K Number
K011745
Device Name
HP-3, BATTETRY OPERATED, FONT WHEEL DRIVE, POWER WHEELCHAIR
Date Cleared
2001-08-30

(85 days)

Product Code
Regulation Number
890.3860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The intended use of the HP-3 is to provide mobility to adults limited to a sitting position that have the capacity to operate a simple hand control.
Device Description
Model HP-3, Power Wheelchair
More Information

Not Found

Not Found

No
The summary describes a standard power wheelchair with a simple hand control and does not mention any AI or ML capabilities.

No.
The device is described as a "Power Wheelchair" with the intended use of providing mobility. It does not provide any diagnostic, preventive, or treatment functions typically associated with therapeutic devices.

No
Explanation: The intended use of the HP-3 is to provide mobility to adults, which does not involve diagnosing any medical condition. It is described as a power wheelchair.

No

The device description explicitly states "Model HP-3, Power Wheelchair," which is a hardware device.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is to provide mobility to adults. This is a physical function, not a diagnostic test performed on samples taken from the body.
  • Device Description: It's described as a "Power Wheelchair," which is a mobility aid.
  • Lack of IVD Indicators: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in the body
    • Diagnosing diseases or conditions
    • Using reagents or assays

The device's function is purely mechanical and related to providing physical support and mobility.

N/A

Intended Use / Indications for Use

The intended use of the HP-3 is to provide mobility to adults limited to a sitting position that have the capacity to operate a simple hand control.

Product codes

ITI

Device Description

Model HP-3, Power Wheelchair

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

adults

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Not Found

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

Not Found

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 890.3860 Powered wheelchair.

(a)
Identification. A powered wheelchair is a battery-operated device with wheels that is intended for medical purposes to provide mobility to persons restricted to a sitting position.(b)
Classification. Class II (performance standards).

0

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Image /page/0/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" around the perimeter. Inside the circle is a stylized image of an eagle or bird-like figure with three curved lines representing its wings or body.

AUG 3 0 2001

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Juan Carlos Rivera President Transworld Mobility Distribution, LLC 6140 Mid Metro Drive, Suite 6 Fort Myers, Florida 33912

Re: K011745

Trade/Device Name: Model HP-3 Power Wheelchair Regulation Number: 890.3825 Regulatory Class: II Product Code: ITI Dated: May 2, 2001 Received: June 5, 2001

Dear Mr. Rivera:

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 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). 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 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

1

Page 2 - Mr. Juan Carlos Rivera

This letter will allow you to begin marketing your device as described in your 510(k) premarket I his letter will anow you to begin marketing your device of your device to a legally marketed notification. The FDA inding of substantial equal thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFF) Part 801 and If you desire specific advice for your devices), please contact the Office of Compliance at
additionally 809.10 for in vitro diagnostic devices), please contact the Office of additionally 809.10 for m Yillo diagnostions on the promotion and advertising of your device, (301) 594-4659. Additionally, for questions on the presses on the regulation please contact the Office or Compliance an (81) ontification's (21CFR 807.97). Other general entitled, "Misoranding by relective to premarket from the Division of Small
information on your responsibilities under the Act may be obtained from the 1800) 638, 2011 on information on your responsionnies under the recent its toll-free number (800) 638-2041 or
Manufacturers International and Consumer Assistance at its toll-boardsmapp html" Manufacturers Internet address "http://www.fda.gov/cdrh/dsma/dsmamain.html".
(301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsma/dsmamain.html".

Sincerely yours,

Mark N Milbersen

Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use Statement

510K number: KO11 745

Device Name: Model HP-3, Power Wheelchair

The intended use of the HP-3 is to provide mobility to adults limited to a Indications For Use: sitting position that have the capacity to operate a simple hand control.

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Mark N Mulberon

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

510(k) Number K011745

Prescription Use______________________________________________________________________________________________________________________________________________________________

OR

Over-The-Counter Use__________________________________________________________________________________________________________________________________________________________