PureZero LIMON Nitrile Powder-Free Exam Gloves, PureZero LIMON-XTRA Nitrile Powder-Free Exam Gloves

K220541 · O&M Halyard, Inc. · LZA · Jun 2, 2022 · General Hospital

Device Facts

Record IDK220541
Device NamePureZero LIMON Nitrile Powder-Free Exam Gloves, PureZero LIMON-XTRA Nitrile Powder-Free Exam Gloves
ApplicantO&M Halyard, Inc.
Product CodeLZA · General Hospital
Decision DateJun 2, 2022
DecisionSESE
Submission TypeSpecial
Regulation21 CFR 880.6250
Device ClassClass 1

Intended Use

The PureZero LIMON Nitrile Powder-Free Exam Gloves with Chemotherapy Drugs, Fentanyl Citrate and Gastric Acid claim and PureZero LIMON-XTRA Nitrile Powder-Free Exam Gloves with Chemotherapy Drugs, Fentanyl Citrate and Gastric Acid claim is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner.

Device Story

Disposable nitrile examination gloves; green, chlorinated, powder-free, textured fingertip, ambidextrous. Used by clinicians in medical settings to prevent cross-contamination. Provides barrier protection against patient fluids and specific chemical agents. Subject device tested for permeation resistance against chemotherapy drugs, fentanyl citrate, and gastric acid per ASTM D6978-05. Output is a physical barrier; healthcare providers use the glove during patient examinations or handling of hazardous drugs to reduce exposure risk. Benefits include protection of both patient and examiner from contamination.

Clinical Evidence

Bench testing only. No clinical data. Testing included ASTM D6978-05 (chemotherapy drug permeation), ASTM D5151-06 (leakage/pinholes), ASTM D6124-06 (residual powder), ASTM D6319-10 (physical dimensions/tensile strength), and ISO 10993 (biocompatibility: irritation, sensitization, systemic toxicity). Results met all acceptance criteria.

Technological Characteristics

Nitrile rubber material; powder-free; chlorinated; textured fingertips. Non-sterile. Dimensions: 9.5 inches (LIMON) or 12 inches (LIMON-XTRA). Complies with ASTM D6319, D5151, D6124, D6978, and ISO 10993 standards.

Indications for Use

Indicated for use as a disposable patient examination glove worn by medical examiners to prevent cross-contamination between patient and examiner. Tested for resistance to permeation by specific chemotherapy drugs, fentanyl citrate, and gastric acid.

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

Related Devices

Submission Summary (Full Text)

