K Number
K220827
Device Name
Electric Wheelchair
Date Cleared
2022-07-05

(105 days)

Product Code
Regulation Number
890.3860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
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: 90*59*99cm, 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.
More Information

Not Found

No
The description details a standard electric wheelchair with manual joystick control and basic speed adjustments. There is no mention of any features that would suggest AI or ML capabilities, such as autonomous navigation, obstacle detection with intelligent response, or adaptive control based on user patterns. The performance studies listed are standard safety and performance tests for wheelchairs, not AI/ML validation.

Yes
The device is intended to provide mobility to disabled or elderly individuals, which addresses a health-related condition, and it falls under the classification of a Class I device (electric wheelchair, pred. K192739).

No
Explanation: The device is an electric wheelchair designed to provide mobility. It does not perform any diagnostic functions or provide information used to diagnose a medical condition.

No

The device description explicitly details numerous hardware components including a motor, battery, frame, wheels, joystick, and controller, indicating it is a physical device with integrated software for control, not a software-only 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 disabled or elderly individuals. This is a physical assistance device, not a diagnostic tool.
  • Device Description: The description details the components and function of an electric wheelchair, which is a mobility aid. There is no mention of analyzing biological samples or providing diagnostic information.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in the body
    • Providing information for diagnosis, monitoring, or prognosis of a disease or condition

The device is a Class II medical device intended for mobility assistance, as evidenced by the predicate device and the standards it was tested against (which are related to wheelchairs and mobility aids).

N/A

Intended Use / Indications for 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.

Product codes

ITI

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.

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 Electrical Wheelchair has been evaluated the safety and performance by lab bench testing according to the following standards:

  • EN 12184:2014 Electrically powered wheelchairs, scooters and their chargers. Requirements and test methods
  • ISO 7176-1: 2014 Wheelchairs - Part 1: Determination of static stability
  • ISO 7176-2: 2017 Wheelchairs - Part 2:Determination of dynamic stability of electrically powered wheelchairs
  • ISO 7176-3: 2012 Wheelchairs - Part 3: Determination of effectiveness of brakes
  • ISO 7176-4: 2008 Wheelchairs Part 4: Energy consumption of electric wheelchairs and scooters for . determination of theoretical distance range
  • ISO 7176-5: 2008 Wheelchairs - Part 5: Determination of overall dimensions, mass and manoeuving space
  • ISO 7176-6: 2018 Wheelchairs - Part 6: Determination of maximum speed, acceleration and deceleration of electric wheelchairs
  • ISO 7176-7: 1998 Wheelchairs - Part 7: Measurement of seating and wheel dimensions
  • ISO 7176-8: 2014 Wheelchairs - Part 8: Requirements and test methods for static, impact and fatigue strengths
  • ISO 7176-9: 2009 Wheelchairs - Part 9: Climatic tests for electric wheelchairs
  • ISO 7176-10: 2008 Wheelchairs - Part 10: Determination of obstacle-climbing ability of electrically powered wheelchairs
  • ISO 7176-11 : 2012 Wheelchairs - Part 11: Test dummies
  • ISO 7176-13 : 1989 Wheelchairs - Part 13: Determination of coefficient of friction of test surfaces
  • ISO 7176-14: 2008 Wheelchairs - Part 14: Power and control systems for electrically powered wheelchairs and scooters - Requirements and test methods
  • ISO 7176-15: 1996 Wheelchairs - Part 15: Requirements for information disclosure,documentation and labeling
  • ISO 7176-16: 2012 Wheelchairs - Part 16: Resistance to ignition of postural support devices
  • ISO 7176-22:2014 Wheelchairs - Part 22: Set-up procedures
  • ISO 7176-25: 2013Wheelchairs - Part 25: Batteries and chargers for powered wheelchairs
  • IEC 62133-2: 2017 Secondary cells and batteries containing alkaline or other non-acid electrolytes -Safety requirements for portable sealed secondary cells, and for batteries made from them, for use in portable applications-part 2: Lithium systems
  • ISO 7176-21: 2009 Wheelchairs - Part 21: Requirements and test methods for electromagnetic compatibility of electrically powered wheelchairs and scooters, and battery chargers
  • IEC 60601-1-2:2015 Medical electrical equipment Part 1-2: General requirements for safety Collateral . standard: Electromagnetic compatibility - Requirements and tests
  • ISO 10993-1:2018 Biological evaluation of medical devices — Part 1: Evaluation and testing within a risk management process
  • ISO 10993-5:2009 Biological evaluation of medical devices - Part 5: Tests for in vitro cytotoxicity
  • ISO 10993-10:2010 Biological evaluation of medical devices — Part 10: Tests for irritation and skin sensitization

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.

