While at the MD&M show in Anaheim, CA this week, I ran into Stephen Olsen, a technical marketing engineer for Mentor Graphics’ embedded division. Stephen was on his way to attend a class of 510(k) clearances. I asked him to write a blog about the class, which he gladly did:
At the MD&M and DesignMED conferences this week, I listened to some FDA experts describe the process inside the FDA to bring a medical device to market. These were former and current inspectors who had detailed knowledge of the FDA including its process for 510(k) clearance. While an excellent overview of the process (I now have a much better picture of what it takes to push a medical device through to receive the coveted FDA clearance necessary to get a product to market) I was still left thinking. And then this one catch phrase emerged—it depends.
While a little phrase such as this might be true for many aspects of product design, there usually is more certainty surrounding government regulation. Or at least there should be. As a medical device manufacturer, I would want to know what testing is necessary for FDA clearance. The answer is “it depends” on how critical that software is. What are the failure modes? And how are the failure modes being minimized in the design?
All well and good, but system architects expect a clear definition of what must be done to achieve certification. They are used to producing clear specifications for their systems and consuming external specifications. I have always liked specifications that use absolutes in their language with words like “must” and “cannot.” Even a range of acceptability is specified if it is critical to the success of the product.
The department of defense with the DO178B is a much more rigorous certification process, and for the highest qualifications, the code must be tested for every entry and exit from every block of code that will go on the aircraft. We’re talking mission-critical software here, but not so with the FDA 510(k) process.
Unfortunately, the FDA has a more nebulous specification with a lot of “it depends” sprinkled in, which is not a reproducible quantifiable process. It’s not all bad. As the FDA collects data on a product group, that collected data or product family is made public, so that every vedor can see what to test for and what to avoid. If there’s a failure attributed to a certain manufacturer, then they can hold the manufacturer to tighter scrutiny. If you have a good product with good history and documentation, then keeping that history clean is paramount to future success with the FDA.
In theory, any operating system can be approved for use in a medical device. But you must keep track of all the software in your device. If you’re working on a Linux platform, you must know where every bit comes from and not just the kernel. Every piece of software that touches the device must be sourced and maintained as to which versions of the code are in your device. I would imagine that this is not a trivial issue with some open-source solutions.
You must identify risks in your system and then show how your implementation eliminates the risk. What if the software stops working? What will your system do? Is there an external software and hardware watchdog to correct for unforeseen software catastrophes?
While system architects want a more detailed specification, the FDA doesn’t give them one, which means you can’t test to the specification. Rest assured, the FDA inspector will delve into your product documentation, and how well you’ve prepared will tell him if your product is complete, or if you need more information. "It depends!''
Note: This blog has been corrected, replacing the word "approval" with "clearance" throughout.
Quality of your blog
Heather,
Sorry, but I am 100% in agreement with George on all issues he raised in his response.
I have subscribed to and read MD+DI for many years. I and my colleagues turn to your publication for Industry Expert Information which is why we spend our valuable time reading it.
Your posting title "Lessons in Validation, Coatings, and 510(k) from Industry Experts" and your further statement "So you'll understand why I turned to expertise outside of our editoiral staff this week." both lead us to believe that your bloggers were in fact considered experts in their respective areas.
So you can see why Im surprised by your reply in which you state "The point of this blog was to get attendee perspective, not provide an expert opinion. Therefore we didn't feel it was necessary to review this as we would a technical article."
Perhaps you should post a warning to readers of your blog that information published is not up to MD+DI usual standards and has been proven to contain incorrect and inaccurate information. Then we can all save our time by not bothering to read it.
I am the grandson of a plumber, nephew to two plumbers and cousin to three plumbers. They are all very capable and hard working people who in their own was helped to build a great nation. Your arrogant collage professor should consider the corollary to his argument "If you can't do it...teach".
Regards
Dan
510k Approval
I am quite surprised that this was published without an expert review.
There is no such thing as a “510k approval”! Premarket notifications (510ks) are administratively cleared based on a “me, too” claim adequately justified by the device manufacturer. FDA inspectors are not involved in the 510k review or clearance of 510k submissions; they work in compliance and most often visit manufacturers after a device has been cleared or approved. Approval and clearance are fundamentally different! Administratively clearance leaves device manufacturers open to civil liability in State courts, whereas FDA approval shields device manufacturers (i.e., Federal preemption doctrine). FDA clearance is relatively cheap and quick; FDA approval is both expensive and time-consuming.
In order to obtain a 510k clearance, the manufacturer must demonstrate in a rational manner (i.e., provide scientifically valid data) that the proposed device is as safe and as effective as a legally marketed predicate AND has the same intended use. Early on that only meant “hardware”, later it included “software”, and most recently it includes “human factors”. In the military arena, there are very different standards for software integrity when one is talking about a handheld device versus a nuclear weapon. Of course “it depends”! While it is “bad business” to over design and over test, it is also imprudent business to under design and under test (remember what we just said about civil liability).
The FDA/CDRH’s very reasonable expectation is that you will comply with “Design Control” regulations for hardware engineering, software engineering (not computer programming), and human factors engineering. This is just a fancy way of saying that you will follow classical systems engineering best practices – known and well documented since the early 1940s. If your organization does not know the difference between a “Requirement” and a “Specification” or “Verification” and “Validation” or how to properly apply statistics to experimental designs and data, then you will probably be more successful in some other business sector that does not rely on modern science and engineering. It all depends upon whether or not you know how to build safe and effective medical devices.
GM Samaras, Pueblo, CO
George, Thanks for your
George,
Thanks for your comments. The point of this blog was to get attendee perspective, not provide an expert opinion. Therefore we didn't feel it was necessary to review this as we would a technical article.
But I'm glad that you did weigh in. As you note, 510(k) is a clearance process, not an approval process. However, this was a guest blog from the point of view of an attendee at MD&M West--someone in the process of learning.
As a consultant, such points may be perfectly clear to you. But you must allow that navigating the medical devices space is no easy task.
Many of the small and start-up companies that work to create products in this industry may have little experience in getting a product through. Should we tell them to "go into plumbing" as my college professor would say to those who couldn't pass his tests? Such a stance seems a bit shortsighted to me.