(203 days)
The device is a motor driven, indoor and outdoor transportation vehicle with the intended use to provide mobility to a disabled or elderly person limited to a seated position.
The ZIPPY scooter consists of a retractable platform which connects the two front wheels and two rear wheels, an adjustable tiller, a lead acid battery with an off-board charger, a motor/electromagnetic brake assembly, a electric motor controller and a seat /backrest set. It can be retracted for transport in a car trunk.
The patient uses the tiller handle/handlebar for steering and a thumb operated potentiometer throttle control lever located at the top of the tiller to engage and disengage the scooter motion in both the forward and reverse directions. When the throttle control lever is released, the electromagnetic brake will be actuated and the scooter is slow to stop.
This is a submission for a motorized scooter, not an AI/ML powered medical device. As such, the requested information regarding AI/ML-specific study design, such as acceptance criteria based on performance metrics (e.g., sensitivity, specificity), ground truth establishment, expert adjudication, MRMC studies, and training/test set details, is not applicable and therefore not present in the provided text.
The document primarily focuses on demonstrating substantial equivalence to a predicate device through non-clinical testing against relevant standards.
Here's a breakdown of the available information based on your request, highlighting where the requested details are not applicable:
1. Table of acceptance criteria and the reported device performance
| Acceptance Criteria | Reported Device Performance |
|---|---|
| Compliance with various standards relating to wheelchairs and medical electrical equipment. Specific performance metrics (e.g., minimum range, maximum speed, stability under certain conditions) are implied by the standards but not explicitly detailed as acceptance criteria with numerical targets in this summary. | The ZIPPY scooter "complied with the requirements of ANSI/RESNA WC. Vol. I Sec. 7, Sec 8 and sec. 21, CISPR 11, IEC 60335-2-29, IEC 60601-1, IEC 61000-4-2, IEC 61000-4-3, IEC 61000-4-8, ISO 7176-1, ISO 7176-2, ISO 7176-3, ISO 7176-4. ISO 7176-5, ISO 7176-6, ISO 7176-9, ISO 7176-10, ISO 7176-11, ISO 7176-13, ISO 7176-14, ISO 7176-15, ISO 7176-16, ISO 14971, ISO 10993-1. ISO 10993-5, and ISO 10993-10." |
2. Sample size used for the test set and the data provenance
- Not Applicable: This is a physical device (scooter), not an AI/ML algorithm that processes data. The "test set" would refer to the specific unit(s) of the scooter tested to ensure compliance with standards, and the provenance would be the manufacturing site (Dongguan Prestige Sporting Goods Co., Ltd. in China). The document does not specify the number of units tested.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
- Not Applicable: For a physical device like a scooter, "ground truth" in the context of expert review for AI/ML performance is not relevant. Compliance with standards is typically assessed through engineering tests and measurements, often performed by certified testing laboratories.
4. Adjudication method for the test set
- Not Applicable: As above, adjudication methods like 2+1 or 3+1 are used for expert consensus on data labeling, which is not relevant for testing a physical mobility device.
5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance
- Not Applicable: This device is a motorized scooter, not an AI system designed to assist human readers. MRMC studies are not relevant.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done
- Not Applicable: This is a physical device, not an algorithm.
7. The type of ground truth used
- Engineering/Performance Standards: The "ground truth" for this device is its adherence and demonstrable compliance with established international and national engineering standards (e.g., ANSI/RESNA WC. Vol. I Sec. 7, Sec 8 and sec. 21, CISPR 11, IEC 60335-2-29, IEC 60601-1, IEC 61000-4-2, etc.). This involves objective measurements and tests to ensure safety, functionality, and durability.
8. The sample size for the training set
- Not Applicable: This is a manufactured physical product. There is no "training set" in the context of machine learning.
9. How the ground truth for the training set was established
- Not Applicable: As above, no training set for this type of device.
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K131302
510(k) Summary
This summary of 510(k) safety and effectiveness information is being submitted in accordance with requirements of 21 CFR Part 807.92.
