US Medical Device Regulation 101
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IRBs and Researchers: Know Your US Medical Device Documentation
Speed the IRB review process by understanding how medical devices are classified and what the IRB must review to approve device research.
What Is a Medical Device?
A medical device is an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including any component, part, or accessory, which is:
- Recognized in the official National Formulary, or the United States Pharmacopeia, or any supplement to them
- Intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease, in man or other animals
- Intended to affect the structure or any function of the body of man or other animals, and which does not achieve its primary intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for the achievement of its primary intended purposes
(21 U.S.C. 321(h)))
Devices in the Marketplace: Characteristics by Class
Regulatory Status |
Class I | Class II | Class III |
Characteristics and Risk | Lowest risk, simple in design | Moderate risk | High risk |
Most Likely Regulatory Pathway | 501(k) exempt | 501(k) clearance | PMA approval |
Example | Prescription sunglasses, elastic bandages, hand splint, pharmacy app displaying information on drug cost, risks, and potential interactions |
Powered/adjustable hospital bed, pulse oximeter, feeding tube, TENS unit, app connecting a spirometer to a smartphone |
Implants (hip, knee, breast), robotic surgical devices, cardiac pacemaker, software for ophthalmic use, smartphone app controlling an insulin pump |
IRB Review Required? |
Maybe* | Yes | Yes |
*Some Class I, 510(k) exempt medical devices do not require testing in human subjects/IRB review before the product can be marketed. However, manufacturers making safety or effectiveness claims in device packaging or advertising materials should conduct studies in human subjects with IRB approval to support those marketing claims.
IRB Review of Device Studies
IDE Exempt Investigations: Studies Not Requiring an SR/NSR Determination
Eligible Studies:
- FDA cleared (510(k)) or approved (PMA) devices used on label
- Noninvasive diagnostic devices not requiring an invasive sampling procedure, not introducing energy into a subject, and not used for purposes of diagnosis without confirmation by a medically established diagnostic product or procedure
- Devices undergoing consumer preference testing, testing of a modification, or testing in combination with another device in commercial distribution so long as the testing is not to establish safety or efficacy and does not place subjects at risk
Provide to IRB:
- Protocol and consent form(s)
- Documentation from FDA if applicable (510(k), PMA, FDA determination of device status)
- Instructions for use, user manuals(s), investigator’s brochure, other official device documentation, and/or a comprehensive description of the device
Studies of Significant Risk and Nonsignificant Risk Medical Devices
Device Status | Significant risk | Nonsignificant risk |
Definition |
|
A device which does not meet the definition of a significant risk device |
Before a Study May Begin | IDE approval from FDA IRB approval of the study IRB approval of the study |
IRB approval of the study |
Example | Investigational cardiac valve, investigational assay used to determine eligibility for participation in some clinical trials | Investigational wearable biometric monitor and accompanying mobile app |
Provide to the IRB |
|
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Definitions
501(k): A premarket submission made to FDA to demonstrate the device to be marketed is as safe and effective (i.e., substantially equivalent) to a legally marketed device that is not subject to premarket approval (PMA) requirements
IDE: Investigational device exemption; FDA authorization allowing a device manufacturer to ship the investigational device for the purposes of clinical research (as regulated in 21 CFR 812)
IDE Exempt: A device study that is exempt from IDE regulations by virtue of the criteria listed in 21 CFR 812.2 (c)
PMA: Premarket approval; the FDA process of scientific and regulatory review to evaluate the safety and effectiveness of Class III medical devices