000 ppm)Idarubicin (1.0 mg/ml 1,000 ppm)Ifosfamide- (50.0 mg/ml 50,000 ppm)Mechlorethamine HCL (1.0 mg/ml 1,000 ppm)Methotrexate- (25.0 mg/ml, 25,000 ppm)Mitomycin C (0.5 mg/ml 500 ppm)Mitoxantrone HCL (2.0 mg/ml 2,000 ppmPaclitaxel (6.0 mg/mL 6,000 ppm)Thiotepa (10.0 mg/ml, 10,000 ppm)Vincristine Sulfate (1.0 mg/ml 1,000 ppm)The tested non-chemotherapy drugs are:MESNA (100.0 mg/ml 100,000 ppm)Trisenax (Arsenic Trioxide) (1.0 mg/ml 1,000 ppm)Fentanyl Citrate Injection (100 mcg/2mL)Note: Carmustine and Thiotepa have extremely low permeation times of 26.7 and 37.6 minutes respectively.Warning: Do Not Use with Carmustine, Thiotepa.Chemotherapy Drug Minimum Breakthrough Detection Time (BDT) in MinutesBleomycin Sulfate 15mg/ml (15000 ppm) >240Busulfan 6mg/ml (6,000 ppm) >240Carboplatin 10mg/ml (10,000 ppm) >240Carmustine (BCNU) 3.3 mg/ml (3,300 ppm) 22.8Chloroquine 50mg/ml (50,000ppm) >240Cisplatin 1mg/ml (1,000 ppm) >240+Cyclophosphamide 20mg/ml (20,000 ppm) >240Cyclosporin 100 mg/ml (100,000 ppm) >240Cytarabine HCL, 100 mg/ml (100,000 ppm) >240Dacarbazine 10 mg/ml (10,000 ppm) >240Daunorubicin HCL, 5 mg/ml (5,000 ppm) >240Docetaxel, 10 mg/ml (10,000 ppm) >240Doxorubicin HCL, 2 mg/ml (2,000 ppm) >240Epirubicin HCL, 2 mg/ml (2,000 ppm) >240Etoposide, 20 mg/ml (20,000 ppm) >240Fludarabine, 25 mg/ml (25,000 ppm) >240Fluorouracil, 50mg/ml (50,000ppm) >240+Gemcitabine, 38mg/ml (38,000ppm) >2400Idarubicin HCL, 1mg/ml (1,000ppm) >2400Ifosfamide, 50mg/ml (50,000ppm) >240Irinotecan, 20mg/ml (20,000ppm) >240Mechlorethamine HCI, 1mg/ml (1,000ppm) >240Melphalan, 5mg/ml (5,000ppm) >240Methotrexate, -25mg/ml (25,000ppm) >240Mitomycin C, 0.5mg/ml (500ppm) >240+Mitoxantrone HCL, 2mg/ml (2,000ppm) >240Oxaliplatin, 5mg/ml (5,000ppm) >240Paclitaxel, 6mg/ml (6,000ppm) >240Paraplatin, 10mg/ml (10,000ppm) >240Retrovir, 10mg/ml (10,000ppm) >2400Rituximab, 10mg/ml (10,000ppm)+ >240Thiotepa, 10mg/ml (10,000ppm) 46.9Topotecan, 1mg/ml(1,000ppm) >240Trisenox, 1mg/ml (1,000ppm) >240Velcade, 1mg/ml (1,000ppm) >240Vincristine Sulfate, 1mg/ml (1,000ppm) >240Fentanyl-Citrate Injection (100-mcg/2ml) >240Please note that the following drugs have extremely low permeation times:Carmustine: 22.8 minutes, Thiotepa: 46.9 minutes, Or*Warning: Do not use with Carmustine and Thiotepa

