K Number
K992156
Device Name
SYNSATION STERILE POWDER FREE, POLYVINYL CHLORIDE MEDICAL EXAMINATION GLOVES
Manufacturer
Date Cleared
1999-10-27

(124 days)

Product Code
Regulation Number
880.6250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
A sterile disposable device intended for medical purpose that is worn on the examiners hand to prevent contamination between patient and examiner.
Device Description
SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves examination gloves are sterile disposable device intended for medical purposes that is worn on the examiners hand to prevent contamination between patient and examiner.
More Information

Not Found

Not Found

No
The device is a medical examination glove, and the summary describes its function as a barrier to prevent contamination. There is no mention of any computational or analytical capabilities that would suggest the use of AI or ML.

No
The device, a medical examination glove, is intended to prevent contamination, not to treat or diagnose a medical condition.

No
Explanation: The device is a medical examination glove, which is used for contamination prevention, not for diagnosing diseases or conditions.

No

The device is described as a "sterile disposable device" and "examination gloves," which are physical hardware components, not software.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are devices intended for use in the collection, preparation, and examination of specimens taken from the human body (such as blood, urine, or tissue) to provide information for the diagnosis, treatment, or prevention of disease.
  • Device Description: The description clearly states the device is a "sterile disposable device intended for medical purposes that is worn on the examiners hand to prevent contamination between patient and examiner."
  • Intended Use: The intended use is to "prevent contamination between patient and examiner."

This device is a barrier worn on the hand for protection, not a device used to analyze specimens from the body for diagnostic purposes.

N/A

Intended Use / Indications for Use

A sterile disposable device intended for medical purpose that is worn on the examiners hand to prevent contamination between patient and examiner.

Product codes

LYZ

Device Description

SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves examination gloves, meet all of the requirements of ASTM D 5250, Poly (Vinyl Chloride) Gloves for Medical Application.
SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves examination gloves meet all the current specifications for ASTM D 5250, Poly (Vinyl Chloride) Gloves for Medical Application.
SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves examination gloves are sterile disposable device intended for medical purposes that is worn on the examiners hand to prevent contamination between patient and examiner.
SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves examination gloves are summarized with the following technological characteristics compared to ASTM or equivalent standards.

CharacteristicsStandard
DimensionsMeets ASTM D 5250
Physical PropertiesMeets ASTM D 5250
Freedom from holesMeets ASTM D 5250
Meets ASTM D 5151
Powder-Free
Meets described test in Attachment VINot more than 2 mg residue by mass.
Meets ASTM D 6124 and ASTM D 5250
Biocompatability
Primary Skin Irritation in Rabbits
Guinea Pig SensitizationPasses
Passes

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

hand of examiner

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

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)

The performance test data of the non clinical tests are the same as mentioned immediately above.
Clinical data is not needed for medical gloves or for most devices cleared by the 510(k) process.
It is concluded that SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves are as safe, as effective, and perform as well as the glove performance standards referenced in Section 7 above and therefore meet:
ASTM listed standards, FDA hole requirements, and labeling claims for the product.

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

Not Found

Predicate Device(s)

Not Found

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

OCT 2 7 1999

SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves Ansell Perry 1875 Harsh Avenue SE Massillon, Ohio 44646 Telephone: 330-833-2811 330-833-6213 Fax:

Checklist Section 21.0

[1]510 (k) Summary
----------------------
  • (2) Ansell Perry 1875 Harsh Avenue SE Massillon, Ohio 44646
    Telephone: 330-833-2811 Fax: 330-833-6213

Contact: James R. Chatterton Telephone: 330-833-2811 Fax: 330-833-6213

June 23, 1999

[3]

Trade Name:SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves
Common Name:Sterile Examination Gloves
Classification Name:Patient Examination Glove, Sterile
  • [4] SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves examination gloves, meet all of the requirements of ASTM D 5250, Poly (Vinyl Chloride) Gloves for Medical Application.
  • [ર] SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves examination gloves meet all the current specifications for ASTM D 5250, Poly (Vinyl Chloride) Gloves for Medical Application.
  • (୧) SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves examination gloves are sterile disposable device intended for medical purposes that is worn on the examiners hand to prevent contamination between patient and examiner.
  • [7] SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves examination gloves are summarized with the following technological characteristics compared to ASTM or equivalent standards.