{0}------------------------------------------------ Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: a symbol on the left and the FDA name and title on the right. The symbol on the left is a stylized representation of a human figure, while the text on the right reads "FDA U.S. FOOD & DRUG ADMINISTRATION" in blue letters. June 2, 2022 ೦&M Halyard, Inc. Angela Bunn Director. Global Regulatory Affairs 1 Edison Drive Alpharetta, Georgia 30005 Re: K220541 Trade/Device Name: PureZero LIMON Nitrile Powder-Free Exam Gloves, PureZero LIMON-XTRA Nitrile Powder-Free Exam Gloves Regulation Number: 21 CFR 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: Class I, reserved Product Code: LZA, LZC, QDO Dated: April 28, 2022 Received: May 3, 2022 Dear Angela Bunn: 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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading. 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. 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 {1}------------------------------------------------ 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 of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems. For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100). Sincerely, For Bifeng Oian, Ph D Acting Assistant Director DHT4B: Division of Infection Control and Plastic Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health Enclosure {2}------------------------------------------------ # Indications for Use ### 510(k) Number (if known) #### K220541 #### Device Name The PureZero LIMON Nitrile Powder-Free Exam Gloves with Chemotherapy Drugs, Fentanyl Citrate and Gastric Acid claim and PureZero LIMON-XTRA Nitrile Powder-Free Exam Gloves #### Indications for Use (Describe) The PureZero LIMON Nitrile Powder-Free Exam Gloves with Chemotherapy Drugs, Fentanyl Citrate and Gastric Acid claim and PureZero LIMON-XTRA Nitrile Powder-Free Exam Gloves with Chemotherapy Drugs, Fentanyl Citrate and Gastric Acid claim is a disposable device intended for medical purposes that is worn on the examiner's hand to prevent contamination between patient and examiner. The following chemotherapy drugs and concentration had NO breakthrough detected up to 240 minutes: | Cisplatin (1 mg/ml) | Cyclophosphamide (20 mg/ml) | |-------------------------------------------|----------------------------------------------------------------------------| | Dacarbazine (10 mg/ml) | Doxorubicin HCI (2 mg/ml) | | Etoposide (20 mg/ml) | Fluorouracil (50 mg/ml) | | Ifosfamide (50 mg/ml) | Methotrexate (25 mg/ml) | | Mitomycin C (0.5 mg/ml) | Mitoxantrone HCI (2 mg/ml) | | Paclitaxel (6 mg/ml) | Vincrinstine Sulfate (1 mg/ml) | | Fentanyl Citrate Injection (100 mcg/2 mL) | Simulated Gastric Acid Fluid/Fentanyl Citrate Injection Mix 50/50 Solution | The following chemotherapy drugs and concentration showed breakthrough detected in less than 90 minutes: ThioTEPA (10 mg/ml), breakthrough detected at 87.6 minutes Carmustine (3.3 mg/ml), breakthrough detected at 34.3 minutes Warning: Not for Use With: Carmustine, ThioTEPA Type of Use (Select one or both, as applicable) Prescription Use (Part 21 CFR 801 Subpart D) Over-The-Counter Use (21 CFR 801 Subpart C) ## CONTINUE ON A SEPARATE PAGE IF NEEDED. {3}------------------------------------------------ {4}------------------------------------------------ This section applies only to requirements of the Paperwork Reduction Act of 1995. ## *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.* The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to: > Department of Health and Human Services Food and Druq Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov "An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number." {5}------------------------------------------------ # 510(k) Summary # K220541 | Date Summary<br>was Prepared | February 10, 2022 | |-------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| | 510(k) Submitter | O & M Halyard, Inc.