K091942 · Zibo Intco Medical Products Co., Ltd. · LYZ · Sep 21, 2009 · General Hospital
Device Facts
Record ID
K091942
Device Name
POWDER-FREE, VINYL PATIENT EXAMINATION GLOVES
Applicant
Zibo Intco Medical Products Co., Ltd.
Product Code
LYZ · General Hospital
Decision Date
Sep 21, 2009
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 880.6250
Device Class
Class 1
Intended Use
A patient examination glove is a disposable device intended for medical purposes that is worn upon the examiner's hands or finger to prevent contamination between patient and examiner (21CFR 880.6250)
Device Story
Patient Vinyl Examination Gloves, Powderfree, Non-Sterile are disposable devices used in clinical or medical settings. Worn by healthcare examiners on hands or fingers to provide a protective barrier, the gloves function to prevent cross-contamination between the patient and the examiner. The device is intended for over-the-counter use.
Indicated for use as a disposable medical glove worn on the examiner's hands or fingers to prevent cross-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.
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Food and Drug Administration 10903 New Hampshire Aveine Document Mail Center -- WO66-G609 Silver Spring, MD .20993-0002
Zibo Intco Medical Products Company, Limited C/O Mr. John Zhao Chief Operating Officer Basic Medical Industries, Incorporated 12390 East End Avenue Chino, California 91710
Re: K091942
Trade/Device Name: Patient Vinyl Examination Gloves, Powderfree, Non-Sterile Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove
Regulatory Class: I
Product Code: LYZ
Dated: August 13, 2009
Received: August 31, 2009
Dear Mr. Zhao:
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. Zhao
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/CDRH Offices/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/MedicalDevices/Safety/ReportaProblem/default.htm 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 (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.
Sincerely vours.
Anthony D. Archer Jr.
Susan Runner, D.D.S., M.A. Acting Division 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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## Zibo Intco Medical Products Co., Ltd. No. 18 Qingtian Road, Qilu Chemical Industry Park, Lizi, Zibo, Shandong, China
## INDICATIONS FOR USE
Zibo Intco Medical Products Co., Ltd. Applicant:
510(k) Number:
091942
Device Name:
Patient Vinyl Examination Gloves, Powderfree, Non-Sterile
Indications of Use:
A patient examination glove is a disposable device intended for medical purposes that is worn upon the examiner's hands or finger to prevent contamination between patient and examiner (21CFR 880.6250)
Prescription Use
Over the Counter Use X
Factory Initials
Shule H. Murphy MD
(Division Sign-Off)
Division of Anesthesiology, General Hospital Infection Control, Dental Devices
510(k) Number:
Panel 1
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