21 C.F.R. § 800.20   Patient examination gloves and surgeons' gloves; sample plans and test method for leakage defects; adulteration.


Title 21 - Food and Drugs


Title 21: Food and Drugs
PART 800—GENERAL
Subpart B—Requirements for Specific Medical Devices

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§ 800.20   Patient examination gloves and surgeons' gloves; sample plans and test method for leakage defects; adulteration.

(a) Purpose. The prevalence of human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS), and its risk of transmission in the health care context, have caused the Food and Drug Administration (FDA) to look more closely at the quality control of barrier devices, such as surgeons' gloves and patient examination gloves (collectively known as medical gloves) to reduce the risk of transmission of HIV and other blood-borne infectious diseases. The Centers for Disease Control (CDC) recommend that health care workers wear medical gloves to reduce the risk of transmission of HIV and other blood-borne infectious deseases. The CDC recommends that health care workers wear medical gloves when touching blood or other body fluids, mucous membranes, or nonintact skin of all patients; when handling items or surfaces soiled with blood or other body fluids; and when performing venipuncture and other vascular access procedures. Among other things, CDC's recommendation that health care providers wear medical gloves demonstrates the proposition that devices labeled as medical gloves purport to be and are represented to be effective barriers against the transmission of blood- and fluid-borne pathogens. Therefore, FDA, through this regulation, is defining adulteration for patient examination and surgeons' gloves as a means of assuring safe and effective devices.

(1) For a description of a patient examination glove, see §880.6250. Finger cots, however, are excluded from the test method and sample plans in paragraphs (b) and (c) of this section.

(2) For a description of a surgeons' glove, see §878.4460 of this chapter.

(b) Test method. For the purposes of this regulation, FDA's analysis of gloves for leaks will be conducted by a water leak method, using 1,000 milliliters (mL) of water. Each medical glove will be analyzed independently. When packaged as pairs, each glove is considered separately, and both gloves will be analyzed. A defect on one of the gloves is counted as one defect; a defect in both gloves is counted as two defects. Defects are defined as leaks, tears, mold, embedded foreigh objects, etc. A leak is defined as the appearance of water on the outside of the glove. This emergence of water from the glove constitutes a watertight barrier failure. Leaks within 1 and 1/2 inches of the cuff are to be disregarded.

(1) The following materials are required for testing: A 23/8-inch by 15-inch (clear) plastic cylinder with a hook on one end and a mark scored 11/2 inches from the other end (a cylinder of another size may be used if it accommodates both cuff diameter and any water above the glove capacity); elastic strapping with velcro or other fastening material; automatic water-dispensing apparatus or manual device capable of delivering 1,000 mL of water; a stand with horizontal rod for hanging the hook end of the plastic tube. The support rod must be capable of holding the weight of the total number of gloves that will be suspended at any one time, e.g., five gloves suspended will weigh about 11 pounds.

(2) The following methodology is used: Examine the sample and identify code/ lot number, size, and brand as appropriate. Examine gloves for defects as follows: carefully remove the glove from the wrapper, box, etc., visually examining each glove for defects. Visual defects in the top 11/2 inches of a glove will not be counted as a defect for the purposes of this rule. Visually defective gloves do not require further testing but are to be included in the total number of defective gloves counted for the sample. Attach the glove to the plastic fill tube by bringing the cuff end to the 11/2-inch mark and fastening with elastic strapping to make a watertight seal. Add 1,000 mL of room temperature water (i.e., 20 °C to 30 °C) into the open end of the fill tube. The water shall pass freely into the glove. (With some larger sizes of long-cuffed surgeons' gloves, the water level may reach only the base of the thumb. With some smaller gloves, the water level may extend several inches up the fill tube.)

(3) Immediately after adding the water, examine the glove for water leaks. Do not squeeze the glove; use only minimal manipulation to spread the fingers to check for leaks. Water drops may be blotted to confirm leaking. If the glove does not leak immediately, keep the glove/filling tube assembly upright and hang the assembly vertically from the horizontal rod, using the wire hook on the open end of the fill tube (do not support the filled glove while transferring). Make a second observation for leaks 2 minutes after addition of the water to the glove. Use only minimal manipulation of the fingers to check for leaks. Record the number of defective gloves.