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SizeS, M, L, XLXS, S, M, L, XL, XXLS, M, L, XL② SimilarasK232266
PowderFreeYesYesYesSame
MaterialNitrileNitrileNitrileSame
ColorBlueBlueBlueSame
OTC useYesYesYesSame
SterilityNon-sterileNon-sterileNon-sterileSame
SinglePatient UseSinge useSinge useSinge useSame
LabelingclaimTested for Use withChemotherapy Drugs andFentanylTested for Use withChemotherapy Drugs andFentanylNot Tested for use withChemotherapy Drugs andFentanylSame asK232266
Dimensions(Length)Min 220mm for size SMin 230mm for size M-XLMin 220mm for size XS, SMin 230mm for size M-XXL230 mm min for all size② SimilarasK232266
Dimensions(width)S: 80±10M: 95±10L: 110±10XL: 120±10XS: 70±10S: 80±10M: 95±10L: 110±10XL: 120±10XXL: 130±10S: 83-89 mmM: 88-100mmL: 103-111mmXL: 114-119mm② SimilarasK232266
Dimensions(thickness)Minimum Palm ≥0.05 mmMinimum Finger ≥0.05 mmMinimum Palm ≥0.05 mmMinimum Finger ≥0.05 mmMinimum ≥ 0.09 (Finger)Minimum ≥0.05 mm(Palm)Same asK232266
PhysicalpropertiesComplies with: ASTMD6319-19Tensile Strength:Before Aging ≥14 MPa, min.After Aging ≥14 MPa, min.Elongation:Before Aging 500%, min.After Aging 400%, min.Complies with: ASTMD6319-19Tensile Strength:Before Aging ≥14 MPa, min.After Aging ≥14 MPa, min.Elongation:Before Aging 500%, min.After Aging 400%, min.Complies with: ASTM D6319-19Tensile Strength:Before Aging ≥14 MPa, min.After Aging ≥14 MPa, min.Elongation:Before Aging 500%, min.After Aging 400%, min.Same
Freedomfrom holesMeets ASTM D 6319-19Tested in accordance withASTM D5151-19 withacceptable resultsMeets ASTM D 6319-19Tested in accordance withASTM D5151-19 withacceptable resultsMeets ASTM D 6319-19Tested in accordance withASTM D5151-19 withacceptable resultsSame

