HAIDA MODEL HD11 MANUAL WHEELCHAIR

K082274 · Jiangyin East China Medical Technology Co., Ltd. · IOR · Aug 19, 2008 · Physical Medicine

Device Facts

• Record ID: K082274
• Device Name: HAIDA MODEL HD11 MANUAL WHEELCHAIR
• Applicant: Jiangyin East China Medical Technology Co., Ltd.
• Product Code: IOR · Physical Medicine
• Decision Date: Aug 19, 2008
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 890.3850
• Device Class: Class 1

Intended Use

It is intended use to provide mobility to physically challenged persons limited to a sitting position on the flat and firm terrain in outdoor or indoor.

Device Story

Manual wheelchair for mobility-impaired individuals. Device features rigid steel frame, nylon upholstery, two 24-inch rear wheels, and two 8-inch front casters. Operated by user or caregiver for indoor/outdoor transport on flat, firm surfaces. Provides patient mobility and independence.

Clinical Evidence

Bench testing only. Device meets performance requirements per ANSI/RESNA WC Vol. 1 (Sections 1, 5, 7, 8, 15, 16) and California Bureau of Home Furnishings 117.

Technological Characteristics

Mechanical manual wheelchair. Materials: steel frame, nylon upholstery. Dimensions: 24-inch rear wheels, 8-inch front casters. Standards: ANSI/RESNA WC Vol. 1, California Bureau of Home Furnishings 117.

Indications for Use

Indicated for physically challenged persons limited to a sitting position requiring mobility assistance on flat, firm indoor or outdoor terrain.

Regulatory Classification

Identification

A mechanical wheelchair is a manually operated device with wheels that is intended for medical purposes to provide mobility to persons restricted to a sitting position.

Predicate Devices

• Solara (K012370)
• AIDC 8500 (K043332)

Submission Summary (Full Text)

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KOY2274

Image /page/0/Picture/1 description: The image shows a logo with a globe-like design at the top. Inside the globe, the letters "HD" are prominently displayed. Below the globe, there are two Chinese characters, which appear to be part of the brand name or company name associated with the logo. The logo has a simple, monochrome design.

Jiangyin East China Medical Technology Co., Ltd.

No.555, Qinfeng Road, Huashi Town, Jiangyin City, Jiangsu, China, 214421 TEL: [phone] FAX: [phone]

## 510(k) Summary

#### Device

Trade name: HAIDA HD 11 manual Wheelchair

Common name: Manual Wheelchair

AUG 1 9 2008

Classification name: Mechanical wheelchair

Medical specialty (Panel): Physical Medicine Device

Regulation number: 890.3850

Product Code: 89IOR

Classification: Class I

#### Predicate devices

Solara (K012370)/ Invacare Corporation AIDC 8500(K043332)/ Aerospace Industrial Development Corporation (AIDC)

#### Intend use of device

It is intended use to provide mobility to physically challenged persons limited to a sitting position on the flat and firm terrain in outdoor or indoor.

#### Device description:

: " ···

It consists of a rigid, mechanical, steel frame and nylon upholstery back and seat. It has two 24" rear wheels and two 8" front casters for turning and maneuverability.

### Substantial equivalence:

It is substantially equivalent to the legal products in USA. They have the same technological characteristics and intended use of the devices.

There are minor differences in performance specifications of the manual wheelchairs, these differences do not alter the intended use function and use of the device, nor do they raise any new questions pertaining to safety or effectiveness.

#### Non-Clinical testing

It meets the applicable performance requirements as specified in ANSI/RESNA WC Vol. 1 Sec. 1, Sec.5, Sec.7, Sec.8, Sec.15, Sec.16 and California Bureau of Home Furnishings 117.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/1/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus, which is a symbol often associated with medicine and healthcare. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the caduceus.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Jiangyin East China Medical Technology Company., Ltd % Junnata Chang, Ph.D. 14F-2 NO. 1 Lane 25 Zhuangjing Road Banqiao, China (Taiwan) 220

AUG 1 9 2008

K082274 Re: Trade/Device Name: HAIDA HD 11 Manual Wheelchair Regulation Number: 21 CFR 890.3850 Regulation Name: Mechanical Wheelchair. Regulatory Class: Class I Product Code: IOR Dated: July 25, 2008 Received: August 11, 2008

Dear Dr. 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 or any Fourtall 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 – Junnata Chang, Ph.D.

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 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 the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at [phone]. You may obtain 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 M. Millman

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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# Statement of Indications for Use

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Device Name: HAIDA HD 11 manual wheelchair

Indications for Use:

To provide mobility to physically challenged persons limited to a sitting position on the flat and firm terrain in outdoor or indoor.

Prescription Use _____________________________________________________________________________________________________________________________________________________________

Over-The-Counter Use _________________________________________________________________________________________________________________________________________________________

:

(Part 21 CFR 801 Subpart D) AND/OR

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

Concurrence of CDRH, Office of Device Evaluation (ODE) Page 1 of 1

| (Division Sign-Off) | |
|------------------------------------------------------------|---------|
| Division of General, Restorative, and Neurological Devices | |
| 510(k) Number | 1082279 |

(Posted November 13, 2003)