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Selecting and Changing the European Authorized Representative

This article explains the roles and responsibilities of a European Authorized Representative for CE Marking of medical devices. The article also provides advice on selecting and changing the European Authorized Representative.

How to Select or Change Your European Authorized Representative Selecting and Changing the European Authorized Representative

European Authorized Representatives are the legal representative of non-European manufacturers for medical devices sold in Europe. If a company already has offices located in Europe, an Authorized Representative is not needed. However, if you don’t have offices in Europe, you must have a legal agreement with an Authorized Representative that is physically located in Europe to be your primary contact for receipt of customer complaints. The Authorized Representative can also act as your liaison between the Competent Authority in Europe and your company.

Why your distributor is not the right choice

Many manufacturers located outside of Europe choose their distributor as an Authorized Representative. Distributors often want to do this, because then their name is required to appear by law on the labeling and the IFU. Unfortunately, your distributor has a conflict of interest. The distributor does not want adverse event reporting, recalls, or even complaints. Therefore, can you be sure that the distributor will notify you immediately of all potential complaints?

In January 2012, the European Commission released a guidance document explaining the roles and responsibilities of European Authorized Representatives: MEDDEV 2.5/10. Distributors rarely have the regulatory expertise to act as an Authorized Representative.

Competent Authorities occasionally audit Authorized Representatives to ensure that the legal requirements are being met. When this happens, clients often ask me to recommend a European Authorized Representative to switch to.

Primary Responsibilities

The EU Authorized Representative has two primary responsibilities:

  1. Complaint handling
  2. Registration of CE Marked devices

The complaint handling function is the reason why the name and address of the European Authorized Representative must appear on the product labeling and IFU. Your distributor may still become aware of potential complaints, and therefore, distributors should still be trained on the importance of forwarding any potential complaints to your company immediately. The registration function is critical for Class I devices that are non-sterile and do not have a measuring function, because those devices do not have a Notified Body involved. It is often valuable to have an Authorized Representative located in one of the Member States where you intend to sell a larger percentage of the product because the labeling will include a physical address in that Member State.

Other ways an Authorized Representative Can Help

Some manufacturers complain that they are paying $3,000-$5,000 each year for a competent authority to do very little. However, Authorized Representatives are required to review your procedures before CE Marking, and anytime you notify them of an update. This additional review of procedures is equivalent to hiring a consultant to review your procedures.

European Authorized Representatives can be helpful at other times too. For example, if your company and your Notified Body do not agree on the classification of a device, the Authorized Representative may be able to assist you in the same way that an experienced regulatory consultant can. If you receive communication from a Competent Authority, the Authorized Representative can act as your liaison. Most important of all, the Authorized Representative can help you determine when complaints require vigilance reporting and provide support if a recall or advisory notice must be initiated.

How to Select an Authorized Representative

I recommend a three-step approach to selecting your Authorized Representative. First, visit the EAARMED website. One of the 15 members of this association should be your starting point because these are the most experienced Authorized Representatives. Next, you should determine which of the 15 members is located in a country that matches the country you intend to sell in. For example, if 100% of your sales are through a distributor located in Italy, Donawa would be a better choice than a German Authorized Representative. Finally, you should obtain quotes and interview more than one Authorized Representative. You want to make sure that the Authorized Representative is responsive and easy to communicate with. It’s surprising how much we learn about responsiveness and communication during the quoting process.

If you need any additional help preparing for the CE Marking product in Europe, please email Rob Packard.

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Status of the European Medical Device Regulations?

This article describes the status of the new European Medical Device Regulations, and it provides some advice for what you should be doing to prepare for the changes.

MudI 600x334 Status of the European Medical Device Regulations?

The picture above is not a picture of people on their way to the local maple sugar shack, trying to get a car unstuck during mud season in Vermont. It’s actually a photo of paid actors reenacting the European negotiations for new medical device regulation. The European Parliament is in the overcoat on the left. The four men on the right represent the various presidents–Greek, Italian, Latvian, and Luxembourg. The Dutch President is driving the horse team in the front in the hopes of getting unstuck in time for next Spring.

Yes, in a word, the negotiations are “stuck”!

My friend Erik Vollebregt did a wonderful job of summarizing the status of negotiations on April 30, in his blog posting. The best guess anyone has is that we might have a final version released next year in Spring 2016. It’s only two years later than I was expecting. I guess they encountered more mud than expected.

There are a number of issues that the member states appear to be stuck on:

  • Ingested products
  • Non-medical devices
  • Companion diagnostics
  • Non-viable human tissues and cells
  • Viable biologic substances
  • Reprocessing single-use devices
  • Genetic testing
  • Implant cards
  • Eudamed & UDI
  • Summary of safety & performance
  • Notified Bodies
  • Pre-market approval
  • Clinical investigations
  • Post-market surveillance
  • Market surveillance & vigilance
  • Reference laboratories
  • Hazardous chemicals
  • Classification rules
  • Governance & oversight

I’m not quite sure whether the remaining list of issues the member states agree upon is shorter than this or longer. Still, this list includes a number of fundamental principles that could dramatically change the nature of medical device regulation in Europe. We expect that many of these issues will be resolved with a compromise of some sort. Still, I suspect every medical device manufacturer with a CE Mark will be extremely busy from 2016-2019 revising their procedures, technical documentation, and training personnel on the new European Medical Device Regulations.

 What Should You Be Doing to Prepare?

