K Number
K101143
Device Name
HEARTWAY POWER MOBILITY SCOOTER, S11
Date Cleared
2010-05-26

(34 days)

Product Code
Regulation Number
890.3800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The device is intended for medical purposes to provide mobility to persons restricted to a seated position.
Device Description
The HEARTWAY Power Mobility Scooter. S11 is an indoor / outdoor electric scooter that is battery operated. It has a base with four-wheeled with a seat. armrests. and a front basket. 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.
More Information

Not Found

No
The description details a standard electric mobility scooter with manual controls and no mention of AI/ML features or related performance studies.

No.
The device is described as a "Power Mobility Scooter" intended to provide mobility to persons restricted to a seated position. It does not provide any therapeutic benefit or treatment for a condition.

No
The device is described as an electric scooter for mobility, not for diagnosing medical conditions. Its intended use is to provide mobility.

No

The device description clearly outlines a physical, battery-operated electric scooter with wheels, a seat, armrests, and hand controls, indicating it is a hardware device.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is clearly stated as providing mobility to persons restricted to a seated position. This is a physical function, not a diagnostic one.
  • Device Description: The description details a power mobility scooter, which is a device for physical movement and transportation. It does not mention any components or functions related to analyzing biological samples or providing diagnostic information.
  • Lack of IVD Indicators: There is no mention of:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in the body
    • Providing information for the diagnosis, monitoring, or treatment of a disease or condition based on in vitro analysis.

The device is a mobility aid, falling under a different regulatory category than IVDs.

N/A

Intended Use / Indications for Use

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

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

INI

Device Description

The HEARTWAY Power Mobility Scooter. S11 is an indoor / outdoor electric scooter that is battery operated. It has a base with four-wheeled with a seat. armrests. and a front basket. 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.

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)

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

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.

K072104

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

Image /page/0/Picture/0 description: The image shows the numbers 1143 written in black ink on a white background. The numbers are handwritten and slightly slanted. The number 1 is written twice, followed by the numbers 4 and 3.

Image /page/0/Picture/1 description: The image shows a logo for HEARTWAY. The logo consists of a stylized floral design above the word "HEARTWAY" in a bold, sans-serif font. The floral design is composed of several petal-like shapes arranged in a circular pattern, all contained within a square.

HEARTWAY MEDICAL

NO.6. ROAD 25 TAICHUNG INDUSTRIAL PARK, TAICHUNG, TAIWAN R.O.C. 408
TEL:886-4-23580357 (Sales) 23583232 (Rep) FAX:886-4-23590786
Web.www.heartway.com.tw

ISC-922
CERTIFIED

2 5 2010

510(k) SUMMARY "

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

No.6. Road 25. Taichung Industrial Park. Taichung, 40850. Taiwan, ROC

Date summary prepared: Device Name:

April 15. 2010

Proprietary Name: HEARTWAY Power Mobility Scooter, S1 l Common or Usual Name: POWERED SCOOTER Classification Name: MOTORIZED 4-WHEELED VEHICLE, Class II, 21 CFR 890.3800 Product Code: INI

Product Code

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 HEARTWAY Power Mobility Scooter. S11 is an indoor / outdoor electric scooter that is battery operated. It has a base with four-wheeled with a seat. armrests. and a front basket. 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 wheelchairs, scooters, and their chargers – requirements and test methods)

Legally marketed device for substantial equivalence comparison: HEARTWAY Power Mobility Scooter. PF6 (K072104)

DI

1

Image /page/1/Picture/0 description: The image shows a logo with the word "HEARTWAY" in bold, block letters. Above the word is a stylized graphic that resembles a butterfly or a flower with rounded petals. The logo is in black and white, with the graphic appearing to be solid black against a white background.

HEARTWAY MEDICAL PRODUCTS CO.,LTD NO 6. ROAD 25 TAICHUNG INCUSTRIAL PARK, TAICHUNG, TAIWAN TEL. BBE-4-23580357 (Sales) - 23583232 (Rep) FAX: 886-4-23590796

Image /page/1/Picture/2 description: The image shows a certification logo. The text "ISO-9001 CERTIFICATED" is stacked on top of each other. The text is in a bold, sans-serif font. The logo is simple and straightforward.

TIV

Summary for substantial equivalence comparison:

According to the above table that the intended use between the two devices is the same. Mainframes materials of the two devices are fixed, and all meet the strength and fatigue tests and they use the same material aspects. Moreover, the suspension of cross brace. footplates. incline degree 10°. and armrest type are all the same. The back upholstery material is also the same fabric and passed the resistance ignition test.

Especially the electronic systems between two devices are the same suppliers, and all passed by the UL certificated, for instance the electronic controller, batteries, and the competent switches and switching power supplies. Thus the same safety level for the two devices is assured.

Owing to the new device is more agile and easy for storage or transportation and the predicate device is more general use. Besides, the new device has a "free-wheel" manual feature that means the new device can be moved without turning it on. Free-wheeling is accomplished by adjusting the free-wheeling lever to the free-wheeling position. Thus the main difference for the two devices is overall appearance, weight capabilities. maximum speed. and the weight are differences between the two devices. The safety levels of the two devices are the same and the overall appearance differences are not safety aspect: They are substantially equivalent.

.

D2

2

Image /page/2/Picture/0 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features a stylized caduceus-like symbol with three wavy lines, representing the department's focus on health and well-being. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged in a circular pattern around the symbol.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

Heartway Medical Products Co., Ltd. % ROC Chinese-European Industrial Research Society Dr. Ke-Min Jen No. 58, Fu-Chiun Street Hsin-Chu City, 30067, Taiwan Republic of China

MAY 2 & 2010

Re: K101143

Trade/Device Name: HEARTWAY Power Mobility Scooter, S11 Regulation Number: 21 CFR 890.3800 Regulation Name: Motorized three-wheeled vehicle Regulatory Class: II Product Code: INI Dated: April 9, 2010 Received: April 22, 2010

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 Amendmonts, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Or ve, 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 note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not machary.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set

3

Page 2 - Dr. Ke-Min Jen

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 100-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH0ffices/ucm1117809.html for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. J Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Preud 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its tolloffree mber (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

http://www.fda.gov/medicaldevices/ResourceforYou/Industry/default.htm.

Sincerely yours.

Sincerely yours,

For

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

Enclosure

4

Indications for Use

510 (K) Number ( If Known ): ____K

Device Name: HEARTWAY Power Mobility Scooter, $11

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 $\sqrt{ }$

(Part 21 CFR 801 Subpart D)

.

(21 CFR 807 Subpart C)

(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 Surgical, Orthopedic, and Restorative Devices

Page 1 of 1

510(k) Number K101143

F1