<br>1 Edison Drive<br>Alpharetta, GA 30005 | | Primary Contact for<br>this 510(k) Submission | Angela L. Bunn, RAC<br>Tel: 470-347-7147<br>Email: angela.bunn@owens-minor.com | | Marketed Common Name | Nitrile Powder-Free Exam Gloves | | Device Submission Trade Name<br>and Description | PureZero LIMON Nitrile Powder-Free Exam Gloves with Chemotherapy Drugs,<br>Fentanyl Citrate and Gastric Acid claim | | | PureZero LIMON-XTRA Nitrile Powder-Free Exam Gloves with Chemotherapy<br>Drugs, Fentanyl Citrate and Gastric Acid claim | | Device Common Name | Patient Examination Gloves | | Device Product Code<br>and Classification Name | LZA Class I, 21 CFR §880.6250 Patient Examination Glove<br>LZC Class I, 21 CFR §880.6250 Patient Examination Glove, Specialty<br>QDO Class 1, 21 CFR §880.6250 Fentanyl and Other Opioid Protection Glove | | Predicate Device | Halyard Sterling* Nitrile Powder-Free Exam Glove with Chemotherapy Drug<br>and Fentanyl Citrate Claim (K191230) | | Subject Device Description | The subject device is a green colored, chlorinated, nitrile, powder-free,<br>textured fingertip, ambidextrous, patient examination gloves. The devices<br>follow consensus standards:<br>ASTM D5151-06 Standard Test Method for Detection of Holes in Medical<br>Gloves | | | ASTM D6319-10 Standard Specification for Nitrile Examination Gloves for<br>Medical Applications | | | ASTM D6124-06 Standard Test Method for Residual Powder on Medical<br>Gloves | | | ASTM D6978-05 Standard Practice for Assessment of Resistance of Medical<br>Gloves to Permeation by Chemotherapy Drugs | | | ISO 10993-11:2017, Biological evaluation of medical devices - Part 11:<br>Tests for Systemic Toxicity | | | ISO 10993-10: 2010: Biological evaluation of medical devices - Part 10: | | | | | Indications for Use | Tests for Irritation and Skin Sensitization<br>The PureZero LIMON Nitrile Powder-Free Exam Gloves with Chemotherapy<br>Drugs, Fentanyl Citrate and Gastric Acid claim and PureZero LIMON-XTRA Nitrile<br>Powder-Free Exam Gloves with Chemotherapy Drugs, Fentanyl Citrate and<br>Gastric Acid claim is a disposable device intended for medical purposes that is<br>worn on the examiner's hand to prevent contamination between patient and<br>examiner. | | | The following chemotherapy drugs and concentration had NO breakthrough<br>detected up to 240 minutes: | | | Cisplatin (1 mg/ml) | | | Cyclophosphamide (20 mg/ml) | | | Dacarbazine (10 mg/ml) | | | Doxorubicin HCI (2 mg/ml) | | | Etoposide (20 mg/ml) | | | Fluorouracil (50 mg/ml) | | | Ifosfamide (50 mg/ml) | | | Methotrexate (25 mg/ml) | | | Mitomycin C (0.5 mg/ml) | | | Mitoxantrone HCI (2 mg/ml) | | | Paclitaxel (6 mg/ml) | | | Vincrinstine Sulfate (1 mg/ml) | | | Fentanyl Citrate Injection (100 mcg/2 mL) | | | Simulated Gastric Acid Fluid/Fentanyl Citrate Injection Mix 50/50 Solution | | | The following chemotherapy drugs and concentration showed breakthrough<br>detected in less than 90 minutes: | | | ThioTEPA (10 mg/ml), breakthrough detected at 87.6 minutes<br>Carmustine (3.3 mg/ml), breakthrough detected at 34.3 minutes<br>Warning: Not for Use With: Carmustine or ThioTEPA | {6}------------------------------------------------ | Technological Characteristics Comparison Table | | | | |------------------------------------------------|---------------------------|------------------------------------------------------------------------------------|------------------------------------------------| | | Subject Device<br>K220541 | Predicate Device<br>Halyard Sterling* Nitrile<br>Powder-Free Exam Glove<br>K191230 | Comparison | | FDA Product Code | LZC, LZA, QDO | LZC | Added LZA and<br>QDO for the<br>Fentanyl Claim | | FDA Classification | Class I | Class I | Same | | Regulation Number | 880.6250 | 880.6250 | Same | | Common Name | Patient Examination Glove | Patient Examination Glove | Same | {7}------------------------------------------------ | Device Trade Name | PureZero LIMON Nitrile Powder-<br>Free Exam Gloves with<br>Chemotherapy Drugs, Fentanyl<br>Citrate and Gastric Acid claim<br>PureZero LIMON-XTRA Nitrile<br>Powder-Free Exam Gloves with<br>Chemotherapy Drugs, Fentanyl<br>Citrate and Gastric Acid claim | Halyard Sterling* Nitrile<br>Powder-Free Exam Gloves with<br>Chemotherapy Drugs and<br>Fentanyl Citrate claim | Similar | |----------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------| | Intended Use | The device is a disposable device<br>intended for medical purposes<br>that is worn on the examiner's<br>hand to prevent contamination<br>between patient and examiner.<br>These gloves were tested for use<br>with chemotherapy drugs,<br>fentanyl citrate and gastric acid<br>as listed on the label. | The device is a disposable<br>device intended for medical<br>purposes that is worn on the<br>examiner's hand to prevent<br>contamination between patient<br>and examiner.<br>These gloves were tested for<br>use with chemotherapy drugs<br>and fentanyl citrate listed on<br>the label. | Similar<br>Adding Gastric Acid<br>Claim | | Technological<br>Characteristics | The glove is a colored, nitrile,<br>powder-free, textured fingertip,<br>ambidextrous, patient<br>examination glove. | The glove is a colored, nitrile,<br>powder-free, textured fingertip,<br>ambidextrous, patient<br>examination glove. | Same | | Sizes of gloves | XS, S, M, L, XL | XS, S, M, L, XL | Same | | Glove Length | PureZero LIMON Nitrile Powder-<br>Free Exam Gloves with<br>Chemotherapy Drugs, Fentanyl<br>Citrate and Gastric Acid claim is<br>9.5 inches in length<br>PureZero LIMON-XTRA Nitrile<br>Powder-Free Exam Gloves with<br>Chemotherapy Drugs, Fentanyl<br>Citrate and Gastric Acid claim<br>is 12 inches in length | Halyard Sterling* Nitrile<br>Powder-Free Exam Glove with<br>Chemotherapy Drugs and<br>Fentanyl Citrate is 9.5 inches in<br>length | Similar<br>Adding a longer<br>length glove | | Texture | Textured fingertips | Textured fingertips | Same | | Sterility | Non-Sterile | Non-Sterile | Same | | Shelf Life | 3-year | None | Different | | Biocompatibility | Based ISO 10993-11 Biological<br>evaluation of Medical devices -<br>Test for Systemic Toxicity, the<br>test article was considered non-<br>toxic. Meets the acceptance<br>criteria. | Based ISO 10993-11 Biological<br>evaluation of Medical devices -<br>Test for Systemic Toxicity, the<br>test article was considered non-<br>toxic. Meets the acceptance<br>criteria. | Same | | | Based on ISO 10993-10<br>Biological evaluation of Medical<br>Devices - Test for Skin<br>Irritation, the test article was<br>considered nonirritating. Meets<br>the acceptance criteria. | Based on ISO 10993-10<br>Biological evaluation of Medical<br>Devices - Test for Skin<br>Irritation, the test article was<br>considered nonirritating. Meets<br>the acceptance criteria. | | | | Based on ISO 10993-10<br>Biological evaluation of Medical<br>Devices - Test for Skin<br>Sensitization. Under the<br>conditions of the study<br>the device is not a sensitizer.<br>Meets the acceptance criteria. | Based on ISO 10993-10<br>Biological evaluation of Medical<br>Devices - Test for Skin<br>Sensitization. Under the<br>conditions of the study<br>the device is not a sensitizer.