HEARTWAY POWER WHEELCHAIR

K132856 · Heartway Medical Products Co., Ltd. · ITI · Jul 15, 2014 · Physical Medicine

Device Facts

• Record ID: K132856
• Device Name: HEARTWAY POWER WHEELCHAIR
• Applicant: Heartway Medical Products Co., Ltd.
• Product Code: ITI · Physical Medicine
• Decision Date: Jul 15, 2014
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 890.3860
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The device is intended for medical purposes to provide mobility to persons restricted to a seated position.

Device Story

HEARTWAY P25 is a battery-operated, four-wheeled power wheelchair for indoor/outdoor mobility. Rider operates device via hand controls on steering column. Features include foldable mainframe, cross-brace suspension, and flip-backward armrests. Device is user-operated; intended for individuals restricted to seated position. Provides mobility benefit by allowing independent navigation. Disassemblable for transport; includes external battery charger. Output is physical movement of chair based on rider input. Safety features include push-to-lock wheel locks and compliance with ISO 7176 series for stability, braking, and climatic testing.

Clinical Evidence

Bench testing only. No clinical data. Performance verified via ISO 7176 series standards including static/dynamic stability, braking effectiveness, energy consumption, dimensions/maneuvering, speed/acceleration, climatic testing, obstacle climbing, and electromagnetic compatibility (EMC) per ANSI/RESNA WC/Vol.2 and IEC/CISPR standards.

Technological Characteristics

Battery-operated power wheelchair. Mainframe: metal. Controller: P&G VR2. Wheels: solid. Dimensions: 830mm length, 650mm width, 1060mm height. Ground clearance: 80mm. Curb climbing: 75mm. Turning radius: 650mm. Max weight capacity: 120kg. Power: 2x 50Ah 12VDC batteries. Charging: External 24VDC charger (UL 1310 certified). Compliance: ISO 7176 series (stability, braking, energy, dimensions, strength, climatic, obstacle, EMC).

Indications for Use

Indicated for persons restricted to a seated position requiring mobility assistance. Suitable for indoor/outdoor use.

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.

Predicate Devices

• HEARTWAY Power Chair, P23 (K100327)

Submission Summary (Full Text)

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#### HEARTWAY MEDICAL PRODUCTS CO

NO.6, ROAD 26, TAICHUNG INDUSTRIAL PARK, TAICHUNG, TAIWAN R.O.C. 408
TEL:[phone] (Sales)- 23583232 (Rep) FAX:[phone]
Web: www.heartway.com.tw
E-mail salatumcharncomte !

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ISO-9001
CERTIFICATED

#### 510(k) SUMMARY " 66

# K132856

Submitter's Name: HEARTWAY Medical Products Co., Ltd.

No.6, Road 25, Taichung Industrial Park, Taichung, 40850, Taiwan, ROC

Date summary prepared: Device Name:

July 15, 2014

| Proprietary Name: | HEARTWAY Power Wheelchair, P25 |
|-------------------------|------------------------------------------|
| Common or Usual Name: | POWERED WHEELCHAIR |
| Classification Name: | POWERED WHEELCHAIR, Class II, |
| | 21 CFR 890.3860 |
| Product Code: | ITI |
| Name of Contact Person: | Dr. Jen, Ke-Min |
| | Tel: [phone] Fax: [phone] |
| | Email:[e-mail] |

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 HEARTWAY Power Wheelchair, P25 is an indoor / outdoor power chair that is It has a base with four-wheeled with a seat, and armrests. battery operated. The movement of the power chair 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 external battery charger.

Performance Testing:

- 1) EMC Report ANSI / RESNA WC/Vol.2: 2009, CISPR 11: 2004+A2:2006, EN61000-4-2: 2008, IEC61000-4-3: 2006, IEC61000-4-8: 2001 (Electrically powered wheelchairs, scooters, and their chargers - requirements and test methods).
- 2) ISO 7176-1 Wheelchairs Part 1: Determination of static stability, 1999.
- 3) ISO 7176-2 Wheelchairs Part 2: Determination of dynamic stability of electric wheelchairs, 2001.

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Image /page/1/Picture/0 description: The image shows a logo with a stylized floral design above the word "HEART-WA". The floral design consists of four rounded petals arranged in a circular pattern, set against a square background. A thin vertical line extends upwards from the left side of the word "HEART-WA", terminating in a small circle.

### HEARTWAY MEDICAL PRODUCTS CO.,L

NO.6, ROAD 26. TAICHUNG INDUSTRIAL PARK, TAICHUNG, TAIWAN R.O.C. 408
TEL:[phone] (Sales)-23583232 (Rep) FAX:[phone]
Web: www.heartway.com.tw

Image /page/1/Picture/3 description: The image shows a logo with the text "TUV CERT" in a stylized font. The logo is surrounded by a circular border. Below the logo, there is a rectangular box with rounded corners, but the text inside is not legible. The image appears to be a certification mark or quality assurance symbol.

4) ISO 7176-3 Wheelchairs - Part 3: Determination of effectiveness of brakes, 2003.

