Regulatory Open Forum

 View Only
Expand all | Collapse all

RTA vs. Substantive Review

  • 1.  RTA vs. Substantive Review

    Posted 17-Jan-2016 20:23

    Hi Regulateers...   Has anyone else recently experienced a rather significant shift in RTA review?  Our last 2 submissions have experienced multiple rounds of questions in the RTA review that don't seem to align with the intent of RTA, but rather substantive review.  A few examples are asking for include:

    • comments on the number of hazards, precautions or contraindications in the submitted labelling
    • software documentation when it was clearly indicated in the submission that there have been zero changes to the software since the last clearance
    • requesting electrical testing when it was clearly indicated in the submission that no changes have been made to the hardware or software since the last clearance

    Looking forward to your experiences/comments!

    Tina

    ------------------------------
    Tina O'Brien RAC, MS
    Sr. Regulatory Affairs Specialist
    Fisher & Payket Healthcare
    Auckland
    New Zealand
    ------------------------------


  • 2.  RE: RTA vs. Substantive Review

    Posted 18-Jan-2016 02:49

    Hi Tina,

    The intent of the RTA checklist is to do an administrative review to ensure that the elements of the submission are complete such that the reviewers can review the submission within the time frames defined in MDUFMA. However we have seen that the reviewers often do a substantive review even when they are not suppose to do that during RTA. 

    In my experience, we have responded to the questions drawing their attention to the section in the submission. Responding to them earlier can save time during substantive review. Also for future reference, I created my own RTA checklist and included it in the submission. Added page number and section numbers in the checklist. When a particular section was not applicable for the submission, I added a note stating the reason.

    Hope this helps.

    Thank you

    ------------------------------
    Shiven Gandhi
    Regulatory Affairs Specialist
    Medtronic
    San Francisco CA
    United States



  • 3.  RE: RTA vs. Substantive Review

    Posted 18-Jan-2016 03:20

    I'm not clear on how substantive questions during RTA review are likely to be helpful compared to the alternative, which is to go ahead and accept the filing and start the substantive review in earnest.

    If I had to guess, I would say that FDA is using this approach to manage its workload somehow.  Easier to review a submission in periodic bursts of 15 days each, than all of a piece in 90 days, maybe.

    ------------------------------
    Julie Omohundro RAC
    Durham NC
    United States



  • 4.  RE: RTA vs. Substantive Review

    Posted 18-Jan-2016 10:27

    Yes, we have had the exact same thing happen just within the last few months.  The questions from FDA were definitely those typically asked during the Substantiative Review.  I'm wondering if the RTA review time has been reduced as the completed RTA checklist is to be included with submission.  Perhaps this enables them to leap ahead to SR while still under RTA clock..?

    ------------------------------
    Gretchen Upton RAC
    San Antonio TX
    United States



  • 5.  RE: RTA vs. Substantive Review

    Posted 18-Jan-2016 11:42
    Tina,

    FDA/CDRH has been under pressure from the US congress and industry (user fees) as for "performance" among many others per MDUFMA and MDUFA III.

    The FDA/CDRH has been working hard as manifested in their recent report and the recently revised the RTA guidance

    The FDA/CDRH has been using RTA process (e.g., administrative review) as a way to better demonstrate their improvement in performance (e.g., using the admin review process by including items suitable for substantive review).  

    Some may view FDA's current RTA practices as "procedurally inappropriate or inconsistent." 

    It is believed that the FDA/CDRH has elected to practice the current RTA policy in an effort to show that the "FDA has met or exceeded all FY 2014 MDUFA III performance goals for 510(k) and PMA applications."  

    Moving forward, it is recommended to best use the FDA's current RTA practices by drafting and submitting 510(k)s with "Practical, Actionable Awareness."  

    Thank you.  

    s/ David
    ______________________________________________
    Dr. David Lim, Ph.D., RAC, ASQ-CQA 
    Phone (Toll-Free): 1-(800) 321-8567

    "Knowledge is power only when it is practiced and put into action." - Regulatory Doctor

    NOTICE: This communication (including any attachments) may contain privileged or confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this communication and/or shred the materials and any attachments and are hereby notified that any disclosure, copying or distribution of this communication, or the taking of any action based on it, is strictly prohibited.





  • 6.  RE: RTA vs. Substantive Review

    Posted 18-Jan-2016 13:59

    Tina:  Consider yourself one of the crowd.  Everybody in the industry is experiencing this with OGD. .

    ------------------------------
    Christopher Smith, CQE, RAC
    Coastal Pharmaceutical Consultants, Inc.
    7950 Old River Road
    Burgaw, NC 28425, USA
    910.259.8877 (land)
    910.789.1232 (mobile)
    chrissmith@coastalpharmaconsultants.com



  • 7.  RE: RTA vs. Substantive Review

    Posted 18-Jan-2016 14:01

    Thanks everyone!  I think you all hit the nail on the head that RTA is being used as a time management tool. 

    Do you think there's any value in pushing back (or escalating) on the clearly SR questions in an effort to get through RTA?

    ------------------------------
    Tina O'Brien RAC, MS
    Sr. Regulatory Affairs Specialist
    Fisher & Payket Healthcare
    Auckland
    New Zealand



  • 8.  RE: RTA vs. Substantive Review

    Posted 18-Jan-2016 15:07

    One more question on this topic...  Is it likely that the person conducing the RTA review is also the SR reviewer?

