Regulatory Open Forum

 View Only
Expand all | Collapse all

Design Verfication-Medical Device(Active Implantable Medical Device)

  • 1.  Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 02-Apr-2019 02:21
    ​Hi All,

       How to effectively conduct a Design verification for an active implantable medical electronic device and its external accessories. Is there any specific templates which covers all the parameters to be considered. How the test protocol will be derived from the design verification plan.

    Regards,
    Jayaram​

    ------------------------------
    Jayaram Abimanyu
    Chennai
    India
    ------------------------------


  • 2.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 03-Apr-2019 11:12
    Hi, Jayaram.

    Verification is simply checking the device against all specifications. We identify the verification method(s) in our Product Requirements Specification document. Testing methods are defined along with the specifications. Your specifications are your parameters. Just be sure every aspect of each specification is fully challenged. Testing should be go/nogo.

    ------------------------------
    Michael Reents
    Bradenton FL
    United States
    ------------------------------



  • 3.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 04-Apr-2019 08:36
    At the end of your discussion, Michael, you make the statement that "testing should be go/no go".  I have been in discussions with FDA where they expressed a different opinion. FDA expects that you record any variable date from testing as a quantitative value. You must demonstrate that the test results are compared to pre-established acceptability criteria and found to meet the criteria.  The purpose in using quantitative values (where they can be established) is to provide sufficient recorded data for investigation that may be required later, without redoing the testing.

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



  • 4.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 09-Apr-2019 16:29
    My FDA experience regarding "go / no-go" testing is like Edwin's.  Here are a few FDA Warning Letter cites echoing Edwin's assertion.  Though these cites were issued in the context of 820.80 inspection, they are still germane to design verification testing because, remember, the 820.80 inspection requirements are to be derived from design outputs and verification:


    • "...There is no documentation to show inspectional results including values for measured wall thickness and results of the visual inspection; results are simply reported as passing..."

    • "...The test results were not documented in sufficient details to demonstrate how the power unit passed its finished product testing. The test results were simply recorded as either "Pass" or "Fail".  For example, your firm failed to explain and document quantitative test results..."

    • "...We reviewed your firm's response and conclude that it is not adequate. Specific test results need to be recorded. Placing an "x" mark only if the test is not within limits is not acceptable..."


    ------------------------------
    Kevin Randall, ASQ CQA, RAC (U.S., Canada, Europe)
    Principal Consultant
    ComplianceAcuity, Inc.
    Golden CO
    United States
    www.complianceacuity.com
    ------------------------------



  • 5.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 10-Apr-2019 11:49
    Hi, Edwin.

    I understand where you are coming from, but believe this applies more to Design Validation, where you are determining the design is capable of consistently performing within acceptable parameters. Verification is determining whether or not the design meets specifications. A design does or does not meet specifications (go/no go). 

    I use the example of the failed healthcare.gov website launch when explaining the difference. At launch, the website would have passed verification in the aspect that it met every specification, but would have failed validation because it could not consistently perform within acceptable parameters.

    It may sound like semantics, but the question was regarding Design Verification. A good Product Specification should include the verification method for each specification. You should know your verification parameters during design, long before you have something to test. This is coming from an engineering perspective and not a QA/RA perspective.

    ------------------------------
    Michael Reents
    Bradenton FL
    United States
    ------------------------------



  • 6.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 10-Apr-2019 15:45
    I must disagree Micheal.  The definition that the FDA uses for verification (all verification, including design and production) in 21 CFR 820.3(aa) is confirmation by examination and provision of objective evidence that specified requirements have been fulfilled. FDA's position is that the requirements for Design Verification must include the specification and the acceptance criteria to be met.  Where discrete measures are taken, recording the values obtained would provide the objective evidence needed to prove the Design Output meets the Design Input requirements.  If the testing process includes discrete measurement and those discrete measurements are not recorded, then "pass" would not be objective evidence.  Additionally, FDA believes that when discrete measurements are taken and not recorded, then for the purposes of any investigation, such as a failure of design verification, then the test would have to be repeated to obtain sufficient information to determine the cause and what corrective action must be taken to correct the failure. 

