K Number
K243172
Device Name
Halyard Purple Nitrile* Powder-Free Exam Gloves, Sterile Pairs; Halyard Purple Nitrile* Powder-Free Exam Gloves, Sterile Singles
Manufacturer
Date Cleared
2025-06-18

(261 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Halyard Purple Nitrile* Powder‐Free Exam Gloves, Sterile Pairs or Sterile Singles, Tested for Use with Chemotherapy Drugs, Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid are disposable devices intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. The following chemotherapy drugs and concentration had NO breakthrough detected up to 240 minutes: - Azacitidine (25 mg/ml) - Bendamustine HCl (5 mg/ml) - Bleomycin Sulfate (15 mg/ml) - Bortezomib (1 mg/ml) - Busulfan (6 mg/ml) - Capecitabine (26 mg/ml) - Carboplatin (10 mg/ml) - Carfilzomib (2 mg/ml) - Cetuximab (2 mg/ml) - Cisplatin (1 mg/ml) - Cladribine (1 mg/ml) - Cyclophosphamide (20 mg/ml) - Cytarabine HCl (100 mg/ml) - Dacarbazine (10 mg/ml) - Dactinomycin (0.5 mg/ml) - Daunorubicin HCl (5 mg/ml) - Decitabine (5 mg/ml) - Docetaxel (10 mg/ml) - Doxorubicin HCl (2 mg/ml) - Epirubicin HCl (2 mg/ml) - Etoposide (20 mg/ml) - Fludarabine Phosphate (25 mg/ml) - Fluorouracil (50 mg/ml) - Fulvestrant (50 mg/ml) - Gemcitabine HCl (38 mg/ml) - Idarubicin HCl (1 mg/ml) - Ifosfamide (50 mg/ml) - Irinotecan HCl (20 mg/ml) - Leuprolide Acetate (5 mg/ml) - Mechlorethamine HCl (1 mg/ml) - Melphalan HCl (5 mg/ml) - Methotrexate (25 mg/ml) - Mitomycin C (0.5 mg/ml) - Mitoxantrone HCl (2 mg/ml) - Oxaliplatin (5 mg/ml) - Paclitaxel (6 mg/ml) - Pemetrexed (25 mg/ml) - Raltitrexed (0.5 mg/ml) - Rituximab (10 mg/ml) - Temsirolimus (25 mg/ml) - Topotecan HCl (1 mg/ml) - Trisenox (Arsenic Trioxide) (1 mg/ml) - Vinblastine Sulfate (1 mg/ml) - Vincristine (1 mg/ml) - Vinorelbine Tartrate (10 mg/ml) The following chemotherapy drugs and concentration showed breakthrough detected in less than 100 minutes: - Carmustine (3.3 mg/ml) No breakthrough up to 44.5 minutes. - Thiotepa (10 mg/ml) No breakthrough up to 99.1 minutes. - **Warning-** Not for use with Carmustine and ThioTEPA The following hazardous drugs (opioids) and concentration had NO breakthrough detected up to 240 minutes: - Fentanyl Citrate Injection (100 mcg/2 ml) - Simulated Gastric Acid Fluid/Fentanyl Citrate Injection Mix 50/50 Solution The following hazardous drugs and concentration had NO breakthrough detected up to 240 minutes: - Chloroquine (50 mg/ml) - Cyclosporin A (100 mg/ml) - Cytovene (10 mg/ml) - Retrovir (10 mg/ml) - Triclosan (2 mg/ml) - Zoledronic Acid (0.8 mg/ml)
Device Description
The Halyard Purple Nitrile* Powder‐Free Exam Gloves, Sterile Pairs or Sterile Singles, Tested for Use with Chemotherapy Drugs, Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid are disposable, 9.5" purple‐colored, chlorinated, nitrile, powder‐free, textured fingertip, ambidextrous, sterile patient examination gloves.
More Information

No.
The product described is a pair of medical gloves, which are physical protective barriers and do not involve any processing or decision-making capabilities that would require an AI model.

No
This device is an exam glove intended to prevent contamination between a patient and examiner, not to treat a disease or condition.

No

Explanation: The device is a medical glove intended to prevent contamination between the patient and examiner, not to diagnose a medical condition.

No

The device is a physical medical device (examination gloves). There is no mention of software components or functionality in the provided summary.

No
The device is an exam glove intended for preventing contamination between patient and examiner. It is a physical barrier and does not perform any in vitro diagnostic function.

N/A

Intended Use / Indications for Use

The Halyard Purple Nitrile* Powder‐Free Exam Gloves, Sterile Pairs or Sterile Singles, Tested for Use with Chemotherapy Drugs, Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid are disposable devices intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

The following chemotherapy drugs and concentration had NO breakthrough detected up to 240 minutes:

