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MDCG 2021-5 and state of the art and standards

  • 1.  MDCG 2021-5 and state of the art and standards

    This message was posted by a user wishing to remain anonymous
    Posted 14-May-2021 17:10
    This message was posted by a user wishing to remain anonymous

    What do folks think of the new MDCG guidance and its impact on standards and state of the art?

    I ask as our Notified Body questioned our use of harmonised standards rather than most recently published standards. While the new guidance doesn't explicitly state that harmonised standards are by definition state of the art, it feels like that is the implication.

    What do others think about this new guidance?


  • 2.  RE: MDCG 2021-5 and state of the art and standards

    Posted 14-May-2021 18:05
    Generally speaking, I find MDCG 2021-5 quite useful.  But at the end of the day, legislative requirements always trump guidance documents.  And the legislative requirement in Regulation 2017/745 (for example) is conformity with the state of the art.  The European harmonized standards process is broken at the moment; consequently, many harmonized standards are no longer state of the art.  Take for example the longstanding EN 1041:2008 that was just superseded by EN ISO 20417:2021 as the latest state of the art. It is a losing battle (and contrary to legislative requirements) to try and convince a notified body to accept a harmonized standard when the standard is no longer state of the art (though there is usually a reasonable grace/transition period allowed). Now, get ready for a whole bunch of further replies; Forum members (and me too) luuuuuuv to expound about harmonized standards...

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    Kevin Randall, ASQ CQA, RAC (Europe, U.S., Canada)
    Principal Consultant
    Ridgway, CO
    United States
    © Copyright 2021 by ComplianceAcuity, Inc. All rights reserved.
    ------------------------------



  • 3.  RE: MDCG 2021-5 and state of the art and standards

    Posted 15-May-2021 07:48
    Lol Kevin

    🤣

    Standards and risk management....

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    Ginger Cantor, MBA, RAC
    Founder/Principal Consultant
    Centaur Consulting LLC
    River Falls, Wisconsin 54022 USA
    715-307-1850
    centaurconsultingllc@gmail.com
    ------------------------------



  • 4.  RE: MDCG 2021-5 and state of the art and standards

    Posted 15-May-2021 12:31
    🤣🤣

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    Kevin Randall, ASQ CQA, RAC (Europe, U.S., Canada)
    Principal Consultant
    Ridgway, CO
    United States
    © Copyright 2021 by ComplianceAcuity, Inc. All rights reserved.
    ------------------------------



  • 5.  RE: MDCG 2021-5 and state of the art and standards

    Posted 15-May-2021 17:50

    You all are not aware of the behind the scenes activities going on around ISO EN 14971:2019, I'm sure. Most of what I know, unfortunately I can't reveal, I'm sure Leo Eisner is in the same position, and he just posted a short description in LinkedIn of the acceptance (finally) of the EC Standardization Request sent to CEN and CENELEC which is supposed to drive the harmonization process forward. ISO 14971:2019 has become mired in what I will describe as a political stand-off where no progress is being made on the harmonized version drafted by the CEN/CENELEC technical committee and acceptance by the Commission's HAS Consultants responsible to recommend standards be harmonized. This has impact on all the standards that include EN ISO 14971:2019 as Normative References, such as EN IEC 60601-1  


    I hope it is resolved soon, but I am not hopeful. 



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    Edwin Bills MEd, CQA, RAC, BSc, CQE, ASQ
    Principal Consultant
    Edwin Bills Consultant
    Overland Park KS
    United States
    elb@edwinbillsconsultant.com
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  • 6.  RE: MDCG 2021-5 and state of the art and standards

    Posted 15-May-2021 18:05
    In my prior post in this thread regarding the HAS consultants response to EN ISO 14971:2019, I believe a number of their more substantive objections are based on subjective unsustainable opinions, bias, and/or demonization of manufacturers (maybe intentional, maybe not) and, in at least one instance, apparent misinterpretation and consequent misuse of supporting background.  As I processed the particular HAS consultant objections that were causing me the most concern (specifically, HAS Cons. #4 - #6), it seems to me that the objections can be readily answered and rebutted.​​

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    Kevin Randall, ASQ CQA, RAC (Europe, U.S., Canada)
    Principal Consultant
    Ridgway, CO
    United States
    © Copyright 2021 by ComplianceAcuity, Inc. All rights reserved.
    ------------------------------



  • 7.  RE: MDCG 2021-5 and state of the art and standards

    Posted 15-May-2021 18:19
    They were overridden once, Kevin, but they came back with even more ludicrous objections which trashed the entire standard and said it needed a complete rewrite based on new requirements they added from who knows where. I believe it has reached the political battle at this point, and I'm not sure how it will be resolved.

