K Number
K220827
Date Cleared
2022-07-05

(105 days)

Product Code
Regulation Number
890.3860
Panel
PM
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The electric wheelchair (Model: DH01108(2)) is a motor driven, and indoor transportation vehicle with the intended use to provide mobility to a disabled or an elderly person limited to a seated position.

Device Description

The proposed device, Electric Wheelchair , mainly powered by rechargeable battery, motivated by motor, driven by user controlling joystick and adjusting speed. The electric wheelchair is composed of front frame, rear frame, backrest frame, armrest, front wheel, controller, battery pack, motor rear wheel, footplate, seat cushion, back cushion, handle.

The electric wheelchair is intended to provide mobility to a person with a disability or an older adult limited to a sitting position.This wheelchair is suitable for the user who with weight less than 100kg.

The device is folding design. This foldable electric wheelchair has front frame, backrest frame,armrest. The wheelchair can be easily folded, when folding the wheelchair, turn over the armrest successively.

Controller : The controller includes a power key/speed adjustment key , a direction joystick and speed light ,battery capacity light.

Joystick: It is used to control the electric wheelchair drive direction and speed. The joystick pushes away in the same direction as the wheelchair moves forward.

The wheelchair also provided with max speed limit setting so that user can select the max speed level by the round key.

Frame design: overall size: 905999cm, net weight: 22kg

The operation mode of the folding mechanism is to remove the locking device by someone else and manually push the backrest frame to complete the folding operation under non-riding state.

The motor of electric wheelchair is DC24V 200W*2; Inner power is DC24, 10Ah; The charger of Lithium ion battery Input:AC 100-240V;50-60Hz;1.2-0.5A; output : DC 24V,2,0A.

AI/ML Overview

The provided text describes a 510(k) premarket notification for an Electric Wheelchair. It focuses on demonstrating substantial equivalence to a predicate device rather than presenting a study proving that the device meets specific acceptance criteria based on its performance in a clinical setting.

Therefore, many of the requested details about acceptance criteria derived from clinical studies, expert-established ground truth, sample sizes for test and training sets, adjudication methods, or MRMC studies are not applicable or available in this document.

However, the document does detail non-clinical testing performed against established international standards to demonstrate safety and performance. I will present the information related to the closest equivalent of "acceptance criteria" and "device performance" available in the document, which are the relevant sections from the comparison to the predicate device and the summary of non-clinical testing.

Here's the information derived from the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

The document doesn't explicitly list "acceptance criteria" against which a device is tested with a singular "reported device performance." Instead, it performs a comparison to a predicate device and states that non-clinical tests were conducted according to various international standards. The "Verdict" column in the tables below indicates whether the subject device meets the same characteristics or if differences are deemed not to raise new safety or effectiveness concerns.