- 5) ISO 7176-4 Wheelchairs Part 4: Energy consumption of electric wheelchairs for determination of theoretical distance range, 2008.
- 6) ISO 7176-5 Wheelchairs Part 5: Determination of overall dimensions, mass and manoeuvring space, 2008.
- 7) ISO 7176-6 Wheelchairs Part 6: Determination of maximum speed, acceleration and deceleration of electric wheelchairs, 2001.
- 8) ISO 7176-7 Wheelchairs Part 7: Determination of seating dimensions Definitions and measuring method, 1998.
- 9) ISO 7176-8 Wheelchairs Part 8: Static, impact and fatigue strength for manual wheelchairs, 1998.
- 10) ISO 7176-9 Wheelchairs Part 9: Climatic tests for electric wheelchairs, 2009.
- 11) ISO 7176-10 Wheelchairs Part 10: Determination of obstacle-climbing ability of electrically powered wheelchairs, 2008.
- 12) ISO 7176-11 Wheelchairs Wheelchairs Part 11: Test dummies, 1992.
- 13) ISO 7176-13 Wheelchairs Part 13: Determination of coefficient of friction of test surfaces, 1989.
- 14) ISO 7176-14 : Power and control system for electric wheelchairs, 2008.
- 15) ISO 7176-15 Wheelchairs Part 15: Requirements for information disclosure, documentation and labelling, 1996.
- 16) ISO 7176-16 Requirements and test methods for resistance to ignition of upholstered parts, 2012.
- 17) ISO 7176-21 : Requirements and test method electromagnetic compatibility of powered wheelchairs and motorized scooters, 2009.

Device major components description:

The maximum weight bearing capacity of the device is 120 kgs / 265 lbs.

The feature of the body structure, the rear two wheels can always contact the surface, and the vehicle can operate on the rough surface. We provide the components and assembling drawing in the User's Manual. But the following surfaces are recommended not to operate on:

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Image /page/2/Picture/0 description: The image shows a logo with a stylized butterfly or flower design above the word "HEARTWA". The butterfly/flower is black and is set against a black square. The word "HEARTWA" is in a bold, sans-serif font. The image is black and white.

#### HEARTWAY MEDICAL PRODUCTS CO.

TAICHUNG INDUSTRIAL PARK, TAICHUNG, TAIWAN 95 - 23583232 (Rep) FAX:[phone]

- Sand surface .
- Wet or icy surface
- Road maintenance hole metal cover
- Too steep incline over 10 degrees.
- . Turning Radius 650 mm / 25.6"
- Ground clearance 80 mm / 3,2"
- Curb climbing ability 75 mm / 3.0"

Compare to the legally marketed device for substantial equivalence: Predicate Device: HEARTWAY Power Chair, P23 (K100327)

Summary for substantial equivalence comparison:

The indications for use between the two devices are the same. Mainframes of two devices are folded and they use the same material. The mainframe materials of the two devices all meet the strength and fatigue tests. The incline capabilities. cross brace suspension, footplates, armrest type, and the warranty are all the same. The back upholstery material is also made of the same fabric and passes the ignition-resistance test in accordance with ISO 7176-16.

Specifically, the electronic systems for two devices are the same controller, i.e., P & G VR2, and are from the same suppliers. The electronic controller, batteries, recharger, and the competent switches and switching power supplies all pass the UL certification. Thus the same safety and effectiveness levels for the two devices are assured.

The main differences for the two devices are overall dimensions. Therefore, the weight limit, cruising range, maximum speed, wheelchair weight, the sizes of wheels and seat, and the relevant specifications for ground clearance and curb climbing ability are different. But two devices all meet the ISO 7176 series standards requirements. Thus for the real-life use instead of different dimensional specifications, the two devices are substantially equivalent.

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Image /page/3/Picture/0 description: The image shows a logo for HEART-WAY. The logo features a stylized heart shape with four lobes, resembling a flower or clover. The word "HEART-WAY" is printed in bold, sans-serif letters below the heart shape. The image appears to be a cropped section from a larger document or advertisement.

# HEARTWAY MEDICAL PRODUCTS CO.,LTD.

NO.6. ROAD 25, TAICHUNG INDUSTRIAL PARK, TAICHUNG: TAIWAN R.O.C. 408 TEL:[phone] (Sales) - 23583232 (Rep) FAX:[phone] Web : www.heartway.com.tw - : •

Image /page/3/Picture/3 description: The image contains two logos. The first logo is the "TUV CERT" logo, which is a certification mark. The second logo is the "ISO-9001 CERTIFICATED" logo, which indicates that the organization is certified to the ISO 9001 standard. The year 2005 and the Japanese word "本当時代" are also present in the image.

