K Number
K062660
Device Name
CATALYSY
Manufacturer
Date Cleared
2006-10-24

(47 days)

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

The Catalyst wheelchair is a manually operated device intended to be used as a means of mobility for persons restricted to a sitting position.

Device Description

The Catalyst is a traditional folding cross-brace wheelchair. It is made of lightweight aluminum tubing similar to what is used on existing products. The frame utilizes two cross tube sets and, when opened, nestles inside of the frame onto 4 hooks to create a box like rigid assembly. Upon the outside of this framework, and to the rear, are assembled 2 machined aluminum axle plates. Stainless steel receivers are mounted within the axle plates. Wheels of varying size and type are connected to the receivers via stainless steel axles. On the front end of the frame are assembled 2 aluminum housings. Caster forks are mounted to these housings via stainless steel axles. A variety of caster wheels and tires are then connected to the forks. Upon the top of the frame is attached a seat sling. Into the rear of the frame assembly 2 backtubes are inserted to the desired height. Backrest upholstery is affixed to the backtubes. Armrests receivers bolt onto the rear of each side frame. Individual Swing Away tubular arms are then inserted into the receivers. If flipback armrests are chosen a receiver is mounted onto the from of each side frame to catch the forward most section of the arm and the rear mounting is pivoting to allow the arm to rotate backward. Height Adjustable arms fit into a receiver that mounts onto the outside of the frame. Wheel locks mount onto the upper side frame and are adjusted so that the brake arm engages with the tire and when in the locked position prevents to the wheel from rotating. Swing Away footrests with footplates and heel loops attach at the front of the chair. There is a plug at the top of the footrest hanger that inserts into an opening at the top front of the wheelchair frame. The footrest hanger is turned 90 degrees away from the frame. Hold the latch, which is midway down the hanger, tightly against the front of the frame and rotate the footrest back towards center. The latch will engage once the footrest hanger is centered.

AI/ML Overview

The provided document is a 510(k) Summary of Safety and Effectiveness for the Catalyst manual wheelchair. It outlines the device description, intended use, comparison to a predicate device, and performance testing results.

Here's a breakdown of the requested information:

1. Table of Acceptance Criteria and Reported Device Performance:

Acceptance Criteria (Standard)Reported Device Performance
ANSI-RESNA WC - Vol 1 - 1998 Section 1: Determination of static stabilityComplies with the standard.
ANSI-RESNA WC - Vol 1 - 1998 Section 8: Static, impact, and fatigue strengthsComplies with the standard.
ANSI-RESNA WC - Vol 1 - 1998 Section 16: Determination of FlammabilityComplies with the standard.
ANSI-RESNA WC - Volume 1 - 1998 Section 5: Determination of Overall Dimensions, Mass and Turning SpaceComplies with the standard.
ANSI-RESNA WC - Volume 1 - 1998 Section 7: Measurement of seating and wheel dimensionsComplies with the standard.
ANSI-RESNA WC - Volume 1 - 1998 Section 93: Maximum Overall DimensionComplies with the standard.

2. Sample Size Used for the Test Set and Data Provenance:

The document does not specify a sample size for the test set or the data provenance (e.g., country of origin, retrospective or prospective). It states that the "Catalyst has been tested," implying a physical testing of the device itself rather than a data-driven study on a set of cases.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications of Those Experts:

This information is not applicable and not provided in the document. The "ground truth" for a medical device like a wheelchair is established through adherence to engineering and safety standards, not through expert consensus on diagnostic interpretations. The device's performance is measured against these established standards.

4. Adjudication Method for the Test Set:

This information is not applicable and not provided in the document. Adjudication methods are typically associated with studies involving human interpretation or subjective assessments, which is not the case for the physical testing of a wheelchair against engineering standards.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and Effect Size of Human Readers Improve with AI vs. Without AI Assistance:

This information is not applicable and not provided in the document. The device is a manual wheelchair, not an AI-assisted diagnostic or therapeutic tool. Therefore, an MRMC study or assessment of AI assistance is irrelevant.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done:

This information is not applicable and not provided in the document. The device is a physical mechanical wheelchair, not an algorithm.

7. The Type of Ground Truth Used:

The ground truth used for this device's acceptance is based on adherence to recognized international engineering and safety standards, specifically:

  • ANSI/RESNA WC Volume 1 - 1998 Standards - Sections 1, 5, 7, 8, 16 & 93.
    • Section 1: Determination of static stability
    • Section 5: Determination of Overall Dimensions, Mass and Turning Space
    • Section 7: Measurement of seating and wheel dimensions
    • Section 8: Static, impact, and fatigue strengths
    • Section 16: Determination of Flammability
    • Section 93: Maximum Overall Dimension

These standards themselves define the "ground truth" for what constitutes a safe and effective manual wheelchair.

