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Europe Update: Notified Body MDD, AIMDD Timelines

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EMERGO SUMMARY OF KEY POINTS

  • Some European Notified Bodies appear to have set early 2020 deadlines for winding down renewals of CE Mark certifications under the Medical Devices Directive (MDD) and Active Implantable Medical Devices Directive (AIMDD).
  • Manufacturers may find it increasingly difficult to obtain MDD and AIMDD certifications starting in late 2019.
  • These timelines should help manufacturers plan their transition strategies for Medical Devices Regulation (MDR) compliance.

Some Notified Bodies (NBs) will soon be designated to the Medical Devices Regulation (EU) 2017/745 (MDR). But how they will manage their Medical Devices Directive 93/42/EEC (MDD) and Active Implantable Medical Devices Directive 90/385/EEC (AIMDD) reviews concurrently with their MDR reviews is yet to be revealed.

Time running out for MDD, AIMD certifications

From contacts with several large NBs, Emergo understands that, depending on the timeline for designation of the NB involved, from the second quarter of 2019 onwards, it will become increasingly difficult to secure AIMDD and MDD certification. Recently Emergo received documents released by two of the larger NBs. In the first of these official documents, January 2019 is the deadline specified for new  Class III MDD and AIMDD devices requiring consultation (e.g. ancillary drug, animal tissue etc.) through August 2019 for new Class I sterile/measuring submissions. Renewal audits as part of the regular certification cycle will no longer be possible starting January 2020, which implies that all certification for the Directives will have ceased by the end of 2019.

The second document has an even steeper timeline, where signed applications for CE Mark certifications must be supplied by January 2019, with all forms and review documents sent in by March 31, 2019. There is, of course, the proviso that both of these NB sources expect MDR designation at the beginning of 2019. Other NBs may have different timelines for their cut-off dates, but Emergo expects the differences among the large NBs be limited.

Planning MDR transition strategies

This initiative helps manufacturers plan their transitions and regulatory strategies. It also illustrates that time is quickly running out for certification under the Directives, and manufacturers will soon only be able to certify under the MDR. It would, of course, be interesting to see how other NBs intend to approach these cut-off issues. Emergo recommends that manufacturers fine tune their plans with their respective NBs to ensure a smooth transition.

The first NB document also provides information about the AIMD/MDD, and asks manufacturers to indicate their plans regarding the MDR.  Let’s hope that there are sufficient NBs available to review the MDR submissions from manufacturers of Class I reusable surgical instruments,  who may not have had experience with an NB and find themselves at the end of the queue in May 2020.

Evangeline Loh, Ph.D., RAC is Global Regulatory Manager and Ronald Boumans is Senior Regulatory Consultant at Emergo.

Learn more about upcoming changes to European medical device regulations:


European Medical Device Regulatory Roundup: May 2018

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Major changes underway in the European medical device and IVD markets require manufacturers to keep up with many complex moving parts. Issues including implementation of the MDR and IVDR, ramifications of Brexit and tightening Notified Body requirements have resulted in a more challenging CE Mark certification process for many companies.

European medical device and IVD news summary May 2018Below, we provide a summary of Emergo European medical device and IVD regulatory coverage from the past several months to help current and prospective CE Mark holders stay abreast of current developments.

Eudamed and UDI developments

Unique Device Identification (UDI) and entry of medical device information into the Eudamed database will be key components of MDR compliance. Our coverage of Eudamed and UDI news includes:

Brexit impact for medical device companies in Europe and the UK

As Brexit negotiations between the UK and EU continue, effects of a British withdrawal from the Union on medical device and IVD manufacturers as well as their Authorized Representatives, Notified Bodies and other counterparties remain a major concern:

Notified Body relationships

How tighter European regulatory control over Notified Bodies as well as MDR and IVDR implementation have affected Notified Body relationships:

Additional medical device and IVD news for Europe

Other recent regulatory developments important to medical device and IVD companies active in Europe include:

Related EU regulatory resources from Emergo:

欧洲医疗器械监管法规综述:2018年5月

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欧洲医疗器械和IVD市场正在发生重大变化,因此制造商需要随时跟上脚步,了解这些不断变化的复杂内容。实施MDR和IVDR、英国脱欧和不断缩紧的公证机构要求,对于很多公司来说,CE标示申请流程变得更加具有挑战性。

<img alt="European medical device and IVD news summary May 2018" src="https://www.emergobyul.com/sites/default/files/styles/media_thumbnail/pu..." style="width: 100px; height: 100px; float: right;">下面我们提供过去几个月来Emergo对欧洲医疗器械和IVD监管法规的简要总结,以帮助当前和未来的CE认证持有人了解当前的形势发展。

Eudamed与UDI发展情况

医疗器械唯一标识(UDI)和在Eudamed数据库中输入医疗器械信息将成为MDR合规性要求的关键部分。我们提供的Eudamed和UDI相关信息包括:

英国脱欧对欧洲和英国医疗器械公司所造成的影响

随着英国与欧盟之间的退欧谈判继续进行,英国退出欧盟对医疗器械和体外诊断器械制造商以及其授权代表、公证机构和其他交易对手的影响仍是主要关注的问题:

公证机构关系

欧盟对于公证机构更加严格的监管控制规定以及MDR和IVDR的实施将对公证机构关系造成影响:

关于欧洲医疗器械和IVD的其他资讯

对活跃在欧洲市场的医疗器械和IVD公司来说,在监管方面其他的重要最新发展情况包括:

来自Emergo的欧盟监管法规相关信息资源:

Article 7

Spring 2018 Updates to European Medical Device Borderline and Classification Manual

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EMERGO SUMMARY OF KEY POINTS:

  • A new version of the Manual on Borderline and Classification has been published.
  • The seven new positions do not contain surprises.
  • It appears the MDEG is not yet involved in device status or classification questions regarding the MDR or IVDR.

On April 23 2018 the European Commission published Version 1.19 of the Manual on Borderline & Classification. Following the release of Version 1.18 in December 2017 it appears the Medical Devices Expert Group (MDEG) on Borderline & Classification is quite active.

European Manual on Borderline & Classification of medical devices updates for May 2018In Version 1.19 of the manual, six product statuses and one classification have been added. The agreed understanding of the status as a medical device, according to the MDEG, does not reveal surprises:

  1. A rugby helmet is not a medical device, because prevention of an injury is not part of the definition of a medical device. Emergo would consider this Personal Protective Equipment (PPE) and it should be placed on the market in accordance with the PPE Directive 89/686 (EEC).
  2. An autopsy saw is not used on a patient or for the benefit of that specific person. Therefore it is not a medical device.
  3. Air cleaned by a UV flow germicidal lamp, intended to decrease the level of microbiological load in hospitals, is not a medical device or used as an accessory of a medical device. Therefore the UV lamp is not considered a medical device.
  4. A water filter, intended to clean water before it is used in wounds or for cleaning devices, is also not used in or on patients and therefore it is not considered a medical device. The filter by itself is not intended to enable a device being used in accordance with its intended use and therefore it should also not be considered an accessory.
  5. A bone void filler that creates a scaffold for new bone formation is considered a medical device, even if it is assisted in that function by animal growth factors. The growth factors are not the main intended mode of action. This is a Class III device according to Rule 8, 13 and 17.
  6. A product that mimics starch in food, which through several steps in the digestive system could lead to weight loss, has a metabolic mode of action. It is not considered a medical device. Emergo would consider this a food substance.

One classification has been added:

  1. Cryotherapy chambers are used to deliver intense cold (around -110 degrees Celsius) to the body for pain relief, limitation of oedema post-surgery, treatment of rheumatologic pathologies and muscular injuries and/or for reduction of inflammation. They are considered active therapeutic medical devices and therefore Rule 9 applies. With these extreme temperatures it is obvious the energy is supplied in a potential hazardous way. Therefore cryotherapy chambers are considered Class IIb medical devices.

So far the MDEG has not produced a position regarding products under the Medical Devices Regulation (MDR) or In-vitro Diagnostics Regulation (IVDR). However, we may soon see the first cases and it will be interesting to see how this will be dealt with.

For now Emergo has reviewed the above cases from the MDR perspective. It will not come as a surprise that the product status of these cases will not change under the MDR. The risk classes of the two recognized medical devices also appear to remain the same, although there is a minor change in the applicable rules. The bone void filler would be in Class III according to rules 8, 14 (similar to rule 13 MDD), 18 (similar to rule 17 MDD) and rule 21. Rule 21 is the new rule about substance based devices. Rule 9 remains applicable for the cryotherapy chambers.

