K Number
K041677
Date Cleared
2004-08-05

(45 days)

Product Code
Regulation Number
890.3800
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The device is intended for medical purposes to provide mobility to persons restricted to a seated position.

Device Description

The KARMA Scooter KS747.2 is an indoor / outdoor Powered Scooter that is battery operated. It has a base with four-wheeled with a seat. The movement of the Scooter is controlled by the rider who uses hand controls located at the top of the steering column. The device can be disassembled for transport and is provided with an onboard battery charger.

AI/ML Overview

This document describes a 510(k) submission for the KARMA Scooter, KS747.2, an electrical scooter. The information provided focuses on the device's substantial equivalence to a predicate device rather than presenting a performance study with specific acceptance criteria and performance metrics typically associated with AI/software devices. Therefore, much of the requested information regarding AI device evaluation cannot be extracted from this document.

Here's an analysis of the provided text in relation to your request:

1. A table of acceptance criteria and the reported device performance

The document does not provide a table of acceptance criteria for specific performance metrics (e.g., accuracy, sensitivity, specificity) of the KARMA Scooter. Instead, it relies on demonstrating substantial equivalence to a predicate device, the WELL SUCCESS A&I Scooter, SC-402 (K041193).

The "performance testing" mentioned is related to safety and electrical standards, not functional performance metrics in the way you might expect for an AI device.

Acceptance Criteria (from predicate device/standards)Reported Device Performance (from KARMA Scooter KS747.2)
Intended Uses: Provide mobility to persons restricted to a seated position.Same
Material/Design Features:
- Size of tiresSame
- Back upholsterySame
- Electronic systems (battery, recharge, electronic controllers)Same supplier, all UL certificated
- Foldable frameSame
- Maximum speedSame
- Removable arm typeSame
- Component warrantySame
- Frame warrantySame
- Back upholstery resistance ignition testPassed by SGS (same material)
Safety Standards:
- EMC Report ANSI / RESNA WC/Vol.2-1998Tested Against
- CISPR 11: 1990Tested Against
- EN61000-3-2: 1995Tested Against
- IEC61000-3-3: 1995 (Electrically Powered Scooters, controller, and their chargers requirements and test methods)Tested Against
Other:
- Warranty periodSame

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

This information is not applicable and not provided in the document as it describes a hardware device submitting for substantial equivalence based on engineering and safety testing, not a clinical study or AI performance evaluation with a "test set" of data.

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 information is not applicable and not provided. The "ground truth" for this device's submission is its adherence to established safety standards and its functional equivalence to a predicate device, not, for example, expert consensus on disease diagnosis which would be relevant for an AI system. The "experts" involved would likely be engineers, safety testers, and regulatory compliance specialists.

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

This information is not applicable and not provided. Adjudication methods are typically used in clinical studies involving human interpretation or AI output, which is not the nature of this submission.

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 information is not applicable and not provided. An MRMC study is relevant for evaluating the impact of AI assistance on human performance in diagnostic tasks. The KARMA Scooter is a mobility device, not a diagnostic AI system.

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

This information is not applicable and not provided. "Standalone performance" refers to the performance of an AI algorithm independent of human interaction. The KARMA Scooter is a physical device controlled by a human, not an algorithm, so this concept does not apply.

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

The "ground truth" implicitly used for this submission is:

  • Adherence to recognized performance and safety standards: ANSI / RESNA WC/Vol.2-1998, CISPR 11: 1990, EN61000-3-2: 1995, IEC61000-3-3: 1995.
  • Demonstration of equivalence in critical specifications and materials to the predicate device, WELL SUCCESS A&I Scooter, SC-402 (K041193), which itself would have met relevant standards and safety requirements. This involves direct comparison of specifications and material certifications (e.g., UL certification for electronic systems, SGS test for back upholstery ignition resistance).

8. The sample size for the training set

This information is not applicable and not provided. "Training set" refers to data used to train an AI model.

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

This information is not applicable and not provided. This concept is specific to AI/machine learning development.

In summary: The provided document is a 510(k) summary for a physical medical device (an electrical scooter). Its acceptance criteria are based on demonstrating substantial equivalence to an existing legally marketed predicate device and conformance to safety and performance standards. The study described focuses on these aspects rather than on the type of AI/software performance evaluation queries you've asked.

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Image /page/0/Picture/0 description: The image shows the text "AUG - 5 2004" on the top left corner. To the right of the date is the logo for Karma home & health care. The logo includes the word "KARMA" in bold, black letters, with the words "home & health care" in a smaller font below. There is also a heart with a wing above the letter "M" in Karma.