  • Azacitidine (25 mg/ml)
  • Bendamustine HCl (5 mg/ml)
  • Bleomycin Sulfate (15 mg/ml)
  • Bortezomib (1 mg/ml)
  • Busulfan (6 mg/ml)
  • Capecitabine (26 mg/ml)
  • Carboplatin (10 mg/ml)
  • Carfilzomib (2 mg/ml)
  • Cetuximab (2 mg/ml)
  • Cisplatin (1 mg/ml)
  • Cladribine (1 mg/ml)
  • Cyclophosphamide (20 mg/ml)
  • Cytarabine HCl (100 mg/ml)
  • Dacarbazine (10 mg/ml)
  • Dactinomycin (0.5 mg/ml)
  • Daunorubicin HCl (5 mg/ml)
  • Decitabine (5 mg/ml)
  • Docetaxel (10 mg/ml)
  • Doxorubicin HCl (2 mg/ml)
  • Epirubicin HCl (2 mg/ml)
  • Etoposide (20 mg/ml)
  • Fludarabine Phosphate (25 mg/ml)
  • Fluorouracil (50 mg/ml)
  • Fulvestrant (50 mg/ml)
  • Gemcitabine HCl (38 mg/ml)
  • Idarubicin HCl (1 mg/ml)
  • Ifosfamide (50 mg/ml)
  • Irinotecan HCl (20 mg/ml)
  • Leuprolide Acetate (5 mg/ml)
  • Mechlorethamine HCl (1 mg/ml)
  • Melphalan HCl (5 mg/ml)
  • Methotrexate (25 mg/ml)
  • Mitomycin C (0.5 mg/ml)
  • Mitoxantrone HCl (2 mg/ml)
  • Oxaliplatin (5 mg/ml)
  • Paclitaxel (6 mg/ml)
  • Pemetrexed (25 mg/ml)
  • Raltitrexed (0.5 mg/ml)
  • Rituximab (10 mg/ml)
  • Temsirolimus (25 mg/ml)
  • Topotecan HCl (1 mg/ml)
  • Trisenox (Arsenic Trioxide) (1 mg/ml)
  • Vinblastine Sulfate (1 mg/ml)
  • Vincristine (1 mg/ml)
  • Vinorelbine Tartrate (10 mg/ml)

The following chemotherapy drugs and concentration showed breakthrough detected in less than 100 minutes:

  • Carmustine (3.3 mg/ml) No breakthrough up to 44.5 minutes.
  • Thiotepa (10 mg/ml) No breakthrough up to 99.1 minutes.
  • Warning- Not for use with Carmustine and ThioTEPA

The following hazardous drugs (opioids) and concentration had NO breakthrough detected up to 240 minutes:

  • Fentanyl Citrate Injection (100 mcg/2 ml)
  • Simulated Gastric Acid Fluid/Fentanyl Citrate Injection Mix 50/50 Solution

The following hazardous drugs and concentration had NO breakthrough detected up to 240 minutes:

  • Chloroquine (50 mg/ml)
  • Cyclosporin A (100 mg/ml)
  • Cytovene (10 mg/ml)
  • Retrovir (10 mg/ml)
  • Triclosan (2 mg/ml)
  • Zoledronic Acid (0.8 mg/ml)

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

LZA, LZC, OPJ, QDO

Device Description

The Halyard Purple Nitrile* Powder-Free Exam Gloves, Sterile Pairs or Sterile Singles, Tested for Use with Chemotherapy Drugs, Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid are disposable, 9.5" purple-colored, chlorinated, nitrile, powder-free, textured fingertip, ambidextrous, sterile patient examination gloves.

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

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Non-Clinical Testing:
Tests were conducted to assess various properties of the gloves:

  • Dimensions: Length, Palm Width (S, M, L), Finger thickness, Palm thickness, Cuff thickness. Results met requirements (Length ≥230 mm, Palm Width S: 70-90 mm, M: 85-105 mm, L: 100-120 mm, all thicknesses ≥0.05 mm).
  • Physical Properties: AQL 4.0. Before Aging: Tensile Strength ≥14 MPa, Ultimate elongation ≥500%. After Aging: Tensile Strength ≥14 MPa, Ultimate elongation ≥400%. Results met requirements.
  • Freedom from Pinholes: AQL 2.5%, No leakage. Results met requirements.
  • Sterility: ANSI/AAMI/ISO 11137 with a SAL of 10⁻⁶. Achieved 10⁻⁶.
  • Powder Free: ASTM D 6124, ASTM D 6319. Acceptance criteria ≤ 2 mg / glove. Results met requirements (average of 0.4 mg/glove).
  • Test for irritation: ISO 10993, Part 23. Acceptance criteria Grade 1. Device was considered not an irritant.
  • Test for acute systemic toxicity: ISO 10993, Part 11. Acceptance criteria: No animals treated with test extracts exhibit greater reaction than control animals. No evidence of acute systemic toxicity.
  • Test for skin sensitization: ISO 10993, Part 10. Acceptance criteria Grade

§ 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.

FDA 510(k) Clearance Letter - K243172

Page 1

U.S. Food & Drug Administration
10903 New Hampshire Avenue
Silver Spring, MD 20993
www.fda.gov

Doc ID # 04017.07.05

June 18, 2025

O&M Halyard, Inc.
Caitlin Senter
Director, Global Regulatory Affairs
9120 Lockwood Blvd
Mechanicsville, Virginia 23116

Re: K243172
Trade/Device Name: Halyard Purple Nitrile* Powder-Free Exam Gloves, Sterile Pairs; Halyard Purple Nitrile* Powder-Free Exam Gloves, Sterile Singles
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: September 30, 2024
Received: May 9, 2025

Dear Caitlin Senter:

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"

Page 2

K243172 - Caitlin Senter Page 2

(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 (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-reporting-combination-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.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rule"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-devices/device-advice-comprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

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-devices/medical-device-safety/medical-device-reporting-mdr-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/medical-devices/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-devices/device-advice-comprehensive-regulatory-assistance/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).