    In the ISO 13485:2016-Medical devices-A practical guide, published by the ISO Technical Committee that published ISO 13485, additional guidance is provided in Clause 7.3.6 which indicates test methods should be qualified, sample size of product required should be statistically selected for verification and the number of tests to be performed. Additionally, verification plans should continue actions to be taken when acceptance criteria are not met.  So ISO is going further than FDA in design verification requirements.

    I have the good fortune to work with FDA in providing training in the Quality System Regulation and have been in situations where this question has come up and the FDA instructors have taken this position.

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



  • 7.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 11-Apr-2019 09:52
    Hi, Bill.

    I must thank you. I did sign up with RAPS in order to learn. I'm very glad I pressed the issue.

    While I might not agree with the FDA regarding what constitutes objective evidence, I do know who's opinion carries more weight. 

    The adage goes "If it's not documented, it didn't happen." The converse is assumed (if it was documented it did happen). If a tester takes a measurement and the expected criteria is that if falls into a specified range, I would think a simple yes or no should suffice. It either fell in range or it did not. If the tester was to lie about pass/fail, they could just as easily lie when recording a value (this is keeping in mind design verification during the design phase, and not DHR during the manufacturing phase). 

    Is there a resource where current FDA interpretations are documented?

    ------------------------------
    Michael Reents
    Bradenton FL
    United States
    ------------------------------



  • 8.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 11-Apr-2019 12:10
    Thanks, Michael for your reply.  Before I posted that reply, I looked for some source documents to quote.  At least documents of which I am aware, and found that interpretation was the key.  It was something skated around with the statements I listed like confirmation by examination and provision of objective evidence that specified requirements have been fulfilled.  Unfortunately what I have to reply on is statements by FDA instructors in some of the courses I teach.

    Kevin Randall has pointed to some FDA Warning Letters on the topic (Comment 34 on Tuesday), which would show FDA is taking enforcement action in this area. I use Warning Letters as part of my self-education process and share them with clients to make points.  Kevin has some excellent quotes from Warning Letters on the topic which I hope are persuasive.

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



  • 9.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 11-Apr-2019 14:08
    ​Let me take a step back and actually muddy the water a bit more for a moment so that in the end we can reach full ComplianceAcuity on the matter.


    Indeed, the Warning Letter citations I gave in my preceding post prove that FDA is certainly prone to pursue enforcement action when inspection results are just recorded qualitatively (i.e., Pass/Fail; Go/No-Go, "X", etc.).  And as Edwin mentioned, additional proof of this is where FDA has echoed this requirement during joint FDA/industry training seminars like the AAMI courses.


    But in conflict with this, the Quality System Regulation preamble at 61 FR 52631 comment group 147 generally seems to actually permit the recording of results qualitatively as Pass/Fail.  Specifically, FDA stated, "…FDA believes that the quality system regulation requires the minimum documentation necessary to ensure that safe and effective devices are designed and produced…Further, the regulation does not specify quantitative data but simply requires that the results be recorded…These records must clearly show whether the product has passed or failed the acceptance activities according to the defined acceptance criteria…If the acceptance records are not clear about how the product failed, then the manufacturer may end up duplicating the acceptance activities in order to perform appropriate investigations…"


    And indeed, the preamble has a lot of weight, as FDA has stated that it can be used in a court of law to show what the intentions of the agency were.  I actually enjoy that because it likewise means industry can also apply the preamble accordingly.


