QUICKIE FREESTYLE POWER WHEELCHAIR, MODEL G-424

K031289 · Sunrise Medical, Inc. · ITI · May 9, 2003 · Physical Medicine

Device Facts

• Record ID: K031289
• Device Name: QUICKIE FREESTYLE POWER WHEELCHAIR, MODEL G-424
• Applicant: Sunrise Medical, Inc.
• Product Code: ITI · Physical Medicine
• Decision Date: May 9, 2003
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 890.3860
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The Center Drive Power Wheelchair's intended use is to empower physically challenged individuals by providing a means of mobility.

Device Story

Center Drive Power Wheelchair provides mobility for physically challenged individuals. Device operates as a powered wheelchair; user-controlled via interface to navigate environments. Intended for use by patients requiring assistance with ambulation. Output is physical movement of the chair. Benefits include increased independence and mobility for the user.

Technological Characteristics

Powered wheelchair; center-drive configuration; electrical energy source. No specific materials or software algorithms described.

Indications for Use

Indicated for physically challenged individuals requiring a means of mobility. No specific age or gender restrictions noted.

Regulatory Classification

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.

Submission Summary (Full Text)

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MAY - 9 2003

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Michael Chellson Director of Regulatory Affairs Sunrise Medical, Inc. 7477 East Dry Creek Parkway Longmont, CO 80503

Re: K031289

Trade/Device Name: Center Drive Power Wheelchair Regulation Number: 21 CFR 890.3860 Regulation Name: Powered wheelchair Regulatory Class: II Product Code: ITI Dated: April 23, 2003 Received: April 29, 2003

Dear Mr. Chellson:

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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such 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 CFR Part 807); labeling (21 CFR Part 801); 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.

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Page 2 -- Mr. Michael Chellson

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). 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 [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Muriam C. Provost

Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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## Indications for Use Statement

| 510(k) Number (if known) | |
|--------------------------|------------------------------------------------------------------------------------------------------------------------------------|
| Device Name | Center Drive Power Wheelchair |
| Indications for Use | The Center Drive Power Wheelchair's intended use is to empower physically challenged individuals by providing a means of mobility. |

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED

Concurrence of CDRH, Office of Device Evaluation (ODE)

| Prescription Use (Per 21 CFR 801. 109) | | OR | Over-The-Counter Use <span style="text-decoration: underline;">✓</span> |
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Miriam C. Provost

(Division Sign-Off) (Division of General, Restorative
Division of General, Restorative Division of Sevices

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Neurological
510(k) Number K031289