K Number
K131909
Date Cleared
2014-02-24

(243 days)

Product Code
Regulation Number
890.3110
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The intended use of the Dalton Lift Chair, Model LC-106 is to provide lift assistance for persons who have difficulty rising from a seated position to a standing position.

Device Description

The Dalton Lift Chair, Model LC-106 is intended to provide lift assistance for persons who have difficulty rising from a seated position to a standing position. It uses standard AC power from an electrical outlet. The device is mainly made of a welded steel frame, upholstery fabric and foam. The chair is assembled to welded steel lifting frame mechanism having a 24V DC motor/actuator powered by AC power from an electrical outlet. A hand-held control device engages the actuator to position the chair to recline, sitting, or standing position.

AI/ML Overview

This document is a 510(k) Summary for the Dalton Lift Chair, Model LC-106. It details the device's characteristics and its substantial equivalence to a predicate device, rather than presenting a study to prove the device meets acceptance criteria. No information about acceptance criteria or specific study results is provided beyond non-clinical testing.

Here's a breakdown of the requested information based on the provided text:

1. A table of acceptance criteria and the reported device performance

The document does not explicitly state "acceptance criteria" for the device's performance. Instead, it lists the device's technical specifications and compares them to a predicate device to establish substantial equivalence.

Characteristic / FeatureSubject Device (Dalton Lift Chair, Model LC-106)Predicate Device (Lift Chair, Model C5)
Maximum Duty Cycle2 min ON / 18 min OFF2 min ON / 18 min OFF
Power Requirements100-240 VAC, 50/60 Hz100-240 VAC, 50/60 Hz
Operating Temperature10°C (50°F) to 40°C (104°F)10°C (50°F) to 40°C (104°F)
Weight Capacity235 lbs (107 kg)325 lbs (147 kg)
Weight of Lift Chair133 lbs133 lbs
Maximum Tilt Angle45 DegreeNot Specified
Seat Height19" (483 mm)18" (457 mm)
Seat Width20" (508 mm)19" (483 mm)
Seat Depth20" (508 mm)20" (508 mm)
Overall Width33" (838 mm)32.75" (832 mm)
Overall Height43" (1092 mm)Not specified
Arm Height25.6" (650 mm)Not specified
Overall Reclined Depth69" (1753 mm)Not specified
Overall Upright Depth34.6" (879 mm)Not specified

The non-clinical testing for the Dalton Lift Chair LC-106 included:

  • IEC 60601-1:1988/A1:1991/A2:1995 for basic safety: "All tests were completed successfully."
  • IEC 60601-1-2 for Electromagnetic Compatibility: "All tests were completed successfully."
  • California Technical Bulletin No. 117: Test Procedure and Apparatus for Testing the Flame Retardance of Resilient Filling Materials Used in Upholstered Furniture: Tests were conducted. (Implied successful, as it contributes to the conclusion of substantial equivalence).
  • Biocompatibility (Upholstery Fabric): Evaluated for Cytotoxicity per ISO 10993-5 and for Skin Irritation and Dermal Sensitization per ISO 10993-10. (Implied successful).

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

This information is not applicable as no clinical test set or data relevant to a diagnostic performance study was conducted. The evaluation was based on non-clinical testing and comparison to a predicate device.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

This information is not applicable as no clinical test set requiring expert-established ground truth was performed.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

This information is not applicable as no clinical test set requiring adjudication was performed.

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

A multi-reader multi-case (MRMC) comparative effectiveness study was not performed. This device is a mechanical lift chair, not an AI-assisted diagnostic tool.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

A standalone performance evaluation in the context of an algorithm or AI was not performed. This is a mechanical device.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

For the non-clinical testing, the "ground truth" would be the specifications and requirements defined by the relevant standards (e.g., IEC 60601-1, IEC 60601-1-2, California Technical Bulletin No. 117, ISO 10993). The device's performance was compared against these standard requirements.

8. The sample size for the training set

This information is not applicable. There is no mention of a training set as this is a mechanical device, not an AI or algorithm-based system that requires machine learning training.

9. How the ground truth for the training set was established

This information is not applicable as there was no training set.

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DALTON INSTRUMENT CORP

16300 Addison Road, Suite 120 Addison, TX 75001

Lift Chair

Ph: 469-522-1200 Fax: 469-522-1202

LC-106 510(K) APPLICATION

K131909

Section 5

510(k) Summary

(Per 21 CFR 807.92)

Submitter's Name and Contact Information: 1.