    This leaves us with some ambiguity.  I mean, the authority of the preamble seems to permit qualitative "Pass/Fail" records, yet FDA enforcement patterns and training narratives prove FDA's repeated history of requiring quantitative results.  I know of no place where FDA has rescinded its preamble stance on allowing qualitative Pass/Fail records.  Yet FDA's Warning Letters and training commentaries remain profound evidence that FDA demands quantitative records.  To bridge this apparent conflict, my recommendation is that, if a firm decides to record inspection/verification results in qualitative fashion rather than quantitatively, then there at least needs to be solid justification for this in the product's risk analysis.  But, while taking such a risk-based approach is the current gold standard in all aspects of GMP, its realistic viability in the context of inspection results will be open to subjective interpretation and will most definitely be scrutinized by the FDA.  In light of the Warning Letter history, the safest compliance strategy is to just hunker down and record inspection/verification results quantitatively.


    Hope this helps,

    ------------------------------
    Kevin Randall, ASQ CQA, RAC (U.S., Canada, Europe)
    Principal Consultant
    ComplianceAcuity, Inc.
    Golden CO
    United States
    www.complianceacuity.com
    © Copyright 2019 by ComplianceAcuity, Inc. All rights reserved.
    ------------------------------



  • 10.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 11-Apr-2019 14:56
    Kevin has found the Preamble comment I was looking for yesterday.  The reason I could not find it, besides the print getting smaller every year, is that it is in the section entitled, "H. Acceptance Activities i. Receiving, In-Process, and Finished Device Acceptance".   So again, some interpretation is required.  Does this apply to not only production, but also design-development activities.  I was thinking the statement was in the Corrective and Preventive Action section and looked there, but thanks to Kevin, we have the citation.

    Adding on to Kevin's recommendation to "hunker down and record inspection/verification results quantitatively" I suggest recording quantitative results.  After all how many key strokes or strokes of the pen does it take, and some test systems provide the results in a manner that can be placed in records directly or in the case of a print, be attached to the Design Verification record.  And it does provide that detailed "objective evidence" FDA prefers.   

    I think we have beat this horse enough.

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



  • 11.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 11-Apr-2019 15:02
    Hi, Kevin.

    Thank you for your input into this. I agree with your conclusion, hunker down and do it. But, as a newcomer to RA, and that only to give knowledge and perspective for my R&D activities, I'm concerned with what else fits into this category. What is it that I think I know, but will be considered wrong by a regulatory body. Especially one that doesn't put into the regulations exactly what it is they intend to enforce.

    ------------------------------
    Michael Reents
    Bradenton FL
    United States
    ------------------------------



  • 12.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 11-Apr-2019 15:18
    I want to be sure to give credit where credit is due.  In looking at some of my resources on this, it looks like I may have originally put at least some of this puzzle together with the help of Dan O'Leary via his publication that can be found at: http://www.ombuenterprises.com/LibraryPDFs/Recording_Acceptance_Sampling_Results.pdf

    ------------------------------
    Kevin Randall, ASQ CQA, RAC (U.S., Canada, Europe)
    Principal Consultant
    ComplianceAcuity, Inc.
    Golden CO
    United States
    www.complianceacuity.com
    ------------------------------



  • 13.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 11-Apr-2019 15:46
    Michael, welcome to one of the more challenging aspects of our profession.  After almost 25 years, I'm still constantly working hard to be sure I understand what FDA is looking for.  Sometimes that consists of me reminding myself what FDA has said in the past, and sometimes that consists of me reminding FDA itself (especially FDA newcomers) what FDA framers said in the past.  But my personal opinion is that, with a proper attitude, commitment to studying hard, and studying the right things, there is, in the end, more clarity than ambiguity.  So, you're on the right track Michael because you're asking the right questions.  And admittedly, this particular topic is certainly one that resides on the foggier side of the bay.