(c) Sample plans. FDA will collect samples from lots of gloves to perform the test for defects described in paragraph (b) of this section in accordance with FDA's sampling inspection plans which are based on the tables of MIL-STD-105E (the military sampling standard, “Sampling Procedures and Tables for Inspection by Attributes,” May 10, 1989). Based on the acceptable quality levels found in this standard, FDA has defined adulteration as follows: 2.5 or higher for surgeons' gloves and 4.0 or higher for patient examination gloves at a general inspection level II. FDA will use single normal sampling for lots of 1,200 gloves or less and multiple normal sampling for all larger lots. For convenience, the sample plans (sample size and accept/reject numbers) are shown in the following tables:

                                 Adulteration Level at 2.5 for Surgeons' Gloves----------------------------------------------------------------------------------------------------------------                                                                                              Number defective                Lot size                            Sample              Sample     Number  ---------------------                                                                         size     examined    Accept     Reject----------------------------------------------------------------------------------------------------------------35,001 and above........................  First.....................        125        125          2          9                                          Second....................        125        250          7         14                                          Third.....................        125        375         13         19                                          Fourth....................        125        500         19         25                                          Fifth.....................        125        625         25         29                                          Sixth.....................        125        750         31         33                                          Seventh...................        125        875         37         3835,000 to 10,001........................  First.....................         80         80          1          7                                          Second....................         80        160          4         10                                          Third.....................         80        240          8         13                                          Fourth....................         80        320         12         17                                          Fifth.....................         80        400         17         20                                          Sixth.....................         80        480         21         23                                          Seventh...................         80        560         25         2610,000 to 3,201.........................  First.....................         50         50          0          5                                          Second....................         50        100          3          8                                          Third.....................         50        150          6         10                                          Fourth....................         50        200          8         13                                          Fifth.....................         50        250         11         15                                          Sixth.....................         50        300         14         17                                          Seventh...................         50        350         18         193,200 to 1,201..........................  First.....................         32         32          0          4                                          Second....................         32         64          1          6                                          Third.....................         32         96          3          8                                          Fourth....................         32        128          5         10                                          Fifth.....................         32        160          7         11                                          Sixth.....................         32        192         10         12                                          Seventh...................         32        224         13         141,200 to 501............................  Single sample.............  .........         80          5          6500 to 281..............................  Single sample.............  .........         50          3          4280 to 151..............................  Single sample.............  .........         32          2          3150 to 51...............................  Single sample.............  .........         20          1          250 to 0.................................  Single sample.............  .........          5          0          1----------------------------------------------------------------------------------------------------------------
                            Adulteration Level at 4.0 for Patient Examination Gloves----------------------------------------------------------------------------------------------------------------                                                                                              Number defective                Lot size                            Sample              Sample     Number  ---------------------                                                                         size     examined    Accept     Reject----------------------------------------------------------------------------------------------------------------10,001 and above........................  First.....................         80         80          2          9                                          Second....................         80        160          7         14                                          Third.....................         80        240         13         19                                          Fourth....................         80        320         19         25                                          Fifth.....................         80        400         25         29                                          Sixth.....................         80        480         31         33                                          Seventh...................         80        560         37         3810,000 to 3,201.........................  First.....................         50         50          1          7                                          Second....................         50        100          4         10                                          Third.....................         50        150          8         13                                          Fourth....................         50        200         12         17                                          Fifth.....................         50        250         17         20                                          Sixth.....................         50        300         21         23                                          Seventh...................         50        350         25         263,200 to 1,201..........................  First.....................         32         32          0          5                                          Second....................         32         64          3          8                                          Third.....................         32         96          6         10                                          Fourth....................         32        128          8         13                                          Fifth.....................         32        160         11         15                                          Sixth.....................         32        192         14         17                                          Seventh...................         32        224         18         191,200 to 501............................  Single sample.............  .........         80          7          8500 to 281..............................  Single sample.............  .........         50          5          6280 to 151..............................  Single sample.............  .........         32          3          4150 to 91...............................  Single sample.............  .........         20          2          390 to 26................................  Single sample.............  .........         13          1          225 to 0.................................  Single sample.............  .........          3          0          1----------------------------------------------------------------------------------------------------------------

(d) Lots of gloves which are tested and rejected using the test method according to paragraph (b) of this section, are adulterated within the meaning of section 501(c) of the Federal Food, Drug, and Cosmetic Act, and are subject to regulatory action, such as detention of imported products and seizure of domestic products.

[55 FR 51256, Dec. 12, 1990]

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