K Number
K111278
Device Name
Z10 WHEELCHAIR PUSH AND BRAKE ASSIST DEVICE
Date Cleared
2011-09-16

(134 days)

Product Code
Regulation Number
890.3860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Provide mobility to persons physically challenged and limited to sitting positions due to: - Palsies/Paralyses . - Loss of limbs - Defective and/or deformed limbs ● - Joint contractures . - Joint defects ● - . Other diseases
Device Description
The z10 is a powerful push and brake assist for manual wheelchairs. It can also be converted into the z10-ce add-on drive with tiller control quickly and easily. In this product version, the user drives and controls the wheelchair independently.
More Information

Not Found

No
The device description and intended use focus on mechanical assistance for wheelchairs and do not mention any AI/ML capabilities. The "Mentions AI, DNN, or ML" field is also marked as "Not Found".

No.
The device's intended use is to provide mobility to persons who are physically challenged, not to directly treat or cure a medical condition or disease. It functions as an assistive technology for transportation.

No

This device is a power add-on drive for manual wheelchairs, designed to provide mobility assistance. It does not perform any diagnostic functions like detecting, identifying, or characterizing a disease or condition.

No

The device description clearly states it is a "powerful push and brake assist for manual wheelchairs" and can be converted into a "power add-on drive with tiller control." This indicates a physical hardware component that provides power and control to the wheelchair, not solely software.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health.
  • Device Function: The z10 is a power add-on drive for manual wheelchairs. Its function is to provide mobility assistance to individuals with physical limitations. It does not perform any tests on biological samples.
  • Intended Use: The intended use clearly describes providing mobility and transportation, not diagnostic testing.

The device is a mobility aid, not a diagnostic tool.

N/A

Intended Use / Indications for Use

In combination with a manual wheelchair, the z10 power add-on drive is intended exclusively as a push and brake assist for the transportation by an assistant of persons who are unable to walk or who have walking disabilities.

In combination with a manual wheelchair, the z10-ce power add-on drive is intended exclusively as a power add-on drive with tiller control for individual use by persons who are unable to walk or who have a walking disability, in order to transport themselves.

The wheelchair/z10 combination may only be used with the components/options listed in the instructions for use.

The z10 power add-on drive may only be used by persons who have received training. Training in use is a prerequisite in order to protect persons from danger and to operate the wheelchair/z10 combination safely and without mistakes.

Provide mobility to persons physically challenged and limited to sitting positions due to:

  • Palsies/Paralyses .
  • Loss of limbs
  • Defective and/or deformed limbs ●
  • Joint contractures .
  • Joint defects ●
  • . Other diseases

Product codes

ITI

Device Description

The z10 is a powerful push and brake assist for manual wheelchairs. It can also be converted into the z10-ce add-on drive with tiller control quickly and easily. In this product version, the user drives and controls the wheelchair independently.

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)

The safety of the z10 Push and Brake Assist has been confirmed by CE certification, and was tested by Mikes Testing Partners in Strasskarchen Germany and TÜV SÜD Product Services GmbH, Hanover, Germany to the following standards:

ISO 7176-14:2008 ISO 7176-21:2009 ANSI/RESNA WC/Vol. 2 : 1998 ISO 10993-1:2003 Cytotoxicity ISO 9999:2007 Assistive products for persons with disability

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

Not Found

Predicate Device(s)

K073701

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 890.3860 Powered wheelchair.

(a)
Identification. A powered wheelchair is a battery-operated device with wheels that is intended for medical purposes to provide mobility to persons restricted to a sitting position.(b)
Classification. Class II (performance standards).

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Image /page/0/Picture/0 description: The image shows the logo for Otto Bock. The logo is in black and white and features the company name in a stylized font. Below the name is the phrase "QUALITY FOR LIFE" in a simple, sans-serif font.

SEP 1 6 2011

K111278

510(k) SUMMARY of SAFETY and EFFECTIVENESS

A. General Information

1. Submitter's Name.:OTTO BOCK Health Care, LP
2. Address:Two Carlson Parkway North, Suite 100
Minneapolis, Minnesota USA 55447-4467
3. Telephone:763-253-5610
4. Contact Person:William Kabitz, Quality Assurance Manager
5. Date Prepared:May 1st, 2011
6. Registration Number:2182293

B. Device

,

ﻨﺘ

1. Name:z10 Push and Brake Assist
2. Trade Name:z10 Push and Brake Assist
3. Common Name:Powered Wheelchair Mover
4. Classification Name:Wheelchair, Powered
5. Product Code:ITI
6. Class:II
7. Regulation Number:21 CFR 890.3860

C. Identification of Legally Marketed Predicate Device

1. Name:Dane Technologies Wheelchair Mover
2. Manufacture:Dane Technologies
3. K Number:K073701
4. Date Cleared:January 8, 2008

D. Description of the Device

The z10 is a powerful push and brake assist for manual wheelchairs. It can also be converted into the z10-ce add-on drive with tiller control quickly and easily. In this product version, the user drives and controls the wheelchair independently.

1

Otto Bock®

JALITY FOR LI

E. Features

The special features of the z10 push and brake assist for wheelchairs includes:

  • Very good operating performance, including uneven surfaces, thanks . to the motor unit, suspension, and generous ground clearance of 8 cm.
  • . Optimum traction, even when going uphill or downhill, thanks to the rear-mounted drive.
  • Range of up to 25 km* for pushing and driving, no creeping loss of . battery capacity thanks to the latest Lithium-lon battery technology.
  • . Speed control up to 6 km/h in 5 levels at the push of a button.
  • Hills and slopes up to 20% and obstacle clearance up to 5 cm . possible.
  • Excellent maneuverability, including indoors. .
  • . Very quiet operation due to the worm gear motor.