Element of Comparison / Test StandardAcceptance Criteria (from Predicate or Standard) / Predicate PerformanceSubject Device PerformanceVerdict
General Characteristics
ManufacturerJERRY MEDICAL INSTRUMENT (SHANGHAI) CO., LTD.Foshan Dahao Medical Technology Co.,Ltd.--
Product CodeITIITISame
Regulation No.21 CFR 890.386021 CFR 890.3860Same
ClassIIIISame
Product nameElectric WheelchairElectric WheelchairSame
Intended UseTo provide mobility to a disabled or an elderly person limited to a seated position.To provide mobility to a disabled or an elderly person limited to a seated position.Same
Use environmentIndoor useIndoor useSame
Patient PopulationDisabled or older adult limited to a sitting positionDisabled or older adult limited to a sitting positionSame
Product structureFoldable armrests, backrest, seat cushion, foldable frame, two rear driving wheels with hub motor/electromagnetic brake assemblies, two pivoting casters, Li-ion batteries, off-board battery charger, control panel, electric motor controller.Front frame, rear frame, backrest frame, two foldable armrests, two pivoting front wheel, controller, lithium-ion battery pack, two motor rear wheel, off-board battery charger, anti-roll wheel, footplate, seat cushion, back cushion, handle.Same
Driving systemDirect drive on the rear wheelsDirect drive on the rear wheelsSame
Number of wheels44Same
Main frame materialAluminium alloyAluminium alloySame
Max. loading220lbs (100kg)220lbs (100kg)Same
Maximum safe operational incline10 degreesSame (within acceptable range)
Speed control methodJoystick control methodJoystick control methodSame
Label and LabelingConforms to FDA Regulatory RequirementsConforms to FDA Regulatory RequirementsSame
Level of Concern of the SoftwareModerateModerateSame
Performance Characteristics
MotorDC24V* 180W*2pcsDC 24V*200W * 2pcsMinor differences in dimensions, will not impact safety.
BatteryDC 24V 20Ah Lithium-ion, 1 pcsLithium-ion 24V, 10AH, 1pcsMinor differences in capacity, will not impact safety/effectiveness.
Battery charger OutputDC 24V, 6 AmpDC 24V, 2.0AmpMinor differences in output, will not impact safety/effectiveness.
Dimensions38.1"x24.0"x37.0" (JRWD6010), 39.3"x23.6"x37.0" (JRWD6012)90cm x59cm x99cmSimilar
Stowage dimensions (Lengthwidthheight)44cm x40cm x46cm (JRWD6010) / 44cm x46cm x46cm (JRWD6012)53cmx38cm x40cmMinor difference, won't cause different performance as all performance tests are according to ISO 7176 series.
Weight, w/ Battery58.4 lbs./26.5kg (JRWD6010), 58.2 lbs./26.4kg (JRWD6012)48.5Ibs./22kgWill not raise any new safety and effectiveness concerns.
Front wheel (inch)8 (PU solid tire)6 (PU solid tire)Smaller sizes, will not raise new safety/effectiveness concerns.
Rear tire (inch)10 (PU solid tire) (JRWD6010), 12 (Pneumatic tire) (JRWD6012)8 (PU solid tire)Will not raise any new safety/effectiveness concerns.
Cruising Range (km)20 (JRWD6012)10-25Actual range varies; will not affect safety/effectiveness.
Obstacle climbing (mm)5025Lower obstacle climbing, but will not affect safety/effectiveness.
Max. Speed (km/h)65.4Smaller max speed, but will not affect product function and safety.
Static stability forward21.8°≥6°Both evaluated per ISO 7176-1:2014, differences won't impact safety/effectiveness.
Static stability rearward19°≥6°Both evaluated per ISO 7176-1:2014, differences won't impact safety/effectiveness.
Static stability sideways19.2°≥6°Both evaluated per ISO 7176-1:2014, differences won't impact safety/effectiveness.
Min. Turning radium1820mm (JRWD6012)900mmDifference brings more convenience; will not raise new safety/effectiveness concerns.
Minimum braking distance1m (JRWD6012)≤1.6m (3°) (max safety slope braking)Similar
Max Speed Forwards3.75 mph (6 km/h)5.4km/hBoth evaluated per ISO 7176-6:2018, differences won't impact safety/effectiveness.
Max. Speed Backward2.80 mph (4.5 km/h)5.4km/hBoth evaluated per ISO 7176-6:2018, differences won't impact safety/effectiveness.
ControllerPG Drives Technology Ltd., newVSIGigaDevice Semiconductor Inc.Different, but both control systems are similar in function and evaluated per ISO 7176-14:2008 and software validation; no new safety/effectiveness concerns.
Main materials (e.g., Frame)Aluminium alloyAluminium alloySame
Materials contacting userArmrest: PU; Backrest: oxford cloth; Seat: oxford cloth; Joystick knob: Santoprene 101-80; Joystick Gaiter: Silicone 3032 (50%) & 5031 (50%); Enclosure Moulding(s): ABS/PC Wonderloy PC-540; Keypad: Silicone keypad coatings TC-2407 & CH-6330Armrest: PU; Backrest: PU; Seat: PU; Joystick controller: TPU(80%), Fire retardant(15%), Fertilize( 5%).Different materials for some components, but biocompatibility evaluation (ISO 10993-1) was performed for the subject device; no new safety/effectiveness concerns.
Biocompatibility of materials contacting userComply with ISO 10993-1, FDA Cytotoxicity (ISO 10993-5:2009), Sensitization and Intracutaneous Reactivity (ISO 10993-10:2010)Comply with ISO 10993-1, FDA Cytotoxicity (ISO 10993-5:2009), Sensitization and Irritation Reactivity (ISO 10993-10:2010)Difference in irritation test (subject device only skin irritation); test qualified material in contact with patient; no new safety/effectiveness concerns.
Compliance with Standards
Electrically powered wheelchairs, scooters and their chargers. Requirements and test methodsEN 12184:2014EN 12184:2014, ISO 7176 series, IEC standards, ISO 10993 seriesComplied
Static stabilityISO 7176-1: 2014ISO 7176-1: 2014Complied
Dynamic stability of electrically powered wheelchairsISO 7176-2: 2017ISO 7176-2: 2017Complied
Effectiveness of brakesISO 7176-3: 2012ISO 7176-3: 2012Complied
Energy consumption/theoretical distance rangeISO 7176-4: 2008ISO 7176-4: 2008Complied
Overall dimensions, mass and manoeuving spaceISO 7176-5: 2008ISO 7176-5: 2018Complied
Maximum speed, acceleration and decelerationISO 7176-6: 2018ISO 7176-6: 2018Complied
Measurement of seating and wheel dimensionsISO 7176-7: 1998ISO 7176-7: 1998Complied
Static, impact and fatigue strengthsISO 7176-8: 2014ISO 7176-8: 2014Complied
Climatic testsISO 7176-9: 2009ISO 7176-9: 2009Complied
Obstacle-climbing abilityISO 7176-10: 2008ISO 7176-10: 2008Complied
Test dummiesISO 7176-11: 2012ISO 7176-11: 2012Complied
Coefficient of friction of test surfacesISO 7176-13: 1989ISO 7176-13: 1989Complied
Power and control systemsISO 7176-14: 2008ISO 7176-14: 2008Complied
Information disclosure, documentation and labelingISO 7176-15: 1996ISO 7176-15: 1996Complied
Resistance to ignition of postural support devicesISO 7176-16: 2012ISO 7176-16: 2012Complied
Set-up proceduresISO 7176-22:2014ISO 7176-22:2014Complied
Batteries and chargers for powered wheelchairsISO 7176-25: 2013ISO 7176-25: 2013Complied
Secondary cells and batteries (Safety requirements)IEC 62133-2: 2017IEC 62133-2: 2017Complied
Electromagnetic compatibility (EMC)ISO 7176-21: 2009ISO 7176-21: 2009Complied
Medical electrical equipment Part 1-2 (EMC)IEC 60601-1-2:2015IEC 60601-1-2:2015Complied
Biological evaluation of medical devices (Risk management)ISO 10993-1: 2018ISO 10993-1: 2018Complied
CytotoxicityISO 10993-5:2009ISO 10993-5:2009Complied
Irritation and skin sensitizationISO 10993-10:2010ISO 10993-10:2010Complied

