Disposable Vinyl Examination Gloves

K241252 · Anqing Pukang Medical Technology Co., Ltd. · LYZ · May 20, 2024 · General Hospital

Device Facts

• Record ID: K241252
• Device Name: Disposable Vinyl Examination Gloves
• Applicant: Anqing Pukang Medical Technology Co., Ltd.
• Product Code: LYZ · General Hospital
• Decision Date: May 20, 2024
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 880.6250
• Device Class: Class 1
• Attributes: 3rd-Party Reviewed

Intended Use

Disposable Vinyl Examination Gloves 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.

Device Story

Disposable Vinyl Examination Gloves are non-sterile, powder-free, ambidextrous gloves made of poly (vinyl chloride) compound. Available in sizes S, M, L, and XL, they are intended for use by healthcare professionals during medical examinations to provide a barrier against contamination. The gloves are worn on the hands to prevent the transfer of microorganisms or fluids between the patient and the examiner. They are single-use devices.

Clinical Evidence

No clinical data. Bench testing only. Biocompatibility testing (ISO 10993-5, 10, 23) confirmed no cytotoxicity, irritation, or sensitization. Physical performance testing (ASTM D5250-19, D6124-06, D5151-19) confirmed compliance with dimensions, tensile strength, elongation, freedom from holes (AQL 2.5), and residual powder limits (<2mg/glove).

Technological Characteristics

Material: Poly (vinyl chloride) compound. Form factor: Ambidextrous, clear, non-sterile, powder-free. Sizes: S, M, L, XL. Standards: ASTM D5250-19 (physical properties/dimensions), ASTM D5151-19 (freedom from holes), ASTM D6124-06 (residual powder), ISO 10993-5/10/23 (biocompatibility).

Indications for Use

Indicated for use as a disposable medical glove worn on the examiner's hand or finger 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.

Predicate Devices

• Disposable Vinyl Examination Gloves (K223008)

Submission Summary (Full Text)

{0}------------------------------------------------

Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

May 20, 2024

Anqing Pukang Medical Technology Co., LTD. % Prithul Bom Most Responsible Person Regulatory Technology Services, LLC 1000 Westgate Drive, Suite 510k Saint Paul, Minnesota 55114

Re: K241252

Trade/Device Name: Disposable Vinyl Examination Gloves Regulation Number: 21 CFR 880.6250 Regulation Name: Non-powdered patient examination glove Regulatory Class: Class I, reserved Product Code: LYZ Dated: May 3, 2024 Received: May 3, 2024

Dear Prithul Bom:

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 (the 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 available 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.

{1}------------------------------------------------

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device" (https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (OS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30, Design controls; 21 CFR 820.90, Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review, the QS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 of medical device-related adverse events) (21 CFR Part 803) for devices or postmarketing safety reporting (21 CFR Part 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 Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 mediation-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 ([e-mail]) or phone [phone] or 301-796-7100).

{2}------------------------------------------------

Sincerely,

# Allan Guan -S

For Bifeng Qian, M.D., Ph.D. Assistant Director DHT4B: Division of Infection Control and Plastic and Reconstructive Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

{3}------------------------------------------------

# Indications for Use

510(k) Number (if known) K241252

Device Name Disposable Vinyl Examination Gloves

Indications for Use (Describe)

Disposable Vinyl Examination Gloves 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.

Type of Use (Select one or both, as applicable)

| Prescription Use (Part 21 CFR 801 Subpart D)

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

## CONTINUE ON A SEPARATE PAGE IF NEEDED.

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 Drug 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."

{4}------------------------------------------------

## 510(K) Summary

This summary of 510(k) is being submitted in accordance with 21 CFR 807.92. Date prepared: May 20, 2024 A. Applicant:

Name: Anqing Pukang Medical Technology Co., LTD. Address: No 7 Haian Road, Anqing City, Anhui,China. Contact: Ms. Min Gao Title: QE Tel: [phone] Email: [e-mail]

Submission Correspondent: Primary contact: Max Li Anqing Pukang Medical Technology Co., LTD. No 7 Haian Road, Anqing City, Anhui,China. Tel: [phone] Email: [e-mail]

## B. Device:

Trade Name: Disposable Vinyl Examination Gloves Common Name: Non-Powdered Patient Examination Glove

Regulatory Information Classification Name: Vinyl Patient Examination Glove Classification: Class I Product code: LYZ Regulation Number: 21 CFR 880.6250 Review Panel: General Hospital and Personal Use

## C. Predicate device:

K223008 Name of the device: Disposable Vinyl Examination Gloves Owner's Name: JIANGXI HANDSPRO PRODUCTS SOLUTIONS CO., LTD.