F. Intended Use Statement

In combination with a manual wheelchair, the z10 power add-on drive is intended exclusively as a push and brake assist for the transportation by an assistant of persons who are unable to walk or who have walking disabilities.

In combination with a manual wheelchair, the z10-ce power add-on drive is intended exclusively as a power add-on drive with tiller control for individual use by persons who are unable to walk or who have a walking disability, in order to transport themselves.

The wheelchair/z10 combination may only be used with the components/options listed in the instructions for use.

The z10 power add-on drive may only be used by persons who have received training. Training in use is a prerequisite in order to protect persons from danger and to operate the wheelchair/z10 combination safely and without mistakes.

2

Image /page/2/Picture/0 description: The image shows the logo for Otto Bock. The logo is in black and white and features a stylized, cursive font. A registered trademark symbol is present to the right of the text.

QUALITY FOR LIFE

G. Technological Characteristics Summary

z10z10-ce
General
Housing Metal:Anthracite metallic
Drive wheel10", airless, grey
Steering casterN/A8" dual, airless, grey
Anti-tipperSwinging anti-tipper
Driving Data
SpeedMax. 6 km/h, 5 levels, continuous fine adjustment within each speed level
Range25 km according to ISO 7176-4
Max. climbing abilityUp to 20%
Maximum obstacle height6 cm4 cm
Turning radiusDepending on the radius of the manual wheelchair
Weights
Drive unit (without battery)21 kg
Tiller control with control panel1.5 kg
Battery pack3.8 kg
Wheelchair adapter plate1.0 kg
z10-ce steering caster unit with adapterN/A8.0 kg
Total weight, z10 without adapter plate26.3 kg34.3 kg
Maximum load capacity (including wheelchair)160 kg
Minimum load capacity20 kg
Dimensions (W x H x D)
Drive unit including battery335 x 580 x 450 mm
Tiller control with control panel550 x 520 x 180 mm
Wheelchair with z10Depends on the manual wheelchair, z10 does not change dimensions
Electrical Installation
Lithium-ion battery24V / 18.4 Ah
Charging time (battery drained)Approx. 4 h
Battery lifespan (complete charging cycles)700 cycles (subsequently 80% charging capacity)
Control unitenAble 40
Operating voltage24 V DC
Motor power100 W
Self-contactingYes
Light module(front) Optional: Hella HL 2000
Wheelchair Adaptation
Minimum seat height38 cm
Minimum seat width38 cm
Adaptation systemAttachment bolt with locking pin
Compatible Otto Bock wheelchairsStart M1/M2/M3/M4/M5, Motus, Avantgarde T/VR, Centro A3
Compatible third-party wheelchairsAdaptable to most wheelchair models commonly available on the
market, limitations depending on the product design of the
wheelchair, please request a list from Otto Bock
Charger
TypeMentzer
Mains plugEuro-plug, 2-pin
Power requirements110 V
Mains frequency50/60 Hz
Dimensions (W x H x D)170 x 140 x 85 mm
Weight

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Otto Bock®

QUALITY FOR LI

H. Safety Testing

The safety of the z10 Push and Brake Assist has been confirmed by CE certification, and was tested by Mikes Testing Partners in Strasskarchen Germany and TÜV SÜD Product Services GmbH, Hanover, Germany to the following standards:

ISO 7176-14:2008 ISO 7176-21:2009 ANSI/RESNA WC/Vol. 2 : 1998 ISO 10993-1:2003 Cytotoxicity ISO 9999:2007 Assistive products for persons with disability

Refer to Appendic C for test reports.

Signatures:

Quality Assurance Manager_

President & CEO US Healthcare _

lthcare

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Image /page/4/Picture/1 description: The image shows a circular seal with text around the perimeter and a stylized bird-like symbol in the center. The text around the perimeter appears to be the name of a government agency or organization, possibly related to health and human services. The bird-like symbol in the center is composed of three curved lines, creating a sense of movement and flight.

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

SEP 16 2511

Otto Bock Healthcare, LP % Mr. William Kabitz Quality Assurance Manager Two Carlson Parkway North, Suite 100 Minneapolis, Minnesota 55447-4467

Re: K111278

Trade/Device Name: 210 and z10ce Push and Brake Assist Regulation Number: 21 CFR 890.3860 Regulation Name: Powered wheelchair Regulatory Class: Class II Product Code: ITI Dated: August 30, 2011 Received: September 02, 2011

Dear Mr. Kabitz:

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 note: CDRH does not evaluate information related to contract liability warranties. We remind you; however, that device labeling must be truthful and not misleading.

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

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Page 2 – Mr. William Kabitz

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 (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.

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/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. 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 Pari 803). please go to

http://www.fda.gov/MedicalDevices/Safety/Reportal?roblem/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 toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely vours.

Sincerely yours,

FOR Pete Vimmerstedt

Mark N. Melkerson

Dic Linda

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

Enclosure

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APPENDIX J

Indications For Use Form

510(k) Number (if known): To be determined

Device Name: z10 and z10ce Push and Brake Assist

Indications for Use:

Provide mobility to persons physically challenged and limited to sitting positions due to:

  • Palsies/Paralyses .
  • Loss of limbs
  • Defective and/or deformed limbs ●
  • Joint contractures .
  • Joint defects ●
  • . Other diseases

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

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

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

Concurrence of CDRH Office of Device Evaluation (ODE)

Signature

(Division Sign Division of Surgical, Orthopedic, and Restorative Devices

510(k) Number K111278