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ResidualPowderMeet the requirements ofASTM D6124Meet the requirements ofASTM D6124Meet therequirements ofASTM D6124Same
Chemotherapyandnon-chemotherapy DrugsTested withMinimumBreakthroughDetectionTime astested perASTM D6978DrugsConcentrationMinimum BreakthroughDetection TimeChemotherapy DrugMinimum BreakthroughDetection Time (BDT)in MinutesNA①DifferentasK232266
The tested chemotherapy drugs are:
Bleomycin sulfate(15.0 mg/ml 15,000 ppm)>240 minBleomycin Sulfate 15mg/ml (15000 ppm)>240
Carboplatin(10.0 mg/ml 10,000 ppm)>240 minBusulfan 6mg/ml (6,000 ppm)>240
Carmustine (BCNU)(3.3mg/ml. 3,300 ppm)26.7Carboplatin 10mg/ml (10,000 ppm)>240
Cisplatine(1.0 mg/mL 1,000 ppm)>240 minCarmustine (BCNU) 3.3 mg/ml(3,300 ppm)22.8
Cyclophosphamide(20.0mg/mL 20,000 ppm)>240 minChloroquine 50mg/ml (50,000ppm)>240
Cytarabine (Cytosine)(100.0 mg/mL 100,000 ppm)>240 minCisplatin 1mg/ml (1,000 ppm)>240
Dacarbazine(10.0 mg/mL. 10,000 ppm)>240 minCyclophosphamide 20mg/ml (20,000 ppm)>240
Doxorubicin HCL(2.0 mg/mL-2,000 ppm)>240 minCyclosporin 100 mg/ml (100,000 ppm)>240
Etoposide (Toposar)(20.0 mg/ml. 20,000 ppm)>240 minCytarabine HCL, 100 mg/ml(100,000 ppm)>240
Fluorouracil (5-Flu)(50.0 mg/mL 50,000 ppm)>240 minDacarbazine 10 mg/ml (10,000 ppm)>240
Idarubicin(1.0 mg/ml 1,000 ppm)>240 minDaunorubicin HCL, 5 mg/ml (5,000 ppm)>240
Ifosfamide(50.0 mg/ml 50,000 ppm)>240 minDocetaxel, 10 mg/ml (10,000 ppm)>240
Mechlorethamine HCL(1.0 mg/ml 1,000 ppm)>240 minDoxorubicin HCL, 2 mg/ml (2,000 ppm)>240
Methotrexate(25.0 mg/mL 25,000 ppm)>240 minEpirubicin HCL, 2 mg/ml (2,000 ppm)>240
Etoposide, 20 mg/ml (20,000 ppm)>240
Mitomycin C+(0.5 mg/mL-500 ppm)>240 minFludarabine, 25 mg/ml (25,000 ppm)>240
Mitoxantrone HCL(2.0 mg/mL 2,000 ppm>240 minFluorouracil, 50mg/ml (50,000ppm)>240
Paclitaxel(6.0 mg/mL 6,000 ppm)>240 minGemcitabine, 38mg/ml (38,000ppm)>240
Thiotepa(10.0 mg/mL 10,000 ppm)37.6Idarubicin HCL, 1mg/ml (1,000ppm)>240
Vincristine Sulfate(1.0 mg/mL 1,000 ppm>240 minIfosfamide, 50mg/ml (50,000ppm)>240
The tested non-chemotherapy drugs are:Irinotecan, 20mg/ml(20,000ppm)>240
MESNA(100.0 mg/mL 100,000 ppm)>240 minMechlorethamine HCI, 1mg/ml (1,000ppm)>240
Trisenox (Arsenic Trioxide)(1.0 mg/ml 1,000 ppm)>240 minMelphalan, 5mg/ml (5,000ppm)>240
Fentanyl Citrate Injection(100 mcg/2mL)>240 minMethotrexate, 25mg/ml (25,000ppm)>240
Mitomycin C, 0.5mg/ml (500ppm)>240
Mitoxantrone HCL, 2mg/ml (2,000ppm)>240
Oxaliplatin, 5mg/ml (5,000ppm)>240
Paclitaxel, 6mg/ml (6,000ppm)>240
Paraplatin, 10mg/ml (10,000ppm)>240
Retrovir, 10mg/ml(10,000ppm)>240
Rituximab, 10mg/ml (10,000ppm)>240
Thiotepa, 10mg/ml (10,000ppm)46.9
Topotecan, 1mg/ml (1,000ppm)>240
Trisenox, 1mg/ml (1,000ppm)>240
Velcade, 1mg/ml(1,000ppm)>240
Vincristine Sulfate, 1mg/ml (1,000ppm)>240
Fentanyl Citrate Injection (100 mcg/2ml)>240
Note: Carmustine and Thiotepa haveextremely low permeation times of26.7 and 37.6 minutes respectively.Please note that the following drugshave extremely low permeation times:Carmustine: 22.8minutes, Thiotepa: 46.9 minutes, Or
Warning: Do Not Use with Carmustine,Thiotepa.*Warning: Do not use withCarmustine and Thiotepa.
MaterialNitrileNitrileNitrileSame
BiocompatibilitySensitizationISO10993-10Under the conditions of thestudy, not an irritant Under theconditions of the study, not asensitizerUnder the conditions of the study,not an irritantUnder the conditions of the study,not a sensitizerUnder theconditions of thestudy, not an irritantUnder theconditions of thestudy, not asensitizerSame
BiocompatibilityCytotoxicityISO10993-5Not PerformedUnder the conditions of thisstudy, the test article extractshowed potential toxicity to L929cells.Cytotoxicity concern wasaddressed by acutesystematic toxicity testing.Not Performed②DifferentasK232266Same asK212578