KARMA MEDICAL 康揚股份有限公司 Tel:886-(0)5-2066688 Fax:886-(0)5-2067788

Http://www.KarmaMedical.com E-mail:eukarma@ms29.hinet.net

510(k) SUMMARY " દ્ધ

Submitter's Name: KARMA Medical Products Co., Ltd.

No. 2363, Sec.2, Da-Shiue Road, Min-Hsiung Shiang, Chia-Yi Hsien, 621, Taiwan, R.O.C.

June 14, 2004

Date summary prepared:

Device Name:

Proprietary Name:

KARMA Scooter, KS747.2

Common or Usual Name: Classification Name:

Electrical Scooter Motorized 4-Wheeled Vehicle, Class II, 21 CFR 890.3800

Indications for Use:

The device is intended for medical purposes to provide mobility to persons restricted to a seated position.

Description of the device:

The KARMA Scooter KS747.2 is an indoor / outdoor Powered Scooter that is battery operated. It has a base with four-wheeled with a seat. The movement of the Scooter is controlled by the rider who uses hand controls located at the top of the steering column. The device can be disassembled for transport and is provided with an onboard battery charger.

Performance Testing:

EMC Report ANSI / RESNA WC/Vol.2-1998, CISPR 11: 1990, EN61000-3-2: 1995, IEC61000-3-3: 1995 (Electrically Powered Scooters, controller, and their chargers requirements and test methods)

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Image /page/1/Picture/0 description: The image shows the logo for Karma Home & Health Care. The word "Karma" is written in a bold, serif font. A heart shape with a swirl inside replaces the letter "A" in "Karma". A wing-like design is attached to the upper right side of the heart. Below "Karma" is the phrase "home & health care" in a smaller, sans-serif font.

KARMA MEDICAL PRODUCTS CO., LTD. 康揚 揚 股 份 有 限 公 司 U.K. U.S.A. TAIWAN THAI. Tel:886-1015-2066688 Fax:886-1015-2067788 Http://www.KarmaMedical.com E-mail:eukarma@ms29.hinet.net

Legally marketed device for substantial equivalence comparison: WELL SUCCESS A&I Scooter, SC-402 (K041193)

Summary for substantial equivalence comparison:

The intended uses, the size of tires, back upholstery, and warranty period between the new device KS747.2 and the predicate device SC-402 are all the same. Especially the electronic systems between two devices are the same suppliers and all passed by the UL certificated including the batteries, recharge, and the electronic controllers. Besides, the two devices are the same foldable frame, maximum speed, removable arm type, same warranty on component and frame, and back upholstery are the same material that also be passed the resistance ignition test by SGS. The major differences existing of the two Powered Scooters are the different overall dimension and weight between the two devices. The overall appearance and weight differences are not safety aspect. So the new device is substantially equivalent to the predicate devices in this aspect.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/12 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features a stylized eagle with three wavy lines emanating from its head, enclosed within a circle. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged around the upper portion of the circle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG = 5 2004

KARMA Medical Products Co., Ltd. C/o Dr. Ke-Min Jen ROC Chinese-European Industrial Research Society No. 58, Fu-Chiun St. Hsin-Chu City, China (Taiwan) 300

Re: K041677

Trade/Device Name: KARMA Scooter, KS-747.2 Regulation Number: 21 CFR 890.3800 Regulation Name: Motorized three-wheeled vehicle Regulatory Class: II Product Code: INI Dated: June 14, 2004 Received: June 21, 2004

Dear Dr. Jen:

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 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.

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Page 2 - Dr. Ke-Min Jen

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 (301) 594-4659. 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 yours.

Sincerely, yours,

Mark A. Mcllhennon

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

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Page__________________________________________________________________________________________________________________________________________________________________________

510 (K) NUMBER ( IF KNOW ): _ TBA

DEVICE NAME: KARMA Scooter, KS-747.2

INDICATIONS FOR USE:

The device is intended for medical purposes to provide mobility to persons restricted to a sitting position.

Prescription Use

AND/OR

Over-The-Counter Use √

(Part 21 CFR 801 Subpart D)

(21 CFR 807 Subpart C)

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

Afcurrence of CDRH, Office of Device Evaluation (ODE)

Division of General, Restorative, and Neurological Devices

K041677

510(k) Number

§ 890.3800 Motorized three-wheeled vehicle.

(a)
Identification. A motorized three-wheeled vehicle is a gasoline-fueled or battery-powered device intended for medical purposes that is used for outside transportation by disabled persons.(b)
Classification. Class II (performance standards).