  1. Update Your Quality System to ISO 13485:2015 Early – The second Draft International Standard (DIS2) for ISO 13485 was released in February, and the final version is expected to be published this Fall. The changes to ISO 13485 are minor, but audits by your Notified Body will be far less complicated if you upgrade your quality system to the new revision before you attempt to address the new European Medical Device Regulations.
  2. Strengthen Your Internal Auditing & CAPA Processes – Companies with strong internal audit programs and CAPA processes have fewer findings resulting from Notified Bodies. When you have multiple outcomes from a previous audit to close, your annual surveillance audits and recertification audits become longer and more complex. These findings must also be closed before a manufacturer may transfer a quality system or CE Certificate from one Notified Body to another. Therefore, strengthening your internal audit and CAPA processes will result in a shorter Notified Body audit, and you will find it much easier to transfer from one Notified Body to another–if your current Notified Body is no longer able to issue a CE Certificate for one or more of your products.
  3. Update Your Technical Files – Companies that have a Design Dossier are required to submit all changes to their Design Dossier for approval before implementation. Still, companies with a Technical File for a lower risk device have their technical documentation sampled periodically. A sampling of technical documentation allows companies to fall behind in their documentation of changes. Re-issue of new CE Certificates will require a more thorough review of these Technical Files that may not have been sampled in several years. Therefore, I recommend that companies allocate resources to updating technical documentation now so that there is less work to update the technical documentation for the new European Medical Device Regulations.
  4. Review Your Product Portfolio and Prune It – The more mature product lines become, the more likely it is that you have products you are maintaining that just aren’t selling. The cost of maintaining your technical documentation and updating everything for compliance with the new European Medical Device Regulations will be expensive. Therefore, you can save some money now and a larger amount of money later by eliminating any products from your CE Certificate that is not selling well. If you have customers that are still buying an older version of the product, now is the time to persuade them to transition to the current version of your product. You don’t want to maintain your Technical File for two versions of the same product.

Regardless of what compromises are made, the new European Medical Device Regulations are guaranteed to be the most substantial change in regulatory requirements that the medical device industry has endured since 2003–much more dramatic than the 2007/47/EC amendment to the Medical Device Directive (MDD).  

Will someone please buy the negotiators a pair of Bogs and a Subaru Crosstrek?

Subaru XTrek 300x199 Status of the European Medical Device Regulations?

Bogs Status of the European Medical Device Regulations?

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CE Marking Approval of a Medical Device (Case Study)

This article explains the process for CE Marking approval of a medical device. For this case study, I selected the same hypothetical client that I chose for my case study on Canadian Medical Device Licensing and a 510k submission to the US FDA. The product is a cyanoacrylate adhesive sold by the makers of Krazy Glue®. This hypothetical client wants to expand its target market to include the healthcare industry by repackaging and marketing the product as a topical adhesive in Europe.

CE marking case study CE Marking Approval of a Medical Device (Case Study)

My client called to ask if I could help obtain CE Marking approval. In Europe, cyanoacrylate is a medical device when it is used as a topical adhesive. My first step is to determine the device classification as per Annex IX in the Medical Device Directive (93/42/EEC as modified by 2007/47/EC). Instead of relying solely upon the Directive, I use guidance documents published on the Europa website–specifically MEDDEV 2.4/1 rev 9 (the following link explains the European MEDDEV guidance documents – http://bit.ly/Whats-a-MEDDEV).

I identified three potential device classifications: 1) Class 1 as per Rule 4 (a non-invasive device which comes into contact with injured skin, if the device is intended to be used as a mechanical barrier, for compression or absorption of exudates); 2) Class 2a as per Rule 7 (a surgically invasive device intended for short-term use [i.e., < 30 days] are in Class 2a; and 3) Class 2b as per Rule 8 (an implantable device). These three applications match the three possible indications that I identified when I was reviewing classifications for Canadian Medical Device Licensing for this product.

If this device were not required to be “sterile,” then a Class 1 device could use the Annex VII route of conformity (i.e., self-declaration). However, even generic bandages are sold as sterile devices. Therefore, whether the device is a sterile Class 1 device or a Class 2a device, obtaining CE Marking approval will still require a Notified Body’s review and approval. The most common route would be the Annex V route of conformity. If my client were to launch their product as a “glue” for internal use, then the device would require an Annex II.3 Full Quality System Certificate or the combination of an Annex V Certificate and a Type Examination Certificate (i.e., Annex III).

STOP!

The previous paragraph was hard to understand, but the source of this jargon is Article 11 of the Medical Device Directive. This one section is the best practices in European legalese. If you want to make something almost unintelligible, copy Article 11. If you’re going to understand this stuff, a flow chart of the various routes to conformity is as good as it gets (still hard to understand, but fewer words). The following simplified table is what I use in my CE Marking webinar:

Classification Routes for CE Marking CE Marking Approval of a Medical Device (Case Study)

What you need to know…

My client only has one product family, and they are currently selling the product in Canada for external use by healthcare professionals—not as an implant. Therefore, the device is a Class 2a device requiring an Annex V certificate. My client will need to do the following:

  1. Select a Notified Body
  2. Submit a Technical File for review and approval
  3. Select a European Authorized Representative, because my client does not have a physical presence in Europe

Fortunately, my client already obtained an ISO 13485:2003 certificate with CMDCAS from their current registrar as part of the Canadian Licensing process. Therefore, the changes required for the Quality System consist of adding a few work instructions to meet European-specific requirements, such as vigilance reporting, creating a technical file, and performing clinical evaluations. My client also needs to add the European Requirements as an applicable regulatory requirement in the Quality Manual.

