PRE-POWDERED VINYL EXAM GLOVES

K042951 · Zibo Hengchang Plastic & Rubber Products Co., Ltd. · LYZ · Mar 10, 2005 · General Hospital

Device Facts

• Record ID: K042951
• Device Name: PRE-POWDERED VINYL EXAM GLOVES
• Applicant: Zibo Hengchang Plastic & Rubber Products Co., Ltd.
• Product Code: LYZ · General Hospital
• Decision Date: Mar 10, 2005
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 880.6250
• Device Class: Class 1
• Attributes: 3rd-Party Reviewed

Intended Use

A patient examination glove is a disposable device intended for medical purpose that is worn on the examiner's hands or finger to prevent contamination between patient and examiner.

Device Story

Pre-powdered vinyl examination gloves; disposable; worn on hands or fingers by healthcare examiners; function as protective barrier to prevent cross-contamination between patient and examiner; intended for medical use.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Vinyl material; pre-powdered; disposable; patient examination glove; Class I device; Product Code LYZ; Regulation 880.6250.

Indications for Use

Indicated for use as a disposable medical device worn on the hands or fingers of healthcare examiners to prevent cross-contamination between the patient and the examiner.

Regulatory Classification

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.

Submission Summary (Full Text)

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Image /page/0/Picture/1 description: The image shows the seal of the Department of Health and Human Services (HHS). The seal is circular and contains the words "DEPARTMENT OF HEALTH AND HUMAN SERVICES. USA" around the perimeter. In the center of the seal is an abstract image of an eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR 1 0 2005

Zibo Hengchang Plastic & Rubber Products Company Limited C/O Mr. Mark Job Responsible Third Party Official Regulatory Technology Services, LLC 1394 250 Street NW Buffalo, Minnesota 55313

Rc: K042951

Trade/Device Name: Pre-Powdered Vinyl Examination Gloves Regulation Number: 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LYZ Dated: February 26, 2005 Received: February 28, 2005

Dear Mr. Job:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and 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) that do not require approval of a premarket approval application (PMA). 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 cither class II (Special Controls) or class III (PMA), 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 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

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Page 2 - Mr. Job

Please be advised that FDA's issuance of a substantial equivalence determination does not Please oe advised that I Dri 5 issualited on that your device complies with other requirements Incall that I DA nas made a decembers and regulations administered by other Federal agencies. 01 the Act of ally i ederal bate regirements, including, but not limited to: registration r out intist comply with and 807); labeling (21 CFR Part 801); good manufacturing practice alla listing (21 CFR Part 607), laceming (DS) regulation (21 CFR Part 820); and if
requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if requirents as set forth in the quality bjoksions (Sections 531-542 of the Act); 21 CFR 1000-1050.

This letter will allow you to begin marketing your device as described in your Section 510(k) I mis letter will anon you to ough time of substantial equivalence of your device to a premarket notification. - The 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), If you desire specific advice for Jour as at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the may obtain other generalianal and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Chiu Lin, Ph.D.

Chiu Lin, Ph.D. Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosurc

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## Indications for Use

510(k) Number (if known): _ K 0 4295)

Device Name: _________PRE-POWDERED VINYL EXAM GLOVES__

Indications for Use:

A patient examination glove is a disposable device intended for medical purpose that A patient examiner's hands or finger to prevent contamination between patient and examiner.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ (Part 21 CFR 801 Subpart D)

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AND/OR

Over-The-Counter Use (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Gouth W. Dechase OMD

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042951