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510k and indications for use

  • 1.  510k and indications for use

    Posted 09-Aug-2017 02:46

    Hi,

     

    Does anybody have an experience with 510k submission where the 510 k has been cleared for improvement in the biomarkers to the actual indication of the predicate device or can a 510 k clearance happen with  a new indication with improvement in biomarker which is not present in the predicate. Or is this a path for a denovo?

     

    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

    .............................................................................
     
    One Powerful Vision.

    Confidentiality: This e-mail is from Ellex Medical Pty Ltd, ABN 35 008 276 060. The contents are confidential and intended only for the named recipient of this e-mail. If the reader of this e-mail is not the intended recipient you are hereby notified that any use, reproduction, disclosure or distribution of the information contained in the e-mail is prohibited. Viruses: Any loss/damage incurred by using this material is not the sender's responsibility. No warranty is made that this material is free from computer virus or other defect. Ellex Medical Pty Ltd entire liability will be limited to resupplying the material. If you have received this e-mail in error, please reply to us immediately and delete the document. 

     



     



  • 2.  RE: 510k and indications for use

    Posted 21-Aug-2017 13:59
    ​Hi Rashmi,

    I'm not sure that I fully understand your question, however a change in indications does require a new 510k.  Have a look at the FDA guidance on assessing changes to a cleared device: https://www.fda.gov/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm080235.htm / http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM514771.pdf (draft).

    If there is a change to the indications, you cannot submit a special 510k - you will likely pursue the traditional pathway.

    Hope this helps,
    Liz


    ------------------------------
    Elizabeth Goldstein RAC
    Regulatory Affairs Specialist
    Medtronic Vascular
    Santa Rosa CA
    United States
    ------------------------------



  • 3.  RE: 510k and indications for use

    Posted 21-Aug-2017 20:58
    ​Theoretically, the first requirement for a predicate is that it have the same intended use as the 510(k) device.  I know there have been/are exceptions to this rule somehow, but I wouldn't be surprised if FDA were not less open to exceptions now that the direct De Novo path is open.

    ------------------------------
    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
    ------------------------------



  • 4.  RE: 510k and indications for use

    Posted 22-Aug-2017 02:21

    Hi Elizabeth,

     

    My query was whether the new device qualifies for a 510 k clearance in the absence of a predicate with the same indications.

     

    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

    .............................................................................
     
    One Powerful Vision.

    Confidentiality: This e-mail is from Ellex Medical Pty Ltd, ABN 35 008 276 060. The contents are confidential and intended only for the named recipient of this e-mail. If the reader of this e-mail is not the intended recipient you are hereby notified that any use, reproduction, disclosure or distribution of the information contained in the e-mail is prohibited. Viruses: Any loss/damage incurred by using this material is not the sender's responsibility. No warranty is made that this material is free from computer virus or other defect. Ellex Medical Pty Ltd entire liability will be limited to resupplying the material. If you have received this e-mail in error, please reply to us immediately and delete the document. 

     



     






  • 5.  RE: 510k and indications for use

    Posted 23-Aug-2017 19:55
    ​​Hi Rashmi,

    As Julie mentioned, your predicate device should have the same intended use, but it is possible to have different indications for use.  The following are a couple of references which may be of interested to you:

    What is Substantial Equivalence

    A 510(k) requires demonstration of substantial equivalence to another legally U.S. marketed device. Substantial equivalence means that the new device is at least as safe and effective as the predicate.

    A device is substantially equivalent if, in comparison to a predicate it:

    • has the same intended use as the predicate; and
    • has the same technological characteristics as the predicate;
      or
    • has the same intended use as the predicate; and
    • has different technological characteristics and the information submitted to FDA;
      • does not raise new questions of safety and effectiveness; and
      • demonstrates that the device is at least as safe and effective as the legally marketed device.

    A claim of substantial equivalence does not mean the new and predicate devices must be identical. Substantial equivalence is established with respect to intended use, design, energy used or delivered, materials, chemical composition, manufacturing process, performance, safety, effectiveness, labeling, biocompatibility, standards, and other characteristics, as applicable.

    https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/HowtoMarketYourDevice/PremarketSubmissions/PremarketNotification510k/ucm2005718.htm#se

    A1Does the change affect the indications for use? The general statement of the "Indications for Use" identifies the target population in a significant portion of which sufficient scientific evidence has demonstrated that the device as labeled will provide clinically significant results and at the same time does not present an unreasonable risk of illness or injury associated with the use of the device.12 Changes in the indications for use section of labeling raise more agency concern than any other aspect of labeling. In fact, most changes in this part of the labeling will require the submission of a 510(k). Any change in the indications for use that limits use to within the currently cleared indication may occur without the submission of a 510(k). For example, the device was cleared for use with three specific indications and the firm decides to market the device for only two of those indications, would not require submission of a new 510(k). Another example would be further limiting the patient population by age or weight e.g., if your device was indicated for use in adults, you could revise the indication to adults 60 years and older but it does not mean you could indicate it for pediatrics. A more difficult case is where the change expands use to closely related populations. In determining whether a change to the indications for use raises issues of safety or effectiveness, the manufacturer should ask whether the change poses any additional risks, expands the use to a new and distinguishable patient population, etc. If the expansion is to a population with similar demographics, diagnosis, prognosis, comorbidity and potential for complications as the original, then a new 510(k) is not ordinarily expected.