The more significant challenge is an assembly of a Technical File for submission. Since the product is already on the market in Canada, all of the technical requirements have been met. The documentation of these requirements now needs to be converted into a format acceptable to a Notified Body. There are three recommended strategies:

  1. Whatever the Notified Body prefers. Some of the Notified Bodies have a checklist of requirements for a Technical File. If such a list exists, the client should organize the Technical File in the same order.
  2. The GHTF STED format (GHTF/SG1/N011:2008). The Global Harmonization Task Force (http://bit.ly/GHTFSTEDGuidance) published this guidance document to standardize the format for submission of regulatory submissions. This is the format required for Class III and IV Canadian medical device license applications. This is also the format specified in the proposed EU Medical Device Regulations that is expected to be released in 2015.
  3. The NB-MED recommended format (NB-MED 2.5.1/rec 5). This document was created by the “Big 5” Notified Bodies. It provides a template in a two-part format for submissions. This was the format I used most often for auditing files and for creating new files. However, the proposed EU Regulations that are anticipated for release in 2015 are closer to the format of the GHTF guidance. Therefore, I no longer recommend this format.

My client chose option 3 for organizing their Technical File because they have full reports for each of the verification and validation tests that were performed, but creating summaries for each report would take longer than assembling a Technical File with copies of each of these full reports.

In all, I estimate that the overall timescale for completing this project is about 60 days–not including review by the Notified Body. Therefore, I suggested that the client obtain a quotation from their registrar for an Annex V Certificate. In addition, I suggested hiring a consultant from Medical Device Academy to help them with the preparation of a Clinical Evaluation. Before 2010, Clinical Evaluations were only required for high-risk devices. As part of the new MDD, clinical evaluations are now needed for all devices. Since the use of and risks associated with cyanoacrylates is well characterized in published literature, my client may use a literature search method for preparing a Clinical Evaluation as per MEDDEV 2.7/1 rev 3.

My client hired an Authorized Representative to handle European registration, receive customer complaints, and to act as a liaison with the Competent Authority in the event of an adverse event. An Authorized Representative Agreement was signed, and the Authorized Representative recommended a few corrections to procedures they reviewed as part of entering the contract with a new client.

The company also hired another clinical consultant from our firm to complete a literature search and write a Clinical Evaluation in four weeks. The complete Technical File was assembled and submitted to the Notified Body electronically with seven weeks of starting the project. The Notified Body’s first round of questions was received within six weeks. The client and I prepared responses to the questions in a week and submitted them to the Notified Body. Fortunately, the responses were thorough, and the Technical File was well-organized from the start. The Notified completed their final review and recommended the product for CE Marking within three more weeks. The Notified Body conducted two-panel reviews to verify the technical, regulatory, and risk aspects of the submission. Finally, the Annex V certificate was received 12 weeks after the initial submission of the Technical File.

If you are interested in additional training or assistance with CE Marking of medical devices, please email Rob Packard (mail to: rob@13485cert.com). We have standardized procedures to meet each of the requirements in the European Regulations and a couple of webinar recordings that explain both the Medical Device Directive and how to create a technical file or design dossier.

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Notified Body Unannounced Audits Have Begun

This article provides an update on the status of unannounced audits by Notified Bodies for CE Marking of medical devices.

unannounced audits Notified Body Unannounced Audits Have Begun

The EU Commission provided recommendations to Notified Bodies last Fall on how they should conduct three different kinds of audits: 1) product assessments, 2) quality system assessments, and 3) unannounced audits (http://bit.ly/Audit-Recommendations). The recommendations do not propose any changes to existing practices for product assessments (i.e., review of CE Marking applications) that are being conducted in accordance with the European Directives, or quality system assessments that are being conducted in accordance with ISO 17021 (http://bit.ly/ISO-17021-2006). The recommendation does, however, propose new auditing practices specific to conducting unannounced audits (http://bit.ly/Unannounced-Audits).

The recommendation is addressed to the Member States, rather than Notified Bodies because the intent is for Competent Authorities in each member state to enforce these recommendations when they are reevaluating existing Notified Bodies for renewal. The intent is that the EU Commission and the Member States will use compliance with the “recommendation” for unannounced audits as one of the criteria for deciding which Notified Bodies would retain their status when the new European Medical Device Regulations were approved in 2015. Therefore, all of the Notified Bodies are scrambling to complete a number of unannounced audits before the end of 2014.

Who will be audited in 2014?

In 2014, the primary targets for unannounced audits will be manufacturers of high-risk, Class III devices. The prime targets for unannounced audits are unlikely to contract manufacturers, because Notified Bodies may not have access to all the technical documentation while they are auditing a contract manufacturer. I expect each of the Notified Bodies to plan at least one unannounced audit of a contract manufacturer for a Class III device that is outsourced. Still, I don’t expect this to be the focus of unannounced auditing activities in 2014.

It is already July, and only a handful of unannounced audits have been performed as “pilots.” Most of the Notified Bodies trained auditors on how to conduct unannounced audits in May or June during their annual auditor training. Therefore, we can expect a dramatic increase in the number of unannounced audits during the remaining months of 2014. If your firm has recently had CE Marking compliance issues with a Class III device, you should expect an auditor soon.

4 Ways unannounced audits are different

Unannounced audits differ from traditional quality system audits in four ways.