    ------------------------------
    Tina O'Brien RAC, MS
    Sr. Regulatory Affairs Specialist
    Fisher & Payket Healthcare
    Auckland
    New Zealand



  • 9.  RE: RTA vs. Substantive Review

    Posted 18-Jan-2016 18:26

    A bit long winded but here's some background:  Last year there were some branches that acted as the guinea pigs to try the interactive RTA process and I now believe it is in practice for all branches.  David's right that there was some criticism that reviewers were RTA'ing (sometimes on day 15) things that were very easy to remedy (e.g. the file says "see label on page ##" and the sponsor forgot to include the label in an attachment).  In this example, if asked, the sponsor could easily send the attachment and the file could be accepted.  But instead they were refused and went back to Day 1, [do not pass GO, do not collect $200].  Once they finally got the necessary documentation in, then they would be accepted.  Interactive RTA was FDA's way to compromise a bit...if the items could be easily sent, then the reviewer should keep it on FDA's clock and work interactively.  If large swaths of items were missing from a submission, the reviewer should refuse it and wait until the sponsor got it right. 

    I heard of some consultants/companies complaining that their files were refused over and over by the lead reviewer, allowing the clock to be reset over and over.  This is not the point of the RTA since when you send in your response to a refusal, you're now saying "I believe I am sending you what you've asked for."  Unless it's still glaringly deficient, it should be accepted. While I like to think that the reviewers are trying hard to accept files that are complete, it was being seen by industry as a way of FDA adding more time to their clock without taking a hit on the MDUFA goals.  And some reviewers were refusing over and over, sometimes for new issues (which is wrong and supremely frustrating).  Again, not my files, but still... :)

    With all this said, these questions should not be SR questions/deficiencies.  If you think it's more along the lines of SR instead of RTA, I would talk to the lead reviewer about that (and maybe the branch chief if you think you need to).  Every 510(k) needs to stand on it's own, however, if you're asked for software documentation and you've indicated that it is identical to K###### (your own company's predicate), then I would say you should not have to include this again.  Make sure that you've included that this device/system is part of a previous submission and include the K-numbers (there is a place for this as well in the CDRH coversheet).  If they just want you to include it all over again when you're just adding to that previously cleared system, I would consider that burdensome and would ask the reviewer why.   

    The new guidance (issued 8/4/15) recommends you not only include the complete RTA checklist but also include the page numbers were everything can be found.  This helps them accept it faster if they choose to use it.  And the person doing the RTA is almost always your lead reviewer.  I've only known a few rare occasions where this is not the case.

    Good luck! 

    ------------------------------
    Allison Komiyama PHD, RAC
    Principal Consultant
    Acknowledge Regulatory Strategies
    San Diego CA
    United States



  • 10.  RE: RTA vs. Substantive Review

    Posted 19-Jan-2016 00:00

    I don't think it matters if it is easy to remedy. It is a drag on FDA's time to start a review, realize the submission is incomplete, notify the submitter, and then wait to receive something "easy" (for the submitter) before the review can continue.

    I think the pressure to implement RTA came from companies that were tired of having review of their complete and carefully QC'd submissions delayed because FDA was wasting too much time on submissions that were not complete or carefully QC'd.

    ------------------------------
    Julie Omohundro RAC
    Durham NC
    United States



  • 11.  RE: RTA vs. Substantive Review

    Posted 19-Jan-2016 03:06

    That's true.  However, I think both parties win with interactive RTA since the sponsor doesn't go back to Day 1 with a refusal, and the lead reviewer doesn't have to re-review the submission when it comes back across their desk.  If a file is refused, you're technically allowed to make changes to your entire 510(k) and then resubmit.  So even if the reviewer only needed the label you forgot to attach, they are supposed to go back through the entire document because you may have decided to remove/alter things. 

    ------------------------------
    Allison Komiyama PHD, RAC
    Principal Consultant
    Acknowledge Regulatory Strategies
    San Diego CA
    United States



  • 12.  RE: RTA vs. Substantive Review

    Posted 19-Jan-2016 10:50

    Tina, in response to your latest question: Yes, I have had the SR be the one who is performing the RTA review.

    ------------------------------
    Kevin Randall RAC
    Principal Consultant
    ComplianceAcuity, Inc.
    Golden CO
    United States



  • 13.  RE: RTA vs. Substantive Review

    Posted 18-Jan-2016 23:43

    Could someone please describe how the inclusion of SR questions affects the overall clearance timeline?  That would seem to me to be the only important issue here.  If it somehow speeds it up, then it's a good thing.  If it slows it down, not so good.  If it has no impact overall, then no harm no foul, IMO.

    ------------------------------
    Julie Omohundro RAC
    Durham NC
    United States



  • 14.  RE: RTA vs. Substantive Review

    Posted 19-Jan-2016 03:13

    Good point.  The lead reviewer has 15 days to decide on RTA.  Tina, correct me if I'm wrong, but if you get an interactive RTA you will get a deadline to procure the items needed within that 15 days or the reviewer will refuse your file.  If the items they're asking for are more SR deficiencies in nature, then you'll need to address these before you're ever accepted.  If you get another round of deficiencies in a hold letter on/around Day 60, then you'll have to address those as well.  Seems like it could potentially increase the review timeline.

    ------------------------------
    Allison Komiyama PHD, RAC
    Principal Consultant
    Acknowledge Regulatory Strategies
    San Diego CA
    United States