2. Sample size used for the test set and the data provenance

The document describes non-clinical bench testing conducted according to ISO and IEC standards. These standards typically specify the number of units or samples required for each test. However, the exact sample sizes for each specific test (e.g., how many wheelchairs were subjected to fatigue strength testing) are not explicitly stated in this summary. The data provenance is "lab bench testing" (Paragraph 6, Page 5) in China (Company Address, Page 3). This is typically prospective testing of manufactured devices.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

This information is not applicable as the document describes non-clinical engineering and laboratory tests against recognized standards, not human-expert-driven ground truth for a clinical dataset.

4. Adjudication method for the test set

This information is not applicable as the document describes non-clinical engineering and laboratory tests based on objective measurements against standard requirements, not subjective assessment requiring adjudication.

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

This information is not applicable. This is a submission for an Electric Wheelchair, not an AI software. The document explicitly states "No animal study and clinical studies are available for our device. Clinical testing was not required to demonstrate the substantial equivalence of the Electric Wheelchair to its predicate device" (Paragraph 9, Page 11).

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

This information is not applicable. This is an Electric Wheelchair, not an algorithm.

7. The type of ground truth used

The "ground truth" in this context is the requirements specified by various international consensus standards (EN 12184, ISO 7176 series, IEC 60601-1-2, IEC 62133-2, ISO 10993 series). The device's components and performance characteristics were tested against these pre-defined, objective criteria.

8. The sample size for the training set

This information is not applicable. This is a physical device, not an AI model requiring a training set.

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

This information is not applicable. (See point 8).

§ 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).