K Number
K973998
Date Cleared
1997-11-18

(28 days)

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

A 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.

Device Description

Classified by FDA 's General and Plastic Surgery Device Panel as Class I, 21CFR 880.6250
Viryl Patient Examination Glove, Power Free, 80LYZ
conform to all requirements of ASTM Standard D5250-92 and FDA water leak test.

AI/ML Overview

This document describes the performance of the Vinyl Patient Examination Gloves, Powder Free, manufactured by Everrise Glove Products Co., Ltd.

1. Table of Acceptance Criteria and Reported Device Performance

The device performance was evaluated against ASTM Standard D5250-92 and FDA water leak test requirements.

TestAcceptance Criteria (ASTM D5250-92 & FDA)Reported Device Performance (Applicant Device)
Length (mm)
Size SMin. 230mm240±5mm
Size MMin. 230mm240±5mm
Size LMin. 230mm240±5mm
Size XLMin. 230mm240±5mm
Width (mm)
Size S85±5mm87±3mm
Size M95±5mm97±3mm
Size L105±5mm107±3mm
Size XL115±5mm114±3mm
Thickness (mm)
FingerMin. 0.05mmMin. 0.08mm
PalmMin. 0.08mmMin. 0.11mm
Physical Properties (Before Aging)
Tensile Strength (Mpa)Min. 9MpaMin. 10Mpa
Ultimate Elongation (%)Min. 300%Min. 300%
Physical Properties (After Aging)
Tensile Strength (Mpa)Min. 9MpaMin. 9.5Mpa
Ultimate Elongation (%)Min. 300%Min. 300%
FDA Water Leak TestMeet AQL 4.0 (for pin-holes with 1000ml water leak test)Meets AQL 4.0 with an Inspection Level of S-4

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

The document does not explicitly state the sample sizes used for the physical property tests (length, width, thickness, tensile strength, ultimate elongation) or the FDA water leak test. The data provenance is Taiwan, R.O.C., where the manufacturer is located. The studies are non-clinical performance studies conducted on the applicant's device. No information on whether they were retrospective or prospective is provided, but standard test methods like ASTM D5250-92 are typically conducted prospectively on a sample set.

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

Not applicable. This device is a physical product (gloves), and performance is assessed against established engineering and safety standards (ASTM D5250-92 and FDA water leak test), which do not involve expert interpretation or ground truth establishment in the way an AI diagnostic algorithm would.

4. Adjudication method for the test set:

Not applicable. Performance is measured against quantitative standards, not through adjudication of expert opinions.

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:

Not applicable. This is a physical medical device (examination gloves), not an AI-powered diagnostic tool engaging human readers.

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

Not applicable. This is a physical medical device.

7. The type of ground truth used:

The "ground truth" for this device's performance is defined by the objective, measurable criteria specified in ASTM Standard D5250-92 and the FDA 1000ml water leak test. These are engineering and quality control standards.

8. The sample size for the training set:

Not applicable. There is no training set as this is a physical product evaluated against standards, not a machine learning algorithm.

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

Not applicable.

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EVERRISE GLOVE PRODUCTS CO., LTD

No. 47, Huan Kung Road, Wang Haun Li, Yung Kang City Tainan Hsien, Taiwan, R.O.C. Nr. 18 1997 TEL: 886-6-2330946, 2332086 FAX: 886-6-2334439

510(K) Summary

K973998

Page 1 of 3

Date of summary prepared : October 9th, 1997

Applicant 트

Everrise Glove Products Co., Ltd. No. 47, Huan Kung Road Wang Haun Li Yung Kang City Tainan Hsien Taiwan, R.O.C. Tel : 886-6-2330946 886-6-2332086 Fax : 886-6-2334439

Contact Person 그

Mr. Jason Chang No. 47, Huan Kung Road Wang Haun Li Yung Kang City Tainan Hsien Taiwan, R.O.C. Tel : 886-6-2330946 886-6-2332086 Fax : 886-6-2334439 E-Mail : everrise@ms14.hinet.net

배 Device Name

Vinyl Patient Examination Gloves, Powder Free

{1}------------------------------------------------

EVERRISE GLOVE PRODUCTS CO., LTD

No. 47, Huan Kung Road, Wang Haun Li, Yung Kang City Tainan Hsien, Taiwan, R.O.C. TEL: 886-6-2330946, 2332086 FAX: 886-6-2334439

Page 2 of 3

Device Description 트

  • (A) Classified by FDA 's General and Plastic Surgery Device Panel as Class I, 21CFR 880.6250
  • (B) Viryl Patient Examination Glove, Power Free, 80LYZ
  • (C) conform to all requirements of ASTM Standard D5250-92 and FDA water leak test.

