COMMISSION IMPLEMENTATION DECISION M/575 was issued 14 April 2021: This is a list of standards the EU Commission is hoping to Harmonize under MDR and IVDR.  One of the issues is the HAS consultant has issued a negative assessment on EN ISO 14971 which the CEN/CLC JTC3 leadership is working with the HAS consultant to address the issues and to draft acceptable European annexes so Harmonization can occur for the standard.  Many of the standards on the list in M/575 reference to EN ISO 14971 so it is highly likely that CEN and CENELEC will reject this newest version of the EU Commission Standardization Request again and we won’t have any Harmonized Standards by the Date of Application (26 May 2021) for the MDR which will cause lots of problems for manufacturers and Notified Bodies and cause more delays for the MDR & likely even for the IVDR I’m sorry to say.  Also, the MDCG 2021-5 “Guidance on standardisation for medical devices” doesn’t seem to clarify when harmonized standards are not published through the Offical Journal of the EU what to do.  In section 3.1 mentions Harmonized standards are voluntary with respect to the MDR & IVDR as they were for the MDD, AIMDD, & IVDD.  The closest the MDCG gets to it is to use the “State of Art” standards approach in section 3.5.

Another important observation is all the newest versions of the General & Collateral IEC 60601 Standards that were issued Summer of 2020 (EN versions were issued later in the year) are listed in Annex I of the EU Commission Standardization Request as the deadline to adopt these standards by 27 May 2024 — These are EN 60601-1, ed. 3.2; EN 60601-1-2, ed. 4.1; EN 60601-1-3, ed. 2.2; EN 60601-1-6, ed. 3.2; EN 60601-1-8, ed. 2.2; EN 60601-1-9, ed. 1.2; EN 60601-1-10, ed. 1.2; EN 60601-1-11, ed. 2.1; & EN 60601-1-12, ed. 1.1 – The Particular Standards EN 60601-2-XX or EN ISO 80601-2-XX listed are primarily based on the previous versions of the General & Collaterals of IEC 60601 standards on the M/575 list so this will likely cause conflicts vs the listed new standards mentioned here.

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Confused this is what Eisner Safety Consultants experts deal with all the time for countries for these and many other standards, regulations, laws, directives, and more. Leo Eisner is an expert on standards development and sit on many standards committees. Let us help you through this process. Need help with Essential Performance. Feel free to schedule a call with Leo www.EisnerSafety.com/Schedule-Call/ or contact Leo at Leo@EisnerSafety.com or through our contact form at https://eisnersafety.com/contact_eisner_safety/.

Notified bodies can now do remote audits for the MDR and IVDR — Member states need to Notify the EU Commission of Notified Bodies not conducting on-site audits & the period of time this will not be happening. So remote audits for these NBs won’t be happening immediately – but this is a big change! EUR-Lex – 52021XC0111(01) – EN – EUR-Lex Each Competent Authority will need to review each separate NB’s justifications and procedures separately and this is a COVID-19 exemption only so this is temporary. Once the Commission says COVID-19 crisis is over this goes away.

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What to do? No worries! You just need to know where and how to look for them. Easy as 1, 2, 3!!!

First, go to the Harmonized Standards website to pick the applicable Directive as you have in the past.

Next, select the applicable Directive which I will use the MDD for this example. Click on the link near the bottom of the page just below the box that says “Publication in the Offical Journal”, as noted below.

Finally, you end up on the list of Harmonized Standards that are published in the Official Journal of the EU. This was the intention of the EU Commission. I asked an associate at the Commission recently what happened to the easy to use HTML listings on the Directives webpages and his response was “Maybe you were looking for the list in html format, but they are no longer published in that format on the sectorial standardisation pages, to prevent any possible discrepancy and confusion with the lists as published in the OJEU, which are the sole valid lists by a legal point of view.” So, there you have it. The OJEU list in pdf or HTML (but the formatting is horrible) can be accessed. I would stick with the download of the pdf version or the OJ version which in this case has the 3 Directives (MDD, AIMDD, & IVDD) altogether, in the language of your choice.

Need help with identifying “State of the Art” Standards for the Medical Device Regulation (as no Harmonized Standards exist yet for the MDR) or for other country requirements. Leo is on many of the standards writing committees including the IEC 60601 series, ISO 15223-1, AAMI CR 507 & COVID-19 Response Team, & CB Scheme ETF-3 Risk Management Group. Feel free to schedule a call with Leo www.EisnerSafety.com/Schedule-Call/ or contact Leo at Leo@EisnerSafety.com.

EU Commission promised 20 Designations

12 Notified Bodies Designated to MDR (9) & IVDR (3*)

*All 3 IVDR Notified Bodies have MDR designation as well, so that can be counted as double counting. It depends on your perspective.

