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"Significant Changes" post MDR

  • 1.  "Significant Changes" post MDR

    This message was posted by a user wishing to remain anonymous
    Posted 13-Feb-2019 20:37
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    This message was posted by a user wishing to remain anonymous

    Per Article 120(3) of the MDR, we are allowed to continue putting our devices on the market that are CE Marked under the MDD after the MDR goes into effect in May 2020 under their MDD certificate provided the cert is still valid, there are no significant changes in design or intended purpose of the device.  That seems clear - if we want to make a significant change to the intended purpose of the device or the design of the device, we have to submit it under MDR and get it CE Marked under the MDR regulation.  All was well and good until someone provided me the attached FAQ published by the CAMD Transition Sub Group.

    On page 10, in response to question 17 about placing MDD compliant devices on the market after MDR DoA, the CAMD states:


    SO....I'm wondering if any of you have an interpretation or guidance on the "design changes related to corrective actions assessed and accepted by the CA" as not being considered a significant change?

    I might be missing something here, but the only design changes related to corrective actions that I can think of where the CA gets involved are those related to FSCAs.  Are they stating that we are allowed to make changes to our MDD certified devices if it is a change to correct a safety issue and we can remain under our MDD certificate and not have to automatically move that device under MDR?  What am I missing and what do you guys think?

    Attachment(s)



  • 2.  RE: "Significant Changes" post MDR

    Posted 14-Feb-2019 05:18
    A corrective action assessed and accepted by a Competent Authority is basically the company has had to perform a Field Safety Corrective Action (FSCA).  This means in practice the company has had to perform a recall or market correction for their device where a Competent Authority has been involved and corrective action is needed for the current product.  This means that the MDD certified product needs to change in some manner, though would not necessarily impact the MDD certificate status as there is a need for patient safety or performance of the device needing corrective action performed.  What maybe you are missing, and my own interpretation is that a change to a device from a corrective action most likely related to an FSCA is probably the least of your worries as to the main issue of why the FSCA has to be performed in the first place.  Also that I would not want to have those discussions with the Notified Body when they walk in for the next surveillance audit, will be very hard to justify keeping that MDD cert in place and not upgrading to a MDR cert.  Remember, under the MDR both Competent Authorities and Notified Bodies have many more obligations, responsibilities, AND authority for devices placed on the market in the EU, they are not going to treat issues with MDD cert products after May 2020 kindly.

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    Richard Vincins RAC
    Vice President Global Regulatory Affairs
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  • 3.  RE: "Significant Changes" post MDR

    This message was posted by a user wishing to remain anonymous
    Posted 15-Feb-2019 08:31
    This message was posted by a user wishing to remain anonymous

    Thank you!

    Richard, you hit the nail on the head.  I guess I'm surprised that they would consider a change made due to a corrective action assessed and accepted by the CA as a non-significant change.  So, if we are still marketing our device under MDD and that were to occur, we could make the change and continue to market under MDD because we wouldn't have to report it to the NB as a significant change (even though they would already be aware b/c of the FSCA reporting).  I'm skeptical that a NB would find this acceptable.  Yet, this document was published by the CAMD.

    As we plan the transition of our products to MDR, I am working to establish guidelines for my company around types of changes that can and cannot be made on the various products at their various stages (MDD certified, Post NB MDD Cutoff, Under MDR Review, Post MDR Review) and this one has me stumped.




  • 4.  RE: "Significant Changes" post MDR

    Posted 15-Feb-2019 08:57
    I'm sorry Anon, but the point that's been missed is that the CA would NOT be aware of these specific types of PMS-instigated design changes "because of the FSCA reporting", but because MDR Article 83(4) requires manufacturers to report such PMS-instigated design changes to the CA, even if there is no FSCA.

    What the CAMD document is saying is that under these specific circumstances, if the CA acccepts the design change after its asessment, then the manufacturer can consider this 'non-significant' from the perspective of advising the NB. However, Article 83(4) also states that these PMS-instigated design changes must be copied to the NB at the time they are notified to the CA, so the NB is going to know about the design change anyway, and will presumably make its own decision on whether any further action is needed.

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



  • 5.  RE: "Significant Changes" post MDR

    This message was posted by a user wishing to remain anonymous
    Posted 21-Feb-2019 15:23
    This message was posted by a user wishing to remain anonymous

    Thanks Roger!

    If I understand what you are saying correctly, this paragraph is telling us that if we make a corrective or preventive change based on information obtained from PMS (an example could be a non-serious incident or a noticed trend that we decided to open a CAPA for and make a design change), then we have to notify the CA and NB.  If the CA accepts the change, then per the CAMD guidance, it would not be considered a significant change for reporting to the NB.  Is that correct?