<br>Meets the acceptance criteria. | | {8}------------------------------------------------ {9}------------------------------------------------ | Standard | Results Subject Device(s) | Results Predicate Device K191230 | Remarks | |-----------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------| | Standard | PureZero LIMON Nitrile Powder-<br>Free Exam Gloves with<br>Chemotherapy Drugs, Fentanyl<br>Citrate and Gastric Acid claim<br><br>PureZero LIMON-XTRA Nitrile<br>Powder-Free Exam Gloves with<br>Chemotherapy Drugs, Fentanyl<br>Citrate and Gastric Acid claim | Halyard Sterling* Nitrile Powder-<br>Free Exam Glove with<br>Chemotherapy Drugs and Fentanyl<br>Citrate claim | | | ASTM D6978-05<br>Standard Practice<br>for Assessment of<br>Resistance of<br>Medical Gloves to<br>Permeation by<br>Chemotherapy<br>Drugs | The following chemotherapy drugs<br>and concentration had NO<br>breakthrough<br>detected up to 240 minutes:<br><br>Cisplatin (1 mg/ml)<br>Cyclophosphamide (20 mg/ml)<br>Dacarbazine (10 mg/ml)<br>Doxorubicin HCI (2 mg/ml)<br>Etoposide (20 mg/ml)<br>Fluorouracil (50 mg/ml)<br>Ifosfamide (50 mg/ml)<br>Methotrexate (25 mg/ml)<br>Mitomycin C (0.5 mg/ml)<br>Mitoxantrone HCI (2 mg/ml)<br>Paclitaxel (6 mg/ml)<br>Vincrinstine Sulfate (1 mg/ml)<br>Fentanyl Citrate Injection (100 mcg/2 mL)<br>Simulated Gastric Acid<br>Fluid/Fentanyl Citrate Injection<br>Mix 50/50 Solution | The following chemotherapy drugs<br>and concentration had NO<br>breakthrough<br>detected up to 240 minutes:<br><br>Arsenic Trioxide (1 mg/ml)<br>Doxorubicin HCL (2 mg/ml)<br>Paclitaxel (6 mg/ml)<br>Azacitidine (Vidaza) (25 mg/ml)<br>Epirubicin (Ellence) (2 mg/ml)<br>Paraplatin (10 mg/ml)<br>Bendamustine (5 mg/ml)<br>Eribulin Mesylate (0.5 mg/ml)<br>Pemetrexed (25 mg/ml)<br>Bortezomib (Velcade) (1 mg/ml)<br>Etoposide (20 mg/ml)<br>Pertuzumab (30 mg/ml)<br>Bleomycin sulfate (15 mg/ml)<br>Fludarabine (25 mg/ml)<br>Raltitrexed (0.5 mg/ml)<br>Busulfan (6 mg/ml)<br>Fluorouracil (50 mg/ml)<br>Retrovir (10 mg/ml)<br>Carboplatin (10 mg/ml)<br>Fulvestrant (50 mg/ml)<br>Rituximab (10 mg/ml)<br>Carfilzomib (2 mg/ml)<br>Gemcitabine (38 mg/ml)<br>Temsirolimus (25 mg/ml)<br>Cetuximab (Erbitux) (2 mg/ml)<br>Idarubicin (1 mg/ml)<br>Trastuzumab (21 mg/ml)<br>Cisplatin (1 mg/ml)<br>Ifosfamide (50 mg/ml) | Similar | | | The following chemotherapy drugs<br>and concentration showed<br>breakthrough detected in less than<br>90 minutes:<br><br>ThioTEPA (10 mg/ml), breakthrough<br>detected at 87.6 minutes<br><br>Carmustine (3.3 mg/ml),<br>breakthrough detected at 34.3<br>minutes. | | | {10}------------------------------------------------ | Cyclophosphamide (20 mg/ml) | | |---------------------------------------------------------------------|--| | Irinotecan (20 mg/ml) | | | Triclosan (2 mg/ml) | | | Cytarabine HCL (100 mg/ml) | | | Mechlorethamine HCL (1 mg/ml) | | | Trisonex (1 mg/ml) | | | Cytovene (10 mg/ml) | | | Melphalan (5 mg/ml) | | | Vincrinstine Sulfate (1 mg/ml) | | | Dacarbazine (10 mg/ml) | | | Methotrexate (25 mg/ml) | | | Vinblastine (1 mg/ml) | | | Daunorubicin HCL (5 mg/ml) | | | Mitomycin-C (0.5 mg/ml) | | | Vinorelbine (10 mg/ml) | | | Decitabine (5 mg/ml) | | | Mitoxantrone (2 mg/ml) | | | Zoledronic Acid (0.8 mg/ml) | | | Docetaxel (10 mg/ml) | | | Oxaliplatin (2 mg/ml) | | | ThioTEPA (10 mg/ml), breakthrough<br>detected at 37.1 minutes | | | Carmustine (3.3 mg/ml),<br>breakthrough detected at 22.9<br>minutes | | | Performance Data | | | | |-----------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------| | ASTM D5151-06<br>Standard Test<br>Method for<br>Detection of Holes<br>in Medical Gloves | Testing of the subject device shows<br>it meets the 2.5% AQL requirement<br>in the standards for leakage. The<br>device meets the acceptance<br>criteria of the standard. | Testing of the subject device shows<br>it meets the 2.5% AQL requirement<br>in the standards for leakage. The<br>device meets the acceptance<br>criteria of the standard. | Same | | ASTM D6124-06<br>Standard