Page 3

K243172 - Caitlin Senter Page 3

Sincerely,

ALLAN GUAN -S

For Bifeng Qian, M.D., Ph.D.
Assistant Director
DHT4C: Division of Infection Control Devices
OHT4: Office of Surgical and Infection Control Devices
Office of Product Evaluation and Quality
Center for Devices and Radiological Health

Enclosure

Page 4

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Form Approved: OMB No. 0910-0120
Expiration Date: 07/31/2026

Indications for Use

See PRA Statement below.

510(k) Number (if known)
K243172

Device Name
Halyard Purple Nitrile* Powder-Free Exam Gloves, Sterile Pairs;
Halyard Purple Nitrile* Powder-Free Exam Gloves, Sterile Singles

Indications for Use (Describe)
The Halyard Purple Nitrile* Powder-Free Exam Gloves, Sterile Pairs or Sterile Singles, Tested for Use with Chemotherapy Drugs, Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid are disposable devices intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

The following chemotherapy drugs and concentration had NO breakthrough detected up to 240 minutes:

  • Azacitidine (25 mg/ml)
  • Bendamustine HCl (5 mg/ml)
  • Bleomycin Sulfate (15 mg/ml)
  • Bortezomib (1 mg/ml)
  • Busulfan (6 mg/ml)
  • Capecitabine (26 mg/ml)
  • Carboplatin (10 mg/ml)
  • Carfilzomib (2 mg/ml)
  • Cetuximab (2 mg/ml)
  • Cisplatin (1 mg/ml)
  • Cladribine (1 mg/ml)
  • Cyclophosphamide (20 mg/ml)
  • Cytarabine HCl (100 mg/ml)
  • Dacarbazine (10 mg/ml)
  • Dactinomycin (0.5 mg/ml)
  • Daunorubicin HCl (5 mg/ml)
  • Decitabine (5 mg/ml)
  • Docetaxel (10 mg/ml)
  • Doxorubicin HCl (2 mg/ml)
  • Epirubicin HCl (2 mg/ml)
  • Etoposide (20 mg/ml)
  • Fludarabine Phosphate (25 mg/ml)
  • Fluorouracil (50 mg/ml)
  • Fulvestrant (50 mg/ml)
  • Gemcitabine HCl (38 mg/ml)
  • Idarubicin HCl (1 mg/ml)
  • Ifosfamide (50 mg/ml)
  • Irinotecan HCl (20 mg/ml)
  • Leuprolide Acetate (5 mg/ml)
  • Mechlorethamine HCl (1 mg/ml)
  • Melphalan HCl (5 mg/ml)
  • Methotrexate (25 mg/ml)
  • Mitomycin C (0.5 mg/ml)
  • Mitoxantrone HCl (2 mg/ml)
  • Oxaliplatin (5 mg/ml)
  • Paclitaxel (6 mg/ml)
  • Pemetrexed (25 mg/ml)

FORM FDA 3881 (8/23) Page 1 of 2

Page 5

  • Raltitrexed (0.5 mg/ml)
  • Rituximab (10 mg/ml)
  • Temsirolimus (25 mg/ml)
  • Topotecan HCl (1 mg/ml)
  • Trisenox (Arsenic Trioxide) (1 mg/ml)
  • Vinblastine Sulfate (1 mg/ml)
  • Vincristine (1 mg/ml)
  • Vinorelbine Tartrate (10 mg/ml)

The following chemotherapy drugs and concentration showed breakthrough detected in less than 100 minutes:

  • Carmustine (3.3 mg/ml) No breakthrough up to 44.5 minutes.
  • Thiotepa (10 mg/ml) No breakthrough up to 99.1 minutes.
  • Warning- Not for use with Carmustine and ThioTEPA

The following hazardous drugs (opioids) and concentration had NO breakthrough detected up to 240 minutes:

  • Fentanyl Citrate Injection (100 mcg/2 ml)
  • Simulated Gastric Acid Fluid/Fentanyl Citrate Injection Mix 50/50 Solution

The following hazardous drugs and concentration had NO breakthrough detected up to 240 minutes:

  • Chloroquine (50 mg/ml)
  • Cyclosporin A (100 mg/ml)
  • Cytovene (10 mg/ml)
  • Retrovir (10 mg/ml)
  • Triclosan (2 mg/ml)
  • Zoledronic Acid (0.8 mg/ml)

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.

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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:

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"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."

FORM FDA 3881 (8/23) Page 2 of 2

Page 6

510(k) Summary for K243172

This summary of 510(k) K243172 is being submitted in accordance with 21 CFR 807.92.

