POWDERED VINYL EXAMINATION GLOVES

K024016 · Top Glove (Zhangjiagang) Co. , Ltd. · LYZ · Feb 3, 2003 · General Hospital

Device Facts

• Record ID: K024016
• Device Name: POWDERED VINYL EXAMINATION GLOVES
• Applicant: Top Glove (Zhangjiagang) Co. , Ltd.
• Product Code: LYZ · General Hospital
• Decision Date: Feb 3, 2003
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 880.6250
• Device Class: Class 1

Indications for Use

Powdered Vinyl 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

Powdered vinyl examination gloves; worn on hands by healthcare or similar personnel; intended to act as a barrier to prevent contamination between the user and the patient. Device is a single-use, disposable glove. No complex processing, software, or electronic components involved.

Clinical Evidence

Bench testing only.

Technological Characteristics

Material: Vinyl (polyvinyl chloride). Form factor: Disposable examination glove. Surface: Powdered. Class I device, regulation 880.6250, product code LYZ.

Indications for Use

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

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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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

## FEB 0 3 2003

Dr. Lim Wee Chai Managing Director Top Glove (Zhangjiagang) Company Limited 3. Zhangjiagang Xi, Tang Road Xi Zhang Town, CHINA 215614

Re: K024016

Trade/Device Name: Powdered Vinyl Examination Gloves Regulation Number: 880.6250 Regulation Name: Patient Examination Glove Regulatory Class: I Product Code: LYZ Dated: November 27, 2002 Received: December 14, 2002

Dear Dr. Chai:

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.

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Page 2 - Dr. Chai

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); 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 Office of Compliance at [phone]. Also, please note the regulation entitled. "Misbranding by reference to premarket notification" (21CFR Part 807.97). 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/dsma/dsmamain.html

Sincerely yours,

Susan Runser

Susan Runner, DDS, MA Interim Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

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

## INDICATIONS FOR USE

| Applicant: | TOP GLOVE (ZHANGJIAGANG) CO. LTD. |
|---------------------------|-----------------------------------|
| 510(k) Number (If known): | * |
| Device Name: | POWDERED VINYL EXAMINATION GLOVES |

Indications For Use:

Powdered Vinyl 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 IF NEEDED)

Concurrence of CDRH Office of Device Evaluation (ODE)


(Division Sign-Off)

Division of Anesthesiology, General Hospital,

Infection Control, Dental Devices

| 510(k) Number: | K024016 |
|----------------|---------|
|----------------|---------|

Prescription Use Per 21 CI'R 801.109 ાર

Over-The-Counter _

(Optional Pormal 1.2-96)

- · For a new submission, do NOT fill in the 510(k) number blank.