Hello there,
I agree with Dan that companies try to minimise their reporting, believing this is some type of admission ... and all it does is result in under-reporting. One of the highest, if not the top from year-to-year, FDA Form 483 observations is related to Medical Device Reporting (MDR) procedure and not properly reporting. Do not let the company mince words or use words to "exempt" themselves from reporting.
The regulation is silent on patient use or use of device, because a malfunction could occur during installation, servicing, checking of a device, or anytime during the life cycle ... then if it were to happen
during patient use could cause a serious injury. Evaluating malfunctions of a device during the life cycle of a device is important, because this evaluation allows the organisation to see emerging risks, potential risks, or other issues which may require reporting. Also agree, show your management FDA Warning Letters of companies not reporting and ask them if they would rather be noise in the MAUDE database or front-page headlines on the Pink Sheet for a FDA Warning Letter issuance?
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Richard Vincins ASQ-CQA, MTOPRA, RAC
Vice President Global Regulatory Affairs
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Original Message:
Sent: 16-Jan-2023 12:52
From: Dan O'Leary
Subject: Patient/User Involvement and MDR's
Your company needs to be careful about language here. The correct word, from 820.198 is "evaluate" not "assess".
820.198(a)(3) requires evaluation of every complaint for reportability under Part 803. Presumably you evaluation criteria now says something like:
1. Is the compliant a malfunction? Y/N
2. If a malfunction, is there patient or user involvement? Y/N
3 If Yes to both 1 and 2 report as a Part 803 MDR, otherwise do not report.
I infer that you think that question 2 should not be part of the evaluation.
To analyze this, start with the definition of malfunction in 803.3(k) which says, in part, "Malfunction means the failure of a device to meet its performance specifications or otherwise perform as intended". Notice that this is silent about patient or user involvement.
To determine reportability look at 803.3(o)(2)(ii) which says, the device has "malfunctioned and that the device or a similar device marketed by the manufacturer or importer would be likely to cause or contribute to a death or serious injury if the malfunction were to recur". Notice that this is silent about patient or user involvement.
To test this, make a plausible scenario. Before the start of the day, the technician tests each device expected for use that day. When she tests your company's device it fails. She notes in the record that if it had failed on a patient it likely contribute to a serious injury. She repairs the device and puts it into service. Her health care organization files a complain with your company alleging a deficiency in reliability.
Your company evaluates the complaint using the new criteria and concludes that a malfunction occurred, since there was no patient involvement, the malfunction is not reportable.
Now apply the evaluation criteria in the regulations.
1 Is the compliant a malfunction? Y/N
2 If a malfunction were to recur could it cause or contribute to death or serious injury? Y/N
3 If Yes to both 1 and 2 report as a Part 803 MDR, otherwise do not report.
Your company evaluates the complaint using the regulation-based criteria and concludes that a malfunction occurred and it could have contributed to a serious injury so it is reportable.
As an aside, it is hard to imagine a complaint without, at least, user involvement. Perhaps the device conducts a periodic self test and reports a malfunction to the manufacturer using the Internet of Things.
In my experience, companies, incorrectly, look for ways to minimize MDR reporting. I suspect that management thinks it is a public admission of bad products. However, these minimization efforts often result in under reporting and, as part of an FDA Investigation, leads to a Warning Letter. A Warning Letter has a far more serious impact on the firm.
Consider searching the FDA Warning Letter database for cases of malfunctions so you help management understand the serious consequences from under reporting.
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Dan O'Leary CQA, CQE
Swanzey NH
United States
Original Message:
Sent: 16-Jan-2023 10:07
From: Anonymous Member
Subject: Patient/User Involvement and MDR's
This message was posted by a user wishing to remain anonymous
RAPS Community,
My company decided to update the way in which we assess complaints for MDR Reportability. We initially were assessing complaints regardless of patient/user involvement however we now only assess malfunctions if a patient or use was involved. I have verbally communicated to Executive Management this is not correct, but they have asked for specific references showing what I stated to be accurate. Besides having them read 21 CFR 820.198 and 21 CFR 803 I have no good way to show them what isnt there; the regulation does not say "only assess malfunctions for reportability if there is patient involvement." I am trying to my job in ensuring we have compliant processes. How would you go about approaching this situation?
Thanks you in advance for your insight!