    On that note, one final clarification in light of your concern, and Edwin's note, "…So again, some interpretation is required…", and my prior mention about how 21 CFR 820.80 inspection requirements are exceedingly germane to design verification.  Remember that there is an intrinsic link between the inspections/verifications done during design verification vs. those ultimately used during production.  They are essentially one and the same coin; just different sides of the same coin, although the verifications ultimately mapped into 820.80 inspections are typically just a subset of the design verifications.  To help give additional substance to this assertion, here's a statement embedded inside the 820.80 product inspection narrative of FDA's old small entity compliance guide:

    "…Design controls in 820.30(f) require device developers to verify the device design. Verification requires each manufacturer to write a test protocol and test, to the maximum feasible extent, all parameters of each device design against the design input specification…The verification test protocol includes the tests that will be performed on production units. Therefore, the production test procedures and some aspects of the inspection procedures are easily derived from the verification protocol…"

    Hope this helps,


    ------------------------------
    Kevin Randall, ASQ CQA, RAC (U.S., Canada, Europe)
    Principal Consultant
    ComplianceAcuity, Inc.
    Golden CO
    United States
    www.complianceacuity.com
    © Copyright 2019 by ComplianceAcuity, Inc. All rights reserved.​
    ------------------------------



  • 14.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 11-Apr-2019 16:34
    Well, it looks as if there is more to be said here.  Kevin continues to come up with spot-on comments, even quoting another of those who frequent this forum.  Dan has some great contributions on many topics as well, including his comments on the EU MDR.

    I want to comment on the use of the Preamble [and other dated FDA documents], which is frequently a great source of information.  Remember it was "FDA's current thinking" in 1996 or rather really in 1994 when it was sent to the FDA lawyers for review.  A lot has happened in the 20+ years since then, so it is always a good idea to look carefully at other literature, especially that of FDA to get up-to-date information.  One Preamble Comment that I am aware of is Comment 13, where it clearly states, in discussion of process validation, While FDA believes that three production runs during process validation...is the accepted standard...The number three is, however, currently {at the time this was written] considered to be the acceptable standard". 

    When someone later questioned FDA pointing out that would conflict with 21 CFR 820.250 on Statistical Techniques, FDA CDRH Compliance was quick to recant the Comment 13 statement.  The Statistical Techniques section required that whenever techniques such as sampling are used that the section of sample size must be done on a statistically valid basis. In checking later references, I found in the QSIT Manual (created in 1999) on page 88 in a note on Process Validation, the following, " Determine whether... 3. Test sample sampling plans were based upon a statistically valid rationale."  So the inspections of Production and Process Control are done to an updated position.  I have crossed out that comment in my copy of the Preamble and use the QSIT to support that position.

    Welcome to Regulatory Affairs Michael, always an exciting and interesting area.

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



  • 15.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 11-Apr-2019 16:50
    Well thank you both very much for this informative, yet unsettling conversation. I see I have my work cut out for me.

    ------------------------------
    Michael Reents
    Bradenton FL
    United States
    ------------------------------



  • 16.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 11-Apr-2019 18:13
    ​It's our privilege to help leave a proper legacy for the next generation.  But indeed, it's a tough, and oftentimes, thankless profession.  I mean, if you do a great job and steer your team clear of compliance pitfalls, then they say, "…Why do we need RA/QA?  Why do we need to do all this extra work?..."  Yet if you succumb to the popularity contest causing compliance to be compromised, then guess who gets fired, or even worse, deposed.  And sometimes you'll be ousted for not succumbing to the popularity contest.  You may find that you always have a bit of a target on your back, from within and without, in this profession; your diplomacy skills will definitely be challenged for sure.  But so goes the hazard of the job.

    ------------------------------
    Kevin Randall, ASQ CQA, RAC (U.S., Canada, Europe)
    Principal Consultant
    ComplianceAcuity, Inc.
    Golden CO
    United States
    www.complianceacuity.com
    ------------------------------



  • 17.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 11-Apr-2019 19:20
    Kevin has said what I would, though probably better than me.  I just hope you don't learn the way I did with 483's, Warning Letter's, lots of time crafting Response Letters with attorneys, and in one unfortunate case witnessing Federal Marshalls seizing products.  In  hindsight I decided that it was better to take training classes than wade my way though all that again.  Mergers and Acquisitions seemed to give me the most positive experiences, though they were hard work.  I try to share my bruises and broken bones along the way to help others avoid the shoals and as my bother would say, "sail the center of the channels and stay out of shallow water".

