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510(k) Data Aggregation

    K Number
    K041190
    Date Cleared
    2004-05-25

    (19 days)

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

    The device is intended for medical purposes to provide mobility to persons restricted to a seated position.

    Device Description

    The A&I Power Wheelchair, PC-401 is an indoor / outdoor Powered Wheelchair that is battery operated. It has a base with four-wheeled with a seat. The movement of the Wheelchair is controlled by the rider who uses hand controls located at the top of the steering column. The device can be disassembled for transport and is provided with an onboard battery charger.

    AI/ML Overview

    The provided document describes the predicate device information, but does not sufficiently detail any studies to prove that the device meets the acceptance criteria. The document states that performance testing was conducted according to certain standards (ANSI / RESNA WC/Vol.2-1998, CISPR 11: 1990, EN61000-3-2: 1995, IEC61000-3-3: 1995), but it does not provide any results from these tests or specific acceptance criteria. Instead, it relies on a comparison to a predicate device to establish substantial equivalence.

    Therefore, the following information can be extracted, but many sections requested in the prompt cannot be fulfilled due to lack of detail in the source document.

    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance Criteria (Implied)Reported Device Performance
    Mechanical Performance
    Cruising Range20-30 km
    Maximum Speed4.4 mph
    Safety Climbing Ability12°
    Weight LimitSame as predicate device (not specified numerically)
    Foldable FrameYes
    Removable Arm TypeYes
    Back Upholstery MaterialPassed resistance ignition test by SGS
    Overall DimensionsDifferent from predicate device
    Size of WheelsDifferent from predicate device
    Seat DimensionsDifferent from predicate device
    Electrical Performance
    Battery TypeSame brand as predicate (UL certified U1 type)
    Control SystemSame brand (Dynamic types)
    RechargerHP8204A (UL certified)
    Electronic SystemsAll passed UL certification (safety level assured)
    Safety Considerations
    Braking time and distanceMet relevant requirements (implied by similar speed)
    Dynamic stabilityMet relevant requirements (implied by similar speed)
    User's climb not to exceed 12°Owner's manual states this

    Note: The document emphasizes "substantial equivalence" to a predicate device (SINON Power Wheelchair, SN-W401, K040319) rather than predefined acceptance criteria for a new device. The "reported device performance" is primarily a comparison against the predicate.

    2. Sample Size Used for the Test Set and Data Provenance

    The document does not specify a separate "test set" or its sample size. The performance testing refers to general compliance with standards, and the comparison is based on device specifications rather than a clinical trial or specific test set.

    • Data Provenance: Not explicitly stated for specific tests, but the device is manufactured in Taiwan, R.O.C. (Republic of China). The testing standards are international.

    3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications of Those Experts

    Not applicable. No ground truth establishment for a test set is mentioned. The assessment is based on engineering specifications and adherence to standards.

    4. Adjudication Method for the Test Set

    Not applicable. No test set requiring adjudication is mentioned.

    5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

    Not applicable. This is a medical device (power wheelchair), not an AI-powered diagnostic tool, so an MRMC study is not relevant.

    6. Standalone (Algorithm Only) Performance

    Not applicable. This is a physical medical device, not an algorithm.

    7. Type of Ground Truth Used

    Not applicable in the typical sense of a diagnostic algorithm. The "ground truth" for the device's performance would be the physical measurements and tests conducted according to the cited standards (ANSI / RESNA, CISPR, EN, IEC) to ensure functionality and safety.

    8. Sample Size for the Training Set

    Not applicable. This is a manufactured product, without a "training set" in the context of machine learning.

    9. How the Ground Truth for the Training Set Was Established

    Not applicable.

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