8. The Sample Size for the Training Set:

This information is not applicable and not provided in the document. As a physical product, there is no "training set" in the context of an algorithm or AI model development. The design and manufacturing processes are likely informed by engineering principles, material science, and previous product development, rather than a formal data training set.

9. How the Ground Truth for the Training Set Was Established:

This information is not applicable and not provided in the document for the reasons explained in point 8. The "ground truth" for manufacturing a wheelchair is established through engineering specifications, material properties, and quality control processes to ensure the final product meets the defined safety and performance standards.

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K06260

Image /page/0/Picture/1 description: The image shows the logo for KI, a company that provides furniture and architectural wall systems. The logo consists of the letters "Ki" in a bold, sans-serif font. The letters are black and are surrounded by an oval shape. The oval shape is also black and is slightly tilted to the right.

4925 Coye Drive Suite D Stevens Point, WI 54481 715-254-0991 715-254-0996 (fax) dhmunsey@kimobility.com

0C1 2 4 2006

October 13, 2006

510(k) Summary of Safety and Effectiveness

Submitter

Ki Mobility 4925 Coye Drive Suite D Stevens Point, WI 54481 USA

Telephone: (715) 254-0991 Fax: (715) 254-0996

Contact: Douglas H. Munsey

510(k) Number: K062660

Trade Name: Catalyst

Common Name: Folding Ultra-Lightweight Manual Wheelchair

Classification Name: Mechanical wheelchair

Classification: Class I

Predicate Device

The predicate device is the Quickie 2 wheelchair. K850536

Device Description

The Catalyst is a traditional folding cross-brace wheelchair. It is made of lightweight aluminum tubing similar to what is used on existing products. The frame utilizes two cross tube sets and, when opened, nestles inside of the frame onto 4 hooks to create a box like rigid assembly. Upon the outside of this framework, and to the rear, are assembled 2 machined aluminum axle plates. Stainless steel receivers are mounted within the axle plates. Wheels of varying size and type are connected to the receivers via stainless steel axles.

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  • Page 2
    On the front end of the frame are assembled 2 aluminum housings. Caster forks are mounted to these housings via stainless steel axles. A variety of caster wheels and tires are then connected to the forks.

Upon the top of the frame is attached a seat sling. Into the rear of the frame assembly 2 backtubes are inserted to the desired height. Backrest upholstery is affixed to the backtubes.

Armrests receivers bolt onto the rear of each side frame. Individual Swing Away tubular arms are then inserted into the receivers. If flipback armrests are chosen a receiver is mounted onto the from of each side frame to catch the forward most section of the arm and the rear mounting is pivoting to allow the arm to rotate backward. Height Adjustable arms fit into a receiver that mounts onto the outside of the frame.

Wheel locks mount onto the upper side frame and are adjusted so that the brake arm engages with the tire and when in the locked position prevents to the wheel from rotating.

Swing Away footrests with footplates and heel loops attach at the front of the chair. There is a plug at the top of the footrest hanger that inserts into an opening at the top front of the wheelchair frame. The footrest hanger is turned 90 degrees away from the frame. Hold the latch, which is midway down the hanger, tightly against the front of the frame and rotate the footrest back towards center. The latch will engage once the footrest hanger is centered.

FeatureDescriptionMaterials
Intended UseThe Catalyst wheelchair is a manually operated device intended to be used as a means of mobility for persons restricted to a sitting position.
Primary Frame Materials6061-T6 Aluminum6061-T6 Aluminum
Folding MethodCollapsible Cross-brace6061-T6 Aluminum
Frame Widths14" to 20"
Overall Width20.5" to 26.5"
Seat Depths14" to 20"
Back Heights8.5" to 19"
Weight Limit220 lbs
Seat Height15" to 21"
Chair Weight23 lbs (w/o footrests)
WarrantyLifetime on frame
Armrests1. Flip Back Height Adjustable -- Desk & Full Length Arm pads2. Flip Back Desk & Full Length Arm pads3. Height Adjustable- Desk & Full Length Arm pads4. Tubular Swing-Away1,2,3 - 6061-T6 Aluminum tubing, ERW 1020 Steel upper, plastic side guard, 303 stainless steel pin, Plastic armrest pad4. - 6061-T6 Aluminum
Front End TypeSwing-Away, Non-Swing AwayWelded 6061-T6 Aluminum
Back TypeStraight with push handles, 8 degree bend with push handles, no push handles6061-T6 Aluminum
Footrests Hangers70°, Elevating legrestWelded 6061-T6 Aluminum
FootplatesComposite, Foam, Angle AdjustableComposite - Nylon 66 with 15% short glass.Foam - 6061-T6 Aluminum with PU foam coverAngle Adj - 6061-T6 Aluminum plate
Extension TubesEx. Short, Short, Medium, Long6061-T6 Aluminum
Back Heights8.5" to 19" in 3 adjustable sections