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    Edwin Bills MEd, CQA, RAC, BSc, CQE, ASQ
    Principal Consultant
    Edwin Bills Consultant
    Overland Park KS
    United States
    elb@edwinbillsconsultant.com
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  • 8.  RE: MDCG 2021-5 and state of the art and standards

    Posted 15-May-2021 18:31
    Yep, I noted their various assertions that the standard needed to be rewritten, which has me scratching my head given that, as mentioned before, it seems to me that a) the objections are readily rebuttable, and b) because the fundamental intent of the Annex Z process is to bridge such gaps.  I too fear that political science is taking over the objective science.  In the meantime, at least we can lean on the tactics, flexibilities, and liberties noted in my earlier post in this thread.

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    Kevin Randall, ASQ CQA, RAC (Europe, U.S., Canada)
    Principal Consultant
    Ridgway, CO
    United States
    © Copyright 2021 by ComplianceAcuity, Inc. All rights reserved.
    ------------------------------



  • 9.  RE: MDCG 2021-5 and state of the art and standards

    Posted 16-May-2021 09:28

    Kevin, you said, "As I processed the particular HAS consultant objections that were causing me the most concern (specifically, HAS Cons. #4 - #6), it seems to me that the objections can be readily answered and rebutted"

     

    Please tell us more about the objections.



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    Dan O'Leary CQA, CQE
    Swanzey NH
    United States
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  • 10.  RE: MDCG 2021-5 and state of the art and standards

    Posted 16-May-2021 10:37
    Hey Dan,

    As a member of the AAMI QM-WG 04 group for risk management standards development, I'm under the same kind of restrictions as Ed and Leo toward the goal of avoiding actions detrimental to the standards development process, and to be sure there are no IP infringements.  However, I will say that as I implement ISO 14971 conformity in quality management systems, particularly important topics for me are establishment of risk acceptance criteria, dealing with the benefit-risk ratio, and managing the "practicability" of risk control.

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    Kevin Randall, ASQ CQA, RAC (Europe, U.S., Canada)
    Principal Consultant
    Ridgway, CO
    United States
    © Copyright 2021 by ComplianceAcuity, Inc. All rights reserved.
    ------------------------------



  • 11.  RE: MDCG 2021-5 and state of the art and standards

    Posted 15-May-2021 01:52
    I have written about the EC Standardization Request which just was accepted by CEN & CENELEC on 12 May - believe it or not. Prior to Acceptance of Standardization Request (I discuss MDCG 2021-5 briefly) and Post Acceptance of the Standardization Request.

    ------------------------------
    Leonard (Leo) Eisner, P.E.
    The "IEC 60601 Guy"
    Principal Consultant, Eisner Safety Consultants
    Phone: (503) 244-6151
    Mobile: (503) 709-8328
    Email: Leo@EisnerSafety.com
    Website: www.EisnerSafety.com
    ------------------------------



  • 12.  RE: MDCG 2021-5 and state of the art and standards

    Posted 15-May-2021 09:33

    The document just adds a layer of confusion to the whole mess. Though CEN and CENELEC just finally found a Standardization Request they could accept. The confusion continues cause they listed Harmonized standards that apparently that will be acceptable. From my perspective that list is flawed. For instance it lists EN ISO 14971:2012 as a Harmonized standard though it is in conflict with the MDR in several places, such as the use of IFU as risk controls. These are not allowed by 2012, but MDR in Annex I Chapter III talks about how to use them among other things. 


