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Biocompatibility -representative sample

  • 1.  Biocompatibility -representative sample

    Posted 15-Jan-2019 22:59
    Hi,
    We have received a query from the 3rd party reviewer for our class II reusable device who has mandated the use of 'finished device' for biocompatibility wherein we have used composite material of the finished device.
     
    As per the guidance "Use of International Standard ISO 10993-1, Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process Guidance for Industry and Food and Drug Administration Staff"
     
    "A. Use of Medical Device in Final Finished Form or Representative Test Article
    When biocompatibility testing is necessary, the Agency recommends testing medical devices in the condition that they will be used, whenever possible. This could include final, packaged devices, or as sterilized by an end user, if appropriate. If the medical device in its final finished form cannot be used for biocompatibility testing, a test article (e.g., coupons or "representative components") may be considered. The representative test article should undergo the same manufacturing and sterilization processes, have the same chemical, physical, and surface properties, and have the same ratio of component materials as the medical device in its final finished form."
     
    The actual standard also mentions "a) Testing shall be performed on the sterile final product, or representative samples from the final product or
    materials processed in the same manner as the final product (including sterilization"
     
    Can you confirm if we need to provide a justification , why we haven't used the final sample ( I have no idea why , Project manager took the decision at that time) and if yes , what is the valid justification that would hold good.
     
    Thanks & Regards,
     
    Rashmi Pillay
    Regulatory Affairs Associate

    Ellex 
    3-4 Second Avenue
    Mawson Lakes SA, 5095
     
    T + 61 8 7074 8105
    rpillay@ellex.com
    W ellex.com
    .............................................................................
     
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  • 2.  RE: Biocompatibility -representative sample

    Posted 16-Jan-2019 03:50
    Hi Rashmi,

    As you already mentioned, ISO 10993 dictates that the biocompatibility testing must be performed on the finished device (including sterilization) or a representative whenever the device cannot be used as a whole. In the case you use a representative portion of the device you have to justify your selection.
    In most of the times, you have to include all the parts of the device using the ratios of the prototype device.
    If you do not have a strong justification of your selection, there might be a possibility the authority will ask you to repeat some studies.

    Hope that helps

    ------------------------------
    Spyros Drivelos
    Medical Devices Manager
    Agia Paraskevi, Athens
    Greece
    ------------------------------



  • 3.  RE: Biocompatibility -representative sample

    Posted 16-Jan-2019 07:12

    Hi Rashmi,

    Yes, I would recommend providing a rationale for the testing approach taken.  A potential legitimate reason for use of a representative sample (instead of final, finished device) could be one of timing; that is, a prototype was tested, because the final device was not yet available.

    In the rationale, I would suggest quoting the relevant parts of the standard (as you have done in your message), and adding a discussion of why the test articles adequately represent the final, finished device.  Considerations to include in the discussion would be use of same materials, in the same proportions, and processed the same way--especially with respect to sterilization, but also in any other processing (e.g., use of mold release agents).

    Hope that helps!

    Ted

    ------------------------------
    Theodore Heise PhD, RAC
    VP Regulatory & Clinical Services
    West Lafayette IN
    United States
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  • 4.  RE: Biocompatibility -representative sample

    Posted 16-Jan-2019 08:21
    Hello Rashmi,

    Yes you need to justify it and push back, or do it over. I have of companies actually grinding up the whole device which seems crazy if components which will not contact patients or users and are in that final blend. 

    Are you following the 2018 version of ISO 10993-1? That version now includes requirements to consider biocomp of parts of a final device broken during shipment which may contact user, or through its lifetime (e.g. degradation),  etc., that you may not have considered before. 

    I would consult with a toxicologist to help write that response, if you haven't already, to  determine how or if it could be justified based on intended use. 







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



  • 5.  RE: Biocompatibility -representative sample

    Posted 16-Jan-2019 10:25
    Rashmi,

    The key here will be the assessment of equivalence of the composite material to the "final manufactured product." You would need to establish that the sample underwent all the manufacturing processes (molding, extruding, adhesives, coatings etc). For anything that is different, you would need to establish that the change couldn't impact biocompatibility. For instance, it is sometimes possible to have ADDED materials in your biocompatibility samples (for instance a coating or processing material) that have been removed from final product. Similarly, you might be able to show that, say, adding a saline wash step can only improve biocompatibility. You also shold show that you haven't added materials , or amounts of materials, from the composite sample to really claim equivalence.

