K Number
K061273
Date Cleared
2006-05-23

(15 days)

Product Code
Regulation Number
890.3850
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The intended use of the 7000 Series Lightweight Wheelchair is to provide mobility to adult persons with limited mobility or adult persons limited to a seated position. The target population for the 7000 Series Lightweight Wheelchair is the United States adult population.

Device Description

The 7000 Series Lightweight Wheelchair is mechanical wheelchair that is lightweight in design (weighs 31.5 lbs) and provides mobility to persons with limited mobility or persons limited to a sitting position. The 7000 Series Lightweight Wheelchair comes in 16", 18" and 20" seat widths and has component adjustments for optimum fitting. The 7000 Series Lightweight Wheelchair has dual crossbar support, flip back removable arms, flame retardant nylon upholstery, removable footrests with heel loops, dual axle positioning and wheel locks.

AI/ML Overview

The Nova Ortho-Med, Inc. 7000 Series Lightweight Wheelchairs underwent non-clinical testing to demonstrate substantial equivalence to a predicate device (Invacare 9000 Series Wheelchair, K881951). The device is a mechanical wheelchair weighing 31.5 lbs, available in 16", 18", and 20" seat widths.

The acceptance criteria and reported device performance are as follows:

1. Table of Acceptance Criteria and Reported Device Performance:

Test StandardAcceptance CriteriaReported Device Performance
ISO 7176-16: Resistance to Ignition of Upholstered PartsPassed California Technical Bulletin 117 - Flammability TestingPassed
ISO 1421: Upholstery Strength TestNo specific quantitative criteria provided; generally implies meeting industry strength requirements.Implicitly Passed (no failure reported).
Nova Orthopedic and Rehabilitation Appliance Inc. - On Road Test for Durability (March 16-25, 2005) (Running Speed: 60 rpm, Weight Load: 163 kgf)- Motion Test passed - Brakes Test passed - Static Test passed - Impact Test passed - Strength Test passedPassed all listed sub-tests.
ISO 7176-11: Test DummiesNo specific acceptance criteria mentioned; likely refers to the standard's methodology for testing.Implicitly Met (no failure reported).
ISO 7176-13: Determination of Coefficient of Friction of Test SurfacesNo specific acceptance criteria mentioned; likely refers to the standard's methodology for testing.Implicitly Met (no failure reported).
ISO 7176: Determine of Effectiveness of BrakesNo specific acceptance criteria mentioned, but implies effective brake operation.Implicitly Passed (On-Road Test explicitly passed brakes).
ISO 7176-15: Requirements for information disclosure, documentation and labelingAdherence to standard for labeling and documentation.Implicitly Met (submission deemed compliant by FDA).
ISO 7176-1: Determination of Static StabilityNo specific acceptance criteria mentioned; implies stable operation.Implicitly Met (Static Test explicitly passed).
ISO WC: Determination of Overall Dimensions, Mass and Turning SpaceConformance to standard for measuring these parameters.Implicitly Met (device description provides these details).

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

The document does not specify a "test set" in the context of human subjects or a dataset. The testing performed was non-clinical, involving physical performance tests on the device itself.

  • Sample Size: The document implies testing was performed on a sample of the 7000 Series Lightweight Wheelchair(s) to demonstrate compliance with the listed ISO standards and an "On Road Test for Durability." The exact number of units tested is not specified.
  • Data Provenance: The testing was conducted by Nova Orthopedic and Rehabilitation Appliance Inc. (for the On-Road Test) and presumably by accredited labs for the ISO standards. The country of origin for the data is not explicitly stated, but Nova Ortho-Med, Inc. is based in the USA. The tests were prospective for the purpose of this submission (i.e., conducted specifically to demonstrate compliance).

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

This question is not applicable to this submission. The "ground truth" for non-clinical performance testing typically refers to the objective results against established engineering and safety standards, not expert consensus on medical conditions. The tests were performed according to defined international standards (ISO) and the results were objectively measured.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

This question is not applicable. Adjudication methods like 2+1 or 3+1 are used in clinical studies where expert disagreement on complex interpretations (e.g., medical images) needs to be resolved to establish ground truth. For non-clinical performance testing, the results are typically determined by objective measurements and evaluation against predefined criteria within the respective standards.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

This question is not applicable as this is a submission for a mechanical wheelchair, not an AI-powered diagnostic device or a device involving human readers for interpretation.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

This question is not applicable as this is a mechanical device, not an algorithm or AI system.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

The "ground truth" for the non-clinical testing was established by adherence to recognized international standards (ISO series) and the successful completion of specific physical performance tests (e.g., flammability, upholstery strength, durability). The criteria within these standards define what constitutes a "passing" result.

8. The sample size for the training set

This question is not applicable as this is a non-AI mechanical device. There is no "training set" in the context of machine learning.

9. How the ground truth for the training set was established

This question is not applicable as there is no "training set" for this mechanical device.

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K061273

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MAY 2 3 2006

Image /page/0/Picture/3 description: The image shows the logo for NOVA ORTHO-MED, INC. The word "NOVA" is in large, stylized letters at the top of the logo. Below that, the words "ORTHO-MED, INC." are printed in a smaller, sans-serif font. Underneath that, the phrase "Commitment to Caring" is printed in an italicized font.