    Also EN ISO 14971:2019 has been accepted as the "state of the art" medical device risk management standard by BSI, which published that in their Compliance Navigator.  So the question is, which do I use?  2012 is harmonized but not in compliance and 2019 is "state of the art" but not harmonized. 


    Behind the scenes there is a war going on between the EU's Harmonization Consultants (HAS) and CEN / CENELEC Technical Committee on 14971 who have major disagreements on the standard, which were overturned in favor of standards committee causing, in my mind, some political repercussions that led to another rejection by the HAS consultants that called for a complete redraft of the standard. 


    Currently it is a mess for a foundational standard called out in many others as a Normative Reference, meaning required, such as in EN IEC 60601-1. 


    so the world of Harmonized Standards will be confused and mucky for some time. Those others may see an easier pathway to become Harmonized. 



    ------------------------------
    Edwin Bills MEd, CQA, RAC, BSc, CQE, ASQ
    Principal Consultant
    Edwin Bills Consultant
    Overland Park KS
    United States
    elb@edwinbillsconsultant.com
    ------------------------------



  • 13.  RE: MDCG 2021-5 and state of the art and standards

    Posted 15-May-2021 12:21
    Edited by Kevin Randall 15-May-2021 12:23

    A key aspect of MDCG 2021-5 that I've found refreshing is the reiteration of the longstanding principle that harmonized standards, and even standards that are considered to represent the "state of the art", are fundamentally voluntary.  This tends to provide another official negotiating tool available to manufacturers when a notified body demands compliance with a certain standard.  That said, in practice, it has typically been, and I think will continue to be, very useful for manufacturers to apply a preexisting standardized paradigm rather than reinventing the wheel and having to argue its conformity invention with the notified body.  Indeed, oftentimes, making and supporting the argument costs more than applying a standardized preexisting paradigm.

    Regarding the HAS consultants response to EN ISO 14971:2019, I believe a number of their more substantive objections are based on subjective unsustainable opinions, bias, and/or demonization of manufacturers (maybe intentional, maybe not) and, in at least one instance, apparent misinterpretation and consequent misuse of supporting background.

    Regarding conflicts between standards and legislation, remember that the Annex Z aspect of the European standard harmonization process is fundamentally intended to act as a bridge where a standard's normative contents conflict with an applicable regulatory requirement.  Case in point, the content deviations published in the Z Annexes of EN ISO 14971:2012 (more about that in a moment).  Accordingly, it is neither expected, nor realistic to expect, that the normative content of a standard like ISO 14971:2007 (the normative heart of EN ISO 14971:2012) or like ISO 14971:2019 (the normative heart of EN ISO 14971:2019) be in full alignment with applicable legislation. Thus, the intended beauty of the Annexes Z.

    That said, the EN ISO 14971:2012 Annexes Z created quite a kerfuffle.  Yet, the kerfuffle was effectively and rightfully clarified (in my opinion) by the Consensus Paper from the Notified Bodies Recommendation Group (NBRG).  For example, NBRG clarified that IFU can in fact be used as a risk control.  I have been practicing and applying the NBRG's reinterpretations for years now without problem.

    In any case, these unavoidable dynamics and challenges are rendered quite manageable (in my opinion) by the fundamentally voluntary nature of harmonized standards along with the flexibility in the "state of the art" concept intended by legislation like the EU MDR.



    ------------------------------
    Kevin Randall, ASQ CQA, RAC (Europe, U.S., Canada)
    Principal Consultant
    Ridgway, CO
    United States
    © Copyright 2021 by ComplianceAcuity, Inc. All rights reserved.
    ------------------------------



  • 14.  RE: MDCG 2021-5 and state of the art and standards

    Posted 16-May-2021 04:12
    Hello to all,

    I always understood, that harmonized standards are related / correlated to a specific EU legislation. Hence, in all that discussion I would first reflect under which EU legislation a standard has been harmonized. Second, I always understood, that the harmonisation has the benefit, that if a standard is used (completely), the assumption of heaving the requirements "completely addressed" holds. 

    In other words, for me it is not primarily a question of state of the art, and the is the fine question of current state of the art. 
    Does this makes sense to the community? 

    PS I'm looking forward to the JWG1 meetings, were we will learn how to proceed with the ISO 14971 harmonisation.