Additional European medical device and IVD regulatory resources:

《欧洲医疗器械边界产品和分类手册》2018年春季最新变化

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Emergo重点摘要:

  • 新版的《医疗器械边界产品分类手册》于近期发布。
  • 新增的七项内容完全在掌握之中。
  • 医疗器械专家组(MDEG)尚未涉及有关MDR或IVDR的器械状态或分类问题。

2018年4月23日,欧盟委员会发布了《医疗器械边界产品分类手册》1.19版。而之前的1.18版是在2017年12月发布的,看来MDEG在医疗器械边界产品和分类工作方面较为积极。

<img alt="European Manual on Borderline & Classification of medical devices updates for May 2018" src="https://www.emergobyul.com/sites/default/files/styles/media_thumbnail/pu..." style="width: 100px; height: 100px; float: right;">在<a href="https://ec.europa.eu/docsroom/documents/29021" target="_blank">1.19版本</a>中,新增了六种产品状态和一种分类类别。根据MDEG,对于医疗器械边界界定的共识并不令人感到意外:

  1. 橄榄球头盔不能视为医疗器械,因为预防创伤并不符合医疗器械的定义。Emergo认为它应当被视为个人防护设备(PPE),此类产品要上市销售应该遵照PPE指令89/686(EEC)的相关规定。
  2. 尸体锯因不用于患者,也不能给特定患者带来益处。因此它不能算作是医疗器械。
  3. 用于清洁空气,旨在降低医院微生物含量的紫外线灭菌灯,不是医疗器械,也不被用作医疗器械附件。因此紫外线灯也不能被视为医疗器械。
  4. 用来对清洁伤口或清洗器械的水进行清洁的水过滤器,不在患者身上或体内使用,因此也不能被视为是一种医疗器械。该过滤器本身也不是用来让某种医疗器械能够按照器预期用途进行使用,因此也不应被视为医疗器械附件。
  5. 为新骨形成提供架构的骨腔填充物被认为是一种医疗器械,尽管此功能是通过动物生长因子的辅助而达到。生长因子不是主要的预期作用模式。按照规则8、13和17,它应该属于III类器械。
  6. 一种模仿食物中所含淀粉成分的产品,能够在通过消化系统的几个步骤后,帮助减轻体重,作用模式是代谢。它不被视为医疗器械。Emergo把它视为一种食品物质。

新增了一项器械分类:

  1. 冷冻治疗室能够向身体输送强冷(约-110摄氏度)以缓解疼痛,将手术后水肿限制住,治疗风湿病和肌肉损伤和/或减轻炎症。应被视为有源治疗性医疗器械,因此适用规则9。在这种极端温度下输送能量,很明显是存在潜在危险的。因此冷冻治疗室被视为IIb类医疗器械。

到目前为止,MDEG对于符合医疗器械法规(MDR)或体外诊断法规(IVDR)相关要求的产品尚未提出明确的立场。但是,我们应该很快就会看到第一个案例,这个案例的处理方式值得关注。

目前,Emergo已经从MDR的角度评析过上述案例。若根据新的MDR规定,这些案例中的产品状态不会作任何改变,并不令人感到意外。尽管适用规则略有变化,但两种获得认可的医疗器械风险等级似乎也将保持不变。根据规则8、14(类似于规则13 MDD)、18(类似于规则17 MDD)和规则21,骨腔填充物将被归为III类器械。新规则21则是关于基于物质的医疗器械。规则9仍适用于冷冻治疗室。

其他欧洲医疗器械和IVD监管信息资源:

Europe’s Eudamed Database: Five Key Questions (Part 1)

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Europe’s Eudamed Database: Five Key Questions (Part 1) Emergo

Compliance with Eudamed database requirements under the European Medical Devices Regulation (MDR) and In-vitro Diagnostics Regulation (IVDR) may be years away, but preparation for the new requirements will take sustained effort. We've identified key issues many manufacturers are dealing with ahead of Eudamed's launch.

Eudamed: Five key questions for medical device and IVD manufacturersIn July 2018 Emergo presented a webinar on Eudamed that generated more than 100 questions from audience members. We’ve distilled these questions and concerns regarding the European medical device database into five major themes, which we cover in a two-part blog post series.

Single Registration Number (SRN) and Local User Administrator (LUA)

The SRN is a code used for unambiguous identification of an economic operator within the EU. Identification codes used for other markets (e.g., GS1 GLN) are not relevant in this context.

Distributors do not need to enter data in Eudamed and therefore are not required to apply for an SRN. Sponsors are not considered economic operators, so for formal reasons they will not be identified by an SRN but by an identification number. In practice there will not be a significant difference between these two, so where applicable the below information should also be considered relevant for the sponsor.

An organization needs one SRN per actor role. Some examples: Manufacturer Alpha is based in one of the EU Member States and they also import devices from non-EU manufacturer Beta. They need one SRN for their role as manufacturer and another for their role as importer. Should they also take care of the role of the Authorized Representative (AR) for the devices of Beta, they would require a third SRN.

If a manufacturer has multiple sites, they still need only one SRN, unless these sites are mentioned on the label (and certificate, IFU etc.) as different legal manufacturers. An AR representing twelve non-EU manufacturers needs one SRN, because the AR is fulfilling the same role for each of those manufacturers. Each SRN is linked to a specific role, and therefore each SRN will have different authorities regarding data entry and access to specific records.

When requesting an SRN,the LUA must also be appointed. The LUA can authorize local users within an SRN, which makes it important position within the Eudamed system. There is no limit to the number of users the LUA can appoint, and users may have different access levels. In order to ensure continuity, the European Commission recommends the appointment of more than one LUA. Expect the identity of the LUA to be verified by the Competent Authorities. It is not decided how these verifications will be done. It is important that each actor requests their SRN themselves, because the Medical Devices Regulation and In-vitro Diagnostic Regulation do not allow delegation of this step; you can only ask for an SRN for Company XYZ if you are Company XYZ. The AR may help and guide a non-EU company through the steps, but companies themselves must perform this step.

The SRN and LUA will be issued/appointed by the relevant National Competent Authority. For EU-based organizations this is the Competent Authority of the Member State where they are based. For non-EU manufacturers this will be the Member State where their AR is based, and for non-EU sponsors this will be the Member State where their Legal Representative is based. At this moment it is not possible to request an SRN or get a LUA appointed. Still, Emergo recommends that you approach your local Competent Authority or that of your AR by sending a registered letter to their general mail address.

There are two very good reasons for this:

  1. You make them aware you want this, and you want this now. At this moment Competent Authorities not developed these procedures, although it does not require much imagination to understand that issuing all these SRNs and LUAs between March 2020 and May 2020 will be an enormous challenge. If they wait too long, they will not be ready for this once Eudamed goes live. Although the MDR allows for a delay in the requirements related to Eudamed if the development of Eudamed is delayed, there are no provisions in case of a bottleneck in the issuing of SRNs by the authorities.
  2. There is also a legal point; if you claim damage because your SRN was not issued in time, you can demonstrate that you have made the authorities aware of your need for an SRN. This will make your case strong, and the authorities will be aware of that. This may help the authorities in setting priorities in time.

For British companies it is not clear how the situation will be after 29 March 2019 (Brexit day). However, except for the hard ‘cliff edge’ scenario it is likely the MDR will be introduced into British law as well. Therefore it is recommended for British companies to prepare for Eudamed as well.

SRN/LUA in short:

  • One SRN for each role.
  • Request SRN and LUA yourselves.
  • Approach your local Competent Authority, or that of your AR for requesting an SRN/LUA.
  • Send a registered letter to your Competent Authority now asking for an SRN/LUA.

Timelines for Eudamed and related data entry deadlines

Eudamed will be developed for medical devices as well as for IVDs. As the IVDR becomes applicable two years after the MDR, the MDR gets a lot of attention. Therefore it may appear as if the focus is only on medical devices. However, at the moment Eudamed goes live it will be available for IVDs as well.

The current timelines indicate that Eudamed will go live on March 26, 2020. This may sound optimistic, but so far the Eudamed team has managed to hit all deadlines and it appears they are still on track for that ambitious goal.

From the day Eudamed goes live it is possible to request an SRN and have an LUA appointed. Once that is done each actor can enter their data into Eudamed.

Unless the go-live date of Eudamed is delayed beyond 26 May 26, 2020, the date of application of the MDR will require manufacturers of medical devices (not IVDs) to start entering data into Eudamed. For the first 18 months the requirement is limited to new information. In general this means that any vigilance case, Field Safety Corrective Action (FSCA), new or changed certificate, new clinical study, etc. needs to be entered in Eudamed. That also implies that all related information needs to be entered: device details (including UDI), certificates, etc. This will help fill Eudamed with data. Of course manufacturers need to have access to Eudamed and therefore the issuing of SRN and appointment of LUA is crucial.

During an 18-month periodafter the application of Eudamed, all data related to the other medical devices manufacturers are placing on the European market must be entered. This includes devices that are certified under the current Medical Devices Directive (MDD). Until devices are registered in Eudamed, the current MDD requirements for registration/notification are presumed to be in place.

For IVDs the situation is generally the same. From the moment Eudamed goes live manufacturers can apply for an SRN and have their LUA appointed. They can start entering data any time after that. From May 26, 2022, the date of application of the IVDR, they must enter new or mutated data and Eudamed must be fully up to date will all data regarding IVDs being placed on the market 18 months later.

Timelines in short:

  • The go-live date for Eudamed is set on March 26, 2020.
  • On that date Eudamed will be functional for medical devices as well as IVDs.
  • From 26 May 26, 2020 for medical devices, and May 26, 2022 for IVDs, it is required to enter new or modified data in Eudamed, including data that is directly linked to these records.
  • During a period of 18 months after the date of application of Eudamed the database must be filled with data on the rest of the devices that are placed on the European market.

