# K201390: Medline Powder-Free Light Blue Nitrile Exam Gloves (Tested for Use with Chemotherapy Drugs)

- Pathway: 510(k) (Traditional)
- Applicant: Medline Industires, Inc.
- Decided: Sep 18, 2020 after 114 days
- Product code: LZC (Medical Glove, Specialty)
- Device class: 1
- Regulation: 21 CFR 880.6250
- Recalls of this device: none
- Data: FDA decisions to Oct 25, 2026; recalls to Oct 12, 2026

## Lineage
Longest line of descent: 5 generations back to K042805 (2004). 6 ancestors in all.
8 later devices descend from it; 6 cite it directly.
0 of 15 devices in its family (counting itself) have a Class I recall.

## Predicates on the family tree (from the FDA summary)
- K172525: Blue Non Sterile Powder Free Nitrile Examination Gloves Tested for Use with Chemotherapy Drugs, Central Medicare Sdn Bhd (2017) Summary page 4.

## Most influential descendants
- K222898: SafeSource Direct Blue Powder-Free Nitrile Exam Gloves (2022), 1 descendant of its own
- K211714: Nitrile Exam Gloves, Powder Free,Blue (Tested for Use with Chemotherapy) (2021), 1 descendant of its own
- K250502: SafeSource Direct Blue Powder-Free Nitrile Exam Gloves (AMERI-TUFF Series 4000, AMERI-TOUCH Series 5000) (2025), 0 descendants of its own
- K222733: Disposable Nitrile Examination Glove (Tested for use with Chemotherapy Drug) (2022), 0 descendants of its own
- K222642: Disposable Nitrile Examination Glove (Tested for use with Chemotherapy Drug) (2022), 0 descendants of its own

## Indications for use
A patient examination glove is a disposable device intended for medical purposes that is worn on the examiner’s hands to prevent contamination between patient and examiner. These gloves were tested for use with chemotherapy drugs, as per ASTM D6978-05 (Reapproved 2019) Standard Practice for Assessment of Medical Gloves to Permeation by Chemotherapy Drugs. Carmustine (BCNU) 3.3 mg/ml 25.3 Minutes Cisplatin 1.0 mg/ml ≥ 240 Minutes Cyclophosphamide (Cytoxan) 20.0 mg/ml ≥ 240 Minutes Dacarbazine (DTIC) 10.0 mg/ml ≥ 240 Minutes Doxorubicin Hydrochloride 2.0 mg/ml ≥ 240 Minutes Etoposide (Toposar) 20.0 mg/ml ≥ 240 Minutes Fluorouracil 50.0 mg/ml 0.5 mg/ml ≥ 240 Minutes Methotrexate 25 mg/ml ≥ 240 Minutes Mitomycin C 0.5 mg/ml ≥ 240 Minutes Paclitaxel (Taxol) 6.0 mg/ml ≥ 240 Minutes Thio-Tepa 10.0 mg/ml 43.7 Minutes Vincristine Sulfate (Oncovin) 1.0 mg/ml ≥ 240 Minutes Please note that the following drugs have low permeation times: Carmustine (BCNU) 3.3 mg/ml 25.3 Minutes Thio-Tepa 10.0 mg/ml 43.7 Minutes Caution: Testing showed an average breakthrough time of 43.7 minutes with Thio-Tepa WARNING: Do not use with Carmustine

Source page: https://510kreport.com/device/K201390
Methodology: https://510kreport.com/methodology