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



  • 18.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 03-Apr-2019 14:27

    The derivation of design verification plans and protocols is an exercise that (when done correctly) begins in the earliest stages of design and development. Specifically, the hidden nucleus of effective design verification is forged via the development of proper design inputs.  I can't overemphasize enough how vital design input development is for the ultimate success of the design verification (and validation) campaign.  Development of a solid foundation of design input requirements is, in my experience, the single most important design and development activity.  Indeed, FDA in its design control guidance document states, "…For complex designs, it is not uncommon for the design input stage to consume as much as thirty percent of the total project time…"

     

    As I noted in a prior commentary, proper design inputs consist of functional, performance, and interfacial requirements that may spread across a variety of topics such as those listed below:

     


    And as Edwin Bills hinted, there is indeed an upstream process for developing the design inputs themselves.  But like in my prior commentary, I'll save a discussion of that for a different thread so that we can stay focused here on the scope of this thread's question, which is aimed at deriving design verification plans.

     

    A proper portfolio of design inputs is what ultimately beckons the particular design verification requirements necessary for a given design. To illustrate this principle, a couple hypothetical examples of common design inputs might be:

     

    • The active implantable electronic device must meet ISO 10993-1:2018 requirements for permanent (> 30 days) blood contact.
     
    • The active implantable electronic device must conform to ISO 14708-1:2014 Implants for surgery – Active implantable medical devices – Part 1: General requirements for safety, marking and for information to be provided by the manufacturer.

     

    Once the inputs are properly derived, the framework of the design verification plan starts to quickly take shape, almost intrinsically; indeed, the verification requirements almost leap into view, even before the corresponding design solutions (outputs) are put forth. Specifically, in the foregoing hypothetical examples, the corresponding design verification methods would be those necessary to methodically challenge and evaluate the design's attributes against the parameters of the targeted ISO standards.  For example, verification planning and protocols would be needed corresponding to the applied elements of ISO 10993 requirements including but not limited to cytotoxicity, sensitization, implantation, etc.  And likewise, for safety challenges that track to the applied ISO 14708-1 safety clause(s).  And also for label/labeling design inspections addressing the ISO 14708-1 clauses for marking and information, and so on and so forth.

     

    There are many benefits of operating the design mechanism in this fashion. Firstly, it's what's necessary to achieve and maintain regulatory compliance.  But also, if the developer has successfully born proper design inputs, then the scope and details of the design verification campaign and verification tasks can be visualized and planned with intelligent deliberation and with orderly intent rather than the guesswork that often led to safety issues and recalls back in the day before design controls became a requirement.  The old cliché "garbage in, garbage out" is as germane here as anywhere.

     

    And by the way, the approach I've laid out also inherently boosts the chances that you'll have the proper test data and information later needed to navigate the confluence with the premarket regulatory clearance/approval process. Faithful practitioners may even find that the nebulae and mysteries triggering the need for FDA pre-sub meetings will be systematically clarified, thereby potentially streamlining the regulatory timetable.

     

    Finally, another key element of properly constructing the design verification campaign is of course to clearly understand the fundamental goal of design verification as distinguished from design validation. That too could warrant an entire corresponding discussion.  But in a nutshell, accomplish design verification by performing the tests, inspections, and/or analyses needed to confirm whether the proposed design solutions (output) meet the corresponding device functional, performance, and interfacial requirements (i.e., the design input). Design verification answers the question, "Did we design the device and its manufacturing process properly?".  This is in contrast to the broader goal of design validation, which is instead to answer, "Did we design the right device and manufacturing process for the user(s) and manufacturer?".

     

    Regarding templates, there are plenty of folks selling off-the-shelf QMS templates; just search the web. In fact, I've in the past purchased one or two myself for benchmarking purposes.  Consequently, I also (as you may have guessed) offer tools and services to help firms set up and operate their design control processes, as I've not yet seen other off-the-shelf templates that ever seem to strike a palatable balance between proper, comprehensive attention to design control principles like those aforementioned and the theoretical waterfall model, yet that also keep the process fluid, real-life-dynamic, implementable, and sustainable.  Oftentimes such templates are too robust, or too meager, or just plain noncompliant.

