KYMCO FORU, MODEL EQ40

K081133 · Kwang Yang Motor Co., Ltd. · INI · Jun 10, 2008 · Physical Medicine

Device Facts

• Record ID: K081133
• Device Name: KYMCO FORU, MODEL EQ40
• Applicant: Kwang Yang Motor Co., Ltd.
• Product Code: INI · Physical Medicine
• Decision Date: Jun 10, 2008
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 890.3800
• Device Class: Class 2

Intended Use

KYMCO ForU EQ40 scooter is intended for an indoor/outdoor scooter that provides transportation for disabled or elderly persons limited to a seated position.

Device Story

Battery-operated motorized three-wheeled scooter for indoor/outdoor transportation. User operates via tiller handle and thumb-actuated potentiometer throttle lever to control forward/reverse motion. Device provides mobility for disabled or elderly individuals restricted to seated positions. No complex software or AI components; mechanical/electrical control system.

Technological Characteristics

Battery-operated motorized three-wheeled vehicle. Control system utilizes tiller handle and thumb-operated potentiometer throttle. Class II device per 21 CFR 890.3800.

Indications for Use

Indicated for disabled or elderly persons limited 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.

Predicate Devices

• AVANTICARE SA4022 (K051538)
• LERADO CHINA LIMITED ForU EQ30 (K072630)

Submission Summary (Full Text)

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K081133

JUN 1 0 2008

Image /page/0/Picture/2 description: The image shows a logo with a stylized letter 'K' inside an oval shape. The 'K' is bold and black, and it fills most of the oval's interior. The oval itself is also black and has a thick outline. The logo appears simple and modern.

# KWANG YANG MOTOR CO., LTD.

No. 35, Wan Hsing Street, San Min Dist., 803, Kaohsiung, Taiwan TEL: [phone] FAX: [phone]

## 510(k) Summary

#### Device

Trade name: KYMCO ForU EQ40 scooter

Common name: Electrical scooter

Classification name: Motorized three-wheeled vehicle

Medical specialty (Panel): Physical Medicine Device

Regulation number: 890.3800

Product Code: 89INI

Classification: Class II

Predicate devices

### AVANTICARE SA4022(K051538)/ LERADO CHINA LIMITED ForU EQ30(K072630)/ KWANG YANG MOTOR CO., LTD.

Intend use of device

KYMCO ForU EQ40 scooter is intended for an indoor/outdoor scooter that provides transportation for disabled or elderly persons limited to a seated position.

### Device description:

The KYMCO ForU EQ40 scooter is an indoor/outdoor transportation vehicles which is battery operated. The movement of the scooter is controlled by a tiller handle and a thumb operated potentiometer throttle control lever to engage and disengage the scooter motion in both the forward and reverse directions.

### Substantial equivalence:

The KYMCO ForU EQ40 scooter is substantially equivalent to the AVANTICARE SA4022 (K051538) and ForU EQ30(K072630) manufactured by LERADO CHINA LIMITED and KWANG YANG MOTOR CO., LTD., respectively.

There are minor differences in performance specifications of the scooters, these differences do not alter the intended function and use of the device, nor do they raise any new questions pertaining to safety or effectiveness. Therefore, KWANG YANG MOTOR CO., LTD. believes that the KYMCO ForU EQ40 scooter is substantially equivalent to legally marketed devices currently in commercial distribution.

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Kwang Yang Motor Company Limited % Junnata Chang 14F-2, No.1 Zhuangjing Road Lane 25 Banqiao, China (Taiwan) 220

JUN 1 0 2008

Re: K081133 Trade/Device Name: KYMCO ForU EQ40 Regulation Number: 21 CFR 890.3800 Regulation Name: Motorized three-wheeled vehicle Regulatory Class: Class II Product Code: INI Dated: May 19, 2008 Received: May 19, 2008

Dear Ms. Chang:

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 - Ms. Junnata Chang

This letter will allow you to begin marketing your device as described in your Section 510(k) promarket notification. The FDA finding of substantial cquivalence 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 Center for Devices and Radiological Health's (CDRH's) Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance. please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at [phone]. For questions regarding of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at [phone]. You may oblain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at toll-free number [phone] or [phone] or the Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours.

Mark W. Milliman

Mark N. Melkerson 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

510(k) Number (if known): K081133

Device Name: KYMCO ForU EQ40

Indications for Use:

To provide mobility to disabled or elderly persons limited to a seated position.

Prescription Use (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use _ X (Part 21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Neil R.P. de forska

(Division Sign-Division of General, Restorative, and Neurological Devices

**510(k) Number** K081133