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Presented by:
Mr.SURAJ P.S
1st M. Pharm-RA
JSSCP, Mysore.
APPROVAL PROCESS FOR
MEDICAL DEVICES IN UNITED STATES
1
What is medical device?
•"an instrument, apparatus, implement, machine, contrivance, implant, in
vitro reagent, or other similar or related article, including a component part,
or accessory which is:
• recognized in the official National Formulary, or the United States
Pharmacopoeia, or any supplement to them,
• intended for use in the diagnosis of disease or other conditions, or in
the cure, mitigation, treatment, or prevention of disease, in man or
other animals, or
• intended to affect the structure or any function of the body of man or
other animals, and which does not achieve its primary intended
purposes through chemical action within or on the body of man or
other animals and which is not dependent upon being metabolized for
the achievement of any of its primary intended purposes."
2
Classification of medical device
Class I
Class I Medical Devices are simple in design and have little to no potential
risk. Medical devices classified as type I must follow general FDA policy
which includes registering the medical device,
proper branding and labeling,
proper manufacturing techniques
and
the FDA must be notified prior to marketing the device. Class I Medical
Devices include tongue depressors, elastic bandages, hand held dental
instruments and examination gloves.
3
Cont…..
Class II
Class II Medical devices are more complicated in design and pose a minimal
risk. Medical devices classified as type II must follow general policy and
special labeling, mandatory performance standards and post market
surveillance.
Most medical devices fall into the Class II medical devices category such as X-
ray machines, powered wheelchairs, infusion pump and surgical and
acupuncture needles.
4
Class III
• Class III Medical Devices are intricate in design and have the strictest guidelines
because they pose the greatest risk. Class III Medical Devices must follow Class I
and Class II guidelines but must also be pre-market approved by the FDA and a
scientific review of the medical device must be made prior to marketing.
• Class III medical devices support or sustain human lives therefore malfunction is
absolutely unacceptable.
• Class III Medical Devices include implanted pacemakers, heart valves and implanted
cerebral simulators.
Cont…..
5
• Code of Federal Regulations (CFR), Title 21, Parts 862–892
• Medical Device Directive 93/42/EEC regulates most devices.
Classification rules are listed in Annex IX of the directive.
• Active Implantable Medical Devices (AIMDs) Directive 90/385/EEC.
AIMDs are regulated as high-risk devices.
• In Vitro Diagnostics (IVDs) Directive 98/79/EC. Most IVDs are
regulated as low-risk devices, except for tests that underpin the safety of
blood and blood products (blood group, HIV and hepatitis tests), where
additional specific requirements equating to a high-risk category apply.
6
REGULATION’S
Overview of Device Regulation
• Medical devices are classified into Class I, II, and III.
• Regulatory control increases from Class I to Class III.
• The device classification regulation defines the regulatory
requirements for a general device type.
• Most Class I devices are exempt from Premarket Notification
510(k);
• Most Class II devices require Premarket Notification 510(k);
and
• Most Class III devices require Premarket Approval. 7
Establishment Registration
• Manufacturers (both domestic and foreign) and initial distributors
(importers) of medical devices must register their establishments with the
FDA.
• All establishment registrations must be submitted electronically.
• All registration information must be verified annually between October 1st
and December 31st of each year.
• In addition to registration, foreign manufacturers must also designate a
U.S. Agent. Beginning October 1, 2007, most establishments are required
to pay an establishment registration fee.
8
Premarket Notification 510(k)
• If sponsor device requires the submission of a Premarket Notification 510(k),
sponsor cannot commercially distribute the device until you receive a letter
of substantial equivalence from FDA authorizing you to do so.
• A 510(k) must demonstrate that the device is substantially equivalent to one
legally in commercial distribution in the United States:
(1) before May 28, 1976; or
(2) to a device that has been determined by FDA to be substantially
equivalent.