Verification and Validation testing demonstrated that no adverse effects have been introduced by these differences and that the device performs as intended. From the results of nonclinical testing described, it can be concluded that DH01108 (2) Electric Wheelchair is substantially equivalent to the legally marketed predicate device.

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

Not Found

Predicate Device(s)

K192739

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).

0

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

July 5, 2022

Foshan Dahao Medical Technology Co.,Ltd % Iris Fung Regulation Manager Guangdong Jianda Medical Technology Co., Ltd 906 Room, Longxiang Garden, Tianhe District Guangzhou, Guangdong 510000 China

Re: K220827

Trade/Device Name: Electric Wheelchair Regulation Number: 21 CFR 890.3860 Regulation Name: Powered Wheelchair Regulatory Class: Class II Product Code: ITI Dated: March 18, 2022 Received: March 22, 2022

Dear Iris Fung:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

1

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 of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

for Heather Dean, PhD Assistant Director, Acute Injury Devices Team DHT5B: Division of Neuromodulation and Physical Medicine Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

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Indications for Use

510(k) Number (if known) K220827

Device Name Electric Wheelchair

Indications for Use (Describe)

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.

Type of Use (Select one or both, as applicable)Prescription Use (Part 21 CFR 801 Subpart D)

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

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3

510(k) Summary

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA and 21 CFR 890.3860.

1. Submitter Information

Sponsor Company Name: Foshan Dahao Medical Technology Co.,Ltd. Address: Building 1, 2nd floor of building 2, 3rd floor of building 3、4、5、6、7, No.9 of Fanye Road,Leping town,Sanshui District,Foshan City,Guangdong Province,528137,China Phone: +86-13760674304 Contact Person (including title): BaoYi Xie (Regulation Manager) E-mail: 709111267@qq.com

Application Correspondent: Guangdong Jianda Medical Technology Co Ltd. Address:906 Room, Longxiang Garden, Tianhe district, Guangzhou, China Contact Person:Ms. Iris Fung Tile: Regulation Manager Tel:+86- 13211147965 Email:mdc-fs@foxmail.com; jianda-lee@foxmail.com

2. Subject Device Information

Type of 510(k) submission: Traditional Common Name: Powered Wheelchair Trade Name: Electric Wheelchair Classification Name: Powered Wheelchair Review Panel: Physical Medicine Product Code: ITI Requlation Number: 21 CFR 890.3860 Regulation Class: Class II

3. Predicate Device Information

Sponsor: JERRY MEDICAL INSTRUMENT (SHANGHAI) CO., LTD. Common Name: Powered Wheelchair Trade Name: Electric Wheelchair 510(k) number: K192739

4

Review Panel: Physical Medicine Product Code: ITI Regulation Number: 21 CFR 890.3860 Regulation Class: Class II

4. 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.

5. 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.

6. Test Summary of Non-clinical Testing

The Electrical Wheelchair has been evaluated the safety and performance by lab bench testing according to the following standards:

5

  • . EN 12184:2014 Electrically powered wheelchairs, scooters and their chargers. Requirements and test methods
  • . ISO 7176-1: 2014 Wheelchairs - Part 1: Determination of static stability
  • . ISO 7176-2: 2017 Wheelchairs - Part 2:Determination of dynamic stability of electrically powered wheelchairs
  • . ISO 7176-3: 2012 Wheelchairs - Part 3: Determination of effectiveness of brakes
  • ISO 7176-4: 2008 Wheelchairs Part 4: Energy consumption of electric wheelchairs and scooters for . determination of theoretical distance range
  • . ISO 7176-5: 2008 Wheelchairs - Part 5: Determination of overall dimensions, mass and manoeuving space
  • . ISO 7176-6: 2018 Wheelchairs - Part 6: Determination of maximum speed, acceleration and deceleration of electric wheelchairs
  • . ISO 7176-7: 1998 Wheelchairs - Part 7: Measurement of seating and wheel dimensions
  • . ISO 7176-8: 2014 Wheelchairs - Part 8: Requirements and test methods for static, impact and fatigue strengths
  • ISO 7176-9: 2009 Wheelchairs - Part 9: Climatic tests for electric wheelchairs
  • . ISO 7176-10: 2008 Wheelchairs - Part 10: Determination of obstacle-climbing ability of electrically powered wheelchairs
  • . ISO 7176-11 : 2012 Wheelchairs - Part 11: Test dummies
  • ISO 7176-13 : 1989 Wheelchairs - Part 13: Determination of coefficient of friction of test surfaces
  • . ISO 7176-14: 2008 Wheelchairs - Part 14: Power and control systems for electrically powered wheelchairs and scooters - Requirements and test methods
  • ISO 7176-15: 1996 Wheelchairs - Part 15: Requirements for information disclosure,documentation and labeling
  • . ISO 7176-16: 2012 Wheelchairs - Part 16: Resistance to ignition of postural support devices
  • . ISO 7176-22:2014 Wheelchairs - Part 22: Set-up procedures
  • . ISO 7176-25: 2013Wheelchairs - Part 25: Batteries and chargers for powered wheelchairs
  • . IEC 62133-2: 2017 Secondary cells and batteries containing alkaline or other non-acid electrolytes -Safety requirements for portable sealed secondary cells, and for batteries made from them, for use in portable applications-part 2: Lithium systems

