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OEM Product Biocompatibility

  • 1.  OEM Product Biocompatibility

    Posted 15-Nov-2022 18:03
    Edited by Taisiya Novopachennaia 15-Nov-2022 18:05

    Hello,

     

    I am working on an EU MDR tech doc submission of a Class IIb CT Scanner. This device is sold with and recommended to be used with an OEM Class I device. The OEM device has buttons that are intended to be pressed by the user but is not intended to come into contact with the patient. The OEM device is CE marked under MDR, however the DoC does not list ISO 10993-1 under product conforming standards. The manufacturer will not provide any reporting or justification for not performing ISO 10993 testing outside of an email stating it is not necessary because of lack of direct or indirect patient contact.

     

    Section 6.1(b) of Annex II in EU MDR states a need for "biocompatibility testing of the device including identification of all materials in direct or indirect contact with the patient or user." My thinking is that biocompatibility testing or a justification report (i.e. materials are common and therefore risk is low) is necessary since MDR specifies the user, not only the patient.

     

    Given that the CT Scanner is sold with the OEM device, is it enough to rely on the MDR CE Mark of the OEM device or do we need to do more due diligence in ensuring that the OEM device is biocompatible?

     

    Thank you in advance!



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    Taisiya Novopachennaia
    San Diego CA
    United States
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  • 2.  RE: OEM Product Biocompatibility

    Posted 16-Nov-2022 01:03
    Hello Taisiya,

    Unfortunately they put the word 'user' in the EU MDR indicating the biocompatibility testing would also be needed or applied to person using a medical device.  Very bad form to put it there because in the GSPR the is references to the human body and patient.  But it is a very slippery slope.  This has been generally accepted in the industry since beginning of time that biocompatibility applies to the patient themselves and not the user.  There are thousands and thousands of medical devices which have interaction with users including push buttons, knobs, selectors, and now screens - would be a huge waste of time and energy if expectations for biocompatibility testing were for these devices.  In my opinion, biocompatibility testing is not needed if no contact is made with the patient and maybe even a justification is not needed.  Simply state, this Class I OEM device does not have any contact with the patient.

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    Richard Vincins ASQ-CQA, MTOPRA, RAC
    Vice President Global Regulatory Affairs
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  • 3.  RE: OEM Product Biocompatibility

    Posted 16-Nov-2022 06:53

     

     

     

    Agree with you Richard, but will note that this likely came from ISO 10993-1 and FDA guidance that treat personal protective equipment (think gloves) as within scope due to their frequent contact with users.

     

    Best regards,

     

    Ted

     

     

     






  • 4.  RE: OEM Product Biocompatibility

    Posted 17-Nov-2022 08:44
    Ted is right on this as well.   I have clients who use a memo by a qualified tox person assessing via risk, what the material is, and whether biocomp testing is needed for user (and also think service personnel).  

    This ties in with ISO 14971 which requires assessment of risks to patient, user, other personnel and environment.   

    That said, FDA did release their biocomp guidance clarification regarding not needing to test items made of general materials well known and used broadly in available consumer applications, which come in contact only with intact skin for short duration.

    Assess, write a memo, include it in your DHF.






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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
    ------------------------------



  • 5.  RE: OEM Product Biocompatibility

    Posted 16-Nov-2022 10:04
    Edited by Kevin Randall 16-Nov-2022 10:05
    Taisiya, we'll need more information about the supply chain model being used for the subject devices.  The answer to your question will depend in part on that.  For sake of quicker discussion, I'll presume that your CT Scanner client is a manufacturer located in Europe's Union.

    In that supply chain model, the Union manufacturer of a Class IIb CT Scanner who includes with the Scanner another manufacturer's CE marked OEM Class I device is essentially required by the EU MDR to assure the proper biocompatibility (as well as other GSPR conformity) of the OEM Class I device.  This is because, in that supply chain model, the Class IIb CT Scanner manufacturer is acting as an EU MDR Article 14 Distributor of the CE marked OEM Class I device.  And wherever an Article 14 Distributor considers or has reason to believe that a device is not in conformity with the requirements of the EU MDR, then it shall not make the device available on the market until it has been brought into conformity.

