K970135 · Sage Products, Inc. · LZC · Aug 25, 1997 · General Hospital
Device Facts
Record ID
K970135
Device Name
NITRILE GLOVES
Applicant
Sage Products, Inc.
Product Code
LZC · General Hospital
Decision Date
Aug 25, 1997
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 880.6250
Device Class
Class 1
Indications for Use
A medical glove worn on the hand of a healthcare worker and similar personnel to prevent contamination between healthcare personnel and patient. In addition, this glove is worn for the protection of the wearer against exposure to chemotherapeutic agents.
Device Story
Nitrile examination glove; 8 mil thickness; non-sterile; fitted or ambidextrous; beaded cuff. Used by healthcare workers and similar personnel in clinical settings to prevent cross-contamination between patient and provider. Provides barrier protection against chemotherapeutic agents. Device is worn on the hand; no electronic or mechanical operation.
Clinical Evidence
Bench testing only. Testing conducted per 21 CFR 800.20, ASTM D412, ASTM 1342-91, ASTM 739-91, NFPA 1999, and Blue Book Memorandum #G95-1 for sensitization and primary irritation.
Indicated for healthcare workers and similar personnel to prevent cross-contamination between personnel and patients, and for protection of the wearer against exposure to chemotherapeutic agents.
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.
{0}
Aug. 20. 1997 5:54AM SAGE PRODUCTS INC No. 4554 3/5
SAGE PRODUCTS INC K970135
Examination AUG 25 1997
# 14 510(k) Summary for Sage Nitrile Gloves, K970135
This summary of safety and effectiveness information is being submitted in accordance with the requirements of SMDA 90.
| Submitter Name | Karen Pinto, Regulatory Affairs Manager |
| --- | --- |
| Company Name | Sage Products Inc. |
| Street Address | 815 Tek Drive, Crystal Lake, IL 60014 |
| Contact Person | Karen Pinto, Regulatory Affairs Manager |
| Telephone of Contact Person | 815-455-4700 ext. 1383 |
| Fax of Contact Person | 815-455-5599 |
| Date of Summary Preparation | May 8, 1997 |
| Device Name | |
| Trade or Proprietary Name | Nitrile Gloves (POWDER FREE EXAMINATION GLOVE) |
| Classification Name | Patient Examination Gloves (CFR: 800.6250) |
| Common Name^{1} | Exam Gloves |
| Indications for Use | A medical glove worn on the hand of a healthcare worker and similar personnel to prevent contamination between healthcare personnel and patient. In addition, this glove is worn for the protection of the wearer against exposure to chemotherapeutic agents. |
| Description: | 8 mil thick, Non Sterile, fitted or ambidextrous, Nitrile gloves with beaded cuff extending beyond the wrist. |
Page 13 of 16 Response to 8/19/1997 Request for Revisions
"Innovative health care products since 1971"
815 Tek Drive ■ P.O. Box 9693 ■ Crystal Lake, IL 60039-9693
815-455-4700 ■ 800-323-2220 ■ Fax: 815-455-5599
{1}
Aug. 20. 1997 5:54AM SAGE PRODUCTS INC
No. 4564 P. 4/5
# SAGE
# PRODUCTS INC
## 14 510(k) Summary for Sage Nitrile Gloves, K970135 (Continued)
### Substantial Equivalence Comparison
| Product Name | Nitrile Gloves | Safeskin | Nitrex | N-Dex | N-Dex | N-Dex |
| --- | --- | --- | --- | --- | --- | --- |
| Manufacturer | Sage Products, Inc. | Safeskin | Delta Hospital Supply, Inc. or Delta Medical Systems | Best | Best | Best |
| Product Code | LZC Undetermined | N-110 | UNT-100 | 8005 | 9005 | 9905 |
| K Number | Has not been assigned yet | Could not locate | Could not locate | Could not locate | K902696 | K915086 |
| Address | Crystal Lake, IL | San Diego, CA | Norwood, Mass or Duluth, GA | Menlo, GA | Menlo, GA | Menlo, GA |