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    Uwe Zeller | Regulatory Affairs / Risk Management Consultant
    Biberach an der Riß, Germany
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  • 15.  RE: MDCG 2021-5 and state of the art and standards

    Posted 16-May-2021 10:55
    Uwe,

    MDCG 2021-5 about which Anon asked is focused on Europe's medical device legislations (e.g., 2017/745, 2017/746, 93/42/EEC, 90/385/EEC, and 98/79/EC).  Accordingly, the discussion here is focused on harmonized standards for those legislations.

    It has been my experience that stakeholders may apply only a portion(s) of a harmonized standard and then can benefit from corresponding presumption of conformity regarding the portion(s) applied.

    Regarding state of the art, remember that consideration of state of the art is an absolute mandate of the aforesaid medical device legislations.  These legislations do not permit consideration of state of the art as a secondary or tertiary endeavor; instead, consideration of state of the art must remain a primary endeavor during the conformity process.


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    Kevin Randall, ASQ CQA, RAC (Europe, U.S., Canada)
    Principal Consultant
    Ridgway, CO
    United States
    © Copyright 2021 by ComplianceAcuity, Inc. All rights reserved.
    ------------------------------



  • 16.  RE: MDCG 2021-5 and state of the art and standards

    Posted 16-May-2021 12:55
    Also of interest Uwe is that the Notified Bodies have a long precedent of accepting that harmonized standards can be applied either in full, or in part, depending on the manufacturer's particular objective regarding a corresponding requirement(s).

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    Kevin Randall, ASQ CQA, RAC (Europe, U.S., Canada)
    Principal Consultant
    Ridgway, CO
    United States
    © Copyright 2021 by ComplianceAcuity, Inc. All rights reserved.
    ------------------------------



  • 17.  RE: MDCG 2021-5 and state of the art and standards

    Posted 17-May-2021 01:09
    Good morning

    Interesting discussion here! Since I work for a Notified Body for part of my time this is something that drives long discussions also among the Lead Auditors and Product Reviewers / Product Specialists. If you ask 4 people you get 5 opinions...

    First of all it's correct what Kevin writes: a standard is not the law, so it's application is voluntary. However, if you want to take that route, you have to provided objective evidence that your way of doing it is "at least as good as". While "harmonized standards provide presumption of meeting the respective essential requirements (ER; MDD) / general safety and performance requirements (GSPR; MDR)" this may in fact represent a conflict with ERs / GSPRs in general. Annex I (§ 1) of the MDR clearly states: "...taking into account the generally acknowledged state of the art." Now looking at some standards like ISO 10993-1 regarding biocompatibility. The harmonized version of the standard (MDD) is EN ISO 10993-1:2009/AC:2010. Now, the last edition is ISO 10993-1:2018. It's therefore difficult to argue that the older version is still state of the art. The compromise made (remember: Swiss people are always great in making compromises :-) ) is that meeting a certain standard is required as soon as a European version (including Annex Zx) is published. This is not a definition aligned with other Notified Bodies but may be an approach one could present the Notified Body in question.

    Cheers, Beat


    ------------------------------
    Beat Steffen
    Founder & CEO
    Confinis AG - Enterprise
    Oberkirch
    Switzerland
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  • 18.  RE: MDCG 2021-5 and state of the art and standards

    Posted 17-May-2021 06:17

    Hi Beat,
    Hi all,

    this thread motivated me to add some more reading time, and going back to Beat's pragmatic approach and to the original post of the Anon, I like to share on citation from MDCG 2015-5 page 13: "The most recent editions of standards published by the standardisers should be considered as reflecting state-of-the-art, regardless of the OJ referencing" (COM statement, Minutes of the meeting of the MDCG Subgroup on Standards held on 20 May 201940, item 3, p. 1)."

    So for my clients, I continue to focus on the current standards (where we all did spend a lot of effort in establishing these);  and I will try NOT to discuss about old standards which are harmonized under the MDD. 



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    Uwe Zeller | Regulatory Affairs / Risk Management Consultant
    Biberach an der Riß, Germany
    ------------------------------