N-DEX BWC PINK NITRILE MEDICAL EXAMINATION GLOVE, NON STERILE

K082428 · Best Glove, Inc. · LZA · Feb 10, 2009 · General Hospital

Device Facts

• Record ID: K082428
• Device Name: N-DEX BWC PINK NITRILE MEDICAL EXAMINATION GLOVE, NON STERILE
• Applicant: Best Glove, Inc.
• Product Code: LZA · General Hospital
• Decision Date: Feb 10, 2009
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 880.6250
• Device Class: Class 1

Indications for Use

The N-DEX® BWC™ Pink Nitrile Powder-Free Medical Examination Glove is a disposable device intended for medical purposes; that is worn on the examiner's hand, to prevent contamination between the patient and examiner. (21 CFR 880.6250) This device has been tested for use with specific chemotherapy drugs. This device is not intended to be used as a chemical barrier.

Device Story

Disposable nitrile examination glove; worn on examiner's hands to prevent cross-contamination between patient and clinician. Device provides barrier protection; tested for use with specific chemotherapy drugs. Used in clinical settings; operated by healthcare professionals. Device is non-sterile, powder-free, pink-colored, 4-mil thickness, and 9.5 inches in length. Benefits include protection against patient-to-clinician contamination and exposure to chemotherapy agents.

Clinical Evidence

No clinical data. Evidence consists of non-clinical bench testing and biocompatibility studies. Biocompatibility testing included ISO 10993-10 (Skin Irritation and Closed Patch Sensitization) and ISO 10993-5 (Cytotoxicity), all of which passed. Physical performance testing confirmed compliance with ASTM D6319, ASTM D6124, and ASTM D5151 standards.

Technological Characteristics

Nitrile rubber material; powder-free; non-sterile. Dimensions: 9.5" length, 4-mil thickness. Conforms to ASTM D6319-00a3, ASTM D6124-06, and ASTM D5151-06. No software or electronic components.

Indications for Use

Indicated for use as a disposable patient examination glove worn on the examiner's hand to prevent contamination between patient and examiner. Suitable for use with specific chemotherapy drugs. Not intended as a chemical barrier.

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

• Ultimate N-DEX® Nitrile Powder-Free Medical Examination Glove (K001375)

Submission Summary (Full Text)

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510(k) Submission For Pink Nitrile Powder-Free Medical Exam Glove

K682428

# Summary Of Safety And Effectiveness

#### A. Information

- 1. Submitter's
Name: Address:

Address:

Best Glove, Inc. 579 Edison Street Menlo, GA 30731-6335 706-862-6712 Neil Dow

FEB 1 0 2009

Telephone Number: Contact person:

2. Name of Device

Trade or Proprietary name:

Common or Usual name:

Classification Name:

3. Predicate Device:

N-DEX® BWC™ Nitrile Powder-Free Medical Examination Glove, Non-Sterile

Non-sterile Powder-Free Patient Examination glove.

Patient Examination Glove (80LZC, 21 CFR 880.6250)

Ultimate N-DEX® Nitrile Powder-Free Medical Examination Glove, Non-Sterile (blue)

Submission Number: K001375

#### 4. Description of Device

The N-DEX® BWC™ Nitrile Powder-Free Medical Examination Glove is a disposable device intended for medical purposes; that is worn on the examiner's hand, to prevent contamination between the patient and examiner.

- Statement of intended use, including descriptions of the disease or conditions that 5. the device will address:
This is a disposable device intended for medical purposes that is worn on the examiners hands to prevent contamination between the patient and the examiner. Powder-Free examination gloves are suitable in situations where powder is not desirable. This device is used for protection against exposure to indicated chemotherapy drugs.

Section K

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Explanation of similarities or differences to predicate device 6.

