K Number
K072630
Device Name
FORU, MODEL EQ30
Date Cleared
2007-10-03

(15 days)

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

The ForU EQ30 scooter is motor driven, indoor transportation vehicles with the intended use to provide mobility to disabled or elderly persons limited to a seated position.

Device Description

The ForU EQ30 scooter is an indoor/outdoor transportation vehicles which is battery operated. The movement of the scooter is controlled by a tiller handle and a thumb operated potentiometer throttle control lever to engage and disengage the scooter motion in both the forward and reverse directions.

AI/ML Overview

This document is a 510(k) premarket notification for a motorized scooter (ForU EQ30 scooter) and does not describe a clinical study or evaluation of an AI/ML device. Therefore, it does not contain the information requested in your prompt regarding acceptance criteria, study details, ground truth establishment, or multi-reader multi-case studies.

The document primarily focuses on establishing "substantial equivalence" to a predicate device (AVANTICARE SA4022) by providing a comparison of specifications and intended use.

Here's a breakdown of why this document cannot fulfill your request:

  • No AI/ML Device: The device is an "Electrical scooter," a physical motorized vehicle, not a software algorithm or AI/ML-driven medical device.
  • No Acceptance Criteria for an Algorithm: The acceptance criteria in this document are for a physical product, primarily focusing on safety and performance specifications (e.g., maximum loading, speed, braking distance) compared to a predicate device, rather than diagnostic accuracy or performance metrics of an algorithm.
  • No "Study" in the AI/ML Sense: The document refers to a "substantial equivalence comparison" which is a technical comparison of specifications, not a clinical study to prove the performance of an AI model against a ground truth.

Therefore, I cannot extract the requested information like sample sizes for test sets, data provenance, number of experts, adjudication methods, MRMC studies, standalone performance, ground truth types, or training set details from this document.

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K072630

Image /page/0/Picture/1 description: The image shows a logo with a stylized letter 'K' inside an oval shape. The 'K' is bold and black, contrasting with the white background of the oval. The oval itself is outlined in black, creating a clean and simple design. The logo appears to be for a company or organization whose name starts with the letter 'K'.

KWANG YANG MOTOR CO., LTD.

No. 35, Wan Hsing Street, San Min Dist., 803, Kaohsiung, Taiwan TEL: +886-7-3822526 FAX: +886-7-3825834

510(k) Summary

Device

OCT 3 2007

Trade name: ForU EQ30 scooter Common name: Electrical scooter

Classification name: Motorized three-wheeled vehicle

Medical specialty (Panel): Physical Medicine Device

Regulation number: 890.3800

Product Code: 89INI

Classification: Class II

Predicate devices

AVANTICARE SA4022(K051538)/ LERADO CHINA LIMITED

Intend use of device

ForU EQ30 scooter is intended for an indoor/outdoor scooter that provides transportation for disabled or elderly persons limited to a seated position.

Device description:

The ForU EQ30 scooter is an indoor/outdoor transportation vehicles which is battery operated. The movement of the scooter is controlled by a tiller handle and a thumb operated potentiometer throttle control lever to engage and disengage the scooter motion in both the forward and reverse directions.

Substantial equivalence:

The ForU EQ30 scooter is substantially equivalent to the AVANTICARE SA4022 (K051538) manufactured by LERADO CHINA LIMITED.

There are minor differences in performance specifications of the scooters, these differences do not alter the intended function and use of the device, nor do they raise any new questions pertaining to safety or effectiveness. Therefore, KWANG YANG MOTOR CO., LTD. believes that the ForU EQ30 scooter is substantially equivalent to legally marketed devices currently in commercial distribution.

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Image /page/1/Picture/0 description: The image shows a symbol that appears to be a stylized representation of a crescent moon within an oval. The crescent moon is positioned at the top of the oval, and there is a horizontal bar or line below it, inside the oval. The symbol is rendered in black against a white background, giving it a stark and simple appearance.

KWANG YANG MOTOR CO., LTD.

No. 35, Wan Hsing Street, San Min Dist., 803, Kaohsiung, Taiwan

5, Wan Hsing Street, San Min Dist., 803, Kaohsiung, Taiwan
TEL: +886-7-3822526 FAX: +886-7-3825834

