K Number
K991992
Device Name
ULTRAFREE THICK STERILE LATEX POWDER-FREE SURGICAL GLOVES
Date Cleared
1999-07-13

(29 days)

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

Not Found

Not Found

No
The device description and performance studies focus on the physical properties and barrier performance of surgical gloves, with no mention of AI or ML.

No.
The device (surgical gloves) is intended to protect a surgical wound from contamination, not to treat or alleviate a disease or condition.

No

Explanation: The device is described as surgical gloves intended to protect a surgical wound from contamination, which is a protective function, not a diagnostic one. The performance studies also focus on material and safety properties, not diagnostic accuracy.

No

The device description clearly states it is a physical product (surgical gloves made of natural rubber latex) and the performance studies focus on physical and biological properties, not software performance.

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

Here's why:

  • Intended Use: The intended use is to protect a surgical wound from contamination and to be worn by operating room personnel during medical procedures. This is a barrier function for protection, not a diagnostic test performed on a sample from the human body.
  • Device Description: The device is described as surgical gloves made of natural rubber latex. This is a physical barrier device.
  • Lack of Diagnostic Elements: There is no mention of analyzing samples (blood, urine, tissue, etc.), detecting biomarkers, or providing diagnostic information about a patient's health status.
  • Performance Studies: The performance studies focus on the physical properties of the gloves (tensile strength, elongation, barrier defects) and biocompatibility (toxicity, reactivity, irritation), which are relevant to their function as a protective barrier, not a diagnostic tool.

IVD devices are used to examine specimens derived from the human body to provide information for the diagnosis, prevention, monitoring, treatment, or alleviation of disease. This description clearly falls outside of that definition.

N/A

Intended Use / Indications for Use

Ultrafree Plus Sterile Latex Powder-Free Surgical Gloves are intended to be worn by operating room personnel to protect a surgical wound from contamination. The gloves are appropriate for use during invasive and non-invasive medical procedures requiring sterility.

These gloves are intended for use in environments within hospitals and other healthcare facilities. The gloves are appropriate for uses during invasive as well as non-invasive surgical 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

Ultrafree Plus Powder-Free Surgical gloves are formulated using natural rubber latex and offered 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
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)

Systemic Toxicity: Glove does not elicit any toxic reactions to acute application.
Intracutaneous Reactivity: No reactivity was observed.
Guinea Pig Maximization: Glove does not display any potential for irritation.
Ultimate Elongation & Tensile Strength: Glove meets or exceeds requirements for rubber surgical gloves per ASTM D3577-99.
Barrier Defects: Glove exceeds requirements per 21 CFR §800.20, AQL = 2.5.
Data/Test Method: Glove meets 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 4 mg of powder residue per glove. The specification limit for the amount of powder residue for this product in the year 1999 will be less than 4.0 mg and will be reduced by 1.0 mg each year until a final limit of not more than 2.0 mg is achieved in accordance with ASTM D3577-99.

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

Barrier Defects: AQL = 2.5.
Powder Residue: below 4 mg of powder residue per glove; specification limit

§ 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

JUL 13 1999

XIV. SUMMARY OF SAFETY AND EFFECTIVENESS

Allegrance

K991992

510(k) SUMMARY OF SAFETY AND EFFECTIVENESS ULTRAFREE PLUS 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, MP-WM
McGaw Park, IL 60085 |
| Telephone: | (847) 785-3337 |
| Date Summary Prepared: | 7/8/99 |
| Product Trade Name: | Ultrafree Plus Sterile Latex Powder-Free Surgical Gloves |
| Common Name: | Surgical Glove |
| Classification: | Glove, Surgical |
| Predicate Devices: | Ultrafree Sterile Latex Powder-Free Surgical Gloves |
| Description: | Ultrafree Plus Powder-Free Surgical gloves are formulated
using natural rubber latex and offered sterile. |
| Intended Use: | Ultrafree Plus Sterile Latex Powder-Free Surgical Gloves are intended
to be worn by operating room personnel to protect a surgical wound
from contamination. The gloves are appropriate for use during
invasive and non-invasive medical procedures requiring sterility. |
| Substantial Equivalence: | Ultrafree Plus Sterile Latex Powder-Free Surgical Gloves are
substantially equivalent to Ultrafree Sterile Latex Powder-Free
Surgical Gloves in that they provide the following characteristics:

  • intended use
  • size, configuration, packaging
  • made of natural rubber latex
  • tensile strength and elongation |

1

:

.

Summary of Testing:

2017

1 YU . フロフ ס / . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Page 2

.

TestResult
Systemic ToxicityGlove does not elicit any
toxic reactions to acute
application.
Intracutaneous ReactivityNo reactivity was observed.
Guinea Pig MaximizationGlove does not display any
potential for irritation.
Ultimate Elongation
& Tensile StrengthGlove meets or exceeds
requirements for rubber
surgical gloves per
ASTM D3577-99.
Barrier DefectsGlove exceeds requirements
per 21 CFR §800.20, AQL = 2.5.
Data/Test MethodGlove meets 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
4 mg of powder residue per glove.
The specification limit for the amount of
powder residue for this product in the
year 1999 will be less than 4.0 mg and
will be reduced by 1.0 mg each year
until a final limit of not more than 2.0
mg is achieved in accordance with
ASTM D3577-99.

.

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circle with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized symbol that resembles a human figure in profile, with three overlapping heads or faces, and three wavy lines below, possibly representing water or movement.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUL 13 1999

Ms. Erica Sethi Manager, Regulatory Affairs Allegiance Healthcare Corporation 1500 Waukegan Road 60085 McGaw Park, Illinois

K991992 Re : Ultrafree Thick Sterile Latex Powder-Free Trade Name: Surgical Gloves Requlatory Class: I Product Code: KGO Dated: June 8, 1999 Received: June 14, 1999

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 devices marketed in interstate abe beated in the env 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 requlations affecting your device can be found in the Code of Federal Requlations, Title 21, Parts 800 to 895. ಗಿ substantially equivalent determination assumes compliance with the Good Manufacturing Practice for Medical Devices: General (GMP) regulation (21 CFR Part 820) and that, through periodic GMP inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP requlation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Reqister.

3

Page 2 - Ms. Sethi

this response to your premarket notification Please note: submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin marketing your device as inforibed in your 510(k) premarket notification. The FDA debtired in jour ------------------------------------------------------------------------------------------------------------------------------------------------------------marketed predicate device results in a classification for your markets predications wour 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) 594-4692. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note ene orgulation entitled, "Misbranding by reference to ene regaration" (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. Ulatowski

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

Enclosure

4

Allegiance

Allegiance Healthcare Corporation
1500 Waukegan Road
McGaw Park, Winois 60085-6787
847.473.1500
FAX: 847,785,2460

Page 1 of 1

Applicant: Allegiance Healthcare Corporation

510(k) Number (if known): K991992

Ultrafree Plus Sterile Latex Powder-Free Surgical Gloves Device Name:

These gloves are intended for use in environments within hospitals Indications For Use: and other healthcare facilities. The gloves are appropriate for uses during invasive as well as non-invasive surgical procedures requiring sterlity. 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)
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Prescription Use (Per 21 CFR 801.109)orOver-The Counter Use X
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(Division Sign-Off)
Division of Dental, Infection Control, and General Hospital Devices
510(k) NumberK991992
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