EMC

  • . ISO 7176-21: 2009 Wheelchairs - Part 21: Requirements and test methods for electromagnetic compatibility of electrically powered wheelchairs and scooters, and battery chargers

6

  • IEC 60601-1-2:2015 Medical electrical equipment Part 1-2: General requirements for safety Collateral . standard: Electromagnetic compatibility - Requirements and tests

Biocompatibility

The parts in contact with the user include: Joystick controller, is made of 80% Thermoplastic poly urethane elastomer rubber(TPU), 15%Fire retardant and 5% Fertilizer. Armrest and seat cushion are made of 100% polyurethane (PU) . All contact materials have passed biological tests and are harmless to humans. Patient-contacting material are carried out biocompatibility assessment in accordance with ISO 10993-1: 2018, including :

  • . ISO 10993-1:2018 Biological evaluation of medical devices — Part 1: Evaluation and testing within a risk management process
  • . ISO 10993-5:2009 Biological evaluation of medical devices - Part 5: Tests for in vitro cytotoxicity
  • . ISO 10993-10:2010 Biological evaluation of medical devices — Part 10: Tests for irritation and skin sensitization

All contact materials have passed biological tests and are harmless to humans.

7. Comparison to Predicate Device

Compare with predicate device, the subject device is very similar in design principle, intended use,

functions, material and the applicable standards. The differences between subject device and predicate device do not raise and new questions of safety or effectiveness.

| Elements of

ComparisonSubject DevicePredicate DeviceVerdict
ManufacturerFoshan Dahao Medical Technology
Co.,Ltd.JERRY MEDICAL INSTRUMENT
(SHANGHAI) CO., LTD.--
Product CodeITIITISame
Regulation No.21 CFR 890.386021 CFR 890.3860Same
ClassIIIISame
Product nameElectric WheelchairElectric WheelchairSame
510 (k)
NumberK220827K192739--
ModelsDH01108 (2)JRWD6010, JRWD6012--
Intended UseThe Electric Wheelchair 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 seatedThe device 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.Same

Table1 General Comparison

7

Elements of ComparisonSubject DevicePredicate DeviceVerdict
position.
Use
environmentIndoor useIndoor useSame
Patient
PopulationThe electric wheelchair is intended to
provide mobility to a person with a
disability or an older adult limited to
a sitting positionThe electric wheelchair is intended to
provide mobility to a person with a
disability or an older adult limited to
a sitting positionSame
Product
structurecomposed of front frame, rear frame,
backrest
frame, two foldable
armrests, two pivoting front wheel,
controller, lithium-ion battery pack,
two motor rear wheel,an off-board
battery charger, anti-roll wheel,
footplate, seat cushion, back cushion,
handle ,a controllerConsists of two foldable armrests, a
backrest, a seat cushion, a foldable
frame, two rear driving wheels with
hub motor/electromagnetic brake
assemblies, two pivoting casters, a Li-
ion batteries, an off-board battery
charger, a control panel, and an
electric motor controller.Same
Driving systemDirect drive on the rear wheelsDirect drive on the rear wheelsSame
Number of
wheels44Same
Main frame
materialAluminium alloyAluminium alloySame
MotorDC 24V*200W * 2pcsDC24V* 180W*2pcsMinor differences
in the dimensions
BatteryLithium-ion 24V, 10AH,1pcsDC 24V 20Ah Lithium-ion,1 pcswill not
impact the safety
Battery chargerInput: 100-240VAC
output : DC 24V ,2.0AmpHigh Power Technology Inc.
HP0180WL2
Input: 100-240 VAC
Output: DC 24V, 6 Ampand
effectiveness
of
the
substantial
equivalence.