1. Unannounced audits are truly unannounced–with no warning at all. Even the US FDA inspectors have the courtesy to call on Friday to inform manufacturers of their intent to visit the following Monday or Tuesday. To ensure that auditors can conduct unannounced audits as planned, Notified Bodies are asking manufacturers to provide information about when production activities will be shut-down.

2. Unannounced audits will always be conducted by an auditing team with at least one person that is qualified to review the technical documentation (i.e., Technical File or Design Dossier) and compare it to the actual production activities. This is similar in some ways to how FDA inspectors review a Device Master Record (DMR) and then compare the DMR to production and process controls they observe in manufacturing. However, the technical experts from Notified Bodies typically have a minimum of five years experience similar designing devices, and a two-person team can spread your resources dangerously thin if you are a smaller company that is used to providing a guide for only one auditor or inspector.

3. Unannounced audits will involve more time spent by auditors in production areas, instead of reading documents in conference rooms. You can expect brief opening meetings because auditors need to review critical processes as quickly as possible. Specifically, the auditors are required to use a risk-based approach to select two of the following processes:

  • design controls
  • establishment of material specifications
  • purchasing control and incoming inspection
  • assembling
  • sterilization
  • batch-release
  • packaging
  • product quality control

If a company conducts sterilization on-site, I would expect this to be a likely prospect for sampling. However, the two areas I hope to be sampled most frequently are: 1) purchasing control & incoming inspection, and 2) batch-release. These two processes are expected to be sampled frequently because these processes facilitate ad hoc sampling and demonstration of testing. This is important because Notified Bodies are expected to observe product testing.

4. Unannounced audits will be conducted at suppliers when critical processes are outsourced. Therefore, if Class III device manufacturers outsource final inspection, packaging, and sterilization–the suppliers providing these services may be unannounced audit targets for multiple Notified Bodies. ISO 13485 certified suppliers have enjoyed a decade of little direct involvement by regulators, but unannounced audits are about to change this.

How will unannounced audits change in the future?

In 2015 and beyond, unannounced audits will be conducted at contract manufacturers and manufacturers. Unannounced audits will also be conducted for all risk classifications of devices–unless the device does not have Notified Body involvement (i.e., Class I, non-sterile, and non-measuring devices). The number of unannounced audits will also increase, because Notified Bodies are required to conduct an unannounced audit for each client at least once during three years–and more frequently for high-risk, Class III devices.

What should be done to prepare?

Preparation for unannounced audits should be very similar to your preparation for FDA inspections (http://bit.ly/FDA-Inspection-Webinar). Still, you will now need to evaluate your suppliers more rigorously to ensure they are also prepared for unannounced audits. The FDA rarely visits suppliers, and they are not allowed to review supplier auditing records. Notified Bodies will not have these restrictions. You will need to demonstrate a good balance between incoming inspection activities and other types of supplier controls. If your incoming inspection activities consist primarily of reviewing paperwork, then you need to balance this with supplier auditing (http://bit.ly/Supplier-Audits) and monitoring of in-process and final inspection nonconformities caused by supplier quality problems.

If you are interested in learning more about unannounced audits by Notified Bodies, please click on this link to pre-register for our webinar recording on the topic: http://bit.ly/unannounced-audits-webinar. Pre-registration pricing is $79, compared to our normal webinar price of $129. The pre-registration period ends on July 18.

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How Are EU Device Regulations Changing and When?

Screen Shot 2014 04 15 at 3.01.52 PM 238x300 How Are EU Device Regulations Changing and When?

This blog, “How Are EU Device Regulations Changing and When?” includes 9 of the most significant proposed changes and compliance deadlines. 

The CE Marking process for medical devices is currently defined in three directives:

  1. Medical Device Directive (MDD), 93/42/EEC (http://bit.ly/M5MDD)
  2. Active Implantable Medical Devices (AIMD) Directive, 90/385/EEC (http://bit.ly/AIMDDirective)
  3. In Vitro Diagnostics Directive (IVDD), 98/79/EC (http://bit.ly/currentIVDD)

The EU Commission proposed revising the system from three directives requiring transposition by member states to two regulations: 1) http://bit.ly/EUIVDProposal, and 2) http://bit.ly/EURegs. The most significant proposed changes are:

  1. The Commission will have the opportunity to review recommendations for CE Marking before approval (i.e., the Scrutiny Process)
  2. The ability to create Common Technical Specifications will be expanded from IVDs to all devices
  3. A new class of “Special” Notified Bodies will be created
  4. Notified Bodies will be audited jointly by Competent Authorities
  5. Unannounced audits will be enforced
  6. Spinal implants, devices that control and monitor active implants, nanomaterials, apheresis machines, and combination products will be reclassified as Class III devices requiring a Design Dossier
  7. Most IVD products will require Notified Body involvement
  8. A Unique Device Identifier (UDI) system will be required for labeling, and the Eudamed database will be expanded
  9. Formatting of Declarations and Technical Files will be revised

When Will, the Final EMDR, be Approved?

The EU Commission took from February 2012 to September 2012 to write a proposal for new European device regulations. Parliament took 13 months (i.e., September 2012 to October 2013) to revise and fast-track its version of the new European device regulations, and the Council will probably take a year to finish their version of the regulations. Therefore, the real negotiations between Parliament and the Council will begin after the 2014 summer holiday. The final approval date is unknown, but my current guess is October 2015.