Application 를

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

Comparison to Predicate Device 이

Non-Clinical Perfomance data

Applicant devices comply with ASTM Standard D-5250-92 and FDA 1000ml water leak test for pin-holes.
.
TestASTM D5250-92Applicant Device
Length (mm)
Size SMin. 230mm240±5mm
MMin. 230mm240±5mm
LMin. 230mm240±5mm
XLMin. 230mm240±5mm
Width (mm)
Size S85±5mm87±3mm
M95±5mm97±3mm
L105±5mm107±3mm
XL115±5mm114±3mm
Thickness (mm)
FingerMin. 0.05mmMin. 0.08mm
PalmMin. 0.08mmMin. 0.11mm
Physical PropertiesBefore Aging
Tensile Strength (Mpa)Min. 9MpaMin. 10Mpa
Ultimate Elongation (%)Min. 300%Min. 300%

{2}------------------------------------------------

EVERRISE GLOVE PRODUCTS CO., LTD No. 47, Huan Kung Road, Wang Haun Li, Yung Kang City Tainan Hsien, Taiwan, R.O.C. TEL: 886-6-2330946, 2332086 FAX: 886-6-2334439

Page 3 of 3

After Aging
Tensile Strength (Mpa)Min. 9MpaMin. 9.5Mpa
Ultimate Elongation (%)Min. 300%Min. 300%
FDA Water Leak TestMeets AQL 4.0 with aInspection Level of S-4

Clinical Performance Data

The results of Modified Draize Test suggest the applicant device did not induce clinically significant irritation nor show any evidence of induced allergic contact dermatitis in human subjects.

Conclusion i

The applicant devices conform fully to ASTM D5250-92 and applicable 21 CFR requirements, and meets FDA 1000ml Water Leak Test.

{3}------------------------------------------------

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Jason Chang ·General Manager Everrise Glove Products Company, Ltd. No. 47, Huan Kung Road Wanq Haun Li, Yung Kang City Tainan Hsien, Taiwan, R.O.C.

K973998 Re: Vinyl Patient Examination Gloves Powder-Free Trade Name: Requlatory Class: I Product Code: LYZ Dated: October 9, 1997 Received: October 21, 1997

Dear Mr. Chang:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act). You may, therefore, market the device, subject to the general controls provisions of the Act. 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.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Requlations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical would Devices: General requlation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Reqister. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531

Image /page/3/Picture/8 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HI" on the left side and "AN SERVICES USA" on the right side. In the center of the seal is an abstract image of an eagle.

NOV 1 8 1997

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Page 2 - Mr. Chang

through 542 of the Act for devices under the Electronic cinfough 542 or the not is on other Federal laws or requlations.

This letter will allow you to begin marketing your device as first ibed in your 510 (k) premarket notification. The FDA acperiod in your tial equivalence of your device to a legally rinding of subblancial equivality in a classification for your markees produce, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4618. Additionally, for questions on compreator as (advertising of your device, please contact che promocron and lawce at (301) 594-4639. Also, please note ene organs or entitled, "Misbranding by reference to the regaracion cherorou, prematice noorroour responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

Tim W. Ulatowski

Timet my A. Ulatowski Director Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radioloqical Health

Enclosure

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Allachment I b

K972998 510(k) Number (if known):

Device Name:_Patient_Examination_Glove, Powder-Free

Indications For Use:

A 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.

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

.: ienzo S. Macheller, Chus, Zim, PhD

(Division Sign-O tion Control, Division of Dental, Infoc and General Hospital D 5 (J/k) Number

scription Use . cr 21 CFR 801.109) OR

Over-The-Counter Use

(Optional Formal 1-2-96)

§ 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.