Date Summary was PreparedJune 18, 2025
510(k) SubmitterO & M Halyard, Inc.
1220 Old Alpharetta Rd., Ste. 320
Alpharetta, GA 30005
Primary Contact for this 510(k) SubmissionCaitlin Senter, MS, RAC
Tel: 678‐221‐7330
Email: caitlin.senter@owens‐minor.com
Marketed Device Trade NameHalyard Purple Nitrile* Powder‐Free Exam Gloves, Sterile Pairs;
Halyard Purple Nitrile* Powder‐Free Exam Gloves, Sterile Singles
Device Submission Trade name and DescriptionHalyard Purple Nitrile* Powder‐Free Exam Gloves, Sterile Pairs;
Halyard Purple Nitrile* Powder‐Free Exam Gloves, Sterile Singles
Device Common NameMedical Exam Gloves
Device Product Code and Classification NameLZA Class I, 21 CFR §880.6250 Polymer Patient Examination Glove
LZC Class I, 21 CFR §880.6250 Medical Glove, Specialty
OPJ Class I, 21 CFR §880.6250 Medical Gloves with Chemotherapy Labeling Claims ‐ Test For Use with Chemotherapy Drugs
QDO Class I, 21 CFR §880.6250 Fentanyl and Other Opioid Protection Glove
Predicate DeviceKimberly‐Clark Purple Nitrile XTRA* Sterile Powder‐Free Exam Glove (Chemotherapy Glove) ‐ 12 Sterile Pairs (K102032)
Reference DevicesHalyard Purple Nitrile, Powder‐Free Exam Gloves Tested for Use with Chemotherapy Drugs, Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid (K213929)
Subject Device DescriptionThe Halyard Purple Nitrile* Powder‐Free Exam Gloves, Sterile Pairs or Sterile Singles, Tested for Use with Chemotherapy Drugs, Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid are disposable, 9.5" purple‐colored, chlorinated, nitrile, powder‐free, textured fingertip, ambidextrous, sterile patient examination gloves.

Page 7

| Indications for Use | Halyard Purple Nitrile* Powder‐Free Exam Gloves, Sterile Pairs or Sterile Singles, Tested for Use with Chemotherapy Drugs, Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid are disposable devices intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

The following chemotherapy drugs and concentration had NO breakthrough detected up to 240 minutes:

  • Azacitidine (25 mg/ml)
  • Bendamustine HCl (5 mg/ml)
  • Bleomycin Sulfate (15 mg/ml)
  • Bortezomib (1 mg/ml)
  • Busulfan (6 mg/ml)
  • Capecitabine (26 mg/ml)
  • Carboplatin (10 mg/ml)
  • Carfilzomib (2 mg/ml)
  • Cetuximab (2 mg/ml)
  • Cisplatin (1 mg/ml)
  • Cladribine (1 mg/ml)
  • Cyclophosphamide (20 mg/ml)
  • Cytarabine HCl (100 mg/ml)
  • Dacarbazine (10 mg/ml)
  • Dactinomycin (0.5 mg/ml)
  • Daunorubicin HCl (5 mg/ml)
  • Decitabine (5 mg/ml)
  • Docetaxel (10 mg/ml)
  • Doxorubicin HCl (2 mg/ml)
  • Epirubicin HCl (2 mg/ml)
  • Etoposide (20 mg/ml)
  • Fludarabine Phosphate (25 mg/ml)
  • Fluorouracil (50 mg/ml)
  • Fulvestrant (50 mg/ml)
  • Gemcitabine HCl (38 mg/ml)
  • Idarubicin HCl (1 mg/ml)
  • Ifosfamide (50 mg/ml)
  • Irinotecan HCl (20 mg/ml)
  • Leuprolide Acetate (5 mg/ml)
  • Mechlorethamine HCl (1 mg/ml)
  • Melphalan HCl (5 mg/ml)
  • Methotrexate (25 mg/ml)
  • Mitomycin C (0.5 mg/ml)
  • Mitoxantrone HCl (2 mg/ml)
  • Oxaliplatin (5 mg/ml)
  • Paclitaxel (6 mg/ml)
  • Pemetrexed (25 mg/ml)
  • Raltitrexed (0.5 mg/ml)
  • Rituximab (10 mg/ml)
  • Temsirolimus (25 mg/ml)
  • Topotecan HCl (1 mg/ml) |

Page 8

  • Trisenox (Arsenic Trioxide) (1 mg/ml)
  • Vinblastine Sulfate (1 mg/ml)
  • Vincristine (1 mg/ml)
  • Vinorelbine Tartrate (10 mg/ml)

The following chemotherapy drugs and concentration showed breakthrough detected in less than 100 minutes:

  • Carmustine (3.3 mg/ml) No breakthrough up to 44.5 minutes.
  • Thiotepa (10 mg/ml) No breakthrough up to 99.1 minutes.
  • Warning- Not for use with Carmustine and ThioTEPA

The following hazardous drugs (opioids) and concentration had NO breakthrough detected up to 240 minutes:

  • Fentanyl Citrate Injection (100 mcg/2 ml)
  • Simulated Gastric Acid Fluid/Fentanyl Citrate Injection Mix 50/50 Solution

The following hazardous drugs and concentration had NO breakthrough detected up to 240 minutes:

  • Chloroquine (50 mg/ml)
  • Cyclosporin A (100 mg/ml)
  • Cytovene (10 mg/ml)
  • Retrovir (10 mg/ml)
  • Triclosan (2 mg/ml)
  • Zoledronic Acid (0.8 mg/ml)

