Great question! As I'm dissecting this scenario, I think that it's important to recognize that there are different types of user requirements - for the sake of simplicity, I'll bucket them as Design requirements and Commercial requirements. Design requirements are the physical and performance characteristics used as the basis for the design of the device*. Commercial requirements may include considerations for the project, but not necessarily be in scope of
device design (e.g. market access, reimbursement, gross margins, patents/IP, ROI, etc).
*excerpted from slide 42 http://www.accessdata.fda.gov/cdrh_docs/presentations/MDSAP-Training/5-Events-Reporting/module/presentation.htmlBased on how "regulatory requirements" are applied under Section 0.2 of ISO 13485: 2016 (limited to QMS and safety and performance of the device), I would consider regulatory requirements to be included in both Design and Commercial buckets. Various QS procedures would cover a number of Commercial requirements (including the
requirement to obtain market access prior to commercialization), while Design Controls would cover the safety and performance of the device (e.g.
evidence needed to support applications for market access). Likewise, if you look at the MDSAP audit sequence, regulators are considering Market Access as a separate (but most definitely linked) module to Design and Development.
To support this scheme, I currently prepare a Regulatory Strategy to cover the QMS/Commercial requirements for market access, QMS requirements, types of submissions required for the target markets, approval timelines (submission to approval), etc. That, in turn, feeds a Regulatory Requirements document that covers the detailed design requirements mandated by the regulations of the target countries. This document includes labelling requirements, special controls, relevant design/testing standards, list of DHF/DMR documentation required for submission in each target country, etc.
Ideally, when V&V is complete, I will have all of the DHF documentation required to submit in all of my target countries irrespective of when those submissions will take place. The design project can move through design transfer and into commercialization phases as a parallel path to market access applications. The task of preparing submission packages, sending them to the regulatory authorities, and getting approvals are managed under my Regulatory Compliance QS procedure. The design project does not have to be revisited for regulatory purposes unless there were a situation where either a target country required additional (unplanned) design documentation OR a new country is added to scope who requires additional (unplanned) design documentation. Either situation would require an update to the Regulatory Requirements document (and possibly the Strategy) to kick off the necessary Design Controls activities to generate the required documentation.
Upon each regulatory approval, the market release QS process would kick in to ensure that all the market access requirements have been met prior to commercialization in that country.
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Tina O'Brien RAC, MS
Director of Regulatory Affairs
Aroa Biosurgery
Auckland
New Zealand
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Original Message:
Sent: 13-Sep-2017 22:25
From: Kevin Randall
Subject: Regulatory Submissions within Design Controls
Hi Tina!
In over twenty years of studying, learning, being taught by accomplished mentors, applying design controls in practice, teaching design controls, and becoming a mentor myself, I've routinely seen the premarket submission requirements articulated in the design inputs. Looking back, I guess I never questioned it, but I'm certainly glad to be thinking about it now.
One thing we know for certain is that FDA, ISO 13485, AdvaMed, AAMI and others all indicate that the design inputs are to include regulatory requirements. We also know that the design inputs must not be incomplete or ambiguous. Question for your/the Forum's consideration: What would be our rationale for including some key regulatory requirements that are important to user needs (like those you've listed) but not others (like the requirement to meet premarket clearance/approval)?
In theory, a particular jurisdiction's premarket regulatory submission requirements are ultimately intended to facilitate patient/user safety. In other words, marketing a device without the appropriate premarket agency reviews is reasonably related to compromised public health. For example, the lack of proper premarket review is what ultimately led to establishing the U.S. FDA's premarket requirements after the U.S. sulfanilamide tragedies in 1937. So, based on that perspective, I'd say it seems reasonable to include the premarket submissions with other important regulatory requirements in the design inputs. Thereafter, obtaining a regulatory approval could be viewed as validating the design of the device, as design validation means confirming that the design meets user needs, where the user needs seem to include proper premarket agency review.
The way I've always seen these line items closed out is via the input-output-verification-validation thread I modeled in my previous post. Thereafter, if new jurisdictions/markets arise that weren't included in the original design inputs, then it essentially means there has been a change in the inputs/requirements. Accordingly, in theory the inputs should be revised as the regulatory requirements change, which would result in a cascade of corresponding changes to the DHF rather than a static DHF.