     

    Hope this helps,



    ------------------------------
    Kevin Randall, ASQ CQA, RAC (U.S., Canada, Europe)
    Principal Consultant
    ComplianceAcuity, Inc.
    Golden CO
    United States
    www.complianceacuity.com
    © Copyright 2019 by ComplianceAcuity, Inc. All rights reserved.
    ------------------------------



  • 19.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 05-Apr-2019 00:42
    Hi kevin,

    Thanks for your valuable insight about device design and verification. But I would further need few line item examples starting from design inputs​ to design outputs to design verification to design validation etc.,.. from the standards like ISO 14708, ISO 10993 and few other standards like packaging, software if any....
    Would like to start from there onwards with your valuable inputs.

    ------------------------------
    Jayaram Abimanyu
    Chennai
    India
    ------------------------------



  • 20.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 09-Apr-2019 00:37
    Hi Kevin,

       Thanks for your valuable insight. Let me wait for your details reply on the question posted earlier.

    ------------------------------
    Jayaram Abimanyu
    Chennai
    India
    ------------------------------



  • 21.  RE: Design Verfication-Medical Device(Active Implantable Medical Device)

    Posted 09-Apr-2019 16:12
    Edited by Kevin Randall 09-Apr-2019 16:14

    As Jayaram alluded, there are many standards that need to be applied for a medical device.  I named only a couple as hypothetical examples.  Here are a couple hypothetical examples modeling the full input to output to verification to validation sequence:

    Example 1: Biocompatibility

    Input: The active implantable electronic device must meet ISO 10993-1:2018 requirements for permanent (> 30 days) blood contact.
    Output: Product specifications / drawings specifying precisely what materials of construction will be used.
    Verification Protocol: ISO 10993 test protocol(s) aimed at assuring the proper cytoxicity, sensitization, implantation of the product's materials of construction (tested individually and/or synergistically).
    Verification Report: ISO 10993 test results and conclusions regarding whether or not the product materials of construction met the biocompatibility requirements.
    Validation: Depending on the nature of the product, additional testing may or may not be needed to prove the product meets user needs.  For many products, the aforementioned verification is inherently sufficient to demonstrate user needs were met.  For other devices, testing in humans may be appropriate.

    Example 2: Labeling - Instructions for Use

    Input: The active implantable electronic device instructions for use shall comply with ISO 14708-1:2014 clause ## requirements (if any) and/or EN 1041, as well as standards for usability (e.g., IEC 62366, AAMI HE-74/75, etc.).
    Output: Instructions for Use content/artwork specifications containing the features and information required by ISO 14708-1 / EN 1041 and written with usability in mind.
    Verification Protocol: Inspection protocol aimed at visual inspection of the Instructions for Use content/artwork to systematically confirm that they contain the features required by ISO 14708-1 / EN 1041 and any particular "formative" aspects (see IEC 62366) created to meet usability requirements.
    Verification Report: Written report documenting the results and conclusions drawn regarding whether the Instructions for Use contain the features required by ISO 14708-1 / EN 1041 requirements and the targeted IEC 62366 formative elements.
    Validation Protocol: A plan for simulated or actual use of the Instructions for Use by actual or simulated users to confirm clinical needs are met and to challenge the Instructions for Use via "summative" testing (see IEC 62366) .
    Validation Report: A written report documenting the results and conclusions regarding whether clinical and usability needs were met.

    Hope this helps.



    ------------------------------
    Kevin Randall, ASQ CQA, RAC (U.S., Canada, Europe)
    Principal Consultant
    ComplianceAcuity, Inc.
    Golden CO
    United States
    www.complianceacuity.com
    © Copyright 2019 by ComplianceAcuity, Inc. All rights reserved
    ------------------------------