On September 12, 2013, Eucamed released the results of an industry survey (http://bit.ly/CostofEURegs) stating that the proposed regulations are expected to increase the cost of regulatory approvals by 17.5 billion Euros for medical device manufacturers collectively. The details of the survey indicate that implementation of the UDI system improved labeling and clinical performance data will require a 7.5 billion Euro investment to implement new software systems to comply with the UDI regulations. Also, industry survey respondents indicated that an additional 2.5 million Euro investment would be required for each new Class III device that is required to undergo the proposed Scrutiny Process in Article 44. Financial implications and political pressures could force the Council and Parliament to make major revisions to the proposed regulations to reduce the cost of implementation.

Some key elements need to be in place before implementation of the proposed regulations can reasonably begin. First, Notified Bodies need more staff to conduct audits and review technical documentation–especially for high-risk devices. Second, the European Databank of Medical Devices (i.e., Eudamed) must be ready to implement UDI labeling and other documentation required by the EMDR (http://bit.ly/Eudamed). Third, the European Commission plans to build a new centralized organization that will be responsible for oversight of the Notified Bodies. Each of these three elements will take more than a year, and planning has only just begun.

What Is The Compliance Deadline?

The original proposal, released in September 2012, indicated that there would be a three-year transition period for implementation of the EMDR from 2014 to 2017. This transition period would begin with the highest risk Class III devices first, and lower risk devices would be phased in over the three years. However, if the EMDR was finalized in October 2015, the implementation period will end at the end of 2018.

A complete review of the new regulations can be found at http://bit.ly/MDDI-article-EU-Device-Reg-Changes.

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European Medical Device Regulations-4 Key Eucomed Recommendations

Screen Shot 2014 04 23 at 10.19.29 AM 300x244 European Medical Device Regulations 4 Key Eucomed RecommendationsEuropean Medical Device Regulations-4 Key Eucomed Recommendations,” reviews why the Eucomed position paper will help draft the new European Medical Device Regulations.

Eucomed, the medical technology industry representative group for Europe, released a new position paper on April 1, 2014, http://bit.ly/Eucomed-April-2014. This paper was created in response to the proposed European Medical Device Regulations, and focuses on four industry concerns:

  1. 1. Introduction of a pre-market “scrutiny process”
  2. 2. Revised clinical requirements
  3. 3. Restriction of hazardous substances
  4. Re-use of single-use devices

History

The original draft of the proposed regulations (i.e., the proposal) was released by the European Commission on September 26, 2012 (http://bit.ly/EUProposal). Europe’s Parliament Committee for Environment, Public Health and Food Safety (ENVI) voted on the Commission’s proposed regulations on September 25, 2013–after three postponed votes. The ENVI Committee made several revisions to the proposed EMDR (i.e., draft legislation), but in general, the ENVI Committee recommended the proposed EMDR. The European Parliament voted on the proposed regulations on October 22, 2013 (i.e., Plenary Vote). Parliament made additional revisions to the draft legislation and mandated negotiation by Parliament representatives (i.e., rapporteurs) with the European Council.

There were three versions of the new EU regulations for the Council to consider:

  1. A proposal by the EU Commission
  2. Draft legislation by the ENVI Committee
  3. Revised draft legislation by Parliament

Eucomed published a position paper on January 30, 2013 (http://bit.ly/EucomedPositionPaper) in response to the original proposal by the Commission, but Eucomed did not respond to the draft legislation until April 1, 2014. Now, the Council has a fourth version to consider–the 2014 Eucomed position paper.

I expected Eucomed to criticize Parliament’s revised draft before the 2013 holidays, but there was no further public response from Eucomed. Instead of being critical of Parliament’s revised draft, Eucomed focused on four industry concerns and made its recommendations for each issue. The Eucomed position paper is specially addressed to the EU Council with the hope of influencing the Council’s version of the new EMDR.

Pre-market “Scrutiny Process” (Article 44)

The EU Commission introduced the concept of the “Scrutiny Process” in Article 44 of the proposed EMDR. Still, the EU Parliament replaced the “Scrutiny Process” with Article 44a in the Parliament Amendment from the Plenary Vote. Article 44a involved a review by the European Medicines Agency for high-risk submissions. Both of these solutions are unpopular with industry. In the April 2014 position paper, Eucomed does not endorse either version. Instead, Eucomed proposed its process for review of premarket submissions, which is referred to as a “Reinforced Control Procedure.”

The Reinforced Control Procedure is a process that is built into the existing Notified Body process. Eucomed outlined the new procedure in detail as an Annex to the position paper.

Revised Clinical Requirements (Articles 49-60)

Eucomed’s April 2014 position paper endorses the proposed regulations by the EU Commission and does not support the stricter legislation proposed by Parliament that mandates Randomized Control Trials (RCTs). In addition, Eucomed listed the following seven points below that the Council should address to ensure that the new Clinical Requirements are “fit-for-purpose”:

  1. Ensure no “one-size-fits-all” approach
  2. Include appropriate elements from pharmaceutical legislation
  3. Consider that effectiveness is measured across the full lifecycle
  4. RCTs are not always practically possible or ethical
  5. Utilize the power of big data and scientific literature
  6. Consider a balanced concept of equivalence
  7. Importance of intellectual property and know-how for medtech companies

Restriction of Hazardous Substances

Eucomed’s position paper encourages the EU Council to support the European Commission’s proposal on the use of hazardous substances in medical devices–not the Parliament version. Eucomed cites the existing horizontal legislation that is in place (i.e., Reach Legislation, http://bit.ly/REACH-Legislation; and RoHS 2, http://bit.ly/RoHS-2). The position paper points out that Parliament’s proposed ban has the following flaws:

  • Proposed ban disregards potential benefits offered by these substances
  • Scope of the proposed ban is broader than can be practically implemented at this time
  • The three-year implementation period is too short of a timeline
  • Four-year period for applying for exemptions is too short a timeframe for industry subject matter experts to submit the required requests
  • The proposed ban is not consistent with the existing REACH and RoHS legislation

Re-use of Single-use Devices

The Eucomed position paper recommends that the EU Council support the EU Commission proposal for addressing the re-use of single-use devices. The Parliament approach stated that all devices should be considered re-usable unless the manufacturer can demonstrate that the device cannot be re-used. The industry response to Parliament’s approach can be summarized in one phrase from the Eucomed paper: “Medical device industry believes that Parliament’s amendments create a potential threat to patient safety.” The Eucomed paper goes on to identify specific deficiencies in the Parliament amendments:

  • Amendment presents a potential threat to patient safety
  • The approach is generic and cannot be applied to all products
  • The process proposed is unclear and may create delays
  • An amendment is not required by other countries and would increase the cost of products to Europeans
  • Roles and responsibilities of manufacturers and reprocessors are unclear
  • Standardization is not feasible

Conclusion

The Eucomed position paper should be helpful to the European Council in framing a more moderate draft for the new European Medical Device Regulations. However, the Council is likely to create a few solutions of its own that will require additional review. I expect to see a draft from the Council this Fall and do not expect Parliament or the Council to reach an agreement on a final version in 2015.

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Are MEDDEVs Required or Optional for CE Marking of Medical Devices?

Excuse me. Are you sure this MEDDEV is required Are MEDDEVs Required or Optional for CE Marking of Medical Devices?This blog answers the question of whether compliance with MEDDEV guidance documents is required or optional for CE marking of medical devices.

MEDDEVs are guidance documents (http://bit.ly/Whats-a-MEDDEV) written by competent authorities—not law. As it states on the Europa website (http://bit.ly/MEDDEV), “The guidelines are not legally binding.” However, the Competent Authorities (http://bit.ly/ContactPoints) take an active role in developing these guidance documents. Therefore, enforcement of the guidance documents by Notified Bodies depends upon which competent authorities helped to develop the specific MEDDEV. MHRA. For example, is the competent authority for the United Kingdom (UK). MHRA has taken an active role in developing many of the MEDDEVs. Therefore any manufacturer that uses a Notified Body in the UK is more likely to consider the MEDDEVs that MHRA helped create to be “required” rather than “recommended”. The following Notified Bodies are under the jurisdiction of MHRA, but each member states’ competent authority has Notified Bodies that could be affected, including:

British Standards Institute (BSI) – NB # 0086
Lloyd’s Register Quality Assurance (LRQA) – NB # 0088
SGS United Kingdom Limited (SGS) – NB # 0120
AMTAC Certification Services – NB # 0473
UL International (UK) LTD – NB # 0843

There are 32 MEDDEVs divided into 15 categories. The most recent revision to a MEDDEV was in January 2013 when MEDDEV 2.12/1, Medical Device Vigilance System, was updated. This particular MEDDEV is the European equivalent to 21 CFR 803 for Medical Device Reporting, but reporting of adverse events is called “vigilance” in the EU. It is essential to keep current with changes to MEDDEVs (http://bit.ly/New-Revised-EU-Regulations) because Competent Authorities require vigilance reporting using the most current version of the MEDDEV form. In the case of the vigilance MEDDEV, the guidance is de facto law. However, the French Competent Authority recently indicated that trend reporting requirements will be required in the future for high-risk devices, and the French Competent Authority refused to accept the form associated with MEDDEV 2.12/1. Instead, France has its form that is preferred for vigilance submissions.

MEDDEV Enforcement

Other MEDDEVs are not as consistently enforced. For example, MEDDEV 2.5/10 (http://bit.ly/ECREPMEDDEV) provides guidance with regard to the roles and responsibilities of European Authorized Representatives. In some cases, Competent Authorities audit Authorized Representatives for compliance with this MEDDEV. Notified Bodies are also auditing agreements between manufacturers and Authorized Representatives. Unfortunately, many manufacturers still rely upon European distributors that are not compliant with MEDDEV 2.5/10, and Notified Body auditors are merely verifying that an Authorized Representative agreement exists.

Another example of inconsistencies between Notified Bodies is demonstrated by how MEDDEV 2.7/1 (http://bit.ly/ER6aMEDDEV) is enforced. This document guides manufacturers on how to perform clinical evaluations. Some Notified Bodies, especially the Notified Bodies under MHRA’s jurisdiction (see the list above), are systematically reviewing the content of clinical evaluations against the MEDDEV guidance. However, other Notified Bodies continue to verify only that a clinical evaluation exists. Differences between Notified Bodies in how they enforce this MEDDEV is less pronounced for Class III devices, where clinical studies are expected. However, this may be due to the lack of clinical expertise at some Notified Bodies.

The European Commission began a pilot program in 2013 for conducting joint audits by Competent Authorities of Notified Bodies to ensure that there is consistency between the Notified Bodies, and how the Competent Authorities enforce regulations (http://bit.ly/Europa-press-release-24-9-2013). Some of the other changes, such as conducting unannounced audits of manufacturers and their supply chains, are being implemented this year (http://bit.ly/Unannounced-Audits).

