Regulatory Open Forum

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  • 1.  MDR for Class IR (Reusable Surgical Instruments)

    Posted 29-Mar-2019 14:58
    I understand that all Class I devices need to be in compliance with the MDR by May 2020 but these are self-certified; however, can anyone provide insight on Class IR Reusable Surgical Instruments. Now that they require Notified Body intervention for the reprocessing aspects, but do not currently have CE certificates, does this mean they also have to be in compliance by May 2020? This will require scheduling an audit with Notified Bodies, who are not ready to review under MDR yet. If a Notified Body is unable to issue a CE certificate under the MDR by May 2020, does this mean these devices cannot be shipped into the EU post that deadline? I know a lot of other manufacturers are struggling with the same thing so it would be good to hear others perspective on this. 

    Thank you.

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    Maham Ansari MS, RAC
    Director, Regulatory Affairs
    Synaptive Medical
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  • 2.  RE: MDR for Class IR (Reusable Surgical Instruments)

    Posted 30-Mar-2019 03:40
    Edited by Richard Vincins 30-Mar-2019 03:42
    Maham,

    Yes your questions are correct that Class I, Reusable Surgical Instruments need to obtain certification by 26 May 2020 because they are no longer "self-declare" devices.  Class I non-sterile, non-measuring, and non-reusable surgical instruments need to be in full compliance by 26 May 2020, though the difference is they are self-declare, so there is no Notified Body intervention.  Current products that are CE Marked rely on their MDD Certificate expiration which could go beyond May 2020 date (up to May 2024).  However, because Class I Reusable Surgical Instruments would not have had a MDD CE Certificate then the presumption is they need to have a MDR CE Certificate​ in order to place on the market.  You are absolutely spot-on with your last question that if a Notified Body is not designated to MDR or because of timing, those companies can not get a MDR CE Certificate for those products, then indeed they can not be placed on the market.  Then the next question is, well then what does my company do?  Beyond praying activities come together next spring (before May 2020) like your NB getting designated and getting schedule, I personally do not know the answer.  What I would suggest is you contact your local Competent Authority, have discussions with them, and get a "waiver" or extension of some sort for your Class I Reusable Surgical Instrument until you can get a MDR CE certificate.  Because in reality, is a Class I Reusable Surgical Instrument any less or any more safe or performs any different from the 10th of May 2020 to the 10th of June 2020?  As we make medical devices for use with human patients, I would strongly hope the answer is no.  So having a MDR CE Certificate to place on the market is not going to make the device any more safe or perform any better.  Unfortunately, we have deadlines but the EU Commission has not thought pragmatically nor issued further guidance on these type of matters.

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    Richard Vincins RAC
    Vice President Global Regulatory Affairs
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  • 3.  RE: MDR for Class IR (Reusable Surgical Instruments)

    Posted 30-Mar-2019 10:10

    First, it is important to note that IM, IS, and IR are not, despite the common usage, classes under the MDR. I have had clients confused by the application of the classification rules in Annex VIII, since they expected a classification of Class IR, say.

    The R, S, or M is a requirement of conformity assessment, not of the device class.  For example, there are additional conformity assessment requirements for a Class IIb active device intended to administer and/or remove a medicinal product. We could call them Class IIbM devices.

    The point is that the conformity assessment requirements for Class I reusable surgical instruments is in Article 52(7), which requires that the manufacturer apply the procedures set out in Chapters I and III of Annex IX, or in Part A of Annex XI.

    Article 52(7.c) says, "However, the involvement of the notified body in those procedures shall be limited, in the case of reusable surgical instruments, to the aspects relating to the reuse of the device, in particular cleaning, disinfection, sterilization, maintenance and functional testing and the related instructions for use."

    You will need to follow the relevant conformity assessment annex which requires a notified body with limited involvement. The second part, NB, is the source of the problem. Without NB involvement, you will not be able to put the CE Mark on the devices, so, after May 26, 2020 you would not be able place new devices on the EU market.

    The Article 120 soft transition would not apply because it requires NB certificates, but you don't have them.

    The only hope is that your NB becomes notified under the EU-MDR and has the correct scope for this work.

    Products under the MDD are not affected up to May 26, 2020. I recommend you inform your customers of the potential problem so they can build inventory in the event of a shortage.



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    Dan O'Leary CQA, CQE
    Swanzey NH
    United States
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  • 4.  RE: MDR for Class IR (Reusable Surgical Instruments)

    Posted 31-Mar-2019 05:26
    Hi,
    From theory to practice - getting the CE cert in due time is a challenge. Did you validate reprocessing alredy for your surgical instruments?
    Some inputs for the protocol may help. 2 main aspects need to be covered - Cleanliness & durability.
    - A0 = 600 & A0 = 3000 in WD
    - alkaline and neutral in WD
    - with pre-disinfection / without pre-disinfection
    - tracking of 3 markers for cleanliness
    - 121°C / 20 min - 134°C / 18 min
    - how many cycles of reprocessing are possible ?
    Depending on your instrument portfolio you end up with a couple of worst cases whether you look at it from the cleanliness / microbio angle or from the durability angle.
    For a SME surgical instrument manufacturer with 5 product families we ended up with 49 cycles....
    This work takes several months to perform, especially the evidence for durability is very time consuming.
    If you want to get a CE certificate for the reprocessing aspects, then you should start the validation works now.
    Kindest regards

