KIMBERLY-CLARK *LAVENDER* NITRILE POWER-FREE EXAM GLOVES

K081260 · Kimberly-Clark Corp. · LZA · Jul 9, 2008 · General Hospital

Device Facts

• Record ID: K081260
• Device Name: KIMBERLY-CLARK *LAVENDER* NITRILE POWER-FREE EXAM GLOVES
• Applicant: Kimberly-Clark Corp.
• Product Code: LZA · General Hospital
• Decision Date: Jul 9, 2008
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 880.6250
• Device Class: Class 1

Intended Use

The Kimberly-Clark* Lavender* Powder-Free Exam Gloves are disposable Devices, intended for medical purposes that are worn on the examiner's hand to prevent contamination between patient and examiner.

Device Story

Disposable, lavender-colored, nitrile, powder-free, textured-fingertip, ambidextrous patient examination glove. Worn by healthcare examiners to provide a barrier against contamination between patient and examiner. Device is non-sterile. No electronic or mechanical components.

Clinical Evidence

No clinical data. Biocompatibility and performance confirmed via non-clinical laboratory and animal-based testing, including ISO 10993-10 (skin irritation, murine local lymph node assay) and ISO 10993-11 (systemic toxicity).

Technological Characteristics

Nitrile material; powder-free; chlorinated; textured fingertip; ambidextrous. Complies with ASTM D 6319-00a (dimensions, physical properties, pinholes), ASTM D 5151-06 (pinholes), and ASTM D 6124-06 (powder-free).

Indications for Use

Indicated for use as a patient examination glove worn on the examiner's hand to prevent contamination between patient and examiner. Intended for medical purposes.

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.

Predicate Devices

• Kimberly-Clark* STERLING* Nitrile Powder-Free Exam Glove (K051347)

Submission Summary (Full Text)

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# ්‍රිග් Kimberly-Clark Corporation

Traditional 510(k) for Kimberly-Clark* Lavender* Nitrile Powder-Free Exam Gloves

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### Section 5. 510(k) SUMMARY

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## SUMMARY OF SAFETY AND EFFECTIVENESS INFORMATION

| Submitter's Name: | Kimberly-Clark Corporation |
|------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Submitter's Address: | 1400 Holcomb Bridge Road<br>Roswell, GA 30076-2199 |
| Submitter's Phone No: | 770-587-8208 |
| Submitter's Fax No. | 920-969-5160 |
| Date of Preparation: | May 1, 2008 |
| Name of Device | |
| Trade Name: | Kimberly-Clark* Lavender* Nitrile Powder-Free Exam Glove |
| Common Name: | Patient examination glove |
| Classification Name: | Glove, Patient Examination, Poly - 80 LZA |
| Legally marketed device<br>to which equivalency is<br>claimed: | Kimberly-Clark* STERLING* Nitrile Powder-Free Exam Glove - K051347 |
| Description of the device: | Lavender colored nitrile, chlorinated, powder-free, textured fingertip,<br>ambidextrous patient examination glove that meets all of the requirements of<br>ASTM D 6319-00a, Standard Specification for Nitrile Examination Gloves for<br>Medical Application. |
| Intended use of device: | The Kimberly-Clark* Lavender* Powder-Free Exam Gloves are disposable<br>Devices, intended for medical purposes that are worn on the examiner's hand<br>to prevent contamination between patient and examiner. |
| Summary of technological<br>characteristics compared<br>to predicate device: | There are no different technological characteristics compared to the predicate<br>device. They are both powder-free non-sterile nitrile exam gloves, the predicate<br>being a light gray color and the subject of this application being a lavender color. |

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### Traditional 510(k) for Kimberly-Clark* Lavender* Nitrile Powder-Free Exam Gloves

## SUMMARY OF SAFETY AND EFFECTIVENESS INFORMATION

(Continued)

| Brief description of Non-<br>Clinical Tests: | Non-Clinical Tests | Standard | Performance |
|-------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------|-------------|
| | Dimensions | ASTM D 6319-00a | Meets |
| | Physical Properties | ASTM D 6319-00a | Meets |
| | Freedom from pinholes | ASTM D 6319-00a | Meets |
| | | ASTM D 5151-06 | Meets |
| | Powder Free | ASTM D 6124-06 | Meets |
| | | ASTM D 6319-00a | Meets |
| | ISO Skin Irritation Study | ISO 10993, Part 10 | Meets |
| | Murine Local Lymph Node Assay | ISO 10993, Part 10 | Meets |
| | ISO Systemic Toxicity Study | ISO 10993, Part 11 | Meets |
| Brief description of Clinical<br>Tests: | No new clinical tests were required to support this 510(k) application. | | |
| Conclusions drawn from the<br>Non-Clinical and Clinical<br>Tests: | Non-clinical laboratory and animal based biocompatibility test data confirm<br>the Kimberly-Clark* Lavender* Nitrile Powder-Free Exam Gloves meet all<br>applicable exam glove performance and biocompatibility requirements. | | |
| Other Information deemed<br>necessary by the FDA: | None | | |

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Richard V. Wolfe Associate Director, Regulatory Affairs Kimberly-Clark Corporation 1400 Holcomb Bridge Road Roswell, Georgia 30076

Re: K081260

Trade/Device Name: Kimberly-Clark* Lavender* Nitrile Powder-Free Exam Gloves Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LZA Dated: June 16, 2008 Received: June 18, 2008

JUL - 9 2008

Dear Mr. Wolfe:

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 either 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. Wolfe

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (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) 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), please contact the Office of Compliance 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 Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Clues

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

Enclosure

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# Kimberly-Clark Corporation

#### INDICATIONS FOR USE

Kimberly-Clark Corporation Applicant:

K081260 510(k) Number:

Device Name: Kimberly-Clark* Lavender* Nitrile Powder-Free Exam Gloves

Based upon 21 CFR§880.6250 "Patient examination glove" Indications for Use:

> A patient examination glove is a medical device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

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Concurrence of CDRH Office of Device Evaluation (ODE)

Prescription Use Per 21CFR 801.109 Subpart D OR

Over-The-Counter X Per 21CFR 801.109 Subpart C

Clus ts

(Division Sign-Off) Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number: K081260