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Due to the wide variety of medical devices, these products are regulated on a risk-based classification system. In Canada and the EU, devices are grouped into four different classes. In the US, they are divided into three groups. Generally, the higher the risk of the medical device, the higher the medical device classification. And with a higher classification come more stringent data requirements to demonstrate the device’s safety, effectiveness and performance (Figure 1).
Figure 1: Relationship between medical device classification and data requirements
The classification procedures in Canada and the EU are quite similar―manufacturers must classify their medical devices according to the rules and criteria set out in the relevant medical device regulations (Canada) and directives (EU), as indicated in Table 1.2-5
In the US, the classifications and ancillary information relating to medical device regulations are published in US Code of Federal Regulations (CFR), Title 21, Parts 862–892. These were introduced in 1976 when the U.S. Food & Drug Administration (FDA) mandated expert advisory panels (classification panels) to consider the different types of medical devices on the market based on the intended user, intended use, the risk-to-benefit ratio and the reliability of the device.
In the US, manufacturers of a new medical device can determine its classification by comparing its intended use and technological features to those that have already been classified. However, if the device is technologically innovative with no existing predicate device, it will automatically be classified as class III. Manufacturers of class III medical devices may petition the FDA for a lower classification via a “de novo” process, based on supporting objective scientific evidence as to the device’s safety and effectiveness. 2-5
|Jurisdiction||Applicable medical device regulations/ directives3,4,6,7|
|Canadai||Medical Devices Regulations (SOR/98–282). Schedule 1. Classification rules for medical devices.
|US||Code of Federal Regulations (CFR), Title 21, Parts 862–892|
Manufacturers, distributors and importers who wish to sell a medical device must obtain an establishment licence for class I devices. For class II, III or IV medical devices, the company must obtain a medical device licence issued by Health Canada. To do so, they must submit a device licence application and include a certificate demonstrating compliance to ISO 13485:2003. The application for class II devices is administrative in nature. Applications for class III devices are based on the submission of summary documents, and those for class IV devices are based on extensive data, including all study reports, quality plan, risk assessments and so on. 5,8,9
Most class I (and also a few class II) medical devices are exempt from registration requirements as specified in the CFR Parts 862–892. If registration is exempted, the manufacturer must register their establishment with the FDA and comply with the applicable Quality System Regulation (QSR), labelling and medical device reporting requirements. For other class I and II devices that are subject to Premarket Notification, a 510(k) application must be submitted for FDA clearance. If the device is classified as a class III device, the manufacturer must go through the Premarket Approval (PMA) procedure, or the de novo procedure to reclassify the product in a lower-risk category before placing it on the market. 5,8,9
For low-risk medical devices (most class I and certain class IIa devices), the manufacturer may make a declaration of conformity with the essential requirements, based on a self-assessment without the involvement of a Notified Body.iii For other medical devices, a Notified Body’s involvement is required. 5,8,9
Technical documentation in the EU
Technical documentation that provides evidence of conformity with the Essential Requirements as specified in the directives is fundamental to the conformity assessment procedures. The Essential Requirements are listed in Annex I of the Medical Device Directive 93/42/EEC and its corresponding amendments (Table 1). The technical documentation should include relevant performance data, procedures, standards, labelling, certifications by a Notified Body and/or the manufacturer’s declaration of conformity. The technical documentation must be maintained at the disposal of the Competent Authorities (national authorities in the EU Member States) for a period of five years after manufacture of the last product. Requests from Competent Authorities to view the technical documentation will usually be triggered by problems in the market.
i If more than one rule applies, a medical device must be assigned the highest class that applies under the various rules.
ii On September 26, 2012, the European Commission proposed regulations that would overhaul the medical device regulatory framework in the EU—one proposal for general medical devices, including active implantables,11 and another for in vitro devices12—imposing tougher rules for assessing the safety and monitoring the use of medical devices and implants. The proposed legislation must be jointly approved by EU governments and lawmakers, which could take up to two years.13 If you are developing a medical device for the EU market, make sure to follow the development of these regulations.
iiiA Notified Body is certification organization that the national authority (the Competent Authority) of an EU Member State designates to carry out one or more of the conformity assessment procedures described in the annex(es) of the EU Directives. It must be qualified to perform all the functions set out in any annex for which it is designated.10
The information presented in these articles is intended to outline the general processes, principles and concepts of the healthcare product development lifecycle. Since regulatory requirements are ever-changing, it is current only as of the date of publication and not intended to provide detailed instructions for product development. Every healthcare product is unique and therefore so is its associated product development lifecycle. Specific advice should be sought from a qualified healthcare or other appropriate professional.
Published: October 17, 2012