Test<br>Method for Residual<br>Powder on Medical<br>Gloves | Residual powder on the subject<br>device is an average of 0.4<br>mg/glove within the powder-free<br>limit of < 2 mg maximum powder<br>per glove and meets the<br>acceptance criteria for powder-<br>free. | Residual powder on the subject<br>device is an average of 0.4 mg/glove<br>within the powder-free limit of < 2<br>mg maximum powder per glove and<br>meets the acceptance criteria for<br>powder- free. | Same | {11}------------------------------------------------ | ASTM D6319-10<br>Standard<br>Specification for<br>Nitrile Examination<br>Gloves for Medical<br>Applications | The physical dimensions of the<br>subject device are within the limits<br>of the standard and the physical<br>properties of the subject device<br>met the requirements for tensile<br>strength before and after aging. | The physical dimensions of the<br>predicate device are within the<br>limits of the standard and the<br>physical properties of the subject<br>device met the requirements for<br>tensile strength before and after<br>aging. | Same | |-------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------| | ISO 10993 Biological<br>evaluation of<br>medical devices | Meets acceptance criteria | Meets acceptance criteria | Same | ## performance characteristics of the subject device | Brief description<br>of non-clinical<br>tests: | Test | Standard | Acceptance Criteria | Results | |------------------------------------------------|---------------------|------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------| | | Dimensions | ASTM D 6319 | | Meets<br>requirements | | | | Length | 235 -250 mm (PureZero<br>LIMON Nitrile) | | | | | Palm Width Size | 295- 325 mm (PureZero<br>LIMON-XTRA Nitrile)<br>XSmall: 60 – 80 mm<br>Small: 70 - 90 mm<br>Med: 85–105 mm<br>Large: 100 - 120 mm<br>X-Large: 110-130 mm | | | | | Finger thickness | 0.10-0.19 mm | | | | | Palm thickness | 0.10-0.16 mm | | | | | Cuff thickness | 0.10-0.13 mm | | | | | | | | | | Physical Properties | ASTM D 6319 | AQL 4.0<br>Before<br>Tensile Strength: ≥14<br>MPa<br>Ultimate elongation:<br>≥500%<br>After | Meets<br>requirements | | | | | | | {12}------------------------------------------------ | | | Tensile Strength: ≥14 MPa<br>Ultimate elongation: ≥400% | | |-------------------------------------|----------------------------|----------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------| | Freedom from<br>Pinholes | ASTM D 6319<br>ASTM D 5151 | AQL 2.5%<br>No leakage | Meets<br>requirements | | Power Free | ASTM D 6124<br>ASTM D 6319 | ≤ 2 mg / glove | Meets<br>requirements | | ISO Indirect<br>Irritation<br>Study | ISO 10993, Part 10 | Primary Irritation Index<br>≤ 2.0 | Under the<br>conditions of<br>The study the<br>device is not<br>an irritant | | ISO Systemic<br>Toxicity<br>Study | ISO 10993, Part 11 | No animals treated with<br>test extracts exhibit<br>greater reaction than<br>control animals | No evidence of<br>systemic<br>toxicity | | ISO Dermal<br>Sensitization | ISO 10993, Part 10 | Grade < 1 | Under the<br>conditions<br>of the study<br>the device is<br>not a<br>sensitizer | | Conclusion: | The conclusions drawn from the nonclinical tests demonstrate that the subject device<br>PureZero LIMON Nitrile Powder- Free Exam Gloves with Chemotherapy Drugs, Fentanyl<br>Citrate and Gastric Acid claim and PureZero LIMON-XTRA Nitrile Powder-Free Exam Gloves<br>with Chemotherapy Drugs, Fentanyl Citrate and Gastric Acid claim, are as safe, as effective,<br>and performs as well as or better than the legally marketed devices cleared<br>under K191230. | |-------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| |-------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
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