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E-mail : [e-mail] : w ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

## Comparison Table _

### Similarities:

| ITEMS | PREDICATE DEVICE | SUBJECT DEVICE |
|--------------------------|--------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------|
| BRAND NAME | HEARTWAY | |
| MANUFACTURER | HEARTWAY Medical Products Co., Ltd. | |
| SERIES | Power Wheelchair System Series | |
| MODEL NO | P23 | P25 |
| 510K NO | K100327 | K132856 |
| INTENDED USE | The device is intended for<br>medical purposes to<br>provide mobility to persons<br>restricted to a sitting<br>position. | Same |
| Frame | Folded | Same |
| Electronics | P & G, VR2<br>controller | Same |
| Suspension | Cross brace | Same |
| Footplates | ABS | Same |
| Incline | 10 degrees | Same |
| Back Upholstery | Fabric | Same |
| Armrest Types | Flip-backward | Same |
| Recharger | 24VDC<br>(UL 1310 certified) | Same |
| Wheel Lock | Push-to-Lock | Same |
| Warranty | 3 years: Main frame<br>1 years: Controller / gear motor /<br>batteries w/o exhaustive and<br>wear parts | Same |
| ITEMS | PREDICATE DEVICE | SUBJECT DEVICE |
| Overall Dimension | | |
| Overall length | 1100 mm / 43.3" | 830 mm / 32.7" |
| Overall width | 660 mm / 26.0" | 650 mm / 25.6" |
| Overall height | 1100 mm / 43.3" | 1060 mm / 41.7" |
| Weight Limit | 135 kgs / 300 lbs | 120 kgs / 265 lbs |
| Maximum Speed | 6.0 km/hr ( 3.8mile/h ) | 9.6 km/hr ( 6.0mile/h ) |
| Batteries<br>Quantity | Two | Two |
| Type | 34Ah 12VDC | 50Ah 12VDC |
| Range per charge | 26~30km / 18 miles | 35km / 22 miles |
| Rear Wheels | 10" x 3.3" solid x 2 | 14" x 3.0" solid x 2 |
| Casters | 6.0" x 2" solid x 2 | 10" x 3.3" solid x 2 |
| Seat Size | | |
| Width | 66 cm / 26.0" | 48 cm / 18.9" |
| Length | 85 cm / 33.5" | 44 cm / 17.3" |
| Height | 30 cm / 11.8" | 53 cm / 20.9" |
| Turning Radius | 550 mm / 21.7" | 650 mm / 25.6" |
| Ground Clearance | 75 mm / 3.0" | 80 mm / 3.2" |
| Curb Climbing<br>Ability | 60 mm / 2.4" | 75 mm / 3.0" |
| Wheelchair Weight | w/i batteries 85kgs / 187 lbs<br>w/o batteries 60kgs / 132 lbs | w/i batteries 125kgs / 276 lbs<br>w/o batteries 75kgs / 165 lbs |

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Image /page/4/Picture/0 description: The image shows a logo for HEART-WAY. The logo consists of a stylized flower or leaf design in black, positioned above the word "HEART-WAY" in bold, black letters. The flower design is abstract, with rounded shapes forming a petal-like structure.

# HEARTWAY MEDICAL PRODUCTS CO.,LTD.

NO.6, ROAD 25, TAICHUNG INDUSTRIAL PARK, TAICHUNG, TAIWAN R.O.C. 408 TEL:[phone] (Sales)·23583232 (Rep) FAX:[phone] Wab : www.heartway.com.tw

Image /page/4/Picture/3 description: The image contains a logo for "TUV CERT". The logo consists of the letters "TUV" stacked on top of the word "CERT", and the entire wordmark is surrounded by two concentric circles. The logo is black and white.

CERTERCATED

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E-mail : [e-mail].w

#### Differences:

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Image /page/5/Picture/0 description: The image shows the text "DEPARTMENT OF HEALTH & HUMAN SERVICES" in a bold, sans-serif font. The text is arranged on a single line and is centered horizontally. The words are all capitalized and evenly spaced.

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

July 15, 2014

HEARTWAY Medical Products Co., Ltd. c/o Dr. Jen. Ke-Min No. 6 Road 25, Taichung Industrial Park Taichung, 40850 Taiwan, ROC

Rc: K132856

Trade/Device Name: HEARTWAY Power Wheelchair. P25 Regulation Number: 21 CFR 890.3860 Regulation Name: Powered Wheelchair Regulatory Class: Class II Product Code: ITI Dated: June 5, 2014 Received: June 12, 2014

Dear Dr. Jen, Ke-Min:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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); medical device reporting (reporting of medical

Image /page/5/Picture/11 description: The image shows the logo for the Department of Health & Human Services USA. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" around the perimeter. Inside the circle is an image of an eagle with its wings spread, symbolizing the department's mission to protect the health of all Americans. The eagle is stylized with three curved lines representing its wings and body.

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Page 2 - Dr. Jen, Ke-Min

device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

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Sincerely yours,

# Felipe Aguel - S

for

Carlos L. Peña, PhD, MS Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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#### DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

#### Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: December 31, 2013 See PRA Statement on last page.

510(k) Number (if known) K132856

#### Device Name

HEARTWAY Power Wheelchair, P25

#### Indications for Use (Describe)

This device is intended for medical purposes to provide mobility to persons restricted to a seated position.

Type of Use (Select one or both, as applicable)

[ ] Prescription Use (Part 21 CFR 801 Subpart D)

[x] Over-The-Counter Use (21 CFR 801 Subpart C)

#### PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

#### FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

# :15 -S Date: 2014.07.15
17:47:42 -04'00'

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