The substantial equivalence comparison of the ForU EQ30 and SA4022

SA4022(K051538)ForU EQ30
Intended useThree scooters are motor driven, indoor and outdoor transportation vehicles with the intended use to providemobility to disabled or elderly persons limited to a seated position.
Maximum loading135 kg (300 lbs)150 kg (330 lbs)
Overall height980 mm (38.5")1250 mm (49.2")
Overall length1160 mm (45.7")1240 mm (48.8")
Overall width540 mm (21.3")560 mm (22")
Seat overall height520 mm (20.5")756 mm (29.8")
Seat overall width457 mm (18")455 mm (17.9")
Seat overall depth406 mm (16")400 mm (15.7")
Seat overall weight15 kg (33 lbs)15.2 kg(33.4 lbs)
Motor output350W x DC24V × 5100 RPM, 1PC350W x DC24V × 1PC
ControllerDynamic DS72K01KYSA 70
DifferentialmechanismDifferential rate: 19.7 : 1
Rear wheel driveSealed transaxle direct drive
Operation modeThumb operated potentiometer throttle control lever
BatteryLead-Acid 12V × 36AH × 2PCsLead-Acid 12V x 31 AH × 2PCs
Battery levelindicatorYes
The substantial equivalence comparison of the ForU EQ30 and SA4022
(Continuous)SA4022(K051538)ForU EQ30
ChargerHP 24V 3/5AMP (Automatic Type) off-boardHP 24V, 5 AMP (Automatic Type) on-board
Front wheel10" x 2" foam filled tire × 2 PCsRim: aluminum alloy10" x 5" pneumatic tire × 2 PCs
BumpersFront/Rear: It's constructed by engineering plasticsFront: It's constructed by steel tubeRear: It's constructed by engineering plastics
ArmrestYes, Foldable
Tiller foldableYes
Backrest reclineYes
Recline angleindicatorNo
HeadrestNo
Height adjustableNo
Rear wheel10" x 2" foam filled tire × 2 PCsRim: aluminum alloy10" x 5" pneumatic tire × 2 PCs
Break systemIntelligent regenerative electromagnetic brake and hand brake
Braking distance1.88 m (74")Forward: 1.24 m (48.8") at max speed
Net weight withbattery81 kg (178 lbs)84.4 kg(185.7 lbs)
Slope grade ability12 degree10 degree
ContinuousThe substantial equivalence comparison of the ForU EQ30 and SA4022
SA4022(K051538)ForU EQ30
Per-charge distance35 km (22 miles)Up to 37 km (23.1 miles)
Maximum speed8.5 km/h (5.3 mph)Up to 8 km/hr (4.7 mph), variable
Speed modeSingle mode, Variable
Turning radius1450 mm (57")1565 mm (61.6")
Maximum curbheight90 mm (3.5")80 mm (3.14")
SuspensionFront: No,Rear: Yes
Head/Tail lightsSignal lightHead/tail lights andSignal lightsignal lights of the EQ30 and SA4022 scooters have the same functions, but only the
styles are different.
Warning lightYes
HornYes
Anti-tip wheelsYes

7-2

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KWANG YANG YANG MOTOR CO., LTD.
6. 35, Wan Hsing Street, San Min Dist., 803, Kaohsiung, Taiwan
F

TEL: +886-7-3825226 FAX: +886-7-3825834

MIRASYS, 4, ANMIN ST., SAN MIN DIST., KAOHSIUNG, TAIWAN

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Image /page/3/Picture/0 description: The image shows a black and white symbol that resembles an eye. The symbol is enclosed in an oval shape. Inside the oval, there is a crescent shape above a horizontal line.

KWANG YANG MOTOR CO., LTD.

No. 35, Wan Hsing Street, San Min Dist., 803, Kaohsiung, Taiwan
TEL: +886-7-3822526 FAX: +886-7-3825834

5, Wan Hsing Street, San Min Dist., 803, Kaohsiung, Taiwan
TEL: +886-7-3822526 FAX: +886-7-3825834

The substantial equivalence comparison of the ForU EQ30 and SA4022

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Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of an eagle with three wing-like shapes extending diagonally upwards and to the right. The eagle is positioned above a wavy line, which may represent water or movement. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the eagle symbol.

0CT 3 2007

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

KWANG YANG MOTOR CO., LTD. % Ms. Juannata Chang No. 35, Wan Hsing Street San Min Dist., 803 Kaohsiung, Taiwan

Re: K072630 Trade/Device Name: ForU EQ30 Scooter Regulation Number: 21 CFR 890.3800 Regulation Name: Motorized three-wheeled vehicle Regulatory Class: Class II Product Code: INI Dated: September 10, 2007 Received: September 18, 2007

Dear Ms. Chang:

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. Iisting 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 -- Ms. Juannata Chang

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) 276-0120 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 toll-free number (800) 638-2041 or (240) 276-3150 or the Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Neil R. B. Oyler

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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  1. Device descriptive information

3.1 Statement of indication for use

Statement of Indications for Use

510(k) Number (if known): _

Device Name: ForU EQ30

Indications for Use:

The ForU EQ30 scooter is motor driven, indoor transportation vehicles with the intended use to provide mobility to disabled or elderly persons limited to a seated position.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ Over-The-Counter Use X (Part 21 CFR 801 Subpart D) (Part 21 CFR 807 Subpart C) AND/OR (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE) Page 1 of 1

Nil R.P. Oglin for mxm

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

510(k) Number K072630

(Posted November 13, 2003)

§ 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).