| Intended Use of Product | Patient examination and personal protection | Patient examination and personal protection | Patient examination and personal protection | Personal protection, Food and Pharmaceutical | Patient examination, personal protection, Food and Pharmaceutical | Patient examination, personal protection, Food and Pharmaceutical |
| Sizes available | xs, s, m, l, xl | xs, s, m, l, xl | s, m, l, xl | s, m, l, xl | s, m, l, xl | s, m, l, xl |
| Material | Nitrile | Nitrile | Nitrile | Nitrile | Nitrile | Nitrile |
| Orientation | Fitted and Ambidextrous | Ambidextrous | Ambidextrous | Ambidextrous | Fitted | Ambidextrous |
| Cuff | Beaded | Beaded | Beaded | Beaded | Beaded | Beaded |
| Color | White | Blue | Blue | Blue | Blue | Blue |
| Product Code | Undetermined | N-110 | UNT-100 | 8005 | 9005 | 9905 |
| Sterility | Non-Sterile | Non-Sterile | Non-Sterile | Non-Sterile | Non-Sterile | Non-Sterile |
| Length (in.) | 12 | 9 1/2 | 11 | 9 1/2 | 11 | 11 |
| Fingertip Thickness (mil) | 8 | 6 | 6 | 8 | 6 | 6 |
| Presence of Donning Powder | No | No | No | Yes | Available with and without | Available with and without |
Page 14 of 16
Response to 8/19/1997 Request for Revisions
"Innovative health care products since 1971"
815 TEX DRIVE ■ P.O. Box 9693 ■ CRYSTAL LAKE, IL 60039-9693
815-455-4700 ■ 800-323-2220 ■ FAX: 815-455-5599
{2}
Aug. 20. 1997 5:55AM SAGE PRODUCTS INC 30.4334 5/5
SAGE PRODUCTS INC
# 14 510(k) Summary for Sage Nitrile Gloves, K970135 (Continued)
## Performance Test Summary
The Sage nitrile glove have been tested per the following standards
- 21 CFR 800.20
- ASTM D412
- ASTM 1342-91
- ASTM 739-91
- NFPA 1999
- Blue Book Memorandum #G95-1, Sensitization, and Primary Irritation Testing
Page 15 of 16
Response to 8/19/1997 Request for Revisions
"Innovative health care products since 1971"
815 TEK DRIVE ■ P.O. Box 9693 ■ CRYSTAL LAKE, IL 60039-9693
815-455-4700 ■ 800-323-2220 ■ FAX: 815-455-5599
{3}
DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
Food and Drug Administration
9200 Corporate Boulevard
Rockville MD 20850
Ms. Karen Pinto
Regulatory Affairs Manager
Sage Products Incorporated
815 Tek Drive
P.O. Box 9693
Crystal Lake, Illinois 60014-9693
AUG 25 1997
Re: K970135
Trade Name: Sage Powder-Free Nitrile Examination Gloves
Regulatory Class: I
Product Code: LZC
Dated: May 23, 1997
Received: June 3, 1997
Dear Ms. Pinto:
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 requirements, 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
{4}
Page 2 - Ms. Pinto
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 (301) 594-4692. Additionally, for questions on
the promotion and advertising of your device, please contact
the Office of Compliance at (301) 594-4639. 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 (800) 638-2041 or (301) 443-6597 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
{5}
Aug. 18. 1997 12:08PM SAGB PRODUCS .NC
No. 4042 1. 5/7
Page 1 of 1
510(k) Number (if known): K970135
Device Name: Sage Nitrile Gloves (POWDER FREE EXAMINATION GLOVE)
Indications For Use:
A medical glove worn on the hand of a healthcare worker and similar personnel to prevent contamination between healthcare personnel and patient. In addition, this glove is worn for the protection of the wearer against exposure to chemotherapeutic agents.
[Section 15, page 16 of 16, Pre-Market Notification: Nitrile Gloves]
(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 Dental, Infection Control, and General Hospital Devices
510(k) Number K970135
Prescription Use
(Per 21 CFR 801.109)
OR
Over-The-Counter Use ☑
(Optional Format 1-2-96)
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