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Kevin Randall, ASQ CQA, RAC (U.S., Canada, Europe)
Principal Consultant
ComplianceAcuity, Inc.
Golden CO
United States
www.complianceacuity.com
Original Message:
Sent: 13-Sep-2017 20:26
From: Tina O'Brien
Subject: Regulatory Submissions within Design Controls
Hi Kevin,
I think that's part of my disconnect, as I don't consider the need for a regulatory/clearance approval as a design input. Certainly the specific labelling requirements, any special controls, or other items related to the design and/or testing of the device required by that regulatory authority would be required for design controls, but not the submission itself. How would obtaining a regulatory approval validate the design of the device - particularly for "low hanging fruit" countries that require nothing more than a few certificates and a copy of the labelling? I can see your point for complex countries that do a thorough document review, but is it REALLY validating anything other than you've made the reviewer happy and allowed them to tick the right boxes?
If you have regulatory submissions as a phase (or part of a phase) in your design controls process, how would you ever be able to close that phase if you're constantly doing registrations across the globe using DHF documentation that never changes?
Thanks!
Tina
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Tina O'Brien RAC, MS
Director of Regulatory Affairs
Aroa Biosurgery
Auckland
New Zealand
Original Message:
Sent: 13-Sep-2017 19:39
From: Kevin Randall
Subject: Regulatory Submissions within Design Controls
Both the FDA (via the QS Regulation preamble) and ISO 13485 (clause 7.3) require that the design and development inputs address applicable regulatory requirements. One of those regulatory requirements would be the corresponding premarket regulatory submission, as it is not possible to fully characterize the applicable regulatory requirements without specifying the required premarket submission. Remember that the design and development inputs must not be incomplete or ambiguous.
Once the corresponding design and development input is written [e.g., "Device must be FDA 510(k)-cleared / CE-marked / Licensed in Canada / Registered on the ARTG, etc., prior to marketing"], then it would progress through the remainder of the design and development process as follows:
- The design and development output would be the submission itself [i.e., FDA 510(k) # K17abcd; EC Technical Documentation File / Design Dossier # abc; Canadian Medical Device License Application file # xyz; etc.]
- The design verification is the FDA 510(k)-clearance letter; the EC Certificate; the Canadian Medical Device License; the ARTG registration, etc.
- The design validation may in this case also be the aforesaid clearances/approvals, as it can be argued that the user needs the product to be the subject of a successful premarket regulatory submission. Alternatively, it would typically also be acceptable to cite the device's successful design validation testing, which shows that the cleared/approved subject device meets user needs/intended uses.
Hope this helps you get going in the right direction.
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Kevin Randall, ASQ CQA, RAC (U.S., Canada, Europe)
Principal Consultant
ComplianceAcuity, Inc.
Golden CO
United States
www.complianceacuity.com
Original Message:
Sent: 13-Sep-2017 18:56
From: Tina O'Brien
Subject: Regulatory Submissions within Design Controls
In your current QS, where do you place regulatory SUBMISSIONS? In all of my previous companies, submissions themselves were a parallel path to design controls within the "cradle to grave" product realization process. Obviously, any regulatory REQUIREMENTS related to the design of the device, labelling, testing, etc. are inputs to design controls.
I'm talking about the act of preparing and submitting a premarket notification/application and the interaction with the regulatory authority. Assuming you've done a solid job of making sure the regulatory requirements were addressed during design controls, the resulting DHF documentation should be suitable for the countries defined at the beginning of the project and likely some "add-on" countries after the fact. Furthermore, the country-specific registrations could be done shortly after V&V is complete or, in some cases, years after.
Why would you put the SUBMISSION process as part of design controls? I am vehemently against this approach as I feel it would add unnecessary burden not only to the submissions, but to the design controls process. Unless I was planning to submit in a new country with a requirement that would impact the existing DHF documentation, it just simply doesn't make sense to me for the submissions requiring even so much as a design review.
Also, have you ever used a regulatory clearance/approval as design validation?
Not sure if this is just simply out of my comfort zone and truly does have merit, or if it just simply doesn't make sense.
Looking forward to your input (and hopefully some confirmation that I'm not crazy)
Tina
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Tina O'Brien RAC, MS
Director of Regulatory Affairs
Aroa Biosurgery
Auckland
New Zealand
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