POWDER FREE LATEX EXAMINATION GLOVES

K970115 · Pt Mbf Buana Multicorpora · LYY · Aug 15, 1997 · General Hospital

Device Facts

• Record ID: K970115
• Device Name: POWDER FREE LATEX EXAMINATION GLOVES
• Applicant: Pt Mbf Buana Multicorpora
• Product Code: LYY · General Hospital
• Decision Date: Aug 15, 1997
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 880.6250
• Device Class: Class 1

Intended Use

Glove worn on hand of healthcare and similar personnel to prevent contamination between healthcare personnel and the patient's body, fluids, waste or environment.

Device Story

Device is a powder-free latex examination glove; worn on hands by healthcare personnel; acts as a physical barrier to prevent cross-contamination between wearer and patient; protects against contact with body fluids, waste, or environmental contaminants; used in clinical or similar settings; provides patient and provider protection through barrier isolation.

Clinical Evidence

No clinical data; bench testing only.

Technological Characteristics

Material: Latex; Form factor: Examination glove; Feature: Powder-free; Sterilization: Not specified; Connectivity: None; Software: None.

Indications for Use

Indicated for use by healthcare and similar personnel as a protective barrier on the hands to prevent cross-contamination between the wearer and the patient's body, fluids, waste, or environment.

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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DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
Food and Drug Administration
9200 Corporate Boulevard
Rockville MD 20850

Mr. Ng Poy Sin
General Manager
Pt Mbf Bauna Multicorpora
J1. Sisingamangaraja No. 170
Medan, 20217
INDONESIA

AUG 15 1997

Re: K970115
Trade Name: Powder Free Latex Examination Gloves
Regulatory Class: I
Product Code: LYY
Dated: June 19, 1997
Received: June 24, 1997

Dear Mr. Ng Poy Sin:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). 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 (Premarket Approval), 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 895. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531

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Page 2 - Mr. Ng Poy Sin

through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin marketing your device as described in your 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 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at [phone]. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number [phone] or [phone] or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

Timothy A. Ulatowski
Director
Division of Dental, Infection Control and General Hospital Devices
Office of Device Evaluation
Center for Devices and Radiological Health

Enclosure

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510 (k) Number (if known): K970115

Device Name: Patient Examination Glove

Indication For Use:

Glove worn on hand of healthcare and similar personnel to prevent contamination between healthcare personnel and the patient's body, fluids, waste or environment.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Chris S. Lin
(Division Sign-Off)
Division of Dental, Infection Control, and General Hospital Devices
510(k) Number K970115

Prescription Use
(Per 21 CFR 801.109)

OR

Over The Counter Use ☑

(Optional Format 1-2-96)

Section 8; page 1 of 1.