POWERED WHEELCHAIR, MODEL C-1000

• K Number: K041211
• Device Name: POWERED WHEELCHAIR, MODEL C-1000
• Manufacturer: OTTO BOCK HEALTH CARE, LP
• Date Cleared: 2004-10-01 ( 144 days)
• Product Code: ITI
• Regulation Number: 890.3860

Intended Use

Provide mobility to persons physically challenged and limited to sitting position.

Device Description

The C-1000 Powered Wheelchair is a front wheel drive powered wheelchair, manufactured in Germany at production facilities of OTTO BOCK HealthCare. The C-1000 has an "H" frame, controlled by a Curtis Instruments MC-2, electronic regenerative disc brakes and Micro Motor.

Predicate Devices

K960951

Reference Devices

Not Found

AI/ML (Artificial Intelligence / Machine Learning)

No
The summary describes a standard powered wheelchair with electronic controls and brakes, with no mention of AI or ML technologies.

Therapeutic

No.
The device's intended use is to provide mobility. While it assists individuals with physical challenges, it does not directly treat or cure an ailment, nor does it restore a damaged or malfunctioning organ or function. Its purpose is compensatory.

Diagnostic

No

Explanation: The "Intended Use" states that the device provides mobility to physically challenged individuals. There is no mention of diagnosing any medical conditions, and the device description outlines its mechanical components as a powered wheelchair.

SaMD (Software as a Medical Device)

No

The device description clearly states it is a "Powered Wheelchair" with physical components like an "H" frame, electronic regenerative disc brakes, and a Micro Motor. This indicates it is a hardware device, not software-only.

IVD (In Vitro Diagnostic)

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 persons physically challenged and limited to sitting position." This describes a device used on a person for physical assistance, not a device used in vitro (outside the body) to examine specimens for diagnostic purposes.
• Device Description: The description details a powered wheelchair with mechanical and electronic components. This aligns with a mobility aid, not an IVD.
• Lack of IVD Indicators: There is no mention of analyzing biological samples, detecting biomarkers, or providing diagnostic information. The focus is entirely on providing mobility.

Therefore, the C-1000 Powered Wheelchair is a medical device, but it falls under the category of a mobility aid, not an In Vitro Diagnostic.

PCCP (Predetermined Change Control Plan) Authorized

N/A

Overview

Intended Use / Indications for Use

The C-1000 is front wheel drive powered wheelchair for active users. These wheelchairs provide mobility to physically challenged persons. The wheelchair can be moved by the user operating the remote control. The wheelchair can also be pushed by an assistant grasping the handles attached to the back rest.
Provide mobility to persons physically challenged and limited to sitting position.

Product codes

ITI

Device Description

The C-1000 Powered Wheelchair is a front wheel drive powered wheelchair, manufactured in Germany at production facilities of OTTO BOCK HealthCare. The C-1000 has an "H" frame, controlled by a Curtis Instruments MC-2, clectronic regenerative disc brakes and Micro Motor.

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

Not Found

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)

The C-1000 was tested by TÜV Product Service to the following standards:

• EN 12184
• ISO 7176 Series .
• ANSI/RESNA WA Vol. 2 Section 21 Amendments 1998 for EMC .
  with the conclusion that "the test sample fulfills the requirements."

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

Not Found

Predicate Device(s)

K960951

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

Regulation Number and Section

§ 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).

Summary

0

Otto Bock
HEALTH CARE

K041211

OCT 1 - 2004

510(k) Summary

510(k) SUMMARY of SAFETY and EFFECTIVENESS

A. General Information

1. Submitter's Name:	OTTO BOCK HealthCare LP
2. Address:	Two Carlson Parkway N., Suite 100
Minneapolis, MN 55447-4467
3. Telephone:	763-489-5105
4. Contact Person:	Bob Clarke
5. Date Prepared:	April 12, 2004
6. Registration Number:	2182293
Device

B. 1. Name: C-1000 Powered Wheelchair 2. Trade Name: C-1000 Powered Wheelchair 3. Common Name: Powered wheelchair 4. Classification Name: Powered wheelchair 5. Product Code: ITI 6. Class: I I 7. Regulation Number: 890.3860

QUALITY FOR LIFE

North American Headquarters Two Carlson Parkway N., Suite Minneapolis, MN 55447-4467 Phone [phone] Fax [phone]

Customer Support & Distribution Center 14630 28t Avenue North Minneapolis, MN 55447-4821 Phone [phone] Fax [phone]

Technical Center 14800 28th Avenue North, Suite Minneapolis, MN 55447-4873 Phone [phone] Fax [phone]

Florida Area Fabrication Center 755 Clay Street Winter Park, FL 32789 Phone [phone] Fax [phone]