9
Premarket Notification (510k)
The sponsors who wants to market in the U.S., a Class I, II, and III
device intended for human use, must submit a 510(k) to FDA unless the
device is exempt from 510(k) requirements of the Federal Food, Drug,
and Cosmetic Act
A 510(k) is a premarket submission made to FDA to demonstrate that the
device to be marketed is at least as safe and effective, that is, substantially
equivalent, to a legally marketed device.
10
11
Premarket Approval (PMA)
• Premarket approval (PMA) is the FDA process of scientific and regulatory
review to evaluate the safety and effectiveness of Class III medical
devices.
• FDA has determined that general and special controls alone are
insufficient to assure the safety and effectiveness of class III devices.
Therefore, these devices require a premarket approval (PMA) application
• PMA approval is based on a determination by FDA that the PMA contains
sufficient valid scientific evidence to assure that the device is safe and
effective for its intended use(s).
• FDA regulations provide 180 days to review the PMA and make a
determination.
• PMA devices often involve new concepts and many are not of a type
marketed prior to the Medical Device Amendments. Therefore, they do not
have a classification regulation in the CFR.
12
Data Requirements – PMA
A Premarket Approval (PMA) application is a scientific, regulatory
documentation to FDA to demonstrate the safety and effectiveness of the
class III device.
Technical Sections
Non-clinical Laboratory Studies Section
Clinical Investigations Section
What is Substantial Equivalence?
A 510(k) requires demonstration of substantial equivalence to another legally
U.S. marketed device. Substantial equivalence means that the new device is at
least as safe and effective as the predicate.
A device is substantially equivalent if, in comparison to a predicate it:
•has the same intended use as the predicate; and
•has the same technological characteristics as the predicate;
Substantial equivalence is established with respect to intended use,
design, energy used or delivered, materials, chemical composition,
manufacturing process, performance, safety, effectiveness, labeling,
biocompatibility, standards, as applicable. 13
Who is Required to Submit a 510(k) ?
1. Domestic manufacturers introducing a device to the U.S. market;
2. Specification developers introducing a device to the U.S. market;
3. Repackers or relabelers who make labeling changes or whose
operations significantly affect the device.
4. Foreign manufacturers/exporters or U.S. representatives of foreign
manufacturers/exporters introducing a device to the U.S. market.
14
When a 510(k) is Not Required ?
1. You sell unfinished devices to another firm for further processing or
sell components to be used in the assembling of devices by other
firms.
2. Your device is not being marketed or commercially distributed. You
do not need a 510(k) to develop, evaluate, or test a device. This
includes clinical evaluation.
3. You distribute another firm's domestically manufactured device. You
may place a label on the device, "Distributed by ABC Firm" or
"Manufactured for ABC Firm," and sell it to end users without
submission of a 510(k).
15
4. In most cases, if you are a repackager or a relabeler you are not
required to submit a 510(k) if the existing labeling or condition of the
device is not significantly changed.
5. Your device was legally in commercial distribution before May 28,
1976 and you have documentation to prove this. These devices are
"grandfathered" and have Preamendment Status.
6. The device is made outside the U.S. and you are an importer of the
foreign made medical device. A 510(k) is not required if a 510(k) has
been submitted by the foreign manufacturer and received marketing
clearance.
Cont….
16
17
Approval
Process
Using the FDA classification database, determine the classification of your device by
researching “Predicate Devices” already registered in the US market.
Implement Quality Management System (QMS) which meets FDA Quality System Regulation
(QSR) found in 21 CFR Part 820. This is also commonly known as FDA Good Manufacturing
Practice (GMP).
Innovative Class II, and all Class III, devices will likely
require clinical studies.
Get “Pre-Submission (Pre-Sub)” feedback from the
FDA.
If clinical studies will be required, apply for an
Investigational Device Exemption (IDE). Develop clinical trial
protocol and conduct studies.*
18
Prepare and submit 510(k) premarket notification
application. Pay 510(k) review fee to FDA. Prepare and
submit Premarket Approval (PMA) application. Pay PMA
submission fee to FDA.