Due to the ongoing debate between the European Council and the European Parliament over the draft of the proposed European Medical Device Regulations (http://bitly.com/EMDR-Frankenstein), the issuance of new and revised MEDDEVs has essentially stopped. When the European Medical Device Regulations (EMDR) are finally approved, the medical device industry can expect to see the content of the MEDDEV guidance documents to be superseded by new requirements in the EMDR.

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How to Identify New and Revised European Medical Device Regulations

%name How to Identify New and Revised European Medical Device RegulationsThis blog offers tips and information for locating the latest European medical device regulations for your next management review meeting. 

There are two primary websites to check for new and revised European Medical Device Regulations. The first location is the Europa website, where the three “New Approach” directives and proposed European Medical Device Regulations (EMDR) can be found. There is also a webpage on the Europa website for guidance documents. The following website is managed by Team-NB–a group of Notified Bodies.

Europa Website for Locating European Medical Device Regulations

When you  check the Europa website for new and revised medical device regulations, the three most important pages to check are:

  1. http://bit.ly/EUrevisions – On-going revision of the medical device directives.
  2. http://bit.ly/EU-current-legislation – Current medical device directives
  3. http://bit.ly/MEDDEV – Guidance MEDDEVs

The first page provides periodic updates on the status of the proposed EMDR. The most recent update on this page was September 26, 2012. If you are following this carefully, and you understand the European legislative process, then you know that there was a vote by the ENVI committee reviewing the EU Commission’s proposal in September 2013. You also would know that the Plenary Vote on the proposal occurred in October 2013. Now, the European Parliament has mandated that the rapporteurs negotiate a final text with the Council–which is going slower than Parliament would like.

The second page has the current legislation. It is not always obvious if amendments have been made. Therefore, you need to review each of the directives to see if it is applicable. The last significant change to the MDD was the M5 version on March 21, 2010 (i.e., amendment 2007/47/EC to 93/42/EEC). There was a commission implementing regulation on September 4, 2013. Two amendments were released in 2012: 1) electronic instructions for use, and 2) medical devices manufactured with tissues of animal origin.

Finally, the third page lists each of the guidance MEDDEV documents. This list also identifies the date of the most recent version for each MEDDEV. The most recent change was to the vigilance reporting guidance document in January 2013.

Team-NB Website

The website for Team-NB is http://bit.ly/Team-NB. On the home page, there is a navigation bar listing archived documents by year. In 2012, there were nine documents released. Several of these documents are related to the PIP Scandal (http://bit.ly/MHRAReport), which is now old news, but there was one guidance document discussing the transition plans for IEC 60601-1. There were another 12 documents released in 2013. The four most recent documents are confidentiality statements, and five are auditor attestations. Therefore, there are only three new documents of importance to manufacturers:

  1. http://bit.ly/Team-NB-eIFU – guidance on the implementation of electronic Instructions For Use (eIFU)
  2. http://bit.ly/CoCNBV3 – 3rd version of the Notified Body Code of Conduct
  3. http://bit.ly/Team-NB-IEC62304 – FAQs for the implementation of EN 62304

The first document explains two positions from Team-NB. The first position identifies labeling requirements and the use of harmonized symbols for companies implementing eIFUs. The second position indicates that implementation of eIFUs is considered a significant change in the QMS that requires:

  1. Notified Body notification before implementation, and
  2. a list of documents needed by Notified Bodies as objective evidence of readiness for implementation.

The code of conduct includes important details about how the Notified Bodies plan to change the auditing process and qualification of certification auditors to address concerns of the European Council. This includes specific interpretations as to the duration of audits, the duration of an initial Design Dossier review, and the initial plan for unannounced audits by Notified Bodies.

The third document contains 73 frequently asked questions and the response to these questions by Team-NB. There are also four annexes. The 73 questions are organized into the following seven sections:

  1. Scope of EN 62304
  2. Placing Software as a MEDICAL DEVICE on the Market
  3. Life-cycle Processes
  4. Risk Assessment and Risk Management
  5. Classification and Segregation
  6. Specifications, Testing, and Tools
  7. SOUP and Legacy Software

Next Steps

Review each source of information and determine if the document impacts your organization’s quality system and procedures. This gap analysis should be performed by someone familiar with the specific process(es) addressed by the regulations. The most likely actions to be taken are:

  1. initiate specific changes to existing procedures
  2. create new procedures, or
  3. initiate a quality plan for more substantial changes to your quality system

If you need more help preparing for your management review, here’s a link to a free webinar I recorded: http://bit.ly/Clause5-6. You will also receive a management review slide deck.

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How Declaration of Conformity (DoC) templates are created

This article about the declaration of conformity for medical device CE Marking identifies three possible sources for creating a template and includes recommendations for making the transition to the proposed EU Medical Device Regulation (EMDR).

%name How Declaration of Conformity (DoC) templates are createdCurrent declaration of conformity requirements

Each of the three “New Approach” Device Directives requires that manufacturers create a Declaration of Conformity (DoC). For the Medical Device Directive (MDD), this requirement is found in Annex II, IV, V, VI, and VII. The “Declaration of Conformity” is part of the title for each of those Annexes. A DoC is required for each CE Marked product family, but the MDD does not guide the format or content. Manufacturers need a controlled template.