Table2 Performance Comparison

| Elements of

ComparisonSubject DevicePredicate DeviceVerdict
JRWD6010JRWD6012
ManufacturerFoshan Dahao Medical
Technology Co.,Ltd.JERRY MEDICAL INSTRUMENT
(SHANGHAI) CO., LTD.--
Dimensions90cm x59cm x99cm38.1"x24.0"x37.0"39.3"x23.6"x37.0"Similar
Stowage
dimensions
(Length*width
*height)53cmx38cm x40cm44cm x40cm
x46cm44cm x46cm
x46cmMinor difference on
Stowage dimensions
will not
cause different
performance as all
performance tests are
performed according to
Elements of
ComparisonSubject DevicePredicate DeviceVerdict
JRWD6010JRWD6012
Weight,w/
Battery48.5Ibs./22kg58.4 lbs./26.5kg58.2 lbs./26.4kgstandard ISO
7176 series
The difference will
not raise any new safety
and effectiveness
concerns and will not
affect the safety and
effectiveness of the
subject device.
Frame designFoldable /
The device consists of a foldable
and non-rigid type of power
wheelchair base with rear drive
and 2 casters in the front and 2
anti-tippers in the rear.Foldable /
The device consists of a foldable and
non-rigid type of power wheelchair
base with rear drive and 2 casters in the
front and two anti-tippers in the rear.Same
Folding
mechanismA foldable seat frames
(The backrest could be folded to
seat)A foldable seat frames
(The backrest could be folded to seat)Same
Front wheel
(inch )6
(PU solid tire)8
(PU solid tire)Smaller sizes of
wheels, The difference
will not raise any new
safety and effectiveness
concerns.
Rear tire
(inch)8
(PU solid tire)10
(PU solid tire)12
(Pneumatic tire)will not raise any new
safety and effectiveness
concerns.
Cruising
Range(km)10-2520Actual Cruising
Range varies depending
on the rider's weight,
environment and battery
usage, this will not
affect the safety and
effectiveness of the
subject device.
Obstacle
climbing(mm)2550Subject Device has a
lower obstacle climbing,
but this will not affect
the safety and
effectiveness of the
subject device.
Max. Speed
(km/h)5.46Subject Device has a
smaller Max. speed, but
this will not affect the
use of the product
function and safety.
Static stability
forward≥6°21.8°Both of the devices are
evaluated according to
standard ISO 7176-
1:2014, so the different
static stability will not
impact the safety and
effectiveness.
Static stability
rearward≥6°19°standard ISO 7176-
1:2014, so the different
static stability will not
impact the safety and
effectiveness.
Static stability
sideways≥6°19.2°static stability will not
impact the safety and
effectiveness.
Max. loading
(kg)220lbs(100kg)220lbs (100kg)Same
Maximum10 degreesSame
Elements of
ComparisonSubject DevicePredicate Device
JRWD6010Predicate Device
JRWD6012Verdict
safe
operational
incline
Min. Turning
radium900mm1820mmThe difference in the
tuming radius will bring
more convenience when
it turns.The difference
will not raise any new
safety and effectiveness
concerns.
Minimum
braking
distancemax safety slope braking: ≤1.6m
(3°)1mSimilar
Max Speed
Forwards5.4km/h3.75 mph (6 km/h)Both of the devices are
evaluated according to
Max. Speed
Backward5.4km/h2.80 mph (4.5 km/h)standard
ISO 7176-
6:2018, so the different
will not impact the
safety and effectiveness
ControllerGigaDevice Semiconductor Inc.PG Drives Technology Ltd., newVSIDifferent Although
different controller is
used, both the control
system, including the
joystick controller, the
electromagnetic brakes
are similar. The joystick
controls the directions
and speed of movement,
and when the joystick is
released, the powered
wheelchair will slow
down to stop and the
brakes will
automatically re-engage.
The controller also
provides the battery
status displaying and
abnormal condition
displaying. Both of the
control systems are
evaluated according to
standard ISO 7176-
14:2008 and software
validation requirement
and there are no new
safety and effectiveness
concerns due to the
difference.
Speed control
methodJoystick control methodJoystick control methodSame
Elements of
ComparisonSubject DevicePredicate DeviceVerdict
ManufacturerFoshan Dahao Medical
Technology Co.,Ltd.JERRY MEDICAL INSTRUMENT
(SHANGHAI) CO., LTD.--
Main materialsFrame: Aluminiumalloy;
Wheel, Armrest: PU;
Backrest: PUFrame: Aluminiumalloy;
Wheel, Armrest: PU;
Backrest: oxford clothThe material for the
Materials
contacting userArmrest: PU;
Backrest:PU
Seat: PU
Joystick controller: TPU(80%),
Fire retardant(15%),
Fertilize( 5% ).Armrest: PU;
Backrest: oxford cloth
Seat: oxford cloth
newVSi electric wheelchair
controller:
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-6330main frame is the same.
Biocompatibility
evaluation
has
been
carried out per
ISO
10993-1.
There are no new safety
and
effectiveness
concerns
due to
the
difference.
Biocompatibility
of materials
contacting userComply with ISO 10993-1, FDA
Cytotoxicity (ISO 10993-5:2009),
Sensitization and Irritation
Reactivity (ISO 10993-10:2010)Comply with ISO 10993-1, FDA
Cytotoxicity (ISO 10993-5:2009),
Sensitization and Intracutaneous
Reactivity (ISO 10993-10:2010)Difference
in
the
Irritation test,the subject
device only made skin
contact with the patient,
so the skin irritation test
was
carried
out
according to ISO10993-
1, and the material in
contact with the patient
was
qualified
by
test.There are no new
safety and effectiveness
concerns due to
the
difference.
Label and
LabelingConforms to FDA Regulatory
RequirementsConforms to FDA Regulatory
RequirementsSame
Level of
Concern of the
SoftwareModerateModerateSame

