PEPPER GREEN MINT POWDERED LATEX EXAMINATION GLOVES

K993605 · Top Glove Sdn. Bhd. · LYY · Dec 20, 1999 · General Hospital

Device Facts

• Record ID: K993605
• Device Name: PEPPER GREEN MINT POWDERED LATEX EXAMINATION GLOVES
• Applicant: Top Glove Sdn. Bhd.
• Product Code: LYY · General Hospital
• Decision Date: Dec 20, 1999
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 880.6250
• Device Class: Class 1

Intended Use

Pepper Green Mint Powdered Latex Examination Gloves are worn on the hands of health care and similar personnel to prevent contamination between health care personnel and the patient.

Device Story

Device is a powdered latex examination glove; worn on hands by healthcare personnel; acts as a barrier to prevent cross-contamination between patient and clinician; used in clinical settings; provides protection during patient examinations.

Clinical Evidence

Bench testing only.

Technological Characteristics

Powdered latex examination glove; Class I medical device.

Indications for Use

Indicated for use by health care and similar personnel to prevent cross-contamination between the wearer and the patient.

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)

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

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" arranged around the top half of the circle. Inside the circle is a stylized symbol that resembles a bird or a human figure with three curved lines representing wings or arms.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

DEC 2 0 1999

Mr. Wee-Chai Lim Managing Director Top Glove Sdn. Bhd. Lot 4968, Jalan Teratai, Batu 6 Off Jalan Meru,41050 Klang Selangor D.E., Malaysia

K993605 Re: Pepper Green Mint Powdered Latex Examination Trade Name: Gloves Requlatory Class: I Product Code: LYY October 22, 1999 Dated: October 25, 1999 Received:

Dear Mr. Lim:

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 The general controls provisions of the Act of the Act. include requirements for annual registration, listing of devices, qood 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 requlations affecting your device can be found in the Code of Federal Requlations, Title 21, Parts 800 to 895. ਸੀ substantially equivalent determination assumes compliance with the Good Manufacturing Practice for Medical Devices: General (GMP) requlation (21 CFR Part 820) and that, through periodic GMP inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP requlation 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

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

Page 2 - Mr. Lim

obligation you might have under sections 531 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 requlation (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 gener 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,

Susan Runco

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

Enclosure

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

3.0 Indicallous for Use Statement: Include the following or equivalent Indications for Use page. The Information, data and labeling claims in the 510(k) submission must support and agree with the Indications for Use statement.

INDICATIONS FOR USE

| Applicant: | TOP GLOVE SDN. BHD. |
|---------------------------|-----------------------------------------------------|
| 510(k) Number (if known): | K 99 3605 |
| Device Name: | PEPPER GREEN MINT POWDERED LATEX EXAMINATION GLOVES |
| Indications For Use: | |

Pepper Green Mint Powdered Latex Examination Gloves are worn on the hands of health care and similar personnel to prevent contamination between health care personnel and the patient.

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

Concurrence of CDRH Office of Device Evaluation (ODE)

Prescription Use Per 21 CPR 801.109 ()){

**Over-the-Counter**

(Optional Pornal 1-2-96)

-

"

- * For a new submission, do NO'l' fill in the 510(k) number blank.
510(k) Number

8-8
For Chunker PhD
(Division Sign-Off)
Division of Dental, Infection Control,
and General Hospital Devices