K Number
K052521
Device Name
NISSIN SERIES MECHANICAL WHEELCHAIR
Date Cleared
2005-09-26

(12 days)

Product Code
Regulation Number
890.3850
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Intended for medical purposes to provide mobility to persons restricted to a sitting position
Device Description
The NISSIN series Mechanical Wheelchair consists of typical components found on most wheelchairs, such as push handles, armrests, backrest, seat frame, cushion, footrest and casters. Many of these components are available in a range of sizes, shapes, angles, forms, materials or coverings. Theses variations allow the chairs to be configured to meet the specific desires and needs of the user.
More Information

Not Found

No
The description details a standard mechanical wheelchair with no mention of AI or ML components or functionality.

No
This device is a mobility aid for persons restricted to a sitting position, which provides support rather than actively treating a disease or condition.

No
Explanation: The device is a mechanical wheelchair intended to provide mobility, not to diagnose medical conditions or diseases.

No

The device description explicitly states it consists of physical components like push handles, armrests, backrest, seat frame, cushion, footrest, and casters, which are hardware components of a mechanical wheelchair.

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 restricted to a sitting position." This describes a physical aid for mobility, not a device used to examine specimens from the human body to provide information for diagnosis, monitoring, or screening.
  • Device Description: The description lists components like push handles, armrests, backrest, seat frame, etc., which are all parts of a mechanical mobility device. There is no mention of reagents, assays, or any components typically associated with in vitro diagnostics.
  • Lack of IVD-related information: The document explicitly states "Not Found" for mentions of image processing, AI/DNN/ML, input imaging modality, anatomical site, indicated patient age range, intended user/care setting, and details about training/test sets and performance studies that would be relevant to an IVD.
  • Predicate Device: The predicate device is another wheelchair (Quickie Suspension Wheelchair Series Model XTR), further confirming the device's classification as a mobility aid.

In summary, the information clearly indicates that this device is a mechanical wheelchair designed for mobility, not an in vitro diagnostic device used for testing biological samples.

N/A

Intended Use / Indications for Use

The NISSIN series Mechanical Wheelchair is intended to be used to empower persons physically challenged to a sitting position by providing a means of mobility.

Intended for medical purposes to provide mobility to persons restricted to a sitting position

Product codes

IOR

Device Description

The NISSIN series Mechanical Wheelchair consists of typical components found on most wheelchairs, such as push handles, armrests, backrest, seat frame, cushion, footrest and casters. Many of these components are available in a range of sizes, shapes, angles, forms, materials or coverings. Theses variations allow the chairs to be configured to meet the specific desires and needs of the user.

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)

Data was provided that demonstrated compliance with the Guidance document for the preparation of premarket notification [510(k)] applications for mechanical and powered wheelchairs, and motorized three-wheeled vehicles (July 26, 1995, reformatted 12/18/97). In addition, data was submitted that demonstrated compliance with ISO 7176. All issues of safety and effectiveness have been addressed.

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

Not Found

Predicate Device(s)

K982989

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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).

0

K05-252/

SEP 2 6 2005

510(k) Summary: NISSIN Mechanical Wheelchair

Summary of Safety and Effectiveness:

Submitted:September 7, 2005
Name of Firm:NISSIN MEDICAL INDUSTRIES (NISSIN) Company, LTD
Darren Reeves, U.S. Agent
Location: 8-7 Hanenishi
Yoyohasi, Aichi-Prefecture, Japan
510(k) Contact:Darren Reeves
866-393-4954
Trade Name:NISSIN series Mechanical Wheelchair
Common Name:Mechanical Wheelchair
Classification:21 CFR Part 890.3850 Mechanical wheelchair

Device Product Code: IOR.

Substantially

Quickie Suspension Wheelchair Series Model XTR by Sunrise Equivalent Device: Medical (K982989)

Device Description:

The NISSIN series Mechanical Wheelchair consists of typical components found on most wheelchairs, such as push handles, armrests, backrest, seat frame, cushion, footrest and casters. Many of these components are available in a range of sizes, shapes, angles, forms, materials or coverings. Theses variations allow the chairs to be configured to meet the specific desires and needs of the user.

Intended Use:

The NISSIN series Mechanical Wheelchair is intended to be used to empower persons physically challenged to a sitting position by providing a means of mobility.

Summary of Safety and Effectiveness:

Data was provided that demonstrated compliance with the Guidance document for the preparation of premarket notification [510(k)] applications for mechanical and powered wheelchairs, and motorized three-wheeled vehicles (July 26, 1995, reformatted 12/18/97). In addition, data was submitted that demonstrated compliance with ISO 7176. All issues of safety and effectiveness have been addressed.

1

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Image /page/1/Picture/2 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized eagle with three lines forming its body and wings. The eagle is facing to the right. The text "DEPARTMENT OF HEALTH AND HUMAN SERVICES, USA" is arranged in a circular fashion around the eagle.

SEP 26 2005

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Nissin Medical Industries Company, LTD c/o Mr. Darren Reeves DP Distribution & Consulting 15637 Fox Cove Circle Moseley, Virginia 23120

Re: K052521

Trade/Device Name: Mechanical Wheelchair Regulation Number: 21 CFR 890.3850 Regulation Name: Mechanical wheelchair Regulatory Class: I Product Code: IOR Dated: September 12, 2005 Received: September 14, 2005

Dear Mr. Reeves:

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.

2

Page 2 - Mr. Darren Reeves

This letter will allow you to begin marketing your device as described in your Section 510(k) This icter will anow you to ogain maining of substantial equivalence of your device to a legally prematicated 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 If you desire specific aarroliance at (240) 276-0120. Also, please note the regulation entitled, Coniact the Office of Computer in the time (21CFR Part 807.97). You may obtain Misoranding of Tereferee to presence to presentibilities under the Act from the Division of Small other general 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,

ZS

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

Enclosure

3

Indications for Use

ので、

the submit and the submit of the sub-

510(k) Number (if known): K052521

Device Name: Mechanical Wheelchalr

Indications For Use:

Intended for medical purposes to provide mobility to persons restricted to a sitting position

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

Over-The-Counter Use (21 CFR 807 Subpart C)

(Registration and Listing are submitted and in process)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

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

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