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9

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Table3 Safety Comparison

8. Summary of substantial equivalence discussion

The DH01108 (2) Electric Wheelchair complied with the requirements of ISO 7176-1:2014, ISO 7176-2:2017, ISO 7176-3:2012, ISO 7176-4:2008, ISO 7176-5:2018, ISO 7176-6:2018, ISO 7176-7:1998, ISO 7176-8:2014, ISO 7176-9:2009, ISO 7176-10:2008, ISO 7176-11:2012, ISO 7176-13:1989, ISO 7176-14:2008, ISO 7176-15:1996, ISO 7176-16:2012, ISO 7176-19:2008, ISO 7176-21:2009, ISO 7176-22:2014,ISO 7176-25: 2013, IEC 60601-1-2:2014, IEC 62133-2:2017,ISO 10993-1:2018, ISO10993-5:2009, ISO 10993-10:2010.

The intended uses for both devices are the same. Mainframes of two devices are folded by way of front and rear close, and frame materials all meet the Tensile Strength, Yield Load, and Elongation tests. The

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design principles of the controller and Driving system are the same, and both meet the requirements of the ISO 7176-14:2008. Software validation is carried out on both control systems. Brake system and speed control are designed in the same way as well, and both meet the requirements of the ISO 7176-3:2012. Maximum obstacle climbing, Max Speed and Static stability different while such differences will not impact the safety and effectiveness of the subject device or raise new safety and effectiveness concerns as well as both meet the requirements of the ISO 7176-6: 2018, ISO 7176-10:2008. The biocompatibility of the Predicate device and Subject device meet the requirements of the ISO 10993-5:2009 & ISO 10993-10:2010.

The flame retardant test of the seat cushion and armrest of subject device is carried out according to the ISO 7176-16 test. Therefore, the subject device meets the flame retardancy of FDA requirements.

In conclusion, the technological characteristics, features, specifications, mode of operation, and intended use of the device substantially equivalent to the predicate devices quoted above. The differences between the subject device and predicate devices do not raise new issues of safety or effectiveness. The differences between the subject device and predicate devices do not raise new issues of safety or effectiveness. .

9. Summary of Clinical Test

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.

10. Conclusion

The differences between DH01108 (2) Electric Wheelchair and its predicate devices do not introduce a new intended use and do not raise new issues of safety and effectiveness. Verification and Validation testing demonstrated that no adverse effects have been introduced by these differences and that the device performs as intended. From the results of nonclinical testing described, it can be concluded that DH01108 (2) Electric Wheelchair is substantially equivalent to the legally marketed predicate device.

11. Summary Prepared Date

17 June 2022