510(k) Summary Nova Ortho-Med, Inc. 7000 Series Lightweight Wheelchairs

Submitter's Name and Address

Nova Ortho-Med, Inc. P.O. Box 3039 Gardena, CA 90247 Phone: (310) 352-3600 Fax: (310) 352-3610

Physical Address Location: 1470 Beachey Place Carson, CA 90746

Contact Person: Sue Chen President, CEO Nova Ortho-Med. Inc.

Date Prepared: October 10, 2005

Name of Device and Proprietary Name: 7000 Series Lightweight Wheelchairs

Common or Usual Name: Manual Wheelchair

Classification Name: Wheelchair, Mechanical

Product Code: IOR

Regulation Number: 890.3850

Regulatory Class: Class 1

Comparison to Predicate Devices:

The 7000 Series Lightweight Wheelchair is substantially equivalent to the Invacare 9000 Series Wheelchair (K881951)

Device Description:

The 7000 Series Lightweight Wheelchair is mechanical wheelchair that is lightweight in design (weighs 31.5 lbs) and provides mobility to persons with limited mobility or persons limited to a sitting position. The 7000 Series Lightweight Wheelchair comes in 16", 18" and 20" seat widths and has component adjustments for optimum fitting. The 7000 Series Lightweight Wheelchair has dual crossbar support, flip back removable arms, flame retardant nylon upholstery, removable footrests with heel loops, dual axle positioning and wheel locks.

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Intended Use:

The intended use of the 7000 Series Lightweight Wheelchair is to provide mobility to adult persons with limited mobility or adult persons limited to a seated position. The target population for the 7000 Series Lightweight Wheelchair is the United States adult population.

Non-Clinical Testing:

ISO 7176-16: Resistance to Ignition of Upholstered Parts - California Technical Bulletin 117 - Flammability Testing: Passed

ISO 1421: Upholstery Strength Test

Nova Orthopedic and Rehabilitation Appliance Inc. - The On Road Test for Durability: Test Date - March 16 - 25, 2005

  • Running Speed: 60 rpm - Weight Load: 163 kgf
    • Motion Test and Brakes Test passed
    • Static, Impact and Strength Test passed -

ISO 7176-11: Test Dummies

ISO 7176-13: Determination of Coefficient of Friction of Test Surfaces

ISO 7176: Determine of Effectiveness of Brakes

ISO 7176-15: Requirements for information disclosure, documentation and labeling.

ISO 7176-1: Determination of Static Stability

ISO WC: Determination of Overall Dimensions, Mass and Turning Space

Discussion of Clinical Testing Performed:

N/A

Conclusions:

The 7000 Series Lightweight Wheelchair has the same intended use and similar technological characteristics as the Invacare 9000 Series Wheelchair (K881951). All non-clinical testing and the predicate comparisons show that there are no safety or effectiveness issues or claims that differ from the predicate device cited. This submission complies with the requirements as stated in 21 CFR Part 807 Subpart E, that a new device is substantially equivalent to a predicate device in 21 CFR 890.3850. The conclusion is that the 7000 Series Lightweight Wheelchair is substantially equivalent to the predicate device.

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Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with three lines forming its body and wings. The eagle is encircled by the text "DEPARTMENT OF HEALTH AND HUMAN SERVICES . USA" in a circular arrangement.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAY 2,3 2006

Nova Ortho-Med, Inc. % Mr. Daniel W. Lehtonen Staff Engineer - Medical Devices Intertek Testing Services NA, Inc. 2307 East Aurora Road Unit B7 Twinsburg, Ohio 44087

Re: K061273

Trade/Device Name: 7000 Series Lightweight Wheelchairs Regulation Number: 21 CFR 890.3850 Regulation Name: Mechanical Wheelchair Regulatory Class: I Product Code: IOR Dated: May 5, 2006 Received: May 8, 2006

Dear Mr. Lehtonen:

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

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Page 2 - Mr. Daniel W. Lehtonen

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 (240) 276-0120. 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 (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.

Sincerely vours

Hulen Lemons

Mark N. Melkerson Acting Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Image /page/4/Picture/0 description: The image shows the logo for Nova Ortho-Med, Inc. The word "NOVA" is in a stylized font, with the letters overlapping each other. Below the word "NOVA" is the text "ORTHO-MED, INC." in a smaller, sans-serif font. Underneath that is the text "Commitment to Caring" in a slightly smaller, italicized font.

Indications for Use

K061273 510(k) Number (if known)_

Device Name: 7000 Series Lightweight Wheelchair

Indications for Use:

The intended use of the 7000 Series Lightweight Wheelchair is to provide mobility to adult persons with limited mobility or adult persons limited to a seated position. The target population for the 7000 Series Lightweight Wheelchair is the United States adult population.

Prescription Use (Part 21 CFR 801 Subpart D) AND/OR

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Hulbert Remer us

(Division Sign-Off) Division of General, Restorative, and Neurological Devices

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510(k) Number K061273

§ 890.3850 Mechanical wheelchair.

(a)
Identification. A mechanical wheelchair is a manually operated device with wheels that is intended for medical purposes to provide mobility to persons restricted to a sitting position.(b)
Classification. Class I (general controls).