K Number
K983962
Device Name
ULTRAFREE TEXTURED STERILE LATEX POWDER-FREE SURGICAL GLOVES
Date Cleared
1999-01-08

(63 days)

Product Code
Regulation Number
878.4460
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
These gloves are intended for use in environments within hospitals and other healthcare facilities. The gloves are appropriate for use during invasive as well as non-invasive medical procedures requiring sterility. They are intended to be worn by operating room personnel to protect a surgical wound from contamination.
Device Description
The Ultrafree Textured Surgical gloves are formulated using natural rubber latex and offered powder-free and sterile.
More Information

Not Found

Not Found

No
The 510(k) summary describes standard surgical gloves and does not mention any AI or ML capabilities. The performance studies focus on material properties and regulatory compliance, not algorithmic performance.

No
The device, surgical gloves, is intended to protect the surgical wound from contamination, which is a barrier function, not a therapeutic one. It does not treat or cure any medical condition.

No
This device is a surgical glove, intended to protect a surgical wound from contamination, not to diagnose a medical condition.

No

The device is described as surgical gloves made from natural rubber latex, which are physical hardware components, not software.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use of these gloves is to protect a surgical wound from contamination and to be worn by operating room personnel during medical procedures. This is a barrier function, not a diagnostic function.
  • Device Description: The description focuses on the material (natural rubber latex), form (powder-free, sterile), and texture. There is no mention of any components or processes related to analyzing biological samples or providing diagnostic information.
  • Lack of IVD Indicators: The document 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 biological samples
    • Providing information for the diagnosis, monitoring, or treatment of a disease or condition based on sample analysis.
    • Mentions of image processing, AI/ML, or specific imaging modalities (which can sometimes be associated with certain types of IVDs, though not exclusively).

The device is clearly a medical device intended for barrier protection during surgical procedures.

N/A

Intended Use / Indications for Use

Ultrafree Textured Sterile Latex Powder-Free Surgical Gloves are intended for use in environments within hospitals and other healthcare facilities. The gloves are appropriate for use during invasive and non-invasive medical procedures requiring sterility. They are intended to be worn by operating room personnel to protect a surgical wound from contamination.

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

KGO

Device Description

The Ultrafree Textured Surgical gloves are formulated using natural rubber latex and offered powder-free and sterile.

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

operating room personnel in environments within hospitals and other healthcare facilities

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)

Test: Primary Skin Irritation; Result: Biocompatability tests successfully performed on Ultrafree Surgical Gloves were considered applicable to Ultrafree Textured Surgical Glove since they are made using the same latex formulation and manufacturing process. Gloves do not display any potential for irritation.
Test: Systemic Toxicity; Result: Gloves do not elicit any toxic reactions to acute application.
Test: Intracutaneous Reactivity; Result: Gloves show no reactivity.
Test: Hemocompatibility; Result: Gloves are hemocompatible exhibiting no lysis.
Test: Guinea Pig Maximization; Result: Gloves do not display any potential for irritation.
Test: Ultimate Elongation & Tensile Strength; Result: Gloves meet or exceed requirements for rubber surgical gloves per ASTM D3577-91.
Test: Barrier Defects; Result: Gloves meet or exceed requirements per 21 CFR §800.20, AQL = 2.5.
Test: Data/Test Method; Result: Gloves meet powder level requirements for "Powder Free" designation using ASTM Standard D6124-97-Standard test method for residual powder on medical gloves. Results generated values below 2 mg of residual powder per glove.

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

Ultimate Elongation & Tensile Strength: Meet or exceed requirements per ASTM D3577-91.
Barrier Defects: Meet or exceed requirements per 21 CFR §800.20, AQL = 2.5.
Powder Level: Below 2 mg of residual powder per glove.

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

Ultrafree Sterile Latex Powder-Free Surgical Gloves

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 878.4460 Non-powdered surgeon's glove.

(a)
Identification. A non-powdered surgeon's glove is a device intended to be worn on the hands of operating room personnel to protect a surgical wound from contamination. A non-powdered surgeon's 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).