Ohio Area Fabrication Center 84 Westpark Road Centerville, OH 45459 Phone [phone] Fax [phone]

Utah Design & Manufacturing Center 3820 W. Great Lakes Drive Salt Lake City, UT 84120-7205 Phone [phone] Fax [phone]

Minnesota Design & Manufacturing Center 820 Sundial Drive Waite Park, MN 56387 Phone [phone] Fax [phone]

Customer Satisfaction Hotline 1.877.OBSOLVE 1.877.627.6583

www.ottobockus.com

1

Image /page/1/Picture/0 description: The image shows the logo for Otto Bock Health Care. The words "Otto Bock" are written in a cursive font, with a line underneath. Below the line, the words "HEALTH CARE" are written in a sans-serif font.

C. Identification of Legally Marketed Devices

1. Name:	Chairman
2. K Number:	K960951
3. Date Cleared:	April 30, 1997

D. Description of the Device

The C-1000 Powered Wheelchair is a front wheel drive powered wheelchair, manufactured in Germany at production facilities of OTTO BOCK HealthCare. The C-1000 has an "H" frame, controlled by a Curtis Instruments MC-2, clectronic regenerative disc brakes and Micro Motor.

E. Intended Use Statement

The C-1000 is front wheel drive powered wheelchair for active users. These wheelchairs provide mobility to physically challenged persons. The wheelchair can be moved by the user operating the remote control. The wheelchair can also be pushed by an assistant grasping the handles attached to the back rest.

F. Technological Characteristics Summary

The C-1000 Wheelchair is substantially equivalent to the Permobil AB Chairman Wheelchair, cleared on April 30, 1997 as K960951.

Each wheelchair is a powered wheelchair for the active user, with a rigid frame and similar characteristics.

The C-1000 was tested by TÜV Product Service to the following standards:

• EN 12184
• ISO 7176 Series .
• ANSI/RESNA WA Vol. 2 Section 21 Amendments 1998 for EMC .

with the conclusion that "the test sample fulfills the requirements."

QUALITY FOR LIFE

North American Headquarters Two Carlson Parkway N., Suite Minneapolis, MN 55447-4467 Phone [phone] Fax [phone]

Customer Support & Distribution Center 14630 28th Avenue North Minneapolis, MN 55447-482 Phone [phone] Fax [phone]

Technical Center 14800 28th Avenue North, Suite Minneapolis, MN 55447-487 Phone 1,800,795,8846 Fax [phone]

Florida Area Fabrication Cente 55 Clay Street Vinter Park, FL 32789 Phone [phone] Fax [phone]

Ohio Area Fabrication Cente Westpark Road enterville, OH 45459 Phone [phone] x 1.937.432.0087

Itah Design & anufacturing Center 820 W. Great Lakes Drive alt Lake City, UT 84120-72 Phone [phone] ax 1.801.956.2401

innesota Design & anufacturing Center 20 Sundial Drive Vaite Park, MN 56387 hone 1.800.688.4832 ax 1.320.251.0110

Customer Satisfaction Hotline 1.877.OBSOLVE 1.877.627.6583

www.ottobockus.com

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Image /page/2/Picture/1 description: The image is a black and white seal for the Department of Health & Human Services - USA. The seal is circular with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is a stylized caduceus symbol, which is a symbol of medicine and health. The caduceus is made up of three intertwined snakes and a staff.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

OCT 1 - 2004

Otto Bock HealthCare, LP C/o Mr. William Jackson W.F. Jackson Associates, Limited 2247 Jennifer Lane St. Paul, Minnesota 55109-2851

Re: K041211

Trade/Device Name: C-1000 Powered Wheelchair Regulation Number: 21 CFR 890.3860 Regulation Name: Powered Wheelchair Regulatory Class: Class II Product Code: ITI Dated: September 18, 2004 Received: September 22, 2004

Dear Mr. Jackson:

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 for associated in 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 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.

3

Page 2 - Mr. William Jackson

This letter will allow you to begin marketing your device as described in your Section 510(k) I his icher will anow you to began mailing of substantial equivalence of your device to a legally premaince notification. " 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 if you dosire of Compliance at [phone]. Also, please note the regulation entitled, eonading 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 other general international and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Mark A. Mellem

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

Enclosure

4

Indications for Use

510(k) Number (if known): K041211

Device Name: C-1000 Powered Wheelchair

Indications for Use:

• Provide mobility to persons physically challenged and limited to sitting . position.
  Prescription Use (Part 21 CFR 801 Subpart D) AND/OR

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Mark N Melbern

al. Restorative, Division of Gener Divisions of Occal Devices

510(k) Number-

Page 1 of 1

1041211