Ronald Boumans is Senior Regulatory Consultant at Emergo in The Netherlands.

Learn more about Eudamed and European medical device regulatory issues at Emergo:

  • EU MDR 2017.745 gap assessment and transition management
  • On-site MDR training for medical device companies
  • Webinar: Eudamed requirements under the European MDR and IVDR

 

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Europe's Eudamed Database: Five Key Questions (Part 2)

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Europe's Eudamed Database: Five Key Questions (Part 2)

In Part Two of Emergo’s series identifying five major questions regarding Eudamed compliance under Europe’s Medical Devices Regulation (MDR) and In-vitro Diagnostics Regulation (IVDR), we cover issues including roles and responsibilities of importers, distributors and Authorized Representatives, plus clinical and performance study issues.

Eudamed: Top 5 questions for medical device and IVD companies part 2In July 2018 Emergo presented a webinar on Eudamed that generated more than 100 questions from audience members. We’ve distilled these questions and concerns regarding the European medical device database into five major themes, which we cover in a two-part blog post series. (Read Part One here.)

Role of importers, distributors and AR

A manufacturer may distribute its devices directly to end users. The majority of manufacturers will however use distributors. Distributors will not have to enter data in Eudamed, but they should access the database to verify that their device information is entered correctly. If that is not the case, the device is not in compliance and they should not distribute it further in Europe.

Manufacturers based outside the EU must use an importer. This importer is a distributor that gets its devices from a manufacturer based outside the EU and then places these products on the European market. The role of the importer is slightly different from that of the distributor (see articles 13 and 14 of the MDR and IVDR). The importer must register itself in Eudamed and apply for a Single Registration Number (SRN) appoint a Local User Administrator (LUA).

Some non-EU companies have their own Authorized Representatives (AR), which also operate as their importers. These roles require different SRNs and cannot fall under the SRN of the manufacturer. Although in practice these steps may be taken by someone based in the manufacturer’s head office, it is very important to make sure such activities are performed by the respective legal persons: Manufacturer XYZ Ltd. uses XYZ Europe Ltd. as their AR, and XYZ Imports Ltd. for importing. Each of these entities must have its own respective SRN.

For non-EU manufacturers using an independent AR and importer, this works basically the same way. Each of these entities must have its own SRN. Both AR and importer may already have an SRN because they are involved with other devices, and they do not require an additional SRN for an extra manufacturer they are representing. The AR and/or importer may assist the manufacturer in getting access to Eudamed and entering data, but they cannot replace the manufacturer’s position. If this AR or importer enters data on behalf of the manufacturer, they must use the SRN of the manufacturer. If they would use their own SRN they would not be able to enter that data. The LUA of the manufacturer must therefore appoint users within the AR or importer. At this moment there is ongoing discussion as to whether the manufacturer may delegate data entry in the vigilance module to the AR. If that would become possible, the AR could enter vigilance information under its own SRN.

Importer, distributor and AR in short:

  • The importer must enter data in Eudamed, this is not required from the distributor.
  •  Manufacturers, importers and ARs must each have their own SRN that gives each of them specific authorities regarding data entry.
  • It is possible for a manufacturer to have others enter data by authorizing them to use his SRN.

Clinical studies and performance studies

Clinical studies are used to investigate the performance and safety of medical devices, while  performance studies investigate the performance of IVDs. Regarding Eudamed, these two types of studies are basically treated the same.

These studies are performed for devices that are not CE-marked, or with CE-marked devices applied outside their intended use. These devices are used on real patients, but they are not CE-marked. This also implies that the information one would expect from a CE-marked device will not be available in Eudamed. Therefore this module is used to make specific information available to the authorities and the public. Another consequence is that studies done outside Europe or previous studies do not require entering into Eudamed.

Information must be entered by the study sponsor. This sponsor can authorize others, like a contract research organization (CRO) or their legal representative, to enter data as well. This must be done by giving them access to the sponsor’s SRN.

Eudamed requires all relevant data to be entered. It is not possible to refer to other databases like Clinicaltrials.gov for that information.

Post-market clinical follow-up (PMCF) or post-market performance follow-up (PMPF) studies, investigations done with CE-marked devices within the scope of their intended purpose, require subjects to be submitted to invasive or burdensome procedures in addition to those performed under normal conditions of use of a devices. These studies also require submitting information to Eudamed (see article 74 for details). Details regarding other PMCF or PMPF studies do not require uploading into Eudamed.

Studies in short:

  • Only clinical studies or performance studies that are ongoing or starting in Europe need to be entered into Eudamed.
  • The sponsor is responsible for entering data, but it can give others access to its SRN for doing this.
  • Full data entry is necessary; no reference to other databases is allowed.

Test environment

The test environment is not yet available. Once this is the case this will be communicated by the Commission and Emergo will of course forward that information. Emergo expects the test environment to be available somewhere in the middle of 2019.

For accessing the test environment it is not necessary to have an SRN. This environment will be available to users outside Europe as well. Users testing can switch between roles. For example, if a manufacturer wants to see how linking a certificate to a device works, it can enter fictional certificate data as if it were a Notified Body. The test environment can be used for testing and training for manual data entry and for machine-to-machine exchanges.

Test environment in short:

  • The test environment is not yet available.
  • Once available it will be open to anybody.
  • This site can also be used for training purposes.

Other Eudamed questions

Other Eudamed questions stemming from the webinar were very diverse. Some answers can be found by going back to the recorded webinar, others can be found in the MDR because the questions refer to the MDR requirements and are not specifically referring to Eudamed.

However, two issues were too important to be left unaddressed:

  1. Nomenclature: no decision has been taken regarding medical devices nomenclature. Therefore it is not possible to say anything about the future of Global Medical Device Nomenclature (GMDN). That is really all that can be said at this stage.
  2. Developing applications: if Eudamed goes live as planned in March 2020, it is important to develop and implement Eudamed applications in 2019. Although it is in this stage difficult to provide a clear indication of what such project require, it is clear Eudamed will influence how a manufacturer organizes its device’s data and regulatory affairs processes. Therefore manufacturers, but also importers and ARs, need to plan big and make sure sufficient budget is available.

Ronald Boumans is Senior Regulatory Consultant at Emergo in The Netherlands.

Learn more about Eudamed and European medical device regulatory issues at Emergo:

  • EU MDR 2017.745 gap assessment and transition management
  • On-site MDR training for medical device companies
  • Webinar: Eudamed requirements under the European MDR and IVDR
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Brexit Update: New UK MHRA Guidance for Medical Device Companies

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Brexit Update: New UK MHRA Guidance for Medical Device Companies Emergo

EMERGO SUMMARY OF KEY POINTS:

  • If there is a deal reached regarding the relationship between the UK and the EU after March 29, 2019 (“Brexit Day”), a transition period will apply that will last until December 31, 2020.
  • The European Medical Devices Regulation (MDR) and In-vitro Diagnostics Regulation (IVDR) will become applicable in the UK.
  • The Clinical Trials Regulation will most likely become applicable. Should the implementation be postponed until after December 31, 2020, this Regulation will become UK law anyway.
  • A “cliff edge” Brexit is still an option.

In early August 2018 the UK Medicines & Healthcare products Regulatory Agency (MHRA) issues three new guidance documents for medical device, IVD and related healthcare sectors to prepare for ramifications of Brexit.

UK MHRA guidelines for medical device and IVD companies through BrexitThe MHRA guidances include:

  1. What the implementation period means for the life science sector
  2. Technical information on what the implementation period means for the life science sector
  3. Update on the Clinical Trials Regulation during the implementation period.

In March 2018 an agreement between European Union and UK negotiators was reached to introduce an implementation period starting March 29, 2019 (Brexit Day) until December 31, 2020. During this time period, most of the current regulatory arrangements would be continued.

This transition period is intended to allow more time for negotiating a permanent deal regulating the relations between the UK and the EU. This transition period will apply if there is an agreement reached. However, if the UK leaves the EU without an agreement—the “no deal” or “cliff edge” Brexit—there will be no transition period. The MHRA considers the “no deal” scenario unlikely and does not provide any guidance for the industry to prepare for that circumstance.

MDR, IVDR implementations still on track

For medical devices and Notified Body certificates there will be no significant changes during the transition period. In May 2020 the Medical Devices Regulation 2017/745 (MDR) will become applicable. As a result of the agreement on the transition, the MDR will become fully applicable in UK after the official Brexit day.

The IVD Regulation 2017/746 (IVDR) will become applicable in May 2022, which falls after the transition period. However, IVDs can already be legally placed on the market if they comply with the IVDR. Therefore the IVDR will also be considered applicable during the transition period. Industry can therefore prepare for full IVDR implementation in the UK in 2022.

Questions regarding the Clinical Trials Regulation (CTR)

For British Notified Bodies the transition period means that their designations will remain valid and they can continue issuing certificates for CE Marking for at least until the end of the transition period.

For the new Clinical Trials Regulation (EU) 536/2014 (CTR), on the other hand, the situation is less straightforward.