    With respect to conformity with the biocompatibility-related GSPR, t
    he EU MDR expects conformity with the generally acknowledged state of the art.  For example, EN ISO 10993-1:2021 as amended.  For several years now, the ISO / EN ISO 10993-1 state of the art has required protection for not just the patient, but also for the user.  Accordingly, though that scope is relatively new after a long history of patient-centric focus, it is nonetheless the current state of the art.  And that is echoed by the EU MDR.  Accordingly, if the biocompatibility conformity evidence is limited to just the patient contacting aspects, or is missing/refused altogether, then that would not be in conformity with the EU MDR.

    ------------------------------
    Kevin Randall, ASQ CQA, RAC (Europe, Canada, U.S.)
    Principal Consultant
    Ridgway, CO
    United States
    © Copyright 2022 by ComplianceAcuity, Inc. All rights reserved.
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  • 6.  RE: OEM Product Biocompatibility

    Posted 16-Nov-2022 04:18
    Hello Taisiya,

    My personal opinion is that you do not need biocompatibility testing for OEM device. However, I would recommend to contact one of the regulatory agencies where the product will be made available and confirm with them. You can use the correspondence with their confirmation for the submission. 
    You can find the contacts of the agencies which are part of Medical Device Coordinating Group here: https://health.ec.europa.eu/system/files/2022-10/mdcg_md-ivd_members_en.pdf

    Have a good day!
    Olga

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    Olga Peycheva
    Dover
    United Kingdom
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  • 7.  RE: OEM Product Biocompatibility

    Posted 16-Nov-2022 14:04
    Hi Taisiya,

    I recently worked on an EU MDR submission for a class IIa and the reviewer insisted the entire medical device system be assessed for biocompatibility, including parts that are only touched by the user, i.e. footswitch. While we did not have to perform biocompatibility for those components, we did however have to show that we assessed each component and provide a justification as to why it was not required. 

    So I agree with your inclination that you should have some justification documented as to why parts of the device that come into contact with the user do not require biocomp and are also compliant with regulations specific to CMR and Phthalates.

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    Christine Stahley RAC
    Regulatory Affairs
    Grafton MA
    United States
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  • 8.  RE: OEM Product Biocompatibility

    Posted 16-Nov-2022 15:01
    Christine,

    '... and the reviewer insisted the entire medical device system be assessed for biocompatibility, including parts that are only touched by the user, i.e. footswitch.'  That just makes me sad and annoyed.  It is a truly sad world we live in today where pragmatism and common sense are lost to checklists and unrealistic expectations.

    While I agree certain components or products could be reviewed ... but a footswitch or a touch panel/buttons?  Next they will be asking for biocompatibility on the iPhones which have Apps on them, because you know Apps can be medical devices !!  


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    Richard Vincins ASQ-CQA, MTOPRA, RAC
    Vice President Global Regulatory Affairs
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  • 9.  RE: OEM Product Biocompatibility

    Posted 16-Nov-2022 15:33
    I had a suspicion it was what the reviewer wanted but I was in disbelief.  We had to get on a call with the reviewer to confirm the request because we honestly didn't think the assessment had to be every single part, including the power cord, that the user touches. Submissions are not getting any easier, that is for sure!

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    Christine Stahley RAC
    Regulatory Affairs
    Grafton MA
    United States
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  • 10.  RE: OEM Product Biocompatibility

    Posted 16-Nov-2022 16:10
    Edited by Michael Hottner 16-Nov-2022 16:11
    Great discussion!