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BiocompatibilityAcuteSystemicToxicityISO10993-11Under the conditions of thestudy, the device extract doesnot induce acute systemictoxicity response.Under the conditions of thisstudy, there was no evidence ofacute systemic toxicity.Under theconditions of thisstudy, there wasno evidence ofacute systemictoxicity.Same
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G. Summary of Non-Clinical Testing

A Biocompatibility

Biocompatibility Testing according to ISO 10993-1:2018, the nature of body contact for the proposed device is Surface Device category, Skin Contact and duration of contact is A-Limited (≤24h). The following tests for the proposed device were conducted to evaluate the biocompatibility of Nitrile Disposable Examination Gloves as per Guidance for Industry and FDA Staff-Medical Glove Guidance Manual issued on January 22, 2008:

  • ISO 10993-10: Primary Skin Irritation
  • · ISO 10993-10: Dermal Sensitization
  • · ISO 10993-11: Systemic Toxicity

> Performance Testing

Physical performance testing of the proposed device were conducted as per ASTM D6319-19 Standard Specification for Nitrile Examination Gloves for Medical Application. Permeation testing was conducted to support the addition of the labeling claim: Tested for use with chemotherapy drugs. In addition, the proposed device was tested according to ASTM D6978-05 (Reapproved 2019) Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs, in which minimum breakthrough times were determined for a wide range of chemotherapy drugs.

To summarize, the performance testing of the subject device was conducted to adequately demonstrate the effectiveness of the device in accordance with the relevant test methods cited below:

  • ASTM D6319-19 Standard Specification for Nitrile Examination Gloves for Medical Application
  • ASTM D6124-06 (2022) Standard Test Method for Residual Powder on Medical Gloves
  • ASTM D5151-19 Standard Test Method for Detection of Holes in Medical Gloves
  • ASTM D6978-05 (Reapproved 2019) Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs

From the test result, we can find the product can meet the requirements as its intended use indicated.

Test MethodPurposeAcceptance CriteriaResults
Dimensions(Length)(width)(thickness)ASTM D6319-19The purpose of the test is toEvaluate the physical dimension ofthe gloveLengthS: $\geq$ 220mmM,L,XL: $\geq$ 230mmWidthS: 80±10mmM: 95±10mmL: 110±10mmXL: 120±10mmPassPassPass

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Physical propertiesASTM D6319-19The purpose of the test is toevaluate the tensile strength andultimate elongation before andafter agingTensile Strength:Before Aging ≥14MPa, min. AfterAging ≥14 MPa, min.Elongation:Before Aging 500%, min.After Aging 400%, min.Pass
Freedom from holesASTM D5151-19The purpose of the test is to detectholes in the glovesNo leakage at samplinglevel of G-1, AQL 2.5Pass
Residual PowderASTM D 6124-06(2022)The purpose of the test is to detectthe powder residue in the glove<2mg per glovePass
Permeation byChemotherapyDrugsASTM D 6978-05(2019)The purpose of the test is to detectthe Permeation time byChemotherapy Drugs and Fentanylof the gloveRefer the above table 2Pass
ISO 10993-10:2021Biocompatibility SkinSensitization Testdetermine the potential of glove topromote skin sensitization afterrepeated applicationsNo dermal reactionsindicative of delayed contacthypersensitivityPass
Biocompatibility AcuteSystemic ToxicityISO10993-11Determine the potential of glove to betoxic after repeated exposureUnder the conditions of thestudy, the device extractdoes not induce acutesystemic toxicity response.Pass
CPSC standards regulatedunder the FHSA Act setforth in 16 CFR 1500.41,determine the potential of glove topromote irritationreactions after repeated applicationsNot dermal irritationreactionsPass

H. Clinical Test Conclusion

No clinical study is included in this submission.

l. Conclusion

The conclusion drawn from the nonclinical tests demonstrates that the subject device in 510(K) submission, the Nitrile Disposable Examination Gloves, tested for Use with Chemotherapy Drugs and Fentanyl is as safe, as effective, and performs as well as or better than the legally marketed predicate device cleared under K232266.

§ 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.