Applicant
Name: Dongguan Prestige Sporting Goods Co., Ltd. Address: 316 Industry District, Qiaotou Area, Houjie Town, Dongguan City, Guangdong Province, 523950, China Contact person: Mr. Alex Wu, Marketing Director Tel: +86-769-85922501 Fax: +86-769-85922505 e-mail: alex@solaxtech.com
Date prepared: Oct. 10, 2013
Device
Trade name: SOLAX
Model: ZIPPY scooter
Common name: Electrical scooter
Classification name: Motorized three-wheeled vehicle
Medical specialty (Panel): Physical Medicine Device
Regulation number: 890.3800
Product Code: INI
Classification: Class II
Predicate device
Trade name: SOLAX Model: MOBIE scooter Manufacture: Dongguan Prestige Sporting Goods Co., Ltd. 510(k) number: K122749 Regulation number: 890.3800 Product Code: INI Classification: Class II
Intend use of device
It is a motor driven, indoor and outdoor transportation vehicle with the intended use to provide mobility to a disabled or elderly person limited to a seated position.
NOV 26 2013
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Device description:
The ZIPPY scooter consists of a retractable platform which connects the two front wheels and two rear wheels, an adjustable tiller, a lead acid battery with an off-board charger, a motor/electromagnetic brake assembly, a electric motor controller and a seat /backrest set. It can be retracted for transport in a car trunk.
The patient uses the tiller handle/handlebar for steering and a thumb operated potentiometer throttle control lever located at the top of the tiller to engage and disengage the scooter motion in both the forward and reverse directions. When the throttle control lever is released, the electromagnetic brake will be actuated and the scooter is slow to stop.
Summary of non-clinical testing
The ZIPPY scooter complied with the requirements of ANSI/RESNA WC. Vol. I Sec. 7, Sec 8 and sec. 21, CISPR 11, IEC 60335-2-29, IEC 60601-1, IEC 61000-4-2, IEC 61000-4-3, IEC 61000-4-8, ISO 7176-1, ISO 7176-2, ISO 7176-3, ISO 7176-4. ISO 7176-5, ISO 7176-6, ISO 7176-9, ISO 7176-10, ISO 7176-11, ISO 7176-13, ISO 7176-14, ISO 7176-15, ISO 7176-16, ISO 14971, ISO 10993-1. ISO 10993-5, and ISO 10993-10.
Statement of substantial equivalence
The design and technological characteristics of the ZIPPY scooter is basically similar to the predicate device chosen. They have same intended use of a motor driven, indoor and outdoor transportation vehicle to provide mobility to a disabled or elderly person limited to a seated position.
There are minor differences between the devices including overall dimensions, distances between front wheels and pre-charging distance do not alter the intended use function and use of the device. Moreover, the non-clinical tests and the predicate comparisons demonstrate that these differences in their technological characteristics do not raise any questions as to the safety and effectiveness. Therefore the ZIPPY scooter is substantially equivalent to the MOBIE (K122749).
Conclusion
In accordance with the Federal Food, Drug and Cosmetic Act. 21 CFR Part 807 and based on the information provided in this premarket notification, Dongguan Prestige Sporting Goods Co., Ltd. concludes that, ZIPPY scooter is substantially equivalent to predicate devices as described herein.
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Image /page/2/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized depiction of an eagle or bird-like figure with outstretched wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the bird-like figure.
DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
November 26, 2013
Dongguan Prestige Sporting Goods Co., Ltd. c/o Ms. Junnata Chang 16F-2(16A), No. 462, Sec. 2 ChongDe Rd., Beitun Dist. Taichung 406 TAIWAN
Re: K131302
Trade/Device Name: SOLAX ZIPPY SCOOTER Regulation Number: 21 CFR 890.3800 Regulation Name: Motorized three-wheeled vehicle Regulatory Class: Class II Product Code: INI Dated: October 10, 2013 Received: October 22, 2013
Dear Ms. Chang:
We have reviewed your Section 510(k) premarket notification of intent to market the device weferenced 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 that I Dri has intacted and regulations administered by other Federal agencies. You must or any I cooral sukatos and regarents, including, but not limited to: registration and listing (21
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Page 2 - Ms. Junnata Chang
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.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. 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 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 toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fdagov/MedicalDevices/ResourcesforYou/Industry/default.htm.
Sincerely yours,
Joyce M. Whang -S
for Victor Krauthamer, Ph.D. Acting Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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Indications for Use
510(k) Number (if known): K131302
Device Name: SQLAX ZIPPY SCOOTER
Indications For Use:
The device is a motor driven, indoor and outdoor transportation vehicle with the intended use to provide mobility to a disabled or elderly person limited to a seated position.
Prescription Use (Part 21 CFR 801 Subpart D) AND/OR
Over-The-Counter Use _ X (21 CFR 807 Subpart C)
(Please Do Not WRITE BELOW THIS LINE - Continue on Another PAGE IF NEEDED)
Concurrence of Center for Devices and Radiological Health (CDRH)
Joyce M. Whang -S
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§ 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).