Mrs. Mei Lein Dalton Instrument Corp. 16300 Addison Road, Suite 120 Addison, TX 75001 Email: daltonint@gmail.com Phone: (469) 522-1200 Fax: (469) 522-1202

Summary Preparation Date: 20 February 2014

2. Device Identification:

Proprietary Name:Dalton Lift Chair, Model LC-106
Generic Name:Electric Positioning Chair
Classification:Class II
Product Code:INO
Regulation Number:21 CFR 890.3110
Review Panel Code:Physical Medicine

3. Predicate Device

The proposed 'Dalton Lift Chair, LC-106' is substantially equivalent to the Lift Chair Model C5 manufactured by Pride Mobility Products Corp., previously cleared under K070950.

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Description of Device 4.

The Dalton Lift Chair, Model LC-106 is intended to provide lift assistance for persons who have difficulty rising from a seated position to a standing position. It uses standard AC power from an electrical outlet. The device is mainly made of a welded steel frame, upholstery fabric and foam. The chair is assembled to welded steel lifting frame mechanism having a 24V DC motor/actuator powered by AC power from an electrical outlet. A hand-held control device engages the actuator to position the chair to recline, sitting, or standing position.

5. Indications for Use

The intended use of the Dalton Lift Chair, Model LC-106 is to provide lift assistance for persons who have difficulty rising from a seated position to a standing position.

Summary of Similar Technological Characteristics 6.

Dalton Instrument Corp. 'Dalton Lift Chair, LC-106' and predicate device 'Lift Chair C5' (K070950) are intended to provide lift assistance for persons who have difficulty rising from a seated position to a standing position. They have the same intended use and indications for use. Their operating principle and technological characteristics are also comparable, as outlined in the following table:

Characteristics /FeaturesSubject DevicePredicate DeviceK070950
Dalton Lift Chair, Model LC-106(Dalton Instrument Corp.)Lift Chair, Model C5(Pride Mobility Products Corp.)
ClassificationClass IIClass II
Product CodeRegulationINO21 CFR 890.3110INO21 CFR 890.3110
Indications for UseThe intended use of the DaltonLift Chair, Model LC-106 is toprovide lift assistance for personswho have difficulty rising from aseated position to a standingposition.The Intended Use of thePride Mobility C5 Lift Chairis to provide lift assistancefor persons who havedifficulty rising from aseated position to astanding position.
Design / Construction
Basic PlatformWelded Steel Lifting FrameWelded Steel Lifting Frame
Drive Mechanism /ActuatorDelta Drive DC 24V(manufactured by Okin RefinedElectric Technology Co. Ltd.)Delta Drive DC 24V(manufactured by Okin RefinedElectric Technology Co. Ltd.)
Command InputHand-held Control device tooperate the various functions ofthe lift chair, such as positioningto recline, sitting or standingpositionHand-held Control device tooperate the various functions ofthe lift chair, such as positioningto recline, sitting or standingposition
Upholstery Fabric(Chair Cover)Made of Microsuede / Microfiber(Polyester material)Made of Polyester material

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Characteristics /FeaturesSubject DevicePredicate DeviceK070950
Dalton Lift Chair, Model LC-106(Dalton Instrument Corp.)Lift Chair, Model C5(Pride Mobility Products Corp.)
Chair CushionMade of Foam(Polyurethane material)Made of Foam(Polyurethane material)
General and TechnicalSpecifications
· Maximum Duty cycle(Mode of operation)2 min ON / 18 min OFF2 min ON / 18 min OFF
· Power Requirements100-240 VAC, 50/60 Hz100-240 VAC, 50/60 Hz
· OperatingTemperature10°C (50°F) to 40°C (104°F)10°C (50°F) to 40°C (104°F)
· Weight Capacity235 lbs (107 kg)325 lbs (147 kg)
· Weight of Lift Chair133 lbs133 lbs
· Maximum Tilt Angle45 DegreeNot Specified
· Seat Height19" (483 mm)18" (457 mm)
· Seat Width20" (508 mm)19" (483 mm)
· Seat Depth20" (508 mm)20" (508 mm)
· Overall Width33" (838 mm)32.75" (832 mm)
· Overall Height43" (1092 mm)Not specified
· Arm Height25.6" (650 mm)Not specified
· Overall ReclinedDepth69" (1753 mm)Not specified
· Overall UprightDepth34.6" (879 mm)Not specified

7. Non-Clinical Testing

The proposed Dalton Lift Chair LC-106 was evaluated per IEC 60601-1:1988/A1:1991/A2:1995 for basic safety. The Electromagnetic Compatibility of the device was evaluated per IEC 60601-1-2. All tests were completed successfully.

The Dalton Lift Chair LC-106 was tested per standard 'California Technical Bulletin No. 117: Test Procedure and Apparatus for Testing the Flame Retardance of Resilient Filling Materials Used in Upholstered Furniture'.

