VINYL POWDER FREE EXAMINATION GLOVE

K091383 · Shun Tong Co., Ltd. · LYZ · Jul 22, 2009 · General Hospital

Device Facts

• Record ID: K091383
• Device Name: VINYL POWDER FREE EXAMINATION GLOVE
• Applicant: Shun Tong Co., Ltd.
• Product Code: LYZ · General Hospital
• Decision Date: Jul 22, 2009
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 880.6250
• Device Class: Class 1

Intended Use

A patient examination Vinyl Powder Free Examination Clove is a disposable device is a disposable device A patient examination Vinyl Powder Free Examiner's hand to prevent intended for medical purpose that is worn on the examiner's hand to prevent intended for medical purpose th intended for medical purpose and examiner.

Device Story

Vinyl Powder Free Examination Glove; disposable device; worn on examiner's hand; intended for medical purposes to prevent cross-contamination between patient and examiner; used in clinical settings.

Clinical Evidence

Bench testing only.

Technological Characteristics

Vinyl material; powder-free; disposable; patient examination glove; Class I device.

Indications for Use

Indicated for use as a disposable patient examination glove worn on the examiner's hand to prevent contamination between patient and 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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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Tan Chee Hoong Senior Operation Manager Shun Tong Company, Limited North of Gao Xing Tong Road Economic Developing District Xinghua City, Jiangsu China 225700

## JUL 222009

Re: K091383

Trade/Device Name: Vinyl Powder Free Examination Glove Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LYZ Dated: June 18, 2009 Received: July 6, 2009

Dear Mr. Tan Chee Hoong:

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 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. Tan Chee Hoong

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to

http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/cdrh/mdr/ for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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/industry/support/index.html.

Sincerely vours.

Antimony, D. W. stain for

Susan Runner, D.D.S., M.A. Acting 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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## Indications for Use

K 091383 510(k) Number (if known):

Device Name: _Vinyl Powder Free Examination Glove

Indications for Use:

A patient examination Vinyl Powder Free Examination Clove is a disposable device is a disposable device A patient examination Vinyl Powder Free Examiner's hand to prevent
intended for medical purpose that is worn on the examiner's hand to prevent
intended for medical purpose th intended for medical purpose and examiner.

Prescription Use ್ AND/OR Fiescription Subpart D)

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Sharlene A. Murphy, MD

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

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510(k) Number:

1 2.83