KYMCO FORU, MODEL EQ20

K082901 · Kwang Yang Motor Co., Ltd. · INI · Oct 28, 2008 · Physical Medicine

Device Facts

• Record ID: K082901
• Device Name: KYMCO FORU, MODEL EQ20
• Applicant: Kwang Yang Motor Co., Ltd.
• Product Code: INI · Physical Medicine
• Decision Date: Oct 28, 2008
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 890.3800
• Device Class: Class 2

Intended Use

KYMCO ForU EQ20 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 indoor/outdoor motorized three-wheeled scooter; provides transportation for disabled or elderly persons. User operates device via tiller handle and thumb-operated potentiometer throttle control lever to engage/disengage motion in forward and reverse directions. Device intended for personal mobility; enhances independence for individuals with limited mobility.

Technological Characteristics

Motorized three-wheeled vehicle; battery-operated; tiller handle steering; thumb-operated potentiometer throttle control. Class II device.

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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K082901

OCT 2 8 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, contrasting with the white space inside the oval. The oval itself is outlined in black, giving the logo a clean and defined appearance. The logo is simple and modern, with a focus on the letter 'K' as the primary element.

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 EQ20 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 EQ20 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 EQ20 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 EQ20 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 EQ20 scooter is substantially equivalent to legally marketed devices currently in commercial distribution.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

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

# OCT 2 8 2008

K082901 Trade/Device Name: KYMCO ForU EQ20 Regulation Number: 21 CFR 890.3800 Regulation Name: Motorized three-wheeled vehicle Regulatory Class: Class II Product Code: INI Dated: September 18, 2008 Received: September 30, 2008

Dear Ms. Chang:

Re:

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 (OS) 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) 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 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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# Statement of Indications for Use

510(k) Number (if known):

Device Name: KYMCO ForU EQ20

Indications for Use: To provide mobility to disabled or elderly persons limited to a seated position.

Over-The-Counter Use __X Prescription Use (Part 21 CFR 801 Subpart D) (Part 21 CFR 807 Subpart C) (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

Q.D. Der Dr.

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

**510(k) Number** | k082901

(Posted November 13, 2003)