K Number
K974120
Device Name
POWDER-FREE VINYL PATIENT EXAMINATION GLOVES
Date Cleared
1997-12-17

(47 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
A patient examination glove is a disposable device intended for medical purposes that is worn on the hand of healthcare and similar personnel to prevent contamination between healthcare personnel and the patient's body, fluids, waste or environment. 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, 21 CFR 880.6250, Powder-Free Vinyl Patient Examination Glove, 80LYZ and meets all requirements of ASTM Standard D5250-92.
More Information

K#964964, K#942042

Not Found

No
The device is a patient examination glove, and the description focuses on material properties, testing standards, and intended use for preventing contamination. There is no mention of AI or ML capabilities.

No
A patient examination glove is intended to prevent contamination, not to treat a medical condition or disease.

No

Explanation: The device is a patient examination glove, intended to prevent contamination. It does not perform any diagnostic function.

No

The device description clearly identifies the device as a physical patient examination glove, which is a hardware device. There is no mention of software components.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly states the device is a "patient examination glove" worn on the hand to prevent contamination between healthcare personnel and the patient. This is a barrier device for infection control, not a device used to examine specimens from the human body to provide information for diagnosis, monitoring, or screening.
  • Device Description: The classification as Class I, 21 CFR 880.6250, Powder-Free Vinyl Patient Examination Glove, further confirms its classification as a general medical device, not an IVD.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in samples
    • Providing diagnostic information
    • Using reagents or assays

The information provided describes a physical barrier device used in a clinical setting for hygiene and infection control.

N/A

Intended Use / Indications for Use

A patient examination glove is a disposable device intended for medical purposes that is worn on the hand of healthcare and similar personnel to prevent contamination between healthcare personnel and the patient's body, fluids, waste or environment.

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.

Product codes

80LYZ

Device Description

Classified by FDA's General and Plastic Surgery Device Panel Class I, 21 CFR 880.6250, Powder-Free Vinyl Patient as Examination Glove, 80LYZ and meets all requirements of ASTM Standard D5250-92.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

healthcare and similar personnel

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

The standards used for Shanghai Super Gloves Co., Ltd. glove production are based on ASTM-D-5250-92. All testing meets requirements for Physical and Dimensions Testing conducted on gloves, Inspection Level S-2, AQL 4.0.

The FDA 1000 ml. Water Fill Test was also conducted with samplings of AQL 2.5, Inspection Level S-4, meeting these requirements. Primary Skin Irritation and Skin Sensitization (allergic contact dermatitis) testing was conducted with results showing no primary skin irritant or sensitization reactions.

Test for Starch at finished inspection is A USP Iodine conducted to insure that our gloves meet our "powder-free" We adhere to all USP Iodine Test methodogy and testing claim. conducted revealed passing results. We will employ the use of with a "powder-residue by weight"and are contracting laboratory to conduct particulate testing for added assurance. Final release testing consists of a light transmission test using a spectrophotometer.

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

Discussion of Clinical Tests Performed: Not Applicable - There is no hypoallergenic claim.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K#964964, K#942042

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

0

DEC I 7 1997

EXHIBIT #1 Page 1 of 2

510 (K) SUMARY

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR §807.92.

The assigned 510(k) number is: 974120

Submitter's Identification: 1.

Ms. Lee Hung Yun-Shan Shanghai Super Gloves Co., Ltd. No. 4, Tingwai Road, Zhuhang Zhen, Jinshan County, Shanghai, China

Date Summary Prepared: October 29, 1997

2. Name of the Device:

Shanghai Super Gloves Co., Ltd. Powder-Free Vinyl Patient Examination Gloves

3. Predicate Device Information:

Sunmax Enterprise Shanghai Co., Ltd. Powder-Free Vinyl Patient Examination Gloves, K#964964 Cheer & Merit Co., Ltd. Powder-Free Vinyl Patient Examination Gloves, K#942042

4 . Device Description:

Classified by FDA's General and Plastic Surgery Device Panel Class I, 21 CFR 880.6250, Powder-Free Vinyl Patient as Examination Glove, 80LYZ and meets all requirements of ASTM Standard D5250-92.