1

SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves Ansell Perry 1875 Harsh Avenue SE Massillon, Ohio 44646 Telephone: 330-833-2811 Fax: 330-833-6213

CharacteristicsStandard
DimensionsMeets ASTM D 5250
Physical PropertiesMeets ASTM D 5250
Freedom from holesMeets ASTM D 5250
Meets ASTM D 5151
Powder-Free
Meets described test in Attachment VINot more than 2 mg residue by mass.
Meets ASTM D 6124 and ASTM D 5250
Biocompatability
Primary Skin Irritation in Rabbits
Guinea Pig SensitizationPasses
Passes
  • [8] The performance test data of the non clinical tests are the same as mentioned immediately above.
  • Clinical data is not needed for medical gloves or for most devices cleared by the 510(k) process. [9]
  • [10] It is concluded that SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves are as safe, as effective, and perform as well as the glove performance standards referenced in Section 7 above and therefore meet:

ASTM listed standards, FDA hole requirements, and labeling claims for the product.

  • This summary will include any other information reasonably deemed necessary by The FDA. [11]

2

Image /page/2/Picture/1 description: The image is a black and white logo for the Department of Health & Human Services - USA. The logo features a stylized eagle with three stripes forming its body and wings. The eagle is facing right. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

0CT 2 7 1999

Mr. James R. Chatterton Vice President Regulatory Ansell Perry Ansell Healthcare Products, Incorporated 1875 Harsh Avenue S.E. Massillon, Ohio 44646

Re : K992156

Trade Name: SYNSATION® Sterile Powder Free, Polyvinyl Chloride Medical Examination Gloves Regulatory Class: I Product Code: LYZ Dated: September 17, 1999 Received: September 20, 1999

Dear Mr. Chatterton:

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 Regulations, Title 21, Parts 800 to 895. A 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 regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in

3

Page 2 - Mr. Chatterton

the Federal Register. Please note: this response to your che rederal neground submission does not affect any remarket notificacion babliable sections 531 through 542 of obligation you might have under becomic Product Radiation
the Act for devices under the Elections or regulations the Act for devices ander one Economics or regulations.

This letter will allow you to begin marketing your device as Inis recei will area your fromarket notification. The FDA described in your 510(x) prematice of your device to a legally
finding of substantial equivalence of your device for your finding of substancial equivalition in a classification for your marketed predicate device rebares in a sem-one of the market.

If you desire specific advice for your device on our labeling II you desire specific advice additionally 809.10 for in regulation (21 cm Fare oss are oss artact the Office of
vitro diagnostic devices), please contact the for quocti vitro diagnostic devices), preabscetionally, for questions on Compliance at (301) 394-4692. "Addresses ontact
the promotion and advertising of your device, please contact the promotion and advercibing or jean-4639. Also, please note the regulation entitled, "Misbranding by reference to the regulation entitled, "Misbranding »7 other general premarked notification - (2) circles under the Act may be information on your responsible mall Manufacturers Assistance obtained Trom the Division of Billing (801) or (301) 443-65597 or at at its toil-free number (000) obliga gov/cdrh/dsmamain.html".
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

INDICATIONS FOR USE

Applicant: _________________ Ansell Perry

K99256 510(K) Number (if known): __

Vinyl Patient Examination Glove, Sterile, Powder Free Device Name:

Indications For Use:

A sterile disposable device intended for medical purpose that is worn on the examiners hand 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)

3

Prescription Use P -- 21 CFR 801.109

OR

(Division Sign-Off)

and General Hospital D 510(k) Numbar

Division of Dental, Infection Control

Over-The-Counter
(Optional Form)

-The-Counter

(Optional Format 1-2-96)

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