The CTR was published in 2014, but its date of application depends on the date by which a fully functional clinical trials portal and database are available. This is planned during 2020, and therefore the CTR will likely become applicable before the end of the transition period. In case this is delayed the UK has agreed to apply the CTR as UK law anyway in order to give researchers more certainty when planning their studies. There will be a problem accessing the database though, although it is expected this will also be solved through negotiations.

No clear Brexit roadmap for industry, regulators

The MHRA states that it is not clear what will happen with Brexit in the long run. Regulatory divergence cannot be ruled out. However, there is a catch. If and only if the European Court of Justice is continues to be recognized in the UK for the interpretation of laws, British Notified Bodies can remain functioning as they do now. The same holds for UK Authorized Representatives. A market can only function if all parties agree on a single interpretation.

It is easy to see that a British judge contradicting the European Court of Justice on an interpretation may result in British Notified Bodies applying rules and regulations in a different way compared to their European colleagues. Something similar would happen to a legal person representing a manufacturer based outside the direct jurisdiction of that market. The problem here is that one of the arguments by the “leave” campaign was about European judges overruling British citizens. Therefore it is unlikely the British parliament will accept an agreement where the European Court of Justice will be recognized.

On October 18 and 19, 2018 there will be an EU Summit focused on adopting a draft withdrawal agreement. If no deal can be struck then, it is expected the EU will withdraw from the negotiations because the Member States and the European Parliament need time to vote on it and want time for preparations. In that case there could be no deal, so the market cannot rule out cliff-edge Brexit.

Ronald Boumans is Senior Regulatory Consultant at Emergo in The Netherlands.

Additional European medical device and IVD regulatory resources:

  • European CE Mark training for medical device companies
  • European MDR gap assessment and transition consulting
  • Clinical trial management for medical devices in Europe
  • Whitepaper: Preparing to change your European Notified Body
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Article 8

MDR Analysis: Does your medical device fall under the scope of new European regulations?

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Now that the European Medical Device Regulation (MDR) is widely available, manufacturers and other industry participants can more accurately predict key issues that will affect them—including how and whether the scope of the new regulations covers their devices.

The MDR text (see page 13 for the definition) as well as its accompanying Annex XVI (page 117) lay out clear indications as to which types of devices will have to comply with the new requirements and which will be covered by separate regulations. Before we go into detail, you might want to read last week’s high level overview of the MDR changes, or download our whitepaper on the MDR.

It is important to note that the MDR covers devices that previously fell under two separate European directives, the Medical Devices Directive (MDD) and the Active Implantable Medical Devices Directive (AIMDD); in vitro diagnostic devices will be covered by the new In Vitro Diagnostics Directive (IVDR).

How the MDR defines "medical device"

The MDR defines the term “medical device” as any “instrument, apparatus, appliance, software, implant, reagent, material or other article” intended to be used for any of the following medical purposes:

  • Diagnosis, prevention, monitoring, treatment or alleviation of disease, disability or injury, where prevention of disability and injury is excluded
  • Investigation, replacement or modification of an anatomical, physiological or pathological process
  • Providing data via in vitro examination of samples derived from a human body

The new regulation also specifies particular types of products that also qualify as medical devices requiring CE Marking:

  • Products intended for cleaning, disinfection and sterilization of medical devices
  • Devices for the control and support of conception, even if they achieve their intended purpose by pharmacological, immunological or metabolic means.

Of course, manufacturers currently certified to market their devices in the European Union should familiarize themselves with the MDR text to determine whether their products do indeed fall under the scope of the new regulation, but some examples of products that do and do not fall under the MDR are provided below.

Is my product a device according to the MDR?

YesNo
  • Products used for cleaning, disinfecting or sterilizing other medical devices (e.g. scope disinfector)
  • Products that utilize viable biological components for their intended purpose (e.g. lactobacillus)
  • Devices for purposes of control or support of conception (e.g. condom, intrauterine device)
  • IVDs, medicinal products, cosmetics and food products; these are regulated elsewhere
  • Software used for any purpose covered by MDR’s definition of a medical device
  • Software used for general administrative purposes, even in healthcare settings

Annex XVI devices

In addition to products meeting the MDR’s definition of medical devices, Annex XVI of the new regulation lists groups of products that, despite having no intended medical purpose, must also meet MDR requirements.

The major product groups in Annex XVI include:

  • Contact lenses and other products used in or on the eye
  • Products introduced into the body via surgically invasive means in order to modify anatomy
  • Products and substances used for facial or other subcutaneous filling
  • Equipment used for liposuction, lipolysis or lipoplasty
  • High-intensity electromagnetic radiation equipment used for skin treatments such as tattoo and hair removal
  • Equipment using electrical or magnetic currents to stimulate the brain

Accessories

Accessories are products that are intended to enable a device to be used in accordance with its intended purpose or to assist the medical functionality of the medical device. They are covered in the scope of the Regulation, similar to the requirements in the Directives. As some products are now added to the definition of a medical device, their accessories will also be covered by the scope of the Regulation. Therefore it is necessary to verify all products used together with these new categories of medical devices to identify accessories as defined in the MDR.

Some examples:

  • Nets for sterilization;
  • Devices used to position or remove invasive or implantable contraceptives;
  • Software used for creating images of the expected effects of breast implants

Borderline products

For the majority of the products it will be relatively straightforward to determine their status. However, Emergo expects that this Regulation will soon create its own list of borderline products. Emergo is interested in the devices and accessories that you consider medical devices, or that should not be covered by this scope. So please send us your examples, with a clear description of the intended purpose and mode of action, so we can analyze the consequences of the new definition.

Gray areas

In some instances, determining whether a product qualifies as a medical device under the MDR will not be a cut and dry affair. As manufacturers begin compliance efforts under the new regulations, some product types will elicit questions from manufacturers that will require further clarification from Brussels.

One such question likely to arise pertains to products listed in Annex XV and accessories. By definition, accessories must be used in relation to the medical purpose of a device, but the products in Annex XV have no medical purpose. So, does this mean that no accessories exist for Annex XVI devices?

Europe Update: Notified Body MDD, AIMDD Timelines

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EMERGO SUMMARY OF KEY POINTS:

  • Some European Notified Bodies appear to have set early 2020 deadlines for renewals of CE Mark certifications under the Medical Devices Directive (MDD) and Active Implantable Medical Device Directive (AIMDD).
  • Manufacturers may find it increasingly difficult to obtain MDD and AIMDD certifications starting in late 2019.
  • These timelines should help manufacturers plan their transition strategies for Medical Devices Regulation (MDR) compliance.

Some Notified Bodies (NBs) will soon be designated to the Medical Devices Regulation (EU) 2017/745 (MDR). But how they will manage their Medical Devices Directive 93/42/EEC (MDD) and Active Implantable Medical Devices Directive 90/385/EEC (AIMDD) reviews concurrently with their MDR reviews is yet to be revealed.

Time running out for MDD, AIMD certifications

From contacts with several large NBs, Emergo understands that, depending on the timeline for designation of the NB involved, from the second quarter of 2019 onwards, it will become increasingly difficult to secure AIMDD and MDD certification. Recently Emergo received documents released by two of the larger NBs. In the first of these official documents, January 2019 is the deadline specified for new  Class III MDD and AIMDD devices requiring consultation (e.g. ancillary drug, animal tissue etc.) through August 2019 for new Class I sterile/measuring submissions. Renewal audits as part of the regular certification cycle will no longer be possible starting January 2020, which implies that all certification for the Directives will have ceased by the end of 2019.

The second document has an even steeper timeline, where signed applications for CE Mark certifications must be supplied by January 2019, with all forms and review documents sent in by March 31, 2019. There is, of course, the proviso that both of these NB sources expect MDR designation at the beginning of 2019. Other NBs may have different timelines for their cut-off dates, but Emergo expects the differences among the large NBs be limited.

Planning MDR transition strategies

This initiative helps manufacturers plan their transitions and regulatory strategies. It also illustrates that time is quickly running out for certification under the Directives, and manufacturers will soon only be able to certify under the MDR. It would, of course, be interesting to see how other NBs intend to approach these cut-off issues. Emergo recommends that manufacturers fine tune their plans with their respective NBs to ensure a smooth transition.

The first NB document also provides information about the AIMD/MDD, and asks manufacturers to indicate their plans regarding the MDR.  Let’s hope that there are sufficient NBs available to review the MDR submissions from manufacturers of Class I reusable surgical instruments,  who may not have had experience with an NB and find themselves at the end of the queue in May 2020.

Learn more about upcoming changes to European medical device regulations:

 

 

 

 

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KPMG and RAPS: Medical Device Companies Under-prepared for European MDR

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EMERGO SUMMARY OF KEY POINTS:

  • A new medical device industry survey finds many firms still lack a firm understanding of the European Medical Devices Regulation (MDR) and related compliance issues.
  • Device manufacturers cite lack of understanding of the MDR as well as shrinking Notified Body capacity as top challenges ahead of the Regulation’s 2020 enforcement deadline.
  • Survey conductors provide several recommendations for manufacturers to more fully prepare for MDR compliance.