5. Intended Use:

A patient examination glove is a disposable device intended for medical purposes that is worn on the hand of healthcare and similar personnel to prevent contamination between healthcare personnel and the patient's body, fluids, waste or environment.

6. Comparison to Predicate Devices:

Shanghai Super Gloves Co., Ltd. Powder-Free Vinyl Patient Examination Gloves, is substantially equivalent in safety and

1

EXHIBIT #1 Page 2 of 2

effectiveness to the Sunmax Enterprise Shanghai Co., Ltd. Powder-Free Vinyl Patient Examination Gloves and the Cheer & Merit Powder-Free Vinyl Patient Examination Gloves.

Discussion of Non-Clinical Tests Performed for Determination 7 . of Substantial Equivalence are as follows:

The standards used for Shanghai Super Gloves Co., Ltd. glove production are based on ASTM-D-5250-92. All testing meets requirements for Physical and Dimensions Testing conducted on gloves, Inspection Level S-2, AQL 4.0.

The FDA 1000 ml. Water Fill Test was also conducted with samplings of AQL 2.5, Inspection Level S-4, meeting these requirements. Primary Skin Irritation and Skin Sensitization (allergic contact dermatitis) testing was conducted with results showing no primary skin irritant or sensitization reactions.

There are no special labeling claims and we do not claim our gloves as hypoallergenic on our labels.

Test for Starch at finished inspection is A USP Iodine conducted to insure that our gloves meet our "powder-free" We adhere to all USP Iodine Test methodogy and testing claim. conducted revealed passing results. We will employ the use of with a "powder-residue by weight"and are contracting laboratory to conduct particulate testing for added assurance. Final release testing consists of a light transmission test using a spectrophotometer.

Discussion of Clinical Tests Performed: 8.

Not Applicable - There is no hypoallergenic claim.

9. Conclusions:

Shanghai Super Gloves Co., Ltd. Vinyl Patient Examination Gloves conform fully to ASTM-D-5250-92 standards as well as CFR references, applicable 21 and, meets pinhole IRDA biocompatibility requirements and labeling requirements, claims as shown by data in Section 7. There are no safety/efficacy issues or new claims from the "substantial equivalence" products cited.

2

Image /page/2/Picture/2 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized image of an eagle with its wings spread, with a human profile incorporated into the body of the eagle. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle image.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

DEC 17 1997

Shanghai Super Gloves Company, Ltd. C/O Ms. Susan D. Goldstein-Falk Official Correspondent MDI Consultants, Incorporated 55 Northern Boulevard, Suite 410 Great Neck, New York 11021

K974120 Re : Powder-Free Vinyl Patient Examination Gloves Trade Name: Requlatory Class: I LYZ Product Code: Dated: October 29, 1997 Received: October 31, 1997

Dear Ms. Goldstein-Falk:

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 The general controls provisions of the Act 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. ਸ substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical General regulation (21 CFR Part 820) and that, Devices: through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP requlation may result in requlatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531

3

Page 2 - Ms. Goldstein-Falk

through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or requlations.

This letter will allow you to begin marketing your device as described in your 510 (k) premarket notification. The FDA finding of substantial equivalence of your device to a leqally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling requlation (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 the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your 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,

Timothy A. Whetstone

Timot Director Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

ATTACHMENT TA

Page_1_of_1

510(k) Number (if known):_ K974120

Device Name:___ Shanghai Super Gloves Co., Ltd. Vinyl Patient Examination Gloves-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)

Phim S. bin
(Division Sign-Off)
Division of Dental, Infection Control,
and General Hospital Devices

General Hospital Devices
510(k) Number K974120

Prescription Use (Per 21 CFR 801.109) CR

Over-The-Counter Use X

(Optional Format 1-2-96)

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