FDA conducts facility inspections of all
major suppliers involved in the design and
production of your device. All parties must
be compliant with FDA QSR
FDA issues 510(k) clearance letter; posts online. FDA issues
PMA approval letter; posts online.
At this time, sponsor must be in full compliance with QSRs. The FDA will not inspect
Class I or II device manufacturers for compliance prior to device registration but does
conduct random inspections and can issue a Form 483 for non-compliance.
19
If you have no local presence in the US, appoint an FDA US Agent representative as a
local point of contact with the FDA.
List your device and register your company using FURLS system on the FDA website
in accordance with 21 CFR Part 807; contract manufacturers and sterilizers must also
register and list. Specify your appointed US Agent. Your FDA Establishment
Registration and Listing must be renewed on a yearly basis
You are now able to sell your device in the US. The FDA listing on their website will
serve as your authorization to commercialize your device in the US. This authorization
does not expire as long as certain types of changes are not made, e.g., design, intended
use.
20
21
510(k) Components
Main component of 510 (k) are:
1. Cover Sheet
2. Cover Letter
3. Table of Contents
4. Labelling
5. Comparative Information
6. Biocompatibility Assessment (If Necessary)
7. Clinical Data
8. Shelf Life (If Necessary)
9. Indication for Use
10. 510 (k) Summary
REFERENCE’S
1. http://neverusewhiteout.blogspot.in/2013/04/fda-proposes-change-to-device-
labels.html
2. http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm
3. http://www.fda.gov/aboutfda/transparency/basics/ucm211822.htm
4. http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/Overview/def
ault.htm
5. http://www.fda.gov/medicaldevices/deviceregulationandguidance/overview/classi
fyyourdevice/ucm051512.htm definition
6. http://www.litron.com/Classification-of-Medical-Devices.asp classification
7. http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm CFR
8. www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/Overview/ overview
9. http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/HowtoMarket
YourDevice/PremarketSubmissions/PremarketApprovalPMA/default.htm#top
10. http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/HowtoMarket
YourDevice/PremarketSubmissions/PremarketNotification510k/ucm142651.htm
contents of 510k 22
23

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medical device regulatory approval in USA

  • 1. Presented by: Mr.SURAJ P.S 1st M. Pharm-RA JSSCP, Mysore. APPROVAL PROCESS FOR MEDICAL DEVICES IN UNITED STATES 1
  • 2. What is medical device? •"an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including a component part, or accessory which is: • recognized in the official National Formulary, or the United States Pharmacopoeia, or any supplement to them, • intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease, in man or other animals, or • intended to affect the structure or any function of the body of man or other animals, and which does not achieve its primary intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for the achievement of any of its primary intended purposes." 2
  • 3. Classification of medical device Class I Class I Medical Devices are simple in design and have little to no potential risk. Medical devices classified as type I must follow general FDA policy which includes registering the medical device, proper branding and labeling, proper manufacturing techniques and the FDA must be notified prior to marketing the device. Class I Medical Devices include tongue depressors, elastic bandages, hand held dental instruments and examination gloves. 3
  • 4. Cont….. Class II Class II Medical devices are more complicated in design and pose a minimal risk. Medical devices classified as type II must follow general policy and special labeling, mandatory performance standards and post market surveillance. Most medical devices fall into the Class II medical devices category such as X- ray machines, powered wheelchairs, infusion pump and surgical and acupuncture needles. 4