Page 9

Subject DevicePredicate Device (K102032)Reference Device (K213929)Comparison
FDA Product CodeLZA, LZC, OPJ, QDOLZA, LZCLZA, OPJ, QDO
FDA ClassificationClass IClass IClass I
Regulation Number880.6250880.6250880.6250
Common NameMedical Exam GloveMedical Exam GloveMedical Exam Glove
Device Trade NameHalyard Purple Nitrile* Powder‐Free Exam Gloves, Sterile Pairs; Halyard Purple Nitrile* Powder‐Free Exam Gloves, Sterile SinglesKimberly‐Clark Purple Nitrile XTRA* Sterile Powder‐Free Exam Glove (Chemotherapy Glove) ‐ 12 Sterile PairsHalyard Purple Nitrile, Powder‐Free Exam Gloves Tested for Use with Chemotherapy Drugs, Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid
Intended Use/Indications for UseHalyard Purple Nitrile* Powder‐Free Exam Gloves, Sterile Pairs or Sterile Singles, Tested for Use with Chemotherapy Drugs, Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid are disposable devices intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. The following chemotherapy drugs and concentration had NO breakthrough detected up to 240 minutes: Azacitidine (25 mg/ml) Bendamustine HCl (5 mg/ml) Bleomycin Sulfate (15A powder‐free 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. In addition, these chemotherapy gloves were tested for use with the following drug concentrations per ASTM D6978‐05: The following drugs had NO breakthrough detected up to 240 minutes: Bleomycin Sulfate (15 mg/ml) Busulfan (6 mg/ml) Carboplatin (10 mg/ml) Cisplatin (1 mg/ml) Cyclophosphamide (20 mg/ml) Cytarabine HCl (100 mg/ml) Dacarbazine (10 mg/ml) Daunorubicin HCl (5 mg/ml) Docetaxel (10 mg/ml) Doxorubicin HCl (Adriamycin) (2 mg/ml)Halyard Purple Nitrile* Powder‐Free Exam Gloves, Tested for Use with Chemotherapy Drugs, Fentanyl Citrate, Simulated Gastric Acid and Fentanyl in Simulated Gastric Acid are disposable devices intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. The following chemotherapy drugs and concentration had NO breakthrough detected up to 240 minutes: Azacitidine (25

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Subject DevicePredicate Device (K102032)Reference Device (K213929)Comparison
mg/ml) Bortezomib (1 mg/ml) Busulfan (6 mg/ml) Capecitabine (26 mg/ml) Carboplatin (10 mg/ml) Carfilzomib (2 mg/ml) Cetuximab (2 mg/ml) Cisplatin (1 mg/ml) Cladribine (1 mg/ml) Cyclophosphamide (20 mg/ml) Cytarabine HCl (100 mg/ml) Dacarbazine (10 mg/ml) Dactinomycin (0.5 mg/ml) Daunorubicin HCl (5 mg/ml) Decitabine (5 mg/ml) Docetaxel (10 mg/ml) Doxorubicin HCl (2 mg/ml) Epirubicin HCl (2 mg/ml) Etoposide (20 mg/ml) Fludarabine Phosphate (25 mg/ml) Fluorouracil (50 mg/ml) Fulvestrant (50 mg/ml) Gemcitabine HCl (38 mg/ml) Idarubicin HCl (1 mg/ml) Ifosfamide (50 mg/ml) Irinotecan HCl (20 mg/ml) Leuprolide Acetate (5 mg/ml) Mechlorethamine HCl (1 mg/ml) Melphalan HCl (5 mg/ml) Methotrexate (25 mg/ml) Mitomycin C (0.5Ellence (Epirubicin) (2 mg/ml) Etoposide (20 mg/ml) Fludarabine (25 mg/ml) Fluorouracil (adrucil) (50 mg/ml) Gemcitabine (38.0 mg/ml)mg/ml) Bendamustine HCl (5 mg/ml) Bleomycin Sulfate (15 mg/ml) Bortezomib (1 mg/ml) Busulfan (6 mg/ml) Capecitabine (26 mg/ml) Carboplatin (10 mg/ml) Carlzomib (2 mg/ml) Cetuximab (2 mg/ml) Chloroquine (50 mg/ml) Cisplatin (1 mg/ml) Cladribine (1 mg/ml) Cyclophosphamide (20 mg/ml) Cyclosporin A (100 mg/ml) Cytarabine (Cytosine) (100 mg/ml) Cytovene (Ganciclovir) (10 mg/ml) Dacarbazine (DTIC) (10 mg/ml) Dactinomycin (0.5 mg/ml) Daunorubicin HCl (5 mg/ml) Decitabine (5 mg/ml) Docetaxel (10 mg/ml) Doxorubicin HCl (2 mg/ml) Epirubicin HCl (Ellence) (2 mg/ml) Etoposide (Toposar) (20 mg/ml) Fludarabine (25 mg/ml) 5‐Fluorouracil (50 mg/ml) Fulvestrant (50 mg/ml) Gemcitabine (38 mg/ml)