The proposed device is identical to the predicate device except for the following:

- ◆ The proposed device has been rendered pink instead of blue.
- The proposed device is shorter in overall length (9½" vs. 11" for the predicate device).
- The proposed device is thinner (4-mil vs. 6-mil for the predicate device) ◆

### B. If SE decision is based on performance:

- 1. Non-Clinical Tests

| Specification | Predicate Device | Proposed Device |
|----------------------------------|----------------------------------------------------------------------------|----------------------------------------------------------------------------|
| | Nitrile Powder-Free<br>Medical Examination<br>Glove, Non-Sterile<br>(blue) | Nitrile Powder-Free<br>Medical Examination<br>Glove, Non-Sterile<br>(pink) |
| Performance standards (conforms) | ASTM D 6319-00a<br>ASTM D 6124-01 | ASTM D 6319-00a3<br>ASTM D 6124-06 |
| Water tightness (conforms) | ASTM D 5151-99 | ASTM D 5151-06 |

### 2. Clinical Tests (Animal Studies)

| Biocompatibility | Predicate Device | Proposed Device |
|-----------------------------------------------------|------------------|-----------------|
| ISO Skin Irritation Study (ISO 10993-10). | Passes | Passes |
| ISO Closed Patch Sensitization Study (ISO 10993-10) | Passes | Passes |
| Cytotoxicity Study (ISO 10993-5) | Not tested | Passes |

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REPORTS OF SAFETY OR EFFECTIVENSS DATA OBTAINED (With specific reference to adverse effects and complications)

See Section J: Biocompatibility Testing.

### CONCLUSIONS DRAWN FROM NON CLINICAL AND CLINICAL TESTS THAT DEMONSTRATE SAFETY AND EFFECTIVENESS, AND PERFORMANCE EQUAL TO OR BETTER THAN THE PREDICATE PRODUCT

The pink Nitrile Powder-Free Medical Examination Glove has been carefully compared to a legally marketed device in the 510(k). The data summaries indicate that the proposed product meets or exceeds accepted scores for the predicate product in both physical and nonclinical tests and satisfies the requirements for a safe and effective powderfree medical glove.

Pursuant to 21 C.F.R. 807.87 (k), I, Neil Dow, Regulatory Affairs and Quality Assurance Manager, certify that to the best of my knowledge and belief, and based upon the data and information submitted to me in the course of my responsibilities as Regulatory Affairs and Quality Assurance Manager for Best Glove, Inc. and in reliance thereupon, the data and information submitted in this premarket notification are truthful and accurate and that no facts material to a review of the substantial equivalence of this device have been knowingly omitted from this submission.

Neil Dow

**Regulatory Affairs and**
**Quality Assurance Manager**

7 Jan. 2009
Date

Section K

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## DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image is a seal for the Department of Health & Human Services - USA. The seal is circular, with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the top half of the circle. The bottom half of the circle contains a stylized image of an eagle.

#### Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

# FEB 1 0 2009

Best Glove, Incorporated Mr. Neil Dow RA/QA Manager 579 Edison Street Menlo, Georgia 30731-6335

Re: K082428

> Trade/Device Name: N-DEX® BWC™ Nitrile Powder-Free Medical Examination Glove, Non-Sterile Regulation Number: 880.6250 Regulation Name: Patient Examination Gloves Regulatory Class: I Product Code: LZC Dated: January 8, 2009 Received: January 13, 2009

Dear Mr. Dow:

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 such 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 statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration

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Page 2 - Mr. Dow

and listing (21 CFR Part 807); labeling (21 CFR Part 801); 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.

This letter will allow you to begin marketing your device as described in your Section 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), please contact the Center for Devices and Radiological Health's (CDRH's) Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. 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 [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours.

Anthony D. nutzman

Ginette Y. Michaud. M.D. Acting 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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510(k) Submission For Pink Nitrile Powder-Free Medical Exam Glove

## Indication for Use

510(k) Number (if known):

Device Name: N-DEX® Pink Nitrile Powder-Free Medical Examination Glove Indications For Use:

The N-DEX® BWC™ Pink Nitrile Powder-Free Medical Examination Glove is a disposable device intended for medical purposes; that is worn on the examiner's hand, to prevent contamination between the patient and examiner. (21 CFR 880.6250)

This device has been tested for use with specific chemotherapy drugs. This device is not intended to be used as a chemical barrier.

Prescription Use (Part 21 CFR 801 Subpart D)

AND/OR

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

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

Concurrence of CDRH, Office Of device Evaluation (ODE)

Shuley M. Murphy
(Division Sign-Off)

Division of Anesthesiology, General Hospital Infection Control, Dental Devices

Section D

510(k) Number: K082428

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