## D. Indications for use of the device:

Disposable Vinyl Examination Gloves is a disposable device intended for medical purposes that is worn on the examiners' hand or finger to prevent contamination between patient and examiner.

#### Device Description: نن

The subject device is a patient examination glove made of Poly (vinyl chloride) compound. It is Non-Sterile, Powder free and is clear in colour. The device is ambidextrous and can be worn on either the left or right hand. (Per 21 CFR 880.6250, class I). The device provides four specifications: S, M, L and XL. The device meets all the

{5}------------------------------------------------

specifications in ASTM D5250-19, Standard specification for Vinyl Examination Gloves. Additionally, the gloves have been tested for biocompatibility per ISO 10993-10, ISO 10993-23, ISO 10993-5

## F. Summary of Technological Characteristics

Disposable Vinyl Examination Gloves are compared with the predicate device in terms of intended use, design, material, specifications, and performance.

The following table shows similarities and differences of use, design, and material between the proposed device and the predicate device.

| Device | Proposed Device | Predicate Device | Result |
|---------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------|
| 510K # | K241252 | K223008 | - |
| Product Name | Disposable Vinyl Examination Gloves | Disposable Vinyl Examination Gloves | - |
| Product Code | LYZ | LYZ | Same |
| Regulation Number | 21 CFR 880.6250 | 21 CFR 880.6250 | Same |
| Indications for use | Disposable Vinyl Examination Gloves 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. | Disposable Vinyl Examination Gloves 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. | Same |
| Powder free | Yes | Yes | Same |
| Design feature | Ambidextrous. | Ambidextrous. | Same |
| Material | Vinyl | Vinyl | Same |
| Color | Clear | Clear | Same |
| Size | S, M, L, XL | S, M, L, XL | Same |
| Sterile | Non-Sterile | Non-Sterile | Same |
| Use | Singe use | Single use | Same |

Table 1 General Comparison of Proposed and Predicate Devices

Table 2 Comparison of Physical, Biocompatibility and Performance Testing

| CHARACTERSTICS | STANDARDS | DEVICE PERFORMANCE | | Remarks | |
|---------------------|-------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------|----------|--|
| | | SUBJECT | PREDICATE | | |
| Name of device | | Disposable Vinyl<br>Examination Gloves | Disposable Vinyl<br>Examination Gloves | --- | |
| Dimensions | ASTMD5250- 19 | Length:<br>S/M/L/XL: ≥230; | Length:<br>S/M/L/XL: ≥230; | Same | |
| | | | | | |
| Physical Properties | ASTMD5250- 19 | Width: | Width: | Same | |
| | | S: 85±5<br>M: 95±5<br>L: 105±5<br>XL: 115±5 | S: 85±5<br>M: 95±5<br>L: 105±5<br>XL: 115±5 | | |
| | | Thickness:<br>Palm: ≥0.08<br>Finger: ≥0.08 | Thickness:<br>Palm: ≥0.08<br>Finger: ≥0.08 | | |
| | | Before Aging<br>Tensile Strength<br>min 11 Mpa<br>Ultimate Elongation<br>Min 300% | Before Aging<br>Tensile Strength<br>min 11 Mpa<br>Ultimate Elongation<br>Min 300% | | |
| | | After Aging<br>Tensile Strength<br>min 11 Mpa<br>Ultimate Elongation<br>Min 300% | After Aging<br>Tensile Strength<br>min 11 Mpa<br>Ultimate Elongation<br>Min 300% | | |
| Powder Free | ASTMD5250- 19 | ≤2 mg/glove | ≤2 mg/glove | Same | |
| Freedom from Holes | ASTM D5250- 19<br>ASTM D5151- 19 | Complies with<br>ASTM D5250- 19<br>and ASTM D5151- 19 G-<br>1, AQL 2.5 | Complies with<br>ASTM D5250- 19<br>and ASTM D5151- 19 G-<br>1, AQL 2.5 | Same | |
| Biocompatibility | Primary Skin<br>Irritation-<br>ISO 10993-<br>23:2021; | Under the conditions of this<br>study, the polar and<br>nonpolar extracts of the test<br>article did not induce skin<br>irritation. | Under the conditions of<br>the study, not an irritant | Similar① | |
| | Dermal<br>Sensitization-<br>ISO 10993-<br>10:2010 | Under the conditions of<br>this test, the polar and<br>non-polar extracts of the<br>test article did not cause<br>skin sensitization<br>reaction. | Under the conditions of<br>the study, not a sensitizer | Same | |
| | In vitro<br>cytotoxicity<br>ISO10993-<br>5:2009 | Under the conditions of<br>this study, the extract of<br>the test article did not<br>show potential toxicity to<br>L-929 cells. | Under conditions of the<br>study, did not show<br>potential toxicity to L-<br>929 cells. Complies with | Same | |