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Subject DevicePredicate Device (K102032)Reference Device (K213929)Comparison
mg/ml) Mitoxantrone HCl (2 mg/ml) Oxaliplatin (5 mg/ml) Paclitaxel (6 mg/ml) Pemetrexed (25 mg/ml) Raltitrexed (0.5 mg/ml) Rituximab (10 mg/ml) Temsirolimus (25 mg/ml) Topotecan HCl (1 mg/ml) Trisenox (Arsenic Trioxide) (1 mg/ml) Vinblastine Sulfate (1 mg/ml) Vincristine (1 mg/ml) Vinorelbine Tartrate (10 mg/ml) The following chemotherapy drugs and concentration showed breakthrough detected in less than 100 minutes: Carmustine (3.3 mg/ml) No breakthrough up to 44.5 minutes. Thiotepa (10 mg/ml) No breakthrough up to 99.1 minutes. Warning‐ Not for use with Carmustine and ThioTEPA The following hazardous drugs (opioids) and concentration had NO breakthrough detected up to 240 minutes: Fentanyl Citrate Injection (100 mcg/2 ml) Simulated Gastric AcidIdarubicin (1 mg/ml) Ifosfamide (50 mg/ml) Irinotecan HCl (20 mg/ml) Leuprolide Acetate Salt (5 mg/ml) Mechlorethamine HCl (1 mg/ml) Melphalan (5 mg/ml) Methotrexate (25 mg/ml) MitomycinC (0.5 mg/ml) Mitoxantrone (2 mg/ml) Oxaliplatin (5 mg/ml) Paclitaxel (6 mg/ml) Pemetrexed (25 mg/ml) Raltitrexed (0.5 mg/ml) Retrovir (10 mg/ml) Rituximab (10 mg/ml) Temsirolimus (25 mg/ml) Topotecan HCl (1 mg/ml) Triclosan (2 mg/ml) Trisenox (1 mg/ml) Vinblastine Sulfate (1 mg/ml) Vincristine (1 mg/ml) Vinorelbine (10 mg/ml) Zoledronic Acid (0.8 mg/ml) The following chemotherapy drugs and concentration showed breakthrough detected in less than 90 minutes: Carmustine (3.3 mg/ml) No breakthrough up toIdarubicin (1 mg/ml) Ifosfamide (50 mg/ml) Irinotecan HCl (20 mg/ml) Leuprolide Acetate Salt (5 mg/ml) Mechlorethamine HCl (1 mg/ml) Melphalan (5 mg/ml) Methotrexate (25 mg/ml) Mitomycin C (0.5 mg/ml) Mitoxantrone (2 mg/ml) Oxaliplatin (5 mg/ml) Paclitaxel (6 mg/ml) Pemetrexed (25 mg/ml) Raltitrexed (0.5 mg/ml) Retrovir (10 mg/ml) Rituximab (10 mg/ml) Temsirolimus (25 mg/ml) Topotecan HCl (1 mg/ml) Triclosan (2 mg/ml) Trisenox (1 mg/ml) Vinblastine Sulfate (1 mg/ml) Vincristine (1 mg/ml) Vinorelbine (10 mg/ml) Zoledronic Acid (0.8 mg/ml) The following chemotherapy drugs and concentration showed breakthrough detected in less than 90 minutes: Carmustine (3.3 mg/ml) No

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Subject DevicePredicate Device (K102032)Reference Device (K213929)Comparison
Fluid/Fentanyl Citrate Injection Mix 50/50 Solution The following hazardous drugs and concentration had NO breakthrough detected up to 240 minutes: Chloroquine (50 mg/ml) Cyclosporin A (100 mg/ml) Cytovene (10 mg/ml) Retrovir (10 mg/ml) Triclosan (2 mg/ml) Zoledronic Acid (0.8 mg/ml)55.3 minutes. Thiotepa (10 mg/ml) No breakthrough up to 78.8 minutes. Warning‐ Not for use with Carmustine and ThioTEPA No breakthrough was detected up to 240 minutes for Fentanyl Citrate Injection (100 mcg/2 ml) and Simulated Gastric Acid Fluid/Fentanyl Citrate Injection Mix 50/50 Solutionbreakthrough up to 55.3 minutes. Thiotepa (10 mg/ml) No breakthrough up to 78.8 minutes. Warning‐ Not for use with Carmustine and ThioTEPA No breakthrough was detected up to 240 minutes for Fentanyl Citrate Injection (100 mcg/2 ml) and Simulated Gastric Acid Fluid/Fentanyl Citrate Injection Mix 50/50 Solution
Technological CharacteristicsColored, 9.5 inch, chlorinated, nitrile, powder‐free, textured fingertip, ambidextrous, sterile patient examination gloveColored, 9.5 inch, chlorinated, nitrile, powder‐free, textured fingertip, ambidextrous, sterile patient examination gloveColored, 9.5 inch, chlorinated, nitrile, powder‐free, textured fingertips, ambidextrous, non‐sterile patient examination glove
Sizes of glovesS, M, LS, M, LXS, S, M, L, XL
ColorPurplePurplePurple