    Confusion often results when discussing the distinction between "indications for use" and the "intended use" of the device. The regulatory term, "intended use," refers to the objective intent of the persons legally responsible for the labeling of the device. Intent may be determined by written expressions or may be shown by the circumstances surrounding the distribution of the device. The concept of intended use has particular relevance in determining whether a device can be cleared for marketing through the premarket notification (510(k)) process or must be evaluated in a premarket approval application (PMA). Manufacturers should recognize that if a particular labeling change results in a "new" intended use for the device, the agency will find the device to be not substantially equivalent and require premarket approval.

    Rather than referring to "intended use" as a determinant in deciding when to submit a 510(k), this guidance identifies several specific labeling changes or modifications that have a major impact on intended use and thus would require the submission of a 510(k).13 Two common labeling changes that impact intended use and would usually require submission of a 510(k) are:
    1. reuse of devices previously labeled "single use only;" and
    2. changes from prescription to over the counter (OTC).14
    One exception to (2) above is providing home-use instructions for devices that remain prescription and whose use in the home is accepted medical practice in the United States. Many prescription devices are used in the home with increasing frequency and the Agency believes that 510(k)s are not necessary to add home-use labeling. The reader is referred, however, to the FDA publication, "Write It Right," 15for techniques to provide clear and understandable home use instructions.

    https://www.fda.gov/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm080235.htm

    Hopefully this is more on track to what you are looking for..!

    Thanks,
    Liz

    ------------------------------
    Elizabeth Goldstein RAC
    Regulatory Affairs Specialist
    Medtronic Vascular
    Santa Rosa CA
    United States
    ------------------------------



  • 6.  RE: 510k and indications for use

    This message was posted by a user wishing to remain anonymous
    Posted 30-Aug-2017 16:28
    This message was posted by a user wishing to remain anonymous

    ​Elizabeth, your response to this question is very clear.  I have a somewhat similar question if you please:

    I am in the process of a 510(k) submission for an IVD assay for detecting a microorganism - the assay and the device needed to run the assay with both be submitted.  A new assay submission is in the works using the same device that is needed to run the first submitted assay.  Both assays will be labeled prescription devices.

    Intended use differences:
    Assay 1 is used to detect a different organism (fungi vs. bacteria) than the new Assay 2.
    Assay 1 will be used by hospital lab professionals in hospital settings and Assay 2 will be used in remote hospital settings by hospital lab professionals.

    Indication for use differences:
    Assay 1 target condition is caused by bacterial infection.
    Assay 2 target condition is caused by fungal infection.

    Everything else is the same in both assays and the device needed to run the assay does not change.

    My question then is will we have to submit a new traditional 510(k) for Assay 2?

    Thank YOU!!!


  • 7.  RE: 510k and indications for use

    Posted 30-Aug-2017 18:37
    Hi anonymous,
    If you are using a different manner of detection funghi vs bacteria, my understanding is that this requires a new 510(k) even if the assay reader is the same. The suggestion for a presubmission is a good one; however, you may wish to try calling DICE or requesting written feedback which generally get quicker feedback for what could be a straightforward question.

    Best,

    ------------------------------
    Michael Nilo
    Network Regulatory Partners
    Nilo Medical Consulting Group
    Portland OR
    United States
    ------------------------------



  • 8.  RE: 510k and indications for use

    Posted 30-Aug-2017 17:47
    ​Hi Rashmi,

    It sounds as if your situations are perfect candidates for the FDA's QSub programme https://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm311176.pdf

    I use this process on a regular basis to get feedback from FDA on submission strategies and data expectations.  It's very helpful to your development team to ensure they're working toward the right goals, and it's also a great way to establish connection with the FDA staff.  It's easy, FREE, and (IMO) very successful.  I highly recommend it.

    Tina

    ------------------------------
    Tina O'Brien RAC, MS
    Director of Regulatory Affairs
    Aroa Biosurgery
    Auckland
    New Zealand
    ------------------------------



  • 9.  RE: 510k and indications for use

    Posted 01-Sep-2017 05:40
    I could not agree more with the team. Also keep in mind the need to avoid grouping too many different predicates together; otherwise you may become a split predicate. 

    How to Find and Effectively Use Predicate Devices

    "The use of split predicates is inconsistent with the 510(k) regulatory standard. Manufacturers may identify "reference devices" within their 510(k) to support scientific methodology or standard reference values."


    ------------------------------
    Timothy Kline, Ph.D., RAC
    Associate Manager, Regulatory Affairs
    ------------------------------



  • 10.  RE: 510k and indications for use

    Posted 02-Sep-2017 04:16
    It's a little hard to understand your question, but we have two Client Alerts on our website that address the difference between intended use and indications for use and how FDA looks at potential need claims.  There is also one on selecting a predicate.  Check those out.

    Mark DuVal, J.D., FRAPS
    DuVal & Associates, P.A.



    Sent from my Verizon, Samsung Galaxy smartphone