A new medical device industry survey shows that many medical device manufacturers still lack long-term plans for compliance to the European Medical Devices Directive (MDR) with a 2020 deadline looming.

The survey, conducted by KPMG and the Regulator Affairs Professional Society (RAPS) earlier in 2018, queried 220 medical device companies regarding their MDR compliance efforts. Only 21% of respondents reported having a deep understanding and a strategy for dealing with MDR’s impact, while 41% of companies indicated little to no understanding of the Regulation. Clearly, many manufacturers have a lot of preparation work ahead of them before MDR comes into force.

Obstacles to MDR compliance

Roughly half of all respondents expressed confidence that they will ultimately be able to meet MDR compliance deadlines. In the meantime, however, companies cite two key challenges to more fully preparing for these major European regulatory changes:

Understanding the MDR: Nearly 80% of respondents currently lack sufficient understanding of the MDR, according to survey results. Without sufficient understanding, these firms have yet to finalize strategies to deal with the Regulation’s significant new requirements.

Availability of designated Notified Bodies: As Emergo has previously reported, Notified Bodies’ capacity to audit medical device clients under the MDR presents a major concern for manufacturers active in the European market. Survey respondents also identify availability of designated Notified Bodies as a significant barrier to MDR compliance; the survey report notes that so far, only 19 Notified Bodies have applied for re-designation under the new Regulation, whereas more than 80 Notified Bodies now hold designations under the MDD. Such a scenario increases the likelihood of “orphaned” manufacturers unable to find Notified Body partners necessary for CE Mark certification under the MDR.

Nuts-and-bolts challenges in terms of MDR impact

Respondents also indicated which MDR compliance areas are presenting the most challenges compared to MDD requirements, with 58% of companies stating that clinical data management rules are the most challenging component of the new Regulation. On a related note, an equal percentage of companies have yet to implement a data collection strategy to address MDR clinical requirements.

Firms also identified legacy device management and working with Notified Bodies as significant challenges, as well.

Recommendations for better MDR preparation

Using information from respondents’ replies, survey conductors listed several high-level challenges to MDR compliance, as well as recommendations to address these issue within the MDR’s 2020 compliance timeframe:

  • Assign staff and allocate resources to read and become more familiar with the MDR and its requirements;
  • Establish and align cross-functional resources and staff to forecast and prepare for business and operational impacts of the new Regulation;
  • Consider MDD and/or Active Implantable Medical Devices Directive (AIMDD) recertification under the current grace period in order to mitigate delays in MDR certification due to Notified Bodies’ capacity challenges;
  • Establish cross-functional teams to manage relationships with economic operators and meet new supply chain requirements under the MDR
  • Develop post-market surveillance (PMS) systems with strong links to risk management functions to help manage quality requirements for new as well as legacy devices in firms’ product portfolios;
  • Develop and implement data collection strategies to address MDR’s PMS requirements as well as compliance with the Eudamed medical device database.

Related European Medical Devices Regulation information from Emergo by UL:

  • European CE Marking strategy for medical device companies
  • On-site European MDR training for medical device manufacturers
  • European MDR gap assessment and transition strategy
  • Whitepaper: Understanding Europe’s new Medical Devices Regulation
  • Webinar: European MDR 2017/745
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欧洲Eudamed数据库: 五个关键问题(第2部分)

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Europe's Eudamed Database: Five Key Questions (Part 2)

Emergo编写了针对欧洲MDR和IVDR的Eudamed合规博文系列,主要讨论其中涉及的五个主题,在第二部分中我们涵盖的问题包括进口商、分销商和授权代理人的角色和责任,以及临床和性能研究问题。

Eudamed: Top 5 questions for medical device and IVD companies part 22018年7月,Emergo举办了一次针对欧洲医疗器械数据库(Eudamed)的 网络研讨会 ,解答了观众的100多个问题。 我们将有关Eudamed的这些问题和疑虑精简为五个主要主题,并会在两篇博文系列中讨论这些主题。 ( 在此阅读第二部分。)

进口商、分销商和AR的职责

制造商可以将其医疗器械直接分销给最终用户。 不过大多数制造商会选择使用分销商。 分销商不需要在Eudamed中输入数据,但他们应该访问数据库,并验证所销售器械的信息是否被正确录入。如果不正确,则表示医疗器械不符合规定,且不应在欧洲进一步分销。

欧盟以外的制造商必须使用进口商。 进口商是一家分销商,它将直接从欧盟以外的制造商处获取器械,然后将这些产品投放到欧洲市场上。 进口商的职责与经销商的职责略有不同(见MDR和IVDR第13和14条)。 进口商必须在Eudamed中注册并申请SRN号,指定本地用户管理员(LUA)。

一些非欧盟公司拥有自己的授权代理人(AR),同时也是他们的进口商。 这些不同的职责方需要不同的SRN,不能使用制造商的SRN。 虽然实际上这些步骤可能都是由制造商总部的人员来实施,但确保此类活动由相应的法人执行是非常重要的:制造商XYZ有限公司使用XYZ欧洲有限公司作为其AR,而XYZ进口商则负责其进口业务。 这些实体都必须拥有各自的SRN。

对于使用独立AR和进口商的非欧盟制造商来说,运行方式是相同的。这些实体都必须拥有各自的SRN。 AR和进口商可能都已经拥有其SRN,因为它们的业务涉及其他器械,对于需要它们提供代理服务的其他制造商,不需要获取额外的SRN。AR及/或进口商可以协助制造商获取Eudamed权限并输入数据,但他们不能取代制造商。如果此AR或进口商代表制造商输入数据,则必须使用制造商的SRN。 他们使用自己的SRN是无法输入数据的。 因此,制造商的LUA必须在AR或进口商内指定用户。 现今的讨论议题是制造商是否可以将警戒模块中的数据输入委托给AR。 如果这一点成为可能,那么AR就可以通过自己的SRN输入警戒信息。

进口商、分销商和AR总结:

  • 进口商必须在Eudamed中输入数据,而分销商不需要这样做。
  •  制造商、进口商和AR必须各自拥有自己的SRN,他们针对数据输入会有特定的权限。
  • 制造商可以授权他人使用其SRN来输入数据。

临床研究和性能研究

临床研究旨在研究医疗器械的性能和安全性, 性能研究则用于调查IVD的性能。 在使用Eudamed时,这两种类型的研究基本上视为相同。

这些研究针对的是没有CE标志的器械,或拥有CE标志,但应用于其预期用途范围之外的器械。 这些器械会使用在真实患者,但没有CE标志。这也意味着有的CE标志器械在Eudamed中可能没有预期的信息。 因此,通过该模块,可以向相关机构和公众提供特定信息。 另外,在欧洲以外进行的研究,或先前的研究则不需要输入Eudamed。

相关信息必须由研究申办方输入。 该申办方可以授权其他人(比如合同研究组织(CRO)或其法定代表人)输入数据。 但必须向他们提供申办方的SRN使用权限。

按照要求,所有的相关数据都必须输入至Eudamed。 不可参考引用 Clinicaltrials.gov 等其他数据库的相关信息。

对于PMCF或PMPF研究、在预期目的范围内使用具有CE标记的器械进行研究,除了在正常使用器械的条件下所进行的操作之外,还要求受试者接受侵入性或繁琐的操作程序。这些研究也需要向Eudamed提交信息(详见第74条)。 有关其他PMCF或PMPF研究的详细信息不需要上传到Eudamed。

针对研究情况的总结:

  • 只有正在进行或正在欧洲开始进行的临床研究或性能研究才需要输入至Eudamed。
  • 研究申办者需要负责输入数据,也可授权他人使用其SRN进行此项操作。
  • 必须输入完整的数据;不允许参考引用其他数据库信息。

测试环境

测试环境尚不可用。 一旦可用,委员会将会进行告知,Emergo则会转发这些信息。 Emergo预期测试环境将在2019年中期左右可用。

测试环境无需SRN就可进入。 欧洲以外的用户也可以使用此测试环境。 用户测试可以在各角色之间切换。 例如,如果制造商想要查看如何将一个证书链接到一个器械,则可以向认证机构一样输入虚构的证书数据。 测试环境可用于手动数据输入,以及机器间交互的测试和培训。

测试环境相关信息总结:

  • 测试环境尚不可用。
  • 一旦可用,将向所有人开放。
  • 该网站也可用于培训目的。

其他与Eudamed相关的 问题

网络研讨会中涉及其他关于Eudamed的问题非常多样化。您可以回看网络研讨会录像了解相关答案,有的答案则可在MDR中找到,因为这些问题涉及MDR要求,并不与Eudamed具体相关。

但有两个问题非常重要,一定要注意:

  1. 命名: 关于医疗器械命名并无任何定论。因此我们无法对全球医疗器械命名(GMDN)的未来发表任何意见。现阶段我们能传达的仅限于此。
  2. 开发应用: 如果Eudamed按计划于2020年3月上线,在2019年开发和实施Eudamed应用则非常重要。虽然在这个阶段很难清楚确认此项目需要哪些要素,但显然Eudamed将对制造商如何组织其器械相关数据和监管事务流程产生影响。因此,制造商、进口商和AR,需要做好长远规划,并确保有足够的预算支持。

