BE-MOBILE 4-WHEELED ELECTRIC SCOOTER, MODEL DK S500
K033239 · Tung Keng Enterprise Co., Ltd. · INI · Nov 12, 2003 · Physical Medicine
Device Facts
Record ID
K033239
Device Name
BE-MOBILE 4-WHEELED ELECTRIC SCOOTER, MODEL DK S500
Applicant
Tung Keng Enterprise Co., Ltd.
Product Code
INI · Physical Medicine
Decision Date
Nov 12, 2003
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 890.3800
Device Class
Class 2
Intended Use
The device is intended for medical purposes to provide mobility to persons restricted to a seated position.
Device Story
Be-Mobile 4-Wheeled Electric Scooter (DK S500) is a battery-operated indoor/outdoor mobility device. It features a four-wheeled base and a seat. The rider operates the scooter using hand controls located on the steering column. The device is designed to be disassembled for transport and includes an onboard battery charger. It functions as a motorized vehicle to provide mobility for individuals with restricted movement. The device is intended for over-the-counter use.
Clinical Evidence
Bench testing only. The device underwent electromagnetic compatibility (EMC) testing according to ANSI/RESNA WC/Vol.2-1998, CISPR 11:1990, EN61000-3-2:1995, and IEC61000-3-3:1995 standards for electrically powered wheelchairs and scooters.
Technological Characteristics
Four-wheeled electric scooter; battery-operated; hand-controlled steering column; modular design for disassembly. Electronic system includes Dynamic Rhino DS72k controller. Complies with ANSI/RESNA WC/Vol.2-1998 and IEC/CISPR electrical safety standards.
Indications for Use
Indicated for persons restricted to a seated position requiring mobility assistance.
Regulatory Classification
Identification
A motorized three-wheeled vehicle is a gasoline-fueled or battery-powered device intended for medical purposes that is used for outside transportation by disabled persons.
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## NOV 1 2 2003
TUNG KENG ENTERPRISE CO., LTI No. 1. Lane 160. Sec. 2 Tan-Fu RD., Tan-Tzu Hsiang Taichung County, Taiwan Tel: +886-4-25321000 Fax: +886-4-25325000 E-mail: dkcity@ms21.hinte.net
## 510(k) SUMMARY " ここ
Submitter's Name: TUNG KENG Enterprise Co., Ltd. No. 1, Lane 160, Sec. 2 Tan-Fu RD., Tan-Tzu Hsiang Taichung County, 427,Taiwan
Date summary prepared:
September 29, 2003
Device Name:
Be-Mobile 4-Wheeled Electric Scooter, DK S500 Proprietary Name: Common or Usual Name: Electrical Scooter Classification Name: Motor Three-Wheeled Vehicle, Class II, 21 CFR 890.3800
Indications for Use:
The device is intended for medical purposes to provide mobility to persons restricted to a seated position.
Description of the device:
The Be-Mobile 4-Wheeled Electric Scooter DK S500 is an indoor / outdoor electric scooter that is battery operated. It has a base with four-wheeled with a seat. The movement of the scooter 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.
Performance Testing:
EMC Report ANSI / RESNA WC/Vol.2-1998, CISPR 11: 1990, EN61000-3-2: 1995, IEC61000-3-3: 1995 (Electrically powered wheelchairs, scooters, and their chargers - requirements and test methods)
Legally marketed device for substantial equivalence comparison: WU'S 4-WHEELED NEO SCOOTER WT-L4 (K013763)
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K6332 TUNG KENG ENTERPRISE CO., LID. No. 1, Lane 160, Sec. 2 Tan-Fu RD., Tan-Tzu Hsiang Taichung County, Taiwan Tel: +886-4-25321000 Fax: +886-4-25325000 E-mail: dkcity@ms21.hinte.net
2/2
Summary for substantial equivalence comparison:
The electronic systems between two devices are the same and all passed by the UL certificated, for instance the electronic controller, batteries and recharge. Thus the same safety level for the two devices is assured. The major differences existing of the two 4-wheelled scooters are the different controller. That means the new device, DK S500, use Dynamic Rhino DS72k controller, and the predicate device, WT-L4, use Curtis PMC controller. Besides the overall dimension, the size of tires, and the weight are differences between the two devices. The overall appearance differences are not safety aspect. So the new device is substantially equivalent to the predicate devices in this aspect.
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DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
NOV 1 2 2003
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
Tung Keng Enterprise Co., Ltd. C/o Dr. Ke-Min Jen ROC Chinese-European Industrial Research Society No. 58, Fu-Chiun St. Hsin-Chu City, China (Taiwan) 300
Re: K033239
Trade/Device Name: Be-Mobile 4 Wheeled Electric Scooter, DK S500 Regulation Number: 21 CFR 890.3800 Regulation Name: Motorized three-wheeled vehicle Regulatory Class: II Product Code: INI Dated: September 29, 2003 Received: October 6, 2003
Dear Dr. Jen:
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 - Dr. Ke-Min Jen
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 (301) 594-4659. 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 (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html
Sincerely yours,
miriam C. Provost
for 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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## 510 (K) NUMBER ( IF KNOW ): TBA
DEVICE NAME: Be-Mobile 4-Wheeled Electric Scooter, DK S500
INDICATIONS FOR USE:
The device is intended for medical purposes to provide mobility to persons restricted to a sitting position.
## ( PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE
Concurrence of CDRH, office of Device Evaluation (ODE )
Prescription Use _______________ OR Over - The - Counter - Use V
( Per 21 CFR 801.109 )
( Optional Format 1-2-96 )
n of General, Restor and Neurological Dovi
510(k) Number_
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