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Subject DevicePredicate Device (K102032)Reference Device (K213929)Comparison
TextureTextured fingertipsTextured fingertipsTextured fingertips
SterilitySterileSterileNon‐Sterile
BiocompatibilityBased on ISO 10993, Part 11 Biological Evaluation of Medical Devices – Test for systemic toxicity, the test article was considered non‐toxic. Meets the acceptance criteria. Based on ISO 10993, Part 23‐ Biological Evaluation of Medical Devices – Test for irritation, the test article was considered non‐irritant. Meets the acceptance criteria. Based on ISO 10993, Part 10 ‐ Biological Evaluation of Medical Devices – Test for skin sensitization, the test article was considered a non‐sensitizer. Meets the acceptance criteria.Based ISO 10993 Biological Evaluation of Medical devices – Test for systemic toxicity, the test article was considered non‐toxic. Meets the acceptance criteria. Based on ISO 10993, Part 10‐ Biological Evaluation of Medical Devices – Test for irritation, the test article was considered non‐irritant. Meets the acceptance criteria. Based on ISO 10993, Part 10 ‐ Biological Evaluation of Medical Devices – Test for skin sensitization, the test article was considered non‐sensitizer. Meets the acceptance criteria.Based ISO 10993 Biological Evaluation of Medical devices – Test for systemic toxicity, the test article was considered non‐toxic. Meets the acceptance criteria. Based on ISO 10993, Part 10‐ Biological Evaluation of Medical Devices – Test for irritation, the test article was considered non‐irritant. Meets the acceptance criteria. Based on ISO 10993, Part 10 ‐ Biological Evaluation of Medical Devices – Test for skin sensitization, the test article was considered non‐sensitizer. Meets the acceptance criteria.
StandardSubject DevicePredicate Device (K102032)Reference Device (K213929)Comparison
ASTM D6978‐05 Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy DrugsThe following chemotherapy drugs and concentration had NO breakthrough detected up to 240 minutes: Azacitidine (25 mg/ml)These chemotherapy gloves were tested for use with the following drug concentrations per ASTM D6978‐05: The following drugs had NO breakthrough detected up to 240 minutes: Bleomycin Sulfate (15 mg/ml)The following chemotherapy drugs and concentration had NO breakthrough detected up to 240 minutes: Azacitidine (25 mg/ml)Similar

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StandardSubject DevicePredicate Device (K102032)Reference Device (K213929)Comparison
Bendamustine HCl (5 mg/ml) Bleomycin Sulfate (15 mg/ml) Bortezomib (1 mg/ml) Busulfan (6 mg/ml) Capecitabine (26 mg/ml) Carboplatin (10 mg/ml) Carfilzomib (2 mg/ml) Cetuximab (2 mg/ml) Cisplatin (1 mg/ml) Cladribine (1 mg/ml) Cyclophosphamide (20 mg/ml) Cytarabine HCl (100 mg/ml) Dacarbazine (10 mg/ml) Dactinomycin (0.5 mg/ml) Daunorubicin HCl (5 mg/ml) Decitabine (5 mg/ml) Docetaxel (10 mg/ml) Doxorubicin HCl (2 mg/ml) Epirubicin HCl (2 mg/ml) Etoposide (20 mg/ml) Fludarabine Phosphate (25 mg/ml) Fluorouracil (50 mg/ml) Fulvestrant (50 mg/ml) Gemcitabine HCl (38 mg/ml) Idarubicin HCl (1 mg/ml) Ifosfamide (50 mg/ml) Irinotecan HCl (20 mg/ml) Leuprolide Acetate (5 mg/ml) Mechlorethamine HCl (1 mg/ml) Melphalan HCl (5 mg/ml)Busulfan (6 mg/ml) Carboplatin (10 mg/ml) Cisplatin (1 mg/ml) Cyclophosphamide (20 mg/ml) Cytarabine HCl (100 mg/ml) Dacarbazine (10 mg/ml) Daunorubicin HCl (5 mg/ml) Docetaxel (10 mg/ml) Doxorubicin HCl (Adriamycin) (2 mg/ml) Ellence (Epirubicin) (2 mg/ml) Etoposide (20 mg/ml) Fludarabine (25 mg/ml) Fluorouracil (adrucil) (50 mg/ml) Gemcitabine (38.0 mg/ml)Bendamustine HCl (5 mg/ml) Bleomycin Sulfate (15 mg/ml) Bortezomib (1 mg/ml) Busulfan (6 mg/ml) Capecitabine (26 mg/ml) Carboplatin (10 mg/ml) Carlzomib (2 mg/ml) Cetuximab (2 mg/ml) Chloroquine (50 mg/ml) Cisplatin (1 mg/ml) Cladribine (1 mg/ml) Cyclophosphamide (20 mg/ml) Cyclosporin A (100 mg/ml) Cytarabine (Cytosine) (100 mg/ml) Cytovene (Ganciclovir) (10 mg/ml) Dacarbazine (DTIC) (10 mg/ml) Dactinomycin (0.5 mg/ml) Daunorubicin HCl (5 mg/ml) Decitabine (5 mg/ml) Docetaxel (10 mg/ml) Doxorubicin HCl (2 mg/ml) Epirubicin HCl (Ellence) (2 mg/ml) Etoposide (Toposar) (20 mg/ml) Fludarabine (25 mg/ml) 5‐Fluorouracil (50 mg/ml) Fulvestrant (50 mg/ml) Gemcitabine (38 mg/ml)