  • 5. Class III • Class III Medical Devices are intricate in design and have the strictest guidelines because they pose the greatest risk. Class III Medical Devices must follow Class I and Class II guidelines but must also be pre-market approved by the FDA and a scientific review of the medical device must be made prior to marketing. • Class III medical devices support or sustain human lives therefore malfunction is absolutely unacceptable. • Class III Medical Devices include implanted pacemakers, heart valves and implanted cerebral simulators. Cont….. 5
  • 6. • Code of Federal Regulations (CFR), Title 21, Parts 862–892 • Medical Device Directive 93/42/EEC regulates most devices. Classification rules are listed in Annex IX of the directive. • Active Implantable Medical Devices (AIMDs) Directive 90/385/EEC. AIMDs are regulated as high-risk devices. • In Vitro Diagnostics (IVDs) Directive 98/79/EC. Most IVDs are regulated as low-risk devices, except for tests that underpin the safety of blood and blood products (blood group, HIV and hepatitis tests), where additional specific requirements equating to a high-risk category apply. 6 REGULATION’S
  • 7. Overview of Device Regulation • Medical devices are classified into Class I, II, and III. • Regulatory control increases from Class I to Class III. • The device classification regulation defines the regulatory requirements for a general device type. • Most Class I devices are exempt from Premarket Notification 510(k); • Most Class II devices require Premarket Notification 510(k); and • Most Class III devices require Premarket Approval. 7
  • 8. Establishment Registration • Manufacturers (both domestic and foreign) and initial distributors (importers) of medical devices must register their establishments with the FDA. • All establishment registrations must be submitted electronically. • All registration information must be verified annually between October 1st and December 31st of each year. • In addition to registration, foreign manufacturers must also designate a U.S. Agent. Beginning October 1, 2007, most establishments are required to pay an establishment registration fee. 8
  • 9. Premarket Notification 510(k) • If sponsor device requires the submission of a Premarket Notification 510(k), sponsor cannot commercially distribute the device until you receive a letter of substantial equivalence from FDA authorizing you to do so. • A 510(k) must demonstrate that the device is substantially equivalent to one legally in commercial distribution in the United States: (1) before May 28, 1976; or (2) to a device that has been determined by FDA to be substantially equivalent. 9
  • 10. Premarket Notification (510k) The sponsors who wants to market in the U.S., a Class I, II, and III device intended for human use, must submit a 510(k) to FDA unless the device is exempt from 510(k) requirements of the Federal Food, Drug, and Cosmetic Act A 510(k) is a premarket submission made to FDA to demonstrate that the device to be marketed is at least as safe and effective, that is, substantially equivalent, to a legally marketed device. 10
  • 11. 11 Premarket Approval (PMA) • Premarket approval (PMA) is the FDA process of scientific and regulatory review to evaluate the safety and effectiveness of Class III medical devices. • FDA has determined that general and special controls alone are insufficient to assure the safety and effectiveness of class III devices. Therefore, these devices require a premarket approval (PMA) application • PMA approval is based on a determination by FDA that the PMA contains sufficient valid scientific evidence to assure that the device is safe and effective for its intended use(s). • FDA regulations provide 180 days to review the PMA and make a determination. • PMA devices often involve new concepts and many are not of a type marketed prior to the Medical Device Amendments. Therefore, they do not have a classification regulation in the CFR.