{6}------------------------------------------------

{7}------------------------------------------------

(1) The new version of standard for Skin Irritation we refer is ISO 10993-23:2021, the test method and process is the same as the old version ISO 10993-10

Analysis: The proposed device has the Skin Sensitization test, Primary Skin Irritation test and the In vitro cytotoxicity test, the same as the predicate device.

## G. Summary of Non-Clinical Testing

#### A Biocompatibility

Biocompatibility Testing according to ISO 10993-1:2018, the nature of body contact for the subject device is Surface Device category, Skin Contact and duration of contact is A-Limited (≤24h). The following tests for the subject device were conducted to evaluated the biocompatibility of Disposable Vinyl Examination Gloves:

- ISO 10993-10: Skin Sensitization test
- ISO 10993-23:Skin Irritation test
- · ISO 10993-5: In vitro cytotoxicity test

#### A Performance Testing

Physical performance testing of the proposed device was conducted as per ASTM D5250-19 Standard Specification for Poly (vinyl chloride) Examination Gloves.

To summarize, the performance testing of the subject device was conducted to adequately demonstrate the effectiveness of the device in accordance with the relevant test methods cited below:

- ASTM D5250-19 Standard Specification for Poly (vinyl chloride) Gloves for Medical Application
- ASTM D6124-06 (Reapproved 2017) Standard Test Method for Residual Powder on Medical Gloves
- ASTM D5151-19 Standard Test Method for Detection of Holes in Medical Gloves

| Test Method | Purpose | Acceptance Criteria | Results |
|--------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------|------------------------------------------------------------------------------------|
| Dimensions<br>(length)<br>(width)<br>(thickness) | The purpose of the<br>test is to evaluate the<br>physical dimension of<br>the glove | Length<br>230 mm min | Pass<br>240 mm min |
| | | Width(mm) | Pass |
| | | S: $85\pm5$<br>M: $95\pm5$<br>L: $105\pm5$<br>XL: $115\pm5$ | S: 89-90mm<br>M: 99 mm<br>L:105-106 mm<br>XL:119-120 mm |
| | | Thickness(mm):<br>Palm: Min 0.08<br>Finger: Min 0.08 | Pass<br>Palm – 0.080mm Min<br>Finger–0.080mm Min |
| Physical<br>properties | The purpose of the<br>test is to evaluate the<br>tensile strength and<br>ultimate elongation<br>before and after<br>aging | Before Aging:<br>Tensile Strength: 11 MPa, min.<br>Elongation: 300%, min. | Pass<br>Before Aging:<br>Tensile Strength: 16.0MPa, min.<br>Elongation: 304%, min. |
| | | After Aging:<br>Tensile Strength: 11 MPa, min.<br>Elongation:300%, min. | After Aging:<br>Tensile Strength:16.7MPa, min.<br>Elongation: 301%, min. |
| | | | |
| Freedom from<br>holes | The purpose of the<br>test is to detect holes<br>in the gloves | No leakage at sampling level of<br>G-1, AQL 2.5 | Pass<br>No leakage, 80 of 80 passed |

{8}------------------------------------------------

| Residual<br>Powder | The purpose of the<br>test is to detect the<br>powder residue in<br>the glove | <2mg per glove | Pass<br>average 0.1 mg per glove |
|--------------------|-------------------------------------------------------------------------------|----------------|----------------------------------|
|--------------------|-------------------------------------------------------------------------------|----------------|----------------------------------|

## H. Clinical Test Conclusion

No clinical study is included in this submission.

#### l. Conclusion

The conclusion drawn from the nonclinical tests demonstrates that the subject device, Disposable Vinyl Examination Gloves, are as safe, as effective, and perform as well as or better than the legally marketed predicate device cleared under K223008.