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StandardSubject DevicePredicate Device (K102032)Reference Device (K213929)Comparison
Methotrexate (25 mg/ml) Mitomycin C (0.5 mg/ml) Mitoxantrone HCl (2 mg/ml) Oxaliplatin (5 mg/ml) Paclitaxel (6 mg/ml) Pemetrexed (25 mg/ml) Raltitrexed (0.5 mg/ml) Rituximab (10 mg/ml) Temsirolimus (25 mg/ml) Topotecan HCl (1 mg/ml) Trisenox (Arsenic Trioxide) (1 mg/ml) Vinblastine Sulfate (1 mg/ml) Vincristine (1 mg/ml) Vinorelbine Tartrate (10 mg/ml) The following chemotherapy drugs and concentration showed breakthrough detected in less than 100 minutes: Carmustine (3.3 mg/ml) No breakthrough up to 44.5 minutes. Thiotepa (10 mg/ml) No breakthrough up to 99.1 minutes. Warning‐ Not for use with Carmustine and ThioTEPA The following hazardous drugs and concentration had NO breakthrough detected up to 240 minutes: Chloroquine (50 mg/ml) Cyclosporin A (100Idarubicin (1 mg/ml) Ifosfamide (50 mg/ml) Irinotecan HCl (20 mg/ml) Leuprolide Acetate Salt (5 mg/ml) Mechlorethamine HCl (1 mg/ml) Melphalan (5 mg/ml) Methotrexate (25 mg/ml) MitomycinC (0.5 mg/ml) Mitoxantrone (2 mg/ml) Oxaliplatin (5 mg/ml) Paclitaxel (6 mg/ml) Pemetrexed (25 mg/ml) Raltitrexed (0.5 mg/ml) Retrovir (10 mg/ml) Rituximab (10 mg/ml) Temsirolimus (25 mg/ml) Topotecan HCl (1 mg/ml) Triclosan (2 mg/ml) Trisenox (1 mg/ml) Vinblastine Sulfate (1 mg/ml) Vincristine (1 mg/ml) Vinorelbine (10 mg/ml) Zoledronic Acid (0.8 mg/ml) The following chemotherapy drugs and concentration showed breakthrough detected in less than 90 minutes: Carmustine (3.3 mg/ml) NoIdarubicin (1 mg/ml) Ifosfamide (50 mg/ml) Irinotecan HCl (20 mg/ml) Leuprolide Acetate Salt (5 mg/ml) Mechlorethamine HCl (1 mg/ml) Melphalan (5 mg/ml) Methotrexate (25 mg/ml) Mitomycin C (0.5 mg/ml) Mitoxantrone (2 mg/ml) Oxaliplatin (5 mg/ml) Paclitaxel (6 mg/ml) Pemetrexed (25 mg/ml) Raltitrexed (0.5 mg/ml) Retrovir (10 mg/ml) Rituximab (10 mg/ml) Temsirolimus (25 mg/ml) Topotecan HCl (1 mg/ml) Triclosan (2 mg/ml) Trisenox (1 mg/ml) Vinblastine Sulfate (1 mg/ml) Vincristine (1 mg/ml) Vinorelbine (10 mg/ml) Zoledronic Acid (0.8 mg/ml) The following chemotherapy drugs and concentration showed breakthrough detected in less than 90 minutes: Carmustine (3.3 mg/ml) No

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StandardSubject DevicePredicate Device (K102032)Reference Device (K213929)Comparison
mg/ml) Cytovene (10 mg/ml) Retrovir (10 mg/ml) Triclosan (2 mg/ml) Zoledronic Acid (0.8 mg/ml)breakthrough up to 55.3 minutes. Thiotepa (10 mg/ml) No breakthrough up to 78.8 minutes. Warning‐ Not for use with Carmustine and ThioTEPAbreakthrough up to 55.3 minutes. Thiotepa (10 mg/ml) No breakthrough up to 78.8 minutes. Warning‐ Not for use with Carmustine and ThioTEPA
ASTM D6978‐05 Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy DrugsThe following hazardous drugs (opioids) and concentration had NO breakthrough detected up to 240 minutes: Fentanyl Citrate Injection (100 mcg/2 ml) Simulated Gastric Acid Fluid/Fentanyl Citrate Injection Mix 50/50 SolutionNot Previously TestedNo breakthrough was detected up to 240 minutes for Fentanyl Citrate Injection (100 mcg/2 ml) and Simulated Gastric Acid Fluid/Fentanyl Citrate Injection Mix 50/50 SolutionDifferent
ASTM D5151‐06 Standard Test Method for Detection of Holes in Medical GlovesTesting of the subject device shows it meets the 2.5% AQL requirement in the standards for leakage. The device meets the acceptance criteria of the standard.Testing of the predicate device shows it meets the 2.5% AQL requirement in the standards for leakage. The device meets the acceptance criteria of the standard.Testing of the reference device shows it meets the 2.5% AQL requirement in the standards for leakage. The device meets the acceptance criteria of the standard.Same
ASTM D6124‐06 Standard Test Method for Residual Powder on Medical GlovesResidual powder on the subject device is an average of 0.4 mg/glove within the powder‐free limit of