    I personally have a really strong opinion here:
    The scope section of ISO 10993-1  clearly defines that the standard applies only to devices with
    - patient contact during intended use
    - user's body only if the device is intended for protection.
    So I would always try to argue that any other user contact is out of scope unless there is a specific risk.

    Section 5.2.2 contains a note about short term user contact to human interfaces for electronic equipment (keyboards, dials, buttons etc.): "If these types of components can be shown to be made from materials in common use for other consumer products with a similar nature of contact, no further biological evaluation is needed."

    A possible approach could be to briefly evaluate those components (e.g. in the risk managment) with the aim to define them as out of scope of ISO 10993-1.

    But it will get really difficult once you try to evalute such components in detail, because:
    a.) You usually still have some customized components and surfaces (e.g. specific coatings, surface finishes or colors),
    b.) Many suppliers do not want to provide details about the chemistry or composition of surface materials (or just don't have the data available), and
    c.) The most clinically relevant endpoints for skin contact are sensitization and irritation. Those are difficult to evaluate if you do not have full information about the chemical composition.

    A client once told me that during a notify body audit the auditor also insistent on an evaluation of EACH user contacting component of a complex system.
    I was lucky so far with a clear distinction between user and patient contact....


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    Michael Hottner
    Köln
    Germany
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  • 11.  RE: OEM Product Biocompatibility

    Posted 16-Nov-2022 19:28
    Thank you to everyone for your responses! Based on the feedback, it seems like the riskiest path forward would be to assume the OEM device does not need biological evaluation or any other report because it is not intended to come into contact with the patient, and the safest logical path forward would be to write a biological evaluation to state why testing is not needed but that the device is safe for its intended use because of common components. Unfortunately, the supplier will not provide very much material/component information so this justification will be difficult to conjure. This discussion has given me helpful insight into the scrutiny that can be expected by NB review. Thank you very much.

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    Taisiya Novopachennaia
    San Diego CA
    United States
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  • 12.  RE: OEM Product Biocompatibility

    Posted 17-Nov-2022 06:48
    Viewing this from a slightly different lens (and playing devil's advocate whilst trying not to disagree too strongly with some of the opinions shared here)....ISO 10993-1 is a risk management standard. The potential harms to people, property and the environment need to be considered. As part of risk identification as per ISO 14971, the contact with users, patients, others etc. needs to be considered. The interaction of the materials with other devices and materials (e.g. cleaning or disinfecting materials) need to be considered. I think everyone agrees that there is no need for biological endpoint testing here, but to demonstrate that the risk has been considered and either assessed fully or discounted with justification, it needs to be documented somewhere in (or linked to) the risk management file. In order to demonstrate the consideration, I think it still has to be documented in some form.

    See also the FDA's draft guidance for biocompatibility of materials in contact with intact skin (although not necessarily 100% applicable in this instance). https://www.fda.gov/media/142959/download

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    Edward Ball
    Manager, Intelligence & Innovation
    United Kingdom
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  • 13.  RE: OEM Product Biocompatibility

    Posted 17-Nov-2022 09:38
    I'd agree that's a pragmatic approach for showing conformity to the rule. And I'd agree that theoretically there could be a hazard to a user. Can anyone think of real life examples of medical devices that actually have posed a material contact biocompatibility risk to a non-patient user?

    As Ted mentioned, PPE like gloves and gowns would affect the user more strongly than the patient. Substance-based devices might affect patient and user simultaneously. Same with combination devices if they leak.

    Probably not iPhones and things that look like ordinary office equipment, even if they use them without wearing protective gloves... Unless we're thinking about latex handgrips and nickel plating???

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    Anne LeBlanc
    United States
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  • 14.  RE: OEM Product Biocompatibility

    Posted 17-Nov-2022 10:00
    That is a good point about leakage Anne. So spillages, leakages, access to normally hidden materials during use, maintenance etc. should be considered. There's that word considered again!

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    Edward Ball
    Manager, Intelligence & Innovation
    United Kingdom
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