Three sources of declaration of conformity examples

There are three possible sources for creating a declaration of conformity template:

  1. Copy another company’s declaration of conformity
  2. Authorized Representatives
  3. Annex III of the proposed European Medical Device Regulations

Most companies are using option number 1—often without knowing it. The problem with this approach is you have no regulatory reference to justify the basis for the content and format of your Declaration.

The second option is to ask your Authorized Representative (AR). The AR is supposed to verify that you have a DoC for each product family and that the company has the required technical documentation for each product family. The AR must provide a DoC for each product they represent to the Competent Authority upon request. Therefore, some ARs provide manufacturers with a template for the DoC to ensure that your DoC meets requirements. This approach gives you a reference of external origin, and you can be sure that the template will meet current requirements.

My new recommendation for Creating A declaration of conformity

Option 3 is my new recommendation for companies. The proposed European Medical Device Regulation (EMDR) was released on September 26, 2012. The proposal provides a prescriptive template for the content of a DoC. This will eventually be required for every DoC. Annex III is only one page long, and there are only ten requirements:

  1. Name of the Manufacturer and the AR
  2. A declaration that DoC Issued under Sole Responsibility of Manufacturer
  3. Unique Device Identifier (UDI)
  4. Product Name and Catalog Numbers
  5. Risk Classification
  6. Declaration Statement of Conformity
  7. Reference to Harmonized Standards and Common Technical Specifications (CTS)
  8. Notified Body Name and Number, Description of Conformity Assessment Procedure and Certificate
  9. Additional Information
  10. Place and Date of Issue, along with the Name and Function of the Person Signing

Instead of waiting for the final approval of the EMDR, I recommend creating a declaration of conformity (DoC) template now that matches the proposed Annex III (you might want to add this to recommendations for improvement in your next management review).

Brigid Glass is the subject matter expert behind most of the conventions that our consulting firm uses for document templates. As with all of our forms, we assign a document control number (e.g., FRM-001), and the revision is “D1” for the first draft. The template is in table format to facilitate easier review by auditors and your AR. The left column of the table lists each of the required elements, and the right column is where the variable data is entered. Variable fields that are examples are in green font, and the content that does not require changing is in black font. There are some comments to explain how to fill in the variable content, and several items that will change when the proposed regulation is approved are identified. The following harmonized symbols from ISO 15233-1 are used in the template, as well:

DoC How Declaration of Conformity (DoC) templates are created

Please click here to download the Medical Device Academy’s declaration of conformity (DoC) template.

 

 

 

 

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CE marking 4 digit number for medical devices

fourdigitquestion CE marking 4 digit number for medical devicesThis article explains the purpose and use of a CE marking four-digit number for medical devices, minimum size requirements, and other considerations. 

CE marking a four-digit number

The CE marking four-digit number that is displayed next to the CE mark on some medical devices is the Notified Body (NB) number. If there is no CE marking four-digit number, this means that the medical device is a Class I device that does not require NB involvement (i.e., self-declaration). If the device is a Class I device, and there is an NB number next to the CE mark, then the device either has a measuring function or is sterile.

Requirements for CE marking a four-digit number

The Medical Device Directive is divided into Articles and Annexes. Section 1 of Article 16 indicates that the European Commission is responsible for the assignment of NB numbers. In Article 17, ¨CE Marking,¨ it states: ¨[The CE] shall be accompanied by the identification number of the notified body responsible for the implementation of the procedures set out in Annexes II, IV, V, and VI.¨ Annex XII defines the minimum size (i.e., 5 mm) of the CE. The requirements for the size of the NB identification number is not included in Annex XII, but NBs interpret the requirements for size as half the height of the ¨CE.¨

Companies are responsible for reproducing the CE Mark on their labeling and the product–including the 4-digit number. However, if the space available on the product is too small to allow a 5 mm ¨CE,¨, then the company is not required to reproduce it on the product. Instead, it is sufficient to reproduce the CE Mark on product labeling and the Instructions For Use (IFU). One source of the artwork for the ¨C¨ and ¨E¨ is the Europa website.

If an NB number is required, usually, there are a couple of different orientations that are allowed by the NB. Most NBs specify that the NB number shall be to the right or beneath the “C” and “E.” However, most NBs have specific instructions available for the reproduction of the CE Mark and the proper orientation of their NB number. Often, the NB will also provide artwork for downloading that includes the NB number in one or more orientation.

Product Failure Investigations

Identification of the NB may not seem important; however, the NB number can help caregivers to identify the NB that approved CE Marking of a product when there is an investigation of product failures with an unknown manufacturer. In that case, the NB will then share this information with the appropriate manufacturer to facilitate an investigation. The NB number is also used to differentiate when the oversight by one NB stops, and a new one begins, after transferring from one NB to another.

If someone wants to know which NB is associated with each NB number, the EU Commission operates the NANDO information system as a database, allowing you to search each of the 60+ NBs by CE marking 4 digit number. The database also allows searching by country, annex/article, product, and horizontal technical competence.

If your company is selecting an NB, you can search the product and technical competency categories to identify which NBs are able to issue CE certificates for your product. There are ten possible technical competencies to use as search criteria. For example, if your company manufactures absorbable sutures (i.e., competency, MDS 7009), there are only 32 NBs (shrinking every day) that have the technical competence to assess your Design Dossier for conformity with the MDD.

If your company is developing porcine-based collagen implants (i.e., competency, MDS 7010), then there are only 24 NBs (shrinking every day) able to issue a Design Examination Certificate for CE Marking. If your company needs additional guidance on how to select an NB, you might consider reading a blog on certification body selection.

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