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● Page 3

Back UpholsterySewn Nylon Parapak 420D w/ ¼" polyurethane foam battingSewn Nylon Parapak 420D w/ ¼" polyurethane foam batting
Seat UpholsterySewn Dacron Polyester Sailcloth - No fillingSewn Dacron Polyester Sailcloth - No filling
Cushion2' foam cushionManufactured and distributed by Hudson Industries. Model - PressureEez 2 General Seat Cushion
Axle PlatesStandard, Curved, Amputee, OffsetMachined 6061-T6 Aluminum
AxleQuick Release or FixedMachined 303 Stainless steel
Wheel Sizes22,24,26
Wheel TypesSpoke, Composite Mag, Octopus (performance spoke)Spoke & Octopus- Machined 6061-T6 Aluminum rims, Stainless steel spokes, Machined 6061 - T6 Aluminum hubMag - Nylon 66 with 15% short Glass
Tire TypesPneumatic, Pneumatic w/ airless insert, Full profile Polyurethane, Low Profile Polyurethane, Iron Cap (puncture resistant), High PressureSynthetic rubber and Urethane
HandrimsAluminum, Plastic Coated, Projections6061-T6 Aluminum, anodized or covered with PVC coating
Caster Sizes4", 5", 6", 7", 8"
Caster TypesPoly, Pneumatic, Pneumatic w/ airless insertNylon 66 with 15-30% short glassSynthetic rubber and Urethane tires
Forks Sizes4", 5", 6", 7"Machined 6061-T6 Aluminum
Fork Stem SizesStd, +3/4", +1 ½"Machined 303 Stainless steel
Wheel LocksPush to Lock, Pull To Lock, Scissor LockMachined 6061-T6 Aluminum
Anti Tips TubesLocate off of the axle to insure safety at all seat heightsCast aluminum housing with 6061-T6 tubes and plastic wheels
Where usedSolid surface
Target PopulationPersons restricted to a sitting position.
StandardsStatic Stability and Fatigue Strength: ANSI/RESNAWheelchair Std. Vol. 1Sections 1, 5, 7, 8, 16 & 93
Tubing thicknesses.070" on frame except front vertical tube, which is .1". X-tube is .070.
Tube properties6061-T4 prior to welding. After welding the

Indications for Use

The Catalyst wheelchair is a manually operated device intended to be used as a means of mobility for persons restricted to a sitting position.

FeatureQuickie 2Catalyst
Intended UseThe Quickie wheelchair is a manuallyoperated device intended to be used as ameans of mobility for persons restrict to asitting position.The Catalyst wheelchair is a manuallyoperated device intended to be used as ameans of mobility for persons restrict to asitting position.
Primary Materials6061-T6 Aluminum6061-T6 Aluminum
Folding MethodCollapsible Cross-braceCollapsible Cross-brace
Frame Widths11" to 22"14" to 20"
Overall Width20.5" to 28.5"20.5" to 26.5"
Seat Depths10" to 20"14" to 20"
Back Heights8.5" to 19"8.5" to 19"
Weight Limit250 lbs (350lbs. Heavy Duty )220 lbs
Seat Height16.75" to 22.75"15" to 21"
Chair Weight27 lbs (w/o footrests)23 lbs (w/o footrests)
WarrantyLifetime on frameLifetime on frame
Armrests1. Flip Back Height Adjustable - Desk & Full Length Arm pads2. Flip Back3. Height Adjustable- Desk & Full Length Arm pads4. Tubular Swing-Away5. Adjustable Locking Flip-up6. Length Adjustable Locking Flip-up5. Flip Back Height Adjustable - Desk & Full Length Arm pads6. Flip Back Desk & Full Length Arm pads7. Height Adjustable- Desk & Full Length Arm pads8. Tubular Swing-Away
Front End TypeSwing-Away, Non-Swing AwaySwing-Away, Non-Swing Away
Back TypeStd, Angle Adjustable, Depth AdjustableStd
Footrests Hangers60°, 70°, 70°V, 90°, Articulating Legrest, Elevating legrest, 90° Elevating, 1-Piece70°, Elevating legrest
FootplatesComposite, Foam, Aluminum, Angle Adjustable, Platform Flip-up, Locking Angle AdjustableComposite, Foam, Angle Adjustable
Extension TubesEx Short, Short, Medium, LongEx Short, Short, Medium, Long
Back UpholsteryLow, Medium, Tall, Adjustable, ReinforcedLow, Medium, Tall, Adjustable
Axle PlatesStandard, Curved, Amputee, OffsetStandard, Curved, Amputee, Offset
Wheel Sizes20,22,24,2622,24,26
Wheel TypesSpoke, Composite Mag, Spinergy (performance spoke), One Arm DriveSpoke, Composite Mag, Octopus (performance spoke)
Tire TypesPneumatic, Pneumatic w/ airless insert, Full profile Polyurethane, Low Profile Polyurethane, Kevlar (puncture resistant), High PressurePneumatic, Pneumatic w/ airless insert, Full profile Polyurethane, Low Profile Polyurethane, Iron Cap (puncture resistant), High Pressure
HandrimsAluminum, Plastic Coated, ProjectionsAluminum, Plastic Coated, Projections
Caster Sizes4", 5", 6", 8", 8x24", 5", 6", 8"
Caster TypesPoly, Semi-Pneumatic, Soft Roll, Pneumatic, Pneumatic w/ airless insertPoly, Pneumatic, Pneumatic w/ airless insert
Forks Sizes3", 4", 5 ¼", 6", 7", Frog Legs4", 5", 6", 7", Frog Legs
Fork Stem SizesStd, +3/4", +1 ½"Std, +3/4", +1 ½"
Caster OptionsMulti-Position Fork, Caster Pin Locks, Quick Release Caster StemsNA
Wheel LocksPush to Lock, Pull To Lock, Scissor Lock, Grade AidPush to Lock, Pull To Lock, Low Profile
Anti Tips TubesYesYes
Power AdapterQuickie ExtenderNA
Where usedSolid surface.Solid surface
Target PopulationPersons restricted to a sitting position.Persons restricted to a sitting position.
StandardsUnknownStatic Stability and Fatigue Strength ANSI/RESNA Wheelchair Std. Vol. 1 Sections 1, 5, 7, 8, 16 & 93
Tubingthicknesses.083" on frame except front vertical tube, which is .125". X-tube is variable in thickness from .083" to .125" as it is a custom extrusion.070" on frame except front vertical tube which is .1". X-tube is .070.
Tube properties6061 - T6 prior to welding. Hardness6061-T4 prior to welding. After welding