Ronald Boumans是Emergo荷兰办事处的高级监管顾问。

在Emergo了解更多关于Eudamed和欧洲医疗器械监管问题的信息:

  • EU MDR 2017.745差距评估和过渡 管理
  • 针对医疗器械公司的现场MDR 培训 
  • 网络研讨会:欧洲MDR和IVDR监管下的Eudamed要求
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最新脱欧信息: 新的针对医疗器械公司的英国MHRA指南

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Brexit Update: New UK MHRA Guidance for Medical Device Companies Emergo

Emergo关键点摘要:

  • 如果在2019年3月29日(“脱欧日”)之后,英国和欧盟之间达成关系协议,那么截至2020年12月31日的过渡期就将付诸实施。
  • 欧洲医疗器械规定(MDR)和体外诊断器械规定(IVDR)将适用于英国。
  • 临床试验法规很可能也将适用于英国。 如果实施推迟到2020年12月31日之后,该法规将成为英国法律。
  • 断崖式脱欧仍有可能发生。

2018年8月初,英国药品和保健产品监管署(MHRA)发布了三份针对医疗器械、体外诊断和相关医疗保健行业的新指导文件,以为英国脱欧做好准备。

UK MHRA guidelines for medical device and IVD companies through BrexitMHRA指导文件包括:

  1. 实施期对生命科学领域意味着什么
  2. 实施期对生命科学领域意义的相关技术信息
  3. 在实施期更新临床试验法规。

2018年3月,欧盟与英国谈判代表达成协议,确立从2019年3月29日(脱欧日)开始到2020年12月31日结束的“实施期”。在此期间,大部分现行监管安排将持续有效。

这一过渡期目的在提供更多时间,让英国与欧盟就彼此间的关系谈判并达成永久性协议。如果达成协议,此过渡期才会实施。 但是,如果英国在没有达成协议的情况下离开欧盟,即无协议或断崖式脱欧,则过渡期将不会实施。 MHRA认为不太可能出现“无协议”脱欧的情况,因此并没有为行业提供任何指导,以应对这种情形。

MDR、IVDR的实施仍在进行中

在过渡期间,医疗器械和公告机构证书不会有重大变化。 2020年5月,医疗器械规定2017/745(MDR)将适用。 就过渡期所达成的协议,在官方英国脱欧日之后,MDR将在英国完全适用。

IVD规定2017/746(IVDR)将于2022年5月(过渡期过后)生效。 而若IVD符合IVDR,则已可合法上市。因此,IVDR也可视为在过渡期适用。 整个行业可以为2022年英国的IVDR全面实施做好准备。

临床试验法规(CTR)的相关问题

对于英国公告机构来说,过渡期意味着他们的资质仍然有效,并且至少可以在过渡期结束前,继续签发CE标志证书。

但对于新的临床试验法规(EU(536/2014(CTR),情况并非如此简单。

CTR发布于2014年,但其申请日期取决于功能完善的临床试验门户和数据库的提供日期。 这计划将于2020年实现,因此CTR可能会在过渡期结束之前开始适用。如果这项内容推迟,英国同意将CTR作为英国法律使用,让研究人员在规划研究项目时提供更多的确定性。 但是访问数据库可能会出现问题,不过预计这一问题也将通过谈判解决。

对于整个行业、监管机构来说,并没有清晰的脱欧路线图

MHRA表示,目前尚不清楚英国脱欧将带来何种长期影响。 不排除会出现监管分歧。 但是,这里可能会有一个玄机。 如果英国继续承认欧洲法院的法律解释(也只有在这种情况下),英国公告机构才能像现在一样继续运作。 这一点对于授权代理人来说也是一样。 只有当所有各方就单一解释达成一致时,市场才能正常运作。

如果英国法官就某个法律解释与欧洲法院相抵触,则不难见到,可能会导致英国公告机构,和在欧洲的同行以不同的方式实施相关规则和法规。类似的事情也可能会发生在直接管辖范围之外的制造商的代理法人身上。支持“脱欧”者的其中一个论点就是指责欧洲法官对英国公民进行否定裁决。 因此,英国议会不太可能接受欧洲法院承认的协议。

2018年10月18日和19日将要举行的欧盟峰会,重点就是要通过一项退出协议草案。 如果不能达成任何协议,欧盟可能会退出谈判,因为成员国和欧洲议会需要时间进行投票,并希望有足够的时间做好准备。 在无协议达成的情况下,市场可能要面对断崖式脱欧。

Ronald Boumans是Emergo荷兰办事处的高级法规顾问。

其他欧洲医疗器械和IVD法规信息资源:

  • 针对医疗器械公司的欧洲CE认证标识 培训 
  • 欧洲MDR差距评估和过渡 咨询
  • 欧洲的医疗器械临床试验 管理 
  • 白皮书:准备好更换您的欧洲公告机构
Insight Type: 
Not Insight

MDR分析: 您的医疗器械是否在新的欧洲法规的管辖范围内?

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鉴于欧洲医疗器械法规(MDR)现在已被广泛应用,制造商和其他行业参与者可以更准确地预测对他们产生影响的关键问题—— 新法规的范围是否以及如何涵盖其医疗器械。

MDR(定义见第13页)及其附件XVI(第117页)明确说明了哪种类型的器械必须符合新的要求,以及哪些将需要遵循单独的法规规定。 在我们进行详细介绍之前,您可以阅读一下上周的MDR变化的高级概述,或者下载我们关于MDR的白皮书

值得注意的是,MDR涵盖了之前两项欧洲指令下的器械,这两个指令是医疗器械指令(MDD)和有源植入性医疗器械指令(AIMDD);体外诊断器械将涵盖在新的体外诊断指令(IVDR)之中。

MDR如何定义“医疗器械”

MDR将“医疗器械”一词定义为旨在用于以下任何医疗目的的任何“工具、仪器、器具、软件、植入物、试剂、材料或其他物品”:

  • 诊断、预防、监测、治疗或减轻疾病、残疾或伤害,但不包括预防残疾和伤害
  • 调查、替换或调节解剖、生理或病理过程
  • 通过对来自人体的样品进行体外检测以提供数据

新法规还规定可划归为医疗器械、需要CE标志的特殊类型的产品:

  • 用于医疗器械清洁、消毒和灭菌的产品
  • 用于控制和支持受孕的装置,即使它们是通过药理学、免疫学或代谢方式达到预期目的也是如此。

当然,目前经过认证可在欧盟市场销售其器械的制造商应该比较熟悉MDR,可以确定他们的产品是否划归在新法规的范围内,不过我们还是在下面提供了一些属于和不属于MDR的产品示例。

根据MDR规定,我的产品属于医疗器械吗?

属于不属于
  • 用于为其他医疗器械清洁、消毒或灭菌的产品(例如示波器消毒器)
  • 利用活细胞生物成分达到预期目的的产品(如乳酸菌)
  • 用于控制或支持受孕的装置(例如避孕套、子宫内装置)
  • IVD、药用产品、化妆品和食品;这些都由其他法规监管
  • 用于MDR医疗器械定义所涵盖的任何目的的软件
  • 用于一般管理目的的软件(甚至是被用在医疗保健环境中)

附件XVI器械

除了符合MDR医疗器械定义的产品外,新法规的附件XVI还列出了没有预期医疗目的,但也必须满足MDR要求的产品组别。

附件XVI中主要的产品组别包括:

  • 隐形眼镜和其他用于眼睛内或眼睛上的产品
  • 通过手术侵入方式进入人,以改变人体解剖结构的产品
  • 用于面部或其他皮下填充的产品和物质
  • 用于吸脂、脂肪分解或脂肪成形术的设备
  • 用于皮肤护理(如纹身和去毛)的高强度电磁辐射设备
  • 使用电流或磁流刺激大脑的设备

附件产品

附件是指在让器械能够根据其预期目被使用,或者对医疗器械的医疗功能提供辅助的产品。它们包含在法规范围内,与指令中的要求类似。 鉴于某些产品现已被添加到医疗器械的定义中,因此其附件也将受到法规范围的约束。因此,有必要使用这些新的医疗器械类别来验证所有一起使用的产品,按照MDR中的定义来确认哪些属于附件。

一些范例:

  • 灭菌网;
  • 用于定位或移除侵入性或植入式避孕药具的装置;
  • 用于创建乳房植入物预期效果图像的软件

边界产品

对于大多数产品来说,想要确定其分类是相对简单的。 Emergo预计该法规将很快创建出边界产品清单。Emergo对您认为其属于医疗器械或认为不应包含在此范围内的器械和附件能提供协助。因此,请将您的范例产品发送给我们,并附上明确的预期目的和作用方式说明,以便我们在新定义下进行分析。

灰色地带

在某些情况下,根据MDR确定产品是否符合医疗器械定义并不容易。有的产品类型会随着制造商开始根据新法规,开展合规性工作而产生问题,而这需要相关负责机构进一步解释说明。

其中可能出现的问题会与附件XV列出的产品和器械附件有关。根据定义,器械附件必须与器械的医疗用途相关,但附件XV中的产品并没有医疗用途。那么,这是否意味着附件XVI中的器械不存在器械附件?