The Upholstery Fabric (Chair Cover) of the Dalton Lift Chair LC-106 that may come in contact with patients is biocompatible. The material was evaluated for Cytotoxicity per ISO 10993-5 and for Skin Irritation and Dermal Sensitization per ISO 10993-10.

8. Clinical Testing

The submission does not rely on any clinical data; therefore no clinical testing was performed.

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Conclusion: 9.

Based on design, technological characteristics, performance specifications and non-clinical bench testing information provided in the submission; the proposed Dalton Lift Chair LC-106 is substantially equivalent to the predicate device, and does not raise any new concerns of safety and effectiveness.

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Public Health Service

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

February 24, 2014

Dalton Instrument Corporation c/o Ms. Mei Lein 16300 Addison Road, Suite 120 Addison, TX 75001

Re: K131909

Trade/Device Name: Dalton Lift Chair. Model LC-106 Regulation Number: 21 CFR 890.3110 Regulation Name: Electric positioning chair Regulatory Class: Class II Product Code: INO Dated: January 10. 2014 Received: January 14, 2014

Dear Ms. Lein:

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 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

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Page 2 - Ms. Mei Lein

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 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/MedicalDevicesforYou/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.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Joyce M. Whang -S

for Carlos L. Peña, Ph.D., M.S. Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: December 31, 2013 See PRA Statement on last page.

510(k) Number (if known) K 131909

Device Name Dalton Lift Chair, Model LC-106

Indications for Use (Describe)

The intended use of the Dalton Lift Chair, Model LC-106 is to provide lift assistance for persons who have difficulty rising from a seated position to a standing position.

Type of Use (Select one or both, as applicable)

_ Prescription Use (Part 21 CFR 801 Subpart D)

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

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

FORM FDA 3881 (9/13)

PSC Publishing Services (30) } 443-6740

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*DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW."

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

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"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

§ 890.3110 Electric positioning chair.

(a)
Identification. An electric positioning chair is a device with a motorized positioning control that is intended for medical purposes and that can be adjusted to various positions. The device is used to provide stability for patients with athetosis (involuntary spasms) and to alter postural positions.(b)
Classification. Class II. The electric positioning chair is exempt from premarket notification procedures in subpart E of part 807 of this chapter, subject to § 890.9 and the following conditions for exemption:(1) Appropriate analysis and non-clinical testing must demonstrate that the safety controls are adequate to ensure safe use of the device and prevent user falls from the device in the event of a device failure;
(2) Appropriate analysis and non-clinical testing must demonstrate the ability of the device to withstand the rated user weight load with an appropriate factor of safety;
(3) Appropriate analysis and non-clinical testing must demonstrate the longevity of the device to withstand external forces applied to the device and provide the user with an expected service life of the device;
(4) Appropriate analysis and non-clinical testing must demonstrate proper environments of use and storage of the device to maximize the longevity of the device;
(5) Appropriate analysis and non-clinical testing (such as that outlined in the currently FDA-recognized editions of ANSI/AAMI/ES60601-1, “Medical Electrical Equipment—Part 1: General Requirements for Basic Safety and Essential Performance,” and ANSI/AAMI/IEC 60601-1-2, “Medical Electrical Equipment—Part 1-2: General Requirements for Basic Safety and Essential Performance—Collateral Standard: Electromagnetic Disturbances—Requirements and Tests”) must validate electromagnetic compatibility and electrical safety;
(6) Appropriate analysis and non-clinical testing (such as that outlined in the currently FDA-recognized editions of ANSI/AAMI/ISO 10993-1, “Biological Evaluation of Medical Devices—Part 1: Evaluation and Testing Within a Risk Management Process,” ANSI/AAMI/ISO 10993-5, “Biological Evaluation of Medical Devices—Part 5: Tests for In Vitro Cytotoxicity,” and ANSI/AAMI/ISO 10993-10, “Biological Evaluation of Medical Devices—Part 10: Tests for Irritation and Skin Sensitization”) must validate that the skin-contacting components of the device are biocompatible;
(7) Appropriate analysis and non-clinical testing (such as that outlined in the currently FDA-recognized editions of IEC 62304, “Medical Device Software—Software Life Cycle Processes”) must validate the software life cycle and that all processes, activities, and tasks are implemented and documented;
(8) Appropriate analysis and non-clinical testing must validate that the device components are found to be non-flammable;
(9) Appropriate analysis and non-clinical testing must validate that the battery in the device (if applicable) performs as intended over the anticipated service life of the device; and
(10) Adequate patient labeling is provided to the user to document proper use and maintenance of the device to ensure safe use of the device by the patient in the intended use environment.