  • 12. 12 Data Requirements – PMA A Premarket Approval (PMA) application is a scientific, regulatory documentation to FDA to demonstrate the safety and effectiveness of the class III device. Technical Sections Non-clinical Laboratory Studies Section Clinical Investigations Section
  • 13. What is Substantial Equivalence? A 510(k) requires demonstration of substantial equivalence to another legally U.S. marketed device. Substantial equivalence means that the new device is at least as safe and effective as the predicate. A device is substantially equivalent if, in comparison to a predicate it: •has the same intended use as the predicate; and •has the same technological characteristics as the predicate; Substantial equivalence is established with respect to intended use, design, energy used or delivered, materials, chemical composition, manufacturing process, performance, safety, effectiveness, labeling, biocompatibility, standards, as applicable. 13
  • 14. Who is Required to Submit a 510(k) ? 1. Domestic manufacturers introducing a device to the U.S. market; 2. Specification developers introducing a device to the U.S. market; 3. Repackers or relabelers who make labeling changes or whose operations significantly affect the device. 4. Foreign manufacturers/exporters or U.S. representatives of foreign manufacturers/exporters introducing a device to the U.S. market. 14
  • 15. When a 510(k) is Not Required ? 1. You sell unfinished devices to another firm for further processing or sell components to be used in the assembling of devices by other firms. 2. Your device is not being marketed or commercially distributed. You do not need a 510(k) to develop, evaluate, or test a device. This includes clinical evaluation. 3. You distribute another firm's domestically manufactured device. You may place a label on the device, "Distributed by ABC Firm" or "Manufactured for ABC Firm," and sell it to end users without submission of a 510(k). 15
  • 16. 4. In most cases, if you are a repackager or a relabeler you are not required to submit a 510(k) if the existing labeling or condition of the device is not significantly changed. 5. Your device was legally in commercial distribution before May 28, 1976 and you have documentation to prove this. These devices are "grandfathered" and have Preamendment Status. 6. The device is made outside the U.S. and you are an importer of the foreign made medical device. A 510(k) is not required if a 510(k) has been submitted by the foreign manufacturer and received marketing clearance. Cont…. 16
  • 18. Using the FDA classification database, determine the classification of your device by researching “Predicate Devices” already registered in the US market. Implement Quality Management System (QMS) which meets FDA Quality System Regulation (QSR) found in 21 CFR Part 820. This is also commonly known as FDA Good Manufacturing Practice (GMP). Innovative Class II, and all Class III, devices will likely require clinical studies. Get “Pre-Submission (Pre-Sub)” feedback from the FDA. If clinical studies will be required, apply for an Investigational Device Exemption (IDE). Develop clinical trial protocol and conduct studies.* 18
  • 19. Prepare and submit 510(k) premarket notification application. Pay 510(k) review fee to FDA. Prepare and submit Premarket Approval (PMA) application. Pay PMA submission fee to FDA. FDA conducts facility inspections of all major suppliers involved in the design and production of your device. All parties must be compliant with FDA QSR FDA issues 510(k) clearance letter; posts online. FDA issues PMA approval letter; posts online. At this time, sponsor must be in full compliance with QSRs. The FDA will not inspect Class I or II device manufacturers for compliance prior to device registration but does conduct random inspections and can issue a Form 483 for non-compliance. 19
  • 20. If you have no local presence in the US, appoint an FDA US Agent representative as a local point of contact with the FDA. List your device and register your company using FURLS system on the FDA website in accordance with 21 CFR Part 807; contract manufacturers and sterilizers must also register and list. Specify your appointed US Agent. Your FDA Establishment Registration and Listing must be renewed on a yearly basis You are now able to sell your device in the US. The FDA listing on their website will serve as your authorization to commercialize your device in the US. This authorization does not expire as long as certain types of changes are not made, e.g., design, intended use. 20
  • 21. 21 510(k) Components Main component of 510 (k) are: 1. Cover Sheet 2. Cover Letter 3. Table of Contents 4. Labelling 5. Comparative Information 6. Biocompatibility Assessment (If Necessary) 7. Clinical Data 8. Shelf Life (If Necessary) 9. Indication for Use 10. 510 (k) Summary
  • 22. REFERENCE’S 1. http://neverusewhiteout.blogspot.in/2013/04/fda-proposes-change-to-device- labels.html 2. http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm 3. http://www.fda.gov/aboutfda/transparency/basics/ucm211822.htm 4. http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/Overview/def ault.htm 5. http://www.fda.gov/medicaldevices/deviceregulationandguidance/overview/classi fyyourdevice/ucm051512.htm definition 6. http://www.litron.com/Classification-of-Medical-Devices.asp classification 7. http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm CFR 8. www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/Overview/ overview 9. http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/HowtoMarket YourDevice/PremarketSubmissions/PremarketApprovalPMA/default.htm#top 10. http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/HowtoMarket YourDevice/PremarketSubmissions/PremarketNotification510k/ucm142651.htm contents of 510k 22
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