欧洲Eudamed数据库: 五个关键问题(第1部分)

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Europe’s Eudamed Database: Five Key Questions (Part 1) Emergo

想要达到欧洲医疗器械规定(MDR)和体外诊断器械法规(IVDR)框架下的Eudamed相关要求,可能需要好几年的时间,且为达到新规定的要求而做好准备将需要付出不懈的努力。我们已经找出了制造商在Eudamed发布之前,许多需要解决的问题。

Eudamed: Five key questions for medical device and IVD manufacturers2018年7月,Emergo举办了一次针对欧洲医疗器械数据库(Eudamed)的网络研讨会,解答了观众的100多个问题。 我们将有关Eudamed的这些问题和疑虑精简为五个主要主题,并会在两篇博文系列中讨论这些主题。

SRN号及本地用户管理员(LUA)

SRN代码是明确识别欧盟内经济运营商的一种代码。用于其他市场的识别代码(例如,GS1 GLN)与此内容并不相关。

经销商无需在Eudamed数据库中输入数据,因此无需申请SRN代码。申办方(Sponsor) 不被视为经济运营商,因此他们不使用SRN,而是通过身份识别代码来进行识别。在实际操作中,这两者之间其实没有太大的差别,因此在有些情况下,下列信息其实也可以视为和申办方有关。

一个组织的每个参与角色都需要一个SRN代码。 一些范例: 制造商Alpha位于欧盟成员国,并且也从非欧盟制造商Beta那里进口医疗器械。作为制造商,他们需要一个SRN代码;而作为进口商他们也需要另一个SRN代码。假如他们还是制造商Beta医疗器械的授权代理人(AR),那么他们将需要第三个SRN代码。

即使一个制造商有多个生产地点,它也仍然只需要一个SRN代码,除非这些地点在不同法定制造商的标签(及证书、IFU等)上面被标出来。代表着12个非欧盟制造商的一个AR只需要一个SRN代码,因为AR是代表每一个制造商在履行相同的职责。每个SRN代码都关联到特定的 角色,因此每个SRN代码在数据输入和访问特定档案方面都具有不同的权限。

在申请SRN代码时,必须指定LUA。LUA可以对SRN内的本地用户进行授权,在Eudamed系统中占有重要地位。LUA可以指定的用户数量没有限制,用户可能具有不同级别的访问权限。 为确保工作的连续性,欧盟委员会建议任命一个以上的LUA。 我们预期LUA身份会需要通过有关主管部门的审查。整个验证手续该如何进行,仍尚未确定。重要的是每个参与者自己都要求要有各自的SRN代码,因为医疗器械法规和体外诊断法规不允许通过委托授权的方式来完成这个步骤;如果您  XYZ公司,那么您只能替XYZ公司申请SRN代码。AR可以协助指导非欧盟公司完成这些步骤,但是具体的操作必须由该公司自己来执行。

SRN代码和LUA将由国家有关主管部门签发/委任。对于设在欧盟的公司组织,这里的有关主管部门指的是其所在的欧盟成员国的有关主管部门。 对于非欧盟制造商而言,这里指的是其AR所在的欧盟成员国,而对于非欧盟代理人而言,这里指的是其法定代表所在的欧盟成员国。 目前是无法申请SRN代码或者获得LUA委任的。 尽管如此,Emergo还是建议您就这一问题通过常用邮件地址发送挂号信,联系您的本地主管部门或您的AR。

这么做有两个非常好的理由:

  1. 您能让他们意识到您的需求,了解您现在立刻就希望获取这些内容。 目前,有关主管部门尚未制定出具体的办事流程,不过不难想象,要在2020年3月至2020年5月间签发所有这些SRN代码和LUA将会是一个巨大的挑战。 要是他们等得太久的话,一旦Eudamed正式上线,他们将会来不及做好准备。 假如Eudamed系统的开发被推迟,那么MDR将允许与Eudamed系统相关的规定要求相应被推迟,但是这些主管部门在签发SRN代码时如果遇到瓶颈的话,MDR对此是没有具体规定的。
  2. 从法律上来看;如果您因为SRN代码未能及时签发而要求损害赔偿的话,您就可以通过以上所说的信函证明您已经很明确的告知有关主管部门您对于SRN代码的需求。 这将对您更有利,而且有关主管部门也将意识到这一点。 这可能有助于有关主管部门及时排入优先处理事项。

对于英国公司而言,目前尚不清楚2019年3月29日(英国脱欧日)后会变成什么情况。除非出现“断崖式脱欧”,MDR可能会被引入英国相关法律当中。因此我们建议英国公司也要为Eudamed系统的到来提前做好准备。

SRN / LUA总结:

  • 每个角色一个SRN代码
  • 自己申请SRN代码和LUA
  • 联系主管当局或您的AR申请SRN / LUA。
  • 立即向您的有关主管部门发送一封挂号信,申请SRN代码 / LUA。

Eudamed系统的时间表和相关数据输入的最后期限

Eudamed系统将既可用于医疗器械,也可用于IVD。 IVDR在MDR颁发两年后才会开始适用,因此MDR开始受到了广泛的关注。从表面上看起来它可能只关注于医疗器械。其实从Eudamed上线的那一刻起,它的适用范围就包括IVD。

按照当前的时间表来看,Eudamed系统将于2020年3月26日上线。这听起来可能有些过于乐观,但是至今为止,Eudamed开发团队已经按期限完成了多项先期目标,现在看来,他们仍在朝着实现这个宏伟目标前进。

从Eudamed上线之日起,您就可以申请SRN代码或委任LUA了。 完成该步骤后,每个参与者就都可以将数据输入Eudamed系统。

除非Eudamed系统的上线日期推迟到2020年5月26日以后,否则一旦MDR开始实施的话,医疗器械(非IVD)制造商将需要开始把数据输入到Eudamed系统中。在前18个月中,这仅限于新信息。 一般会包括所有的警戒案件、现场安全纠正措施 (FSCA)、新办或变更证书、新的临床研究等,这些都需要输入到Eudamed系统中。这也意味着需要输入所有相关信息: 医疗器械详细信息(包括UDI)、证书等。这将有助于Eudamed系统的数据录入。 当然,制造商需要有访问Eudamed系统的权限,因此签发SRN代码和委任LUA至关重要。

在应用Eudamed后的18个月内,欧洲市场其他医疗器械制造商的所有相关数据都必须输入其中。 这包括按照当前医疗器械指令(MDD)规定进行认证的器械。 医疗器械在Eudamed系统中进行注册之前,当前的MDD关于注册登记/通知的有关规定应该继续适用。

对于体外诊断器械而言,情况基本相同。 Eudamed系统一旦上线,制造商就可以申请SRN代码并指定他们的LUA。可以在此后任何时间开始输入数据。从2022年5月26日IVDR开始实施之日起,他们必须输入所有新增或变化的数据,而且Eudamed系统必须及时得到更新,包含与18个月后投放到市场上的体外诊断器械相关的所有数据。

简要时间表:

  • Eudamed系统的上线日期定于2020年3月26日。
  • 自该日起,Eudamed系统将开始实行,既适用于医疗器械,也适用于IVD器械。
  • 对于医疗器械而言,从2020年5月26日开始(对于体外诊断器械而言,从2022年5月26日开始),需要在Eudamed输入新增或修改的数据,包括与这些档案直接相关联的纪录。
  • 在Eudamed系统开始实行后的18个月内,其他投放到欧洲市场上的医疗器械数据必须被输入到该数据库中。

Ronald Boumans是Emergo荷兰办事处的高级法规顾问。

由Emergo协助您了解更多关于Eudamed和欧洲医疗器械监管问题的信息:

  • EU MDR 2017.745差距评估和过渡期 管理
  • 针对医疗器械公司的现场MDR 培训 
  • 网络研讨会:欧洲MDR和IVDR监管下的Eudamed要求

 

Insight Type: 
Not Insight

KPMG和RAPS: 医疗器械公司对欧洲MDR的准备不足

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Emergo关键点摘要:

  • 一项新的医疗器械行业调查发现,许多公司仍然缺乏对欧洲医疗器械法规(MDR)及相关合规性问题的深刻理解。
  • 器械制造商认为,对MDR理解的欠缺以及欧盟公告机构能力的萎缩是2020年该法规强制执行期限之前他们所面临的最大挑战。
  • 该调查的执行者为制造商提出了一些建议,以便制造商为MDR合规做好更充分的准备。

一项新的医疗器械行业调查显示,许多医疗器械制造商仍然缺乏如何遵守欧洲医疗器械指令(MDD)的长期计划,尽管该指令的最后期限(2020年)已迫在眉睫。

2018年早些时候由毕马威(KPMG)和监管事务专业协会(RAPS)开展的这项调查询问了220家医疗器械公司在MDR合规性方面做出的努力。 只有21%的受访者表示对MDR有深刻理解并对其影响有应对策略,而41%的公司则表示对该法规几乎没有理解。 很明显,在MDR生效之前,许多制造商还有很多准备工作要做。

