K Number
K091418
Device Name
C.T.M. MOBILITY SCOOTER, MODEL HS-628, INVACARE ORION
Date Cleared
2009-07-06

(54 days)

Product Code
Regulation Number
890.3800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The C.T.M. Mobility Scooter HS-628 is an indoor/outdoor scooter that provides transportation for a disabled or elderly person.
Device Description
The C.T.M. Mobility Scooter HS-628 is an indoor/outdoor scooter that is battery operated, has three wheels, a padded seat with adjustable armrests, and hand controls at the top of the steering column allowing the rider to control the scooter. It is provided with an off-board battery charger.
More Information

Not Found

No
The description focuses on basic mobility scooter features and explicitly states "Mentions AI, DNN, or ML: Not Found".

No
The device provides transportation for disabled or elderly individuals but does not directly treat or alleviate a medical condition. It's a mobility aid, not a therapeutic tool.

No
The device, a mobility scooter, is explicitly described as providing transportation and does not perform any diagnostic functions or analyze medical conditions.

No

The device description clearly outlines a physical mobility scooter with hardware components like wheels, a seat, armrests, hand controls, and a battery charger. It is not solely software.

No, the C.T.M. Mobility Scooter HS-628 is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostics are tests performed on samples taken from the human body (like blood, urine, or tissue) to detect diseases, conditions, or infections.
  • Device Function: The C.T.M. Mobility Scooter HS-628 is a transportation device designed to help disabled or elderly individuals move around. It does not perform any tests on biological samples.
  • Intended Use: The intended use clearly states it provides "transportation for a disabled or elderly person." This is a mobility aid, not a diagnostic tool.

The provided information about the device description, lack of image processing, AI/ML, anatomical site, etc., further supports that this is a physical mobility device and not an IVD.

N/A

Intended Use / Indications for Use

The C.T.M. Mobility Scooter HS-628 is an indoor/outdoor scooter that provides transportation for a disabled or elderly person.

Product codes (comma separated list FDA assigned to the subject device)

INI

Device Description

The C.T.M. Mobility Scooter HS-628 is an indoor/outdoor scooter that is battery The C.L.M. Hooney Doubler wheels, a padded seat with adjustable armrests, and hand controls at the top of the steering column allowing the rider to control the scotter. It is provided with an off-board battery charger.

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)

Comparative performance testing and clinical evaluations were not submitted as part of this 510(k).

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K030387

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 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).

0

C.T.M. Mobility Scooter HS-628 510(k) Notification

K091418

JUL - 6 2009

510(k) SUMMARY

Submitter's name:C.T.M. Homecare Product, Inc.
6191 Schaefer Ave., Suite B, Chino, CA 91710

Linda J. Bovard, Bovard Consulting, LLC Contact name and address: 29611 Simmons Road, Eugene, OR 97405 (541) 345-5431

2/11/09 Date summary prepared:

Device name:

Proprietary name: Common or usual name: Classification name:

C.T.M. Mobility Scooter HS-628 or Orion Electric scooter Motorized three-wheeled vehicle (890.3800). Motorized 3-wheeled vehicle (89 INI).

Legally marketed device for substantial equivalence comparison:

The predicate device is the C.T.M. Mobility Scooter HS-890 submitted by C.T.M. Homecare Product, Inc. and cleared for marketing under 510(k) *K030387.

Description of the device:

The C.T.M. Mobility Scooter HS-628 is an indoor/outdoor scooter that is battery The C.L.M. Hooney Doubler wheels, a padded seat with adjustable armrests, and hand controls at the top of the steering column allowing the rider to control the scotter. It is provided with an off-board battery charger.

Intended use of device:

The C.T.M. Mobility Scooter HS-628 is an indoor/outdoor scooter that provides transportation for a disabled or elderly person.

Technological characteristics:

The device features of the C.T.M. Mobility Scooter HS-628 and the HS-890 are very I he uevice features of the or med, have one motor, and have automatic braking systems. similar. Dour are battery operated, sided with both scooters. The target population is identical and the use parameters are similar.

Testing conducted:

Tests listed in the Guidance Document for the Preparation of Premarket Notification I costs Insted in the Gatance Boomical and Scooters, and Motorized Three Wheeled [ 710(k)] Applications for noomarted and the results included in the submission.

Performance testing:

Comparative performance testing and clinical evaluations were not submitted as part of this 510(k).

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/1/Picture/1 description: The image shows the seal of the U.S. Department of Health & Human Services. The seal features a stylized eagle with its wings spread, symbolizing protection and service. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES. USA" are arranged in a circular pattern around the eagle.

Public Health Service

C.T.M. Homecare Product, Inc. % Bovard Consulting LLC Ms. Linda Bovard 29611 Simmons Road Eugene, Oregon 97405

JUL - 6 2009

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Re: K091418

Trade/Device Name: C.T.M. Mobility Scooter HS-628 Regulation Number: 21 CFR 890.3800 Regulation Name: Motorized three-wheeled vehicle Regulatory Class: II Product Code: INI Dated: May 11, 2009 Received: May 13, 2009

Dear Ms Bovard:

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.

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) 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. Linda Bovard

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0120. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please contact the CDRH/Office of Surveillance and Biometrics/Division of Postmarket Surveillance at 240-276-3464. For more information regarding the reporting of adverse events, please go to http://www.fda.gov/cdrh/mdr/:

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,

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

Enclosure

3

C.T.M. Mobility Scooter HS-628 510(k) Notification

Indications for Use

510(k) Number (if known):

Device Name: C.T.M. Mobility Scooter HS-628

Indications for Use:

The C.T.M. Mobility Scooter HS-628 is an indoor/outdoor scooter that provides transportation for a disabled or elderly person.

Prescription Use (Part 21 CFR 801 Subpart D)

AND/OR

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

signature

(Division Sign-Off) Division of Surgical, Orthopedic, and Restorative Devices

510(k) Number K0914/8