What’s the difference between PMS, PSUR, and PSR?

This blog is intended to help clear your justified confusion if you are wondering what the difference is between PMS, PSUR, and PSR.

The nine most terrifying words in the English language are, “I’m from the Government, and I’m here to help.” That quote is from a speech by President Reagan on August 12, 1986.  One of the goals of the European Parliament and Council was “to ensure effective coordination of [competent authority] market surveillance activities and to clarify the applicable procedures.” After studying the new European MDR, I can confidently say that the European Parliament and Council have done their job well. My boss is a regulatory consultant with 30 years of experience, and he asked me to explain the difference between PMS, PSUR, and PSR.

To answer that question as objectively as possible, and cite my sources, I have included a copy and paste directly from Regulation (EU) 2017/745. Red text is my commentary, while the italicized text is a quotation from the most relevant article within the new EU regulations.

Under the New MDR, the only Class IIa, Class IIb, and Class III products are definitively required to have a Periodic Safety Update Report (PSUR). The PSUR needs to be updated annually for Class III and Class IIb implants, and the PSUR needs to be updated at least every two years for Class IIb (non-implants) and Class IIa devices. The PSUR must be available to your notified body, and upon request, the competent authorities. In contrast with the PSUR, Post-Market Surveillance (PMS) reports are required for Class I devices. Finally, a manufacturer’s Periodic Summary Report (PSR), relates to specific cases of Serious Incidents and Field Safety Corrective Actions (FSCA’s) based upon an agreement between the manufacturer and the competent authority or authorities instead of submitting individual FSCA reports.  This is confusing because the PSUR also meets the requirements of a PMS Report as defined in Article 85, but we don’t call it a PMS Report.

“Article 83 – Post-market surveillance system of the manufacturer

1. For each device, manufacturers shall plan, establish, document, implement, maintain, and update a post-market surveillance system in a manner that is proportionate to the risk class and appropriate for the type of device. That system shall be an integral part of the manufacturer’s quality management system referred to in Article 10(9).”

In Matthew’s words, “Manufacturers are required to establish a PMS system for every device or device family.”

“Article 84 – Post-market surveillance plan

The post-market surveillance system referred to in Article 83 shall be based on a post-market surveillance plan, the requirements for which are set out in Section 1.1 of Annex III. For devices other than custom-made devices, the post-market surveillance plan shall be part of the technical documentation specified in Annex II.”

In Matthew’s words, “Article 84 requires you to have a PMS plan in your quality system.”

“Article 85 – Post-market surveillance report

Manufacturers of class I devices shall prepare a post-market surveillance report summarizing the results and conclusions of the analyses of the post-market surveillance data gathered as a result of the post-market surveillance plan referred to in Article 84 together with a rationale and description of any preventive and corrective actions taken. The report shall be updated when necessary and made available to the competent authority upon request.”

In Matthew’s words, “A Class I device requires a PMS report, while the other product classifications require a PSUR.”

“Article 86 – Periodic safety update report

1.1 – Manufacturers of class IIa, class IIb, and class III devices shall prepare a periodic safety update report (‘PSUR’) for each device and were relevant for each category or group of devices summarizing the results and conclusions of the analyses of the post-market surveillance data gathered as a result of the post-market surveillance plan referred to in Article 84 together with a rationale and description of any preventive and corrective actions taken. Throughout the lifetime of the device concerned, that PSUR shall set out:

(a)	the conclusions of the benefit-risk determination;

(b)	the main findings of the PMCF; and

(c)	the volume of sales of the device and an estimated evaluation of the size and other characteristics of the population using the device and, where practicable, the usage frequency of the device.

Manufacturers of class IIb and class III devices shall update the PSUR at least annually. That PSUR shall, except in the case of custom-made devices, be part of the technical documentation as specified in Annexes II and III.

Manufacturers of class IIa devices shall update the PSUR when necessary and at least every two years. That PSUR shall, except in the case of custom-made devices, be part of the technical documentation as specified in Annexes II and III.

For custom-made devices, the PSUR shall be part of the documentation referred to in Section 2 of Annex XIII.

2. For class III devices or implantable devices, manufacturers shall submit PSURs by means of the electronic system referred to in Article 92 to the notified body involved in the conformity assessment in accordance with Article 52. The notified body shall review the report and add its evaluation to that electronic system with details of any action taken. Such PSURs and the evaluation by the notified body shall be made available to competent authorities through that electronic system.
3. For devices other than those referred to in paragraph 2, manufacturers shall make PSURs available to the notified body involved in the conformity assessment and, upon request, to competent authorities.”

In Matthew’s words, “Barring specified exemptions, manufacturers of a Class IIa device would need to submit a PSUR and update it at least every two years.”

“Article 87 – Reporting of serious incidents and field safety corrective actions

9. For similar serious incidents that occur with the same device or device type and for which the root cause has been identified or a field safety corrective action implemented or where the incidents are common and well documented, the manufacturer may provide periodic summary reports instead of individual serious incident reports, on condition that the coordinating competent authority referred to in Article 89(9), in consultation with the competent authorities referred to in point (a) of Article 92(8), has agreed with the manufacturer on the format, content, and frequency of the periodic summary reporting. Where a single competent authority is referred to in points (a) and (b) of Article 92(8), the manufacturer may provide periodic summary reports following an agreement with that competent authority.”

In Matthew’s words, “Periodic summary reports (PSRs) refer to significant incidents (SIs) and field safety corrective actions (FSCAs). PSRs require an agreement between the manufacturer and the competent authority(s) for cases where there is a group of common, well-known, and documented SIs or FSCA’s with a known root-cause. PSRs are an alternative to submitting individual SI and FSCA reports.”

Additional Quality System Resources

My boss also asked me to update the procedures for post-market surveillance (SYS-019) and vigilance (SYS-036). The PMS procedure includes requirements for Articles 83-86. The vigilance procedure includes the requirements for Articles 87-92.

About the author

Matthew is a talented writer that missed his calling as a political satirist. Medical Device Academy is lucky to have him as a quality system expert and gap analysis guru. Matthew was asked to answer this question for a client in response to an email. He wrote the entire blog in less than one hour, but he didn’t think it was worthy of publishing. The boss disagreed. Please show Matthew some love with your comments below or by ordering the book from Amazon ($5 pre-order discount until August 28, 2020).