    From there it gets more complex. Sometimes you can do extracts testing on products from the two different processes/material amounts. If you can show the extracts are the same (at the same levels) you can sometimes rationalize that you don't need to repeat all the other testing. Though there are complexities in some products that make even this hard (for instance products that have breakdown products as they age)

    Good luck with this one!

    g-

    ------------------------------
    Ginger Glaser RAC
    Chief Technology Officer
    MN
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  • 6.  RE: Biocompatibility -representative sample

    Posted 16-Jan-2019 11:52
    ​Hi Rashmi
    Using composite material of a device in lieu of the finished device is allowed in biocompatibility testing as long as the composite material is deemed representative or worse case representation of the patient contacting materials in the finished device.  As you quoted, this is also stated in ISO 10993-1.  Depending on the complexity and the size of the finished device, it is practical to use coupons or representative samples for some tests such as hemocompatibility and implantation, etc.  However, you should provide a rationale for this approach.  Your rationale should include a comparison of ratio of composite materials in the test article versus the final device, sterilization conditions, manufacturing process including use of any coatings, solvents, or mold release agents, etc.

    ------------------------------
    Raji Pidikiti
    Lakewood CO
    United States
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  • 7.  RE: Biocompatibility -representative sample

    Posted 16-Jan-2019 16:36
    ​Thank you all for your feedback.

    The TP reviewer hasn't officially sent me the Deficiency letter but this his point of argument.

    "Please understand the FDA guidance is the overriding standard in this case.  The FDA has been very particular about accepting only testing on the final finished device.  Others have tried this approach, FDA has not accepted any rationale or testing on a coupon"

    Has anybody tried this approach and was it accepted by the FDA ?

    Regards

    Rashmi

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    RashmiAdelaideAustralia
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  • 8.  RE: Biocompatibility -representative sample

    Posted 16-Jan-2019 18:50
    Hi Rashmi

    Yes, 

    1) my client used component tesrung because it was transient use, Intact skin with well known materials, not additionally processed, etc.

    2) I could show other devices in exact same procode used the exact same way for same intended use/indications for use had been cleared two months before
    With absolutely no biocomp testing. I knew this because they had used a 510(k) statement, and I asked for the 510(k) and it clearly showed none was submitted or asked for.   Both devices were cleared second half of 2017.

    3) Guidance is guidance. It is not law or regulation.  It does not have weight of law. The preambles usually state they are current thinking that can be deviated from with justification.

    I can almost guess what Third Party you used because they tried to read the riot act to me on this and refused to even send to FDA for their supervisory review. But when I pointed out items #1-3 above, they capitulated and sent it.  FDA did not even question anything on biocomp in their review.

    So, yes you can push back nicely, but have a strong case, and if you have evidence they are not fairly applying the same criteria to equivalent situations, you can use that.
     
    Remember you are also playing a relationship game too.  So you can try to make the case logically and show fairness. Hopefully don't poison the well for the long term.  It may be less expensive in terms of time and money to just do it.

    Here is another thought.  FDA is promoting rational use of animals- less is more if possible. Would repeating the test unnecessarily use animals?

    Good luck!

    Ginger






  • 9.  RE: Biocompatibility -representative sample

    Posted 17-Jan-2019 10:06
    Rashmi,

    One thing I forgot to add previously is that FDA did an internal review of reasons for 510(k) delays and Biocompatability disagreements were the highest item. It is possible your 3rd party has been burned on this and thus is being crazy conservative.

    Thus, I'd agree with the other Ginger's comment that you should push them to submit it anyway. Dr. Shuren and Dr. Maisel are personnally interested in this topic (and believe the reviewers often go beyond practicality) and I know of a couple situations in which they have personally intervened to resolve a question like this. If you can get it into FDA (and they open again) you would have this appeal process available.

    That said, start with a really tight scientific rationale.

    g-

    ------------------------------
    Ginger Glaser RAC
    Chief Technology Officer
    MN
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  • 10.  RE: Biocompatibility -representative sample

    Posted 17-Jan-2019 14:25
    ​​Hi, Rashimi, glad to see you are still with us!

    You have gotten plenty of good (and interesting) advice on this matter.  I wanted to add the suggestion that, if the project manager is still with the company, and you have no idea why they chose to test the composite material, you start by finding this out.  If you are lucky, they knew what they were doing.  In that case, just have them write down their explanation and submit it.

    I can't say I'm especially optimistic that this will work, but it's easy and costs you nothing, so to me the reasonable first step before you pursue anything more time-consuming and/or that costs money.


    ------------------------------
    Julie Omohundro, ex-RAC (US, GS), still an MBA
    Principal Consultant
    Class Three, LLC
    Durham, North Carolina, USA
    919-544-3366 (T)
    434-964-1614 (C)
    julie@class3devices.com
    ------------------------------



  • 11.  RE: Biocompatibility -representative sample

    Posted 17-Jan-2019 17:55
    ​Thanks once again for all your valuable feedback, we are using the information of the cleared devices from the original manufacturers of the contact devices , which the 3rd party reviewer is willing to accept , just requiring declaration from the original manufacturers that the contacting devices remain the same as that in the cleared devices and the  510k numbers of the cleared devices . This seems to be the easiest approach rather than  pushing back to use our biocomp data.

    Regards,

    Rashmi

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    RashmiAdelaideAustralia
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