    I was overlooking the fact that Article 83 will be effective even though the device would still be under its MDD certification, since that article is one of the mandatory articles that goes into effect May 2020 even if no products are being submitted for CE certification under MDR at that time.

    -A




  • 6.  RE: "Significant Changes" post MDR

    Posted 22-Feb-2019 08:18
    Crazy though it might seem, that's the way I read it, Anon.

    So you raise a PMS-instigated CAPA, which results in a design change; you then report this to the CA with a copy to the NB; the CA then apparently, according to the CAMD FAQ document, "assesses" the report and if it "accepts" the report, the design change is considered not to be significant, so you don't need to inform the NB (except that you already have). 

    The CAMD FAQ goes further than the MDR on this - there is nothing in the MDR that says the CA will "assess" or "accept" the manufacturer's report - the manufacturer is just required to send the report to the CA - period. So what happens if the CA doesn't "accept" the report? No information on this in either the MDR or in the CAMD FAQ.

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



  • 7.  RE: "Significant Changes" post MDR

    This message was posted by a user wishing to remain anonymous
    Posted 22-Feb-2019 13:02
    This message was posted by a user wishing to remain anonymous

    Yes, I noticed that the CAMD expects the CA to assess and accept the change but the regulation only states the manufacturer has to inform the CA at the time the change is implemented.  Sounds like the left hand doesn't know what the right hand is doing.

    Since the CAMD document has this information in the section about continuing to market your device under MDD unless you make a significant change, I can only interpret this as meaning that we can make those types of changes and per Article 83 notify the CA and NB, but not be required to change our certification to MDR as a result of those changes.  But, I am still skeptical that a NB would agree to this especially given that some are already cutting off the review of significant changes under MDD.  There's still too much ambiguity in this statement for me to feel comfortable recommending to my company that we can make these types of changes under MDD as a non-significant change without further clarification - when in doubt, I will stick to the regulation which does not include this language.

    I really appreciate your input and pointing me to Article 83.  I clearly overlooked that.

    -A



  • 8.  RE: "Significant Changes" post MDR

    Posted 14-Feb-2019 05:54
    Hello Anon,

    You may have missed an important but rather strange requirement in Article 83(4), related to Post-market Surveillance, which reads:

    "If, in the course of the post-market surveillance, a need for preventive or corrective action or both is identified, the manufacturer shall implement the appropriate measures and inform the competent authorities concerned and, where applicable, the notified body. Where a serious incident is identified or a field safety corrective action is implemented, it shall be reported in accordance with Article 87."

    You can see from the inclusion of the final sentence that this informing the CAs of preventive and/or corrective action is not the same as reporting FSCAs.

    So I guess that when such PMS-related Corrective Actions are reported to the CAs concerned, the CA should advise whther they consider the change 'significant'. Quite how this is going to work out in practice is anybody's guess!

    It is also rather strange that the Article 83(4) requirement uses the term "preventive or corrective action", when 'preventive action' is not defined in the MDR, but 'corrective action' is defined thus:

    "'corrective action' means action taken to eliminate the cause of a potential or actual non-conformity or other undesirable situation;"

    So where the term 'corrective action' is used in the MDR, according to its definition, it always includes 'preventive action', so inclusion of "preventive" in Article 83(4) is essentially redundant.

    Hope this helps.

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



  • 9.  RE: "Significant Changes" post MDR

    Posted 14-Feb-2019 06:52

    Design changes related to corrective action are intended to make the device function correctly after discovery of a problem. They do not make the device different, add new functionality, etc.

    For example, a manufacturer determines that a bearing is failing early. A design change would introduce a bearing with a longer life. An FSCA would modify the devices already shipped. The patient or user would consider the device the same after the FSCA in terms of what it does. They should be happy that the does it longer.



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    Dan O'Leary
    Swanzey NH
    United States
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  • 10.  RE: "Significant Changes" post MDR

    Posted 22-Feb-2019 10:59
    Take a look at document NBOG BPG 2014-3 Guidance for manufacturers and Notified Bodies on reporting of Design Changes and Changes of the Quality System which details general guidance on what a significant change is.

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    Marcelo Antunes
    Regulatory Strategy Consultant
    São Paulo
    Brazil
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  • 11.  RE: "Significant Changes" post MDR

    This message was posted by a user wishing to remain anonymous
    Posted 22-Feb-2019 13:02
    This message was posted by a user wishing to remain anonymous

    Thanks - I'm well aware of that guidance.  This question is more specifically asking about information published by the CAMD regarding product continuing to be distributed under valid MDD certificates after MDR becomes effective.

    -A