MDR合规的障碍

大约半数受访者表示相信他们最终能够在最后期限之前达到MDR合规。 然而,与此同时这些公司还提出了为应对这些重大欧洲法规监管变化做出更充分的准备所面临的两大关键挑战:

理解MDR:根据调查结果,近80%的受访者目前对MDR缺乏足够的理解。 由于没有充分的理解,这些公司尚未最终确定针对该法规重要新规定的应对策略。

指定公告机构的现状:正如Emergo之前报道的那样,公告机构对医疗器械客户开展MDR审核的能力限度是活跃在欧洲市场的制造商面临的一个主要顾虑。 调查受访者还将指出,指定公告机构的可用性是实现MDR合规的一个重大障碍;调查报告指出,到目前为止,只有19家公告机构申请被重新指定为新法规的公告机构,而现在有超过80家公告机构拥有MDD指名。 这种情况增加了“孤儿”制造商无法在该法规(MDR)下找到必须具备CE标志认证的合作公告机构的可能性。

MDR影响方面的具体挑战

受访者还指出了与MDD规定相比,哪些MDR合规领域面临的挑战最多,58%的公司表示临床数据管理规则是新法规中最具挑战性的组成部分。 根据相关备注信息所示,相同比例的公司尚未开始实施数据收集策略来满足MDR临床要求。

受访公司还指出停产器械的管理和与公告机构的合作也是他们所面临的重大挑战。

对MDR做出更好准备的建议

根据受访者回复的信息,调查执行者列出了实现MDR合规的几个高级别挑战,并给出了在2020年MDR合规时限到来前解决这些问题的建议:

  • 指定人员阅读相关资料,熟悉MDR及其规定;
  • 确立和协调跨职能资源和人员,以预测和准备新法规产生的业务和运营方面的影响;
  • 考虑在当前的宽限期内完成MDD和/或主动植入式医疗器械指令(AIMDD)重新认证,以弥补由于公告机构能力有限导致的MDR认证延迟;
  • 建立跨职能团队来管理与经济经营者之间的关系,并满足MDR下的新供应链要求
  • 开发与风险管理功能密切相关的上市后监管(PMS, Post-market Surveillance)系统,以帮助管理公司产品组合中新器械和旧器械的质量要求;
  • 制定和实施数据收集策略,以满足MDR的PMS规定,并确保遵循Eudamed医疗设备数据库规范。

Emergo by UL提供的相关欧洲医疗器械法规相关信息:

  • 为医疗器械公司提供欧洲CE标志认证策略
  • 为医疗器械制造商提供现场欧洲MDR 培训
  • 欧洲MDR差距评估和过渡策略
  • 白皮书:帮助理解欧洲新的医疗器械法规
  • 网络研讨会:欧洲MDR 2017/745
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MDR and IVDR Implementation: Update from the European Commission

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EMERGO SUMMARY OF KEY POINTS:

  • MDR and IVDR implementations still on track as planned.
  • The first Notified Bodies to be designated may be announced by the end of 2018.
  • Eudamed is advancing as planned.
  • Brexit is a matter of concern, but all UK based Notified Bodies appear to be taking appropriate actions.

The European Commission reports that implementation efforts for the EU Medical Devices Regulation (MDR) 2017/45 and In Vitro Diagnostic Medical Devices Regulation (IVDR) 2017/746 remain on track, as well as related efforts regarding Notified Body designations and Eudamed database development.

In her closing statement on MDR and IVDR implementation, Elżbieta Bieńkowska, Member of the EC, gave answers to concerns raised by the European Parliament about the transition process of the current Directives to the new Regulations). She denies being “optimistic and calm,” but rather “realistic and confident.”

First Notified Body designations to MDR, IVDR by year’s end?

So far, 34 of the current 60 Notified Bodies for medical devices and IVDs have applied for designation under the MDR and/or IVDR. According to Ms. Bieńkowska there have been no delays in the application process. In fact, the process appears to be slightly ahead of schedule: the first Notified Bodies designated under the MDR and/or IVDR can be expected before the end of 2018. However, Emergo has yet to receive confirmation from its Notified Body sources on this issue.

Eudamed progress

The development of Eudamed is on schedule as well. The implementation plan was published in May 2018, within developers’ planned timeframe, and the functional specifications are now in the draft stage and being reviewed by the EC’s Medical Device Coordination Group (MDCG) for adoption.

Brexit’s impact on Notified Bodies

Brexit has its own dynamics and there too is an issue with Notified Bodies. UK-based Notified Bodies have each taken measures to transfer CE Mark certification operations to European Member States and obtain accreditation to current European Directives for these offices. However, it is not yet fully clear whether these developments mean that all current CE Mark certificates can be easily transferred from UK to European jurisdictions

The European Commission is monitoring the transition and is confident so far all measures appear to be going according to plan: “all is on track.”

Related European MDR and IVDR resources from Emergo by UL:

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European Commission’s Latest Updates to Borderline & Classification Manual

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EMERGO SUMMARY OF KEY POINTS:

  • Second update IN 2018 of the Manual on Borderline and Classification.
  • Five new cases added, providing useful illustrations of how the definition of a medical device and the classification rules should be understood.
  • For the MDR there could be some significant differences.

On October 30, 2018 the European Commission published the most recent version of the Borderline & Classification Manual. This document provides guidance on establishing the status of medical devices and IVDs, as well as their risk classifications. The current version, version 1.20 replaces version 1.19 released in April 2018.

A total of six new items have been added to the latest version of the manual:

Borderline – medical intended purpose

  1. Mattress covers against mites; although mattress covers could be part of the treatment plan of patients suffering from allergy, the cover – under the bedlinen – is not acting directly acting on the patient; it acts on the mites. Therefore this product should not be considered a medical device. Emergo comment: this is a useful illustration of how the definition of a medical device should be applied.
  2. Lubricants intended for body massages and/or sexual intercourse; lubricants can be used for alleviation of vaginal dryness should be considered medical devices. The same goes for lubricants specifically intended by the manufacturer to be used together with a condom in order to enable it to function as intended. However, if they are only intended for body massage or to stimulate sexual intercourse they should not qualify as medical devices.

Classification

  1. Trial hip prosthesis heads or stems; trial hip prosthesis heads or stems are used to determine the exact size of the prosthesis before the implantation of the definitive implant. These products should not be considered “reusable surgical instruments” because they are not used as part of a surgical procedure (cutting, drilling, sawing, scratching, scraping, clamping, retracting, clipping or similar procedures: see Annex IX, Chapter I, Section 1.3). Therefore Rule 6 applies: Class lla.

Software and mobile applications

  1. Product intended to facilitate conception based on basal body temperature; this product uses body temperature and information on the menstrual cycle for predicting ovulation in order to facilitate conception. It is not intended to be used for prevention of conception. Therefore this is considered an active device to which Rule 12 applies: Class I.
  2. Product intended to facilitate conception and enable contraception based on basal body temperature; this is almost the same intended use as the above mentioned device. However, this product is also intended to be used for prevention of pregnancy. Therefore Rule 14 applies and this should be considered a device of Class llb.
  3. Stand-alone software application for conception and contraception purposes using data entered by the patient; this device has the same medical claims as the above mentioned device, but this device relies on the user manually entering all data, including body temperature measured with a normal thermometer. For this device too, Rule 14 applies: Class llb.

MDR: similarities and differences

With just over 18 months until the date of application of the Medical Devices Regulation (MDR), it is also interesting to see how these cases would work out under the new legislation:

  1. Mattress covers against mites; no difference under the MDR: not a medical device.
  2. Lubricants intended for body massages and/or sexual intercourse; no difference under the MDR: the “medical” claims result in a status as a medical device.
  3. Trial hip prosthesis heads or stems; no change under the MDR, therefore Rule 6 applies: Class lla.
  4. Product intended to facilitate conception based on basal body temperature; under the MDR the classification may change. Rule 11 is about “Software,” but does not explicitly limit its use to software as a medical device. If that understanding of the rule would be correct, all devices incorporating software would have to be classified according to Rule 11 as well. For such devices, this would result in Class lla, as an error in this software in the worst case would result in no pregnancy. This is not a serious deterioration of the state of health of the user. In case Rule 11 does not apply, Rule 13 applies: Class I.
  5. Product intended to facilitate conception and enable contraception based on basal body temperature; here too, the question is if Rule 11 would apply. If it does, there is an ethical question: how should an unwanted pregnancy be determined? Is this an “irreversible deterioration of person’s health” or a “serious deterioration of a person’s health?” This would make the difference between Class lll, Class llb. This is not clear and additional guidance is needed. If Rule 11 does not apply, Rule 15 would apply: Class llb.
  6. Stand-alone software application for conception and contraception purposes using data entered by the patient; for this device the same issue applies as above: Class lll or Class llb, depending the understanding of the classification rules.

The above issues illustrate that some cases in the current Manual on Borderline and Classification can be used for the MDR. However, this should always be done with great care. There are differences and, especially for IVDs, the classification rules have significantly changed.

Additional European medical device and IVD regulatory information from Emergo by UL:

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