    ------------------------------
    Michael Maier
    Senior Partner
    Switzerland
    michael.maier@medidee.com
    www.medidee.com
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  • 5.  RE: MDR for Class IR (Reusable Surgical Instruments)

    Posted 01-Apr-2019 04:23
    There's one important piece of information that has been overlooked so far, and that is the fact that there is a European Standard that should, at some time in the future, be harmonised under the MDR to provide a presumption of conformity to the reprocessing GSPRs in the MDR, this being EN ISO 17664:2017, 'Processing of health care products -- Information to be provided by the medical device manufacturer for the processing of medical devices'.

    This is the most recent version of the standard, but this version is not yet listed as being harmonised under the MDD. The previous version is listed under the MDD, however, this being EN ISO 17664:2004, 'Sterilization of medical devices -- Information to be provided by the manufacturer for the processing of resterilizable medical devices'.

    Note the difference in title and scope between the two versions. While the earlier version applied only to devices that needed to be sterilised between uses, the new version also covers devices that require only disinfection between uses.

    The standard provides a 'road map' to the validations that manufacturers should undertake to meet MDR requirements.

    It should also be noted that currently the European Commission has not formally identified any standards that would provide a presumption of conformity to the MDR - the standards list available on the Commission website still lists only standards harmonised for the MDD.

    Hope this is helpful.

    ------------------------------
    Roger Gray
    VP Quality and Regulatory
    Donawa Lifescience Consulting
    Clinical Studies - Regulatory - Quality Systems
    Rome, Italy
    +39 06 578 2665
    rgray@donawa.com
    www.donawa.com
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  • 6.  RE: MDR for Class IR (Reusable Surgical Instruments)

    Posted 02-Apr-2019 02:40
    Note that the deadline of 26 May 2020 applies to "placing on the market". Any device that was placed on the EU marked before the deadline (e.g. imported in the EU with a view of further distribution, sold to distributors, etc.) can still be sold ("made available") after May 2020 also in absence of a valid MDR certificate. This could bridge a gap between May 2020 and the availability of the certificate.


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    Andrea Sparti
    Regulatory Affairs Manager
    Bienne
    Switzerland
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  • 7.  RE: MDR for Class IR (Reusable Surgical Instruments)

    Posted 02-Apr-2019 11:20
    Thanks for the great discussion everyone. 
    Andrea, you mentioned that if a device is placed in the EU before the deadline (e.g. imported in the EU with a view of further distribution, sold to distributors, etc.), it can still be sold ("made available") after May 2020 in absence of a valid MDR certificate.  <g class="gr_ gr_236 gr-alert gr_gramm gr_inline_cards gr_run_anim Punctuation only-ins replaceWithoutSep" id="236" data-gr-id="236">Please</g> would you mind elaborating on this a bit? For instance, if a manufacturer stockpiles the device in its own warehouse in the EU, would that still count as 'placing on the market' and therefore sold post-May 2020? If it cannot stockpile the device in its own warehouse, then would a third party's warehouse work? Or does it have to be in distribution and outside the hands of the manufacturer, i.e. with a distributor or customer?

    Thank you.

    ------------------------------
    Maham Ansari, MS, RAC
    Director, Regulatory Affairs
    Synaptive Medical
    Canada
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  • 8.  RE: MDR for Class IR (Reusable Surgical Instruments)

    Posted 02-Apr-2019 13:53
      |   view attached
    Dear Maham,
    I confirm Andrea's comment - check out the definitions in MDR for "placing on the market" and "making available" and also check the blueguide sections referring to "placing on the market". (see uploaded file - blueguide)
    Then you also can check https://ec.europa.eu/info/sites/info/files/qa_brexit_industrial_products_en.pdf - this addresses specifically the brexit issue but gives additional explanations on the understanding of "placing on the market".

    Kind Regards

    ------------------------------
    Michael Maier
    Senior Partner
    Medidee Services SA
    Switzerland
    michael.maier@medidee.com
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    Attachment(s)



  • 9.  RE: MDR for Class IR (Reusable Surgical Instruments)

    Posted 03-Apr-2019 02:30
      |   view attached
    In addition to Michael's comment and references, check also the EU Commission's Intepretative document on placing on the market ​(attached). In general, the product needs to be tranfered from manufacturing to distribution and for non-EU manufacturers it needs to be imported. Your warehouse in the EU will be likely managed by an entity, which will be the importer, to which the products will be transferred. This will count as placing on the market. Products in your warehouse in Canada, on the contrary have not yet been placed on the EU market, even if they are meant to be shipped there. For EU manufacturers and non-EU manufacturers alike, products that are within the distribution chain in the EU, also if composed of affiliates, are considered as placed on the market.
    There are a few issues to be aware of, for instance if final packaging and labelling occur in the EU warehouse, then products that have cleared customs are not placed on the marked (as manufactuing is not completed yet).


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    Andrea Sparti
    Regulatory Affairs Manager
    Bienne
    Switzerland
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    Attachment(s)