Technological Comparison to the Predicate Device

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11'welcing.

It is Ki Mobility's conclusion that the Catalyst manual wheelchair is substantially equivalent to the Quickie 2 manual wheelchair currently marketed by Sunrise Medical.

Summary of Performance Testing

The Catalyst has been tested and found to comply with the ANSI-RESNA WC Volume 1 1998 standards sections 1, 5, 7, 8, 16 & 93.

Conclusions

As stated above, Ki Mobility's conclusion is that the Catalyst wheelchair is safe, effective, complies with the appropriate medical device standards, and is substantially equivalent to the Quickie 2 wheelchair.

This 510(k) Summary of Safety and Effectiveness may be copied and submitted to interested parties as required by 21CFR807.92.

STANDARDTITLE and COMMENTS
ANSI-RESNA WC - Vol 1-1998 Section 1Determination of static stability
ANSI-RESNA WC - Vol 1-1998 Section 8Static, impact, and fatigue strengths
ANSI-RESNA WC- Vol 1- 1998 Section 16Determination of Flammability
ANSI-RESNA WC -Volume 1-1998 Section 5Determination of Overall Dimensions, Mass and Turning Space
ANSI-RESNA WC -Volume 1-1998 Section 7Measurement of seating and wheel dimensions
ANSI-RESNA WC -Volume 1-1998 Section 93Maximum Overall Dimension

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/5/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle or bird-like symbol with three curved lines forming its body and wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the symbol. The text is in all capital letters and is evenly spaced around the circle.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Ki Mobility LLC % Mr. Douglas H. Munsey 4925 Coye Drive, Suite D Stevens Point, Wisconsin 54481

OCT 2 4 2006

Re: K062660

Trade/Device Name: Catalyst Regulation Number: 21 CFR 890.3850 Regulation Name: Mechanical Wheelchair Regulatory Class: Class I Product Code: IOR Dated: October 6. 2006 Received: October 10, 2006

Dear Mr. Munsey:

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 – Mr. Douglas H. Munsey

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) 276-0120Also, 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 (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Kavita Buelow

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

Enclosure

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INDICATIONS FOR USE

Applicant:

Ki Mobility 4925 Coye Drive Suite D Stevens Point, WI 54481 USA

Telephone: (715) 343-1280 Fax: (715) 343-1280 510(k) Number: K062660

Device Name: Catalyst

Indications for Use:

The Catalyst wheelchair is a manually operated device intended to be used as a means of mobility for persons restricted to a sitting position.

Prescription Use (Per 21 CFR 801.116)

Over-The-Counter OR X

(Please do not write below this line -- continue on another page if needed)

bashase-Puchand

(Division Sign-Off) Concurrence of CDRH, Office of Device Evaluation (ODE) (Division of General, Restorative, and Neurological Devices

510(k) Number K062460

§ 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).