0

K983962

8 1999 JAN

! 上

XIV. SUMMARY OF SAFETY AND EFFECTIVENESS

Allegiance

510(k) SUMMARY OF SAFETY AND EFFECTIVENESS ULTRAFREE TEXTURED STERILE LATEX POWDER-FREE SURGICAL GLOVES

| Manufacturer: | Allegiance Healthcare Sdn. Bhd.
Plot 87, Kampung Jawa
11900 Bayan Lepas
Penang, West Malaysia |
|-------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Regulatory Affairs Contact: Erica Sethi | Allegiance Healthcare Corporation
1500 Waukegan Road, Bldg. K
McGaw Park, IL 60085 |
| Telephone: | (847) 785-3337 |
| Date Summary Prepared: | October 21, 1998 |
| Product Trade Name: | Ultrafree Textured Sterile Latex Powder-Free Surgical Gloves |
| Common Name: | Surgical Glove |
| Classification: | Glove, Surgeon's |
| Predicate Devices: | Ultrafree Sterile Latex Powder-Free Surgical Gloves |
| Description: | The Ultrafree Textured Surgical gloves are formulated using
natural rubber latex and offered powder-free and sterile. |
| Intended Use: | Ultrafree Textured Sterile Latex Powder-Free Surgical Gloves are
intended for use in environments within hospitals and other
healthcare facilities. The gloves are appropriate for use during
invasive and non-invasive medical procedures requiring sterility.
They are intended to be worn by operating room personnel to
protect a surgical wound from contamination. |
| Substantial Equivalence: | The Ultrafree Textured Sterile Latex Powder-Free Surgical Gloves
are substantially equivalent to Ultrafree Sterile Latex Powder-Free
Surgical Gloves in that they provide the following characteristics:

  • same intended use
  • same sizes, configuration, packaging
  • both made of natural rubber latex
  • same tensile strength and thickness profiles |
    | Summary of Testing: | |
    | Test | Result |
    | Primary Skin
    Irritation | Biocompatability tests successfully performed on Ultrafree Surgical
    Gloves were considered applicable to Ultrafree Textured Surgical
    Glove since they are made using the same latex formulation and
    manufacturing process. Gloves do not display any potential for
    irritation. |
    | Systemic Toxicity | Gloves do not elicit any toxic reactions to acute application. |
    | Intracutaneous Reactivity | Gloves show no reactivity. |
    | Hemocompatibility | Gloves are hemocompatible exhibiting no lysis. |
    | Guinea Pig Maximization | Gloves do not display any potential for irritation. |
    | Ultimate Elongation
    & Tensile Strength | Gloves meet or exceed requirements for rubber surgical gloves
    per ASTM D3577-91. |
    | Barrier Defects | Gloves meet or exceed requirements per 21 CFR
    §800.20, AQL = 2.5. |
    | Data/Test Method | Gloves meet powder level requirements for "Powder Free"
    designation using ASTM Standard D6124-97-Standard test method
    for residual powder on medical gloves. Results generated values
    below 2 mg of residual powder per glove. |

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K983962

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Image /page/2/Picture/2 description: The image shows a partial view of a logo or emblem, featuring a stylized graphic element on the left. The graphic consists of three curved lines or shapes stacked vertically, resembling a simplified representation of a wing or a flowing object. To the right of the graphic, there is a partial word or name, with only the letters 'DEPART' visible. The overall impression is that of an official or organizational symbol, possibly related to a department or agency.

1000 JAN

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Ms. Erica Sethi Allegiance Healthcare Corporation 1500 Waukegan Road, Building K McGaw Park, Illinois 60085

Re: K983962 Ultrafree Textured Sterile Latex Powder-Free Trade Name: Surgical Gloves Requlatory Class: I Product Code: KGO Dated: December 16, 1998 December 17, 1998 Received:

Dear Ms. Sethi:

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 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 (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 reqistration, listing of devices, good manufacturing practice, labeling, and prohibitions aqainst 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 requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (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 requlation may result in regulatory In addition, FDA may publish further announcements action. 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

3

Page 2 - Ms. Sethi

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 legally 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 regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4692. 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" (21CFR 807.97). Other genera 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/dsma/dsmanain.html".

Sincerely yours,

Timothy A. Ulatowski

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

Enclosure

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Image /page/4/Picture/0 description: The image shows the word "Allegiance" in a stylized font. To the left of the word is a symbol that looks like a plus sign made up of small squares. The word is written in a bold, sans-serif font, with the letters slightly slanted to the right. The overall impression is one of strength and stability.

..............................................................................................................................................................................

Allegiance Healthcare Corporation 1500 Waukegan Road McGaw Park, Illinois 60085-6787 847.473.1500 FAX: 847.785.2460

Page 1 of 1

Applicant:Allegiance Healthcare Corporation
510(k) Number:K983962
Device Name:Ultrafree Textured Sterile Latex Powder-Free Surgical Gloves
Indications For Use:These gloves are intended for use in environments within hospitals and other healthcare facilities. The gloves are appropriate for use during invasive as well as non-invasive medical procedures requiring sterility. They are intended to be worn by operating room personnel to protect a surgical wound from contamination.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)
Prescription Use
(Per 21 CFR 801.109)or
Over The Counter Use
(Division Sign-Off)
Division of Dental, Infection Control

Division of Dental, Infection, Et
and General Hospital Device:
510(k) Number K983662