2 NB’s are likely to be “de-designated” (not sure of the proper term yet) end of Jan 2020 based on Brexit. That would be BSI Assurance UK Ltd.

The EU Commission has promised more NB’s to be designated in the 1st quarter of 2020. Let’s hope this will get us to at least 20 NB’s.

Two last-minute Christmas presents were BSI Group Netherlands IVDR and Medcert’s MDR designations on 24 & 25 Dec respectively.

Few products have been CE marked to the MDR that have gone through a NB review process. Typically the process is taking at least a year or more. Your quality system and product files need to be reviewed.

You are running out of time with the transition only about 5 months away.

Not all NB’s have full coverage of the NANDO codes so check the NANDO database (MDR link) or check with your NB.

May you have a Happy, Safe, & Prosperous New Year and may your medical device be CE Marked under the MDR in the New Year.

This post is on the Eucomed Press Release is Pleased with the EU Commissions’s work on the Joint Plan for Immediate Actions for Medical Devices.

On 18 June 2014 Eucomed released a Press Release about a document the EU Commission released on 17 June 2014.  The title of the document is “COMMISSION STAFF WORKING DOCUMENT Implementation of the Joint Plan for Immediate Actions under the existing Medical Devices legislation”.  Eucomed seems to be pleased with the EU Commission on the approach they are taking in this Joint Plan document.  In the press release Eucomed says: “The Commission’s assessment confirms that much needed improvements to Europe’s notified body system have been successfully implemented and are already yielding tangible results.  The Commission also outlines a series of remaining gaps in the system that it believes can only be appropriately addressed in the new Regulation.” The document comes from the Secretary-General of the European Commission and is addressed to the EU Council (Mr Uwe CORSEPIUS, Secretary-General of the Council of the European Union).

The Commission Staff Working Document provides some background about the history of why this occurred (the Joint Plan) and as Eucomed stated this document “outlines system improvements achieved thus far and highlights remaining gaps to be addressed in new Regulation”. The Commission Staff Working Document says: “As an immediate response to the PIP” (Poly Implant Prothèse Company) “crisis” (fraudulently made breast implants)”, the Commission, in February 2012, took the initiative of agreeing with the Member States a Joint Plan for Immediate Actions aimed at tightening controls and at restoring patient confidence in the regulatory system on the basis of existing legislation, pending the adoption by the co-legislator of the new legislation and its subsequent entry into application. 

Two years after the launch of the Joint Plan, this Commission Staff Working Document communicates the achievements of the plan. It also proposes some aspects that should be continued and intensified.” 

The press release from  Eucomed some very positive comments such as: “The conclusions outlined in the….document reflect the collective feedback from Eucomed member companies that Europe’s notified body system is now subject to tightened controls with tangible results such as unannounced audits of manufacturers and notified bodies.” :”Eucomed…welcomes the Commussion’s concrete progress…”

Serge Bernasconi, Eucomed CEO said “The Action Plan very much reflects our recommendation to implement a ‘reinforced control procedure’ rather than turning the system on its head with a complex, costly and overly bureaucratic measure like the ‘scrutiny procedure’ contained in the Commission’s initial proposal and the European Parliament’s first reading agreement.”

In conclusion of the press release Eucomned goes on to say: “Eucomed also welcomes the Commission’s clear delineation in the final pages of their report of the issues that are critical to a strengthened system and must be addressed in the new Regulation, including the obligations of notified bodies, clinical evaluation and vigilance. The European medical device industry also welcomes the Commission’s reference to registries and looks forward to further dialogue on the topic. …Mr Bernasconi said, ‘…perhaps more importantly, in this document they have made clear where there is more work to be done. I am hopeful that the Commission’s emphasis on these points will serve as inspiration to the Council as it continues negotiations towards its position.'”

Below is the conclusion section of the Commission’s Staff Working Document which is what Eucomed was praising in the conclusion of their press release.

Substantial progress has until now been made in the implementation of the plan. In particular the following achievements can be noted:

• Member States have re-assessed the qualifications of the notified bodies in charge of assessing high-risk devices, thus the vast majority of notified bodies. Member States have, in many cases, modified the scope of the activities of the notified bodies;
• A majority of Member States have requested their notified bodies to carry out unannounced audits and have asked notified bodies to ensure they are informed about incident reports. Notified bodies have reported that they are in the process of launching the unannounced audits; 
• Joint audits of notified bodies by teams involving auditors from several Member States and the Commission (FVO) have until May 2014 been carried out in 22 out of 23 countries having notified bodies and is scheduled for the remaining. The voluntary joint audits have been judged as very useful by all parties involved; 
• Two Commission measures, respectively to ensure a consistent application of the criteria to be met for the designation of notified bodies and on the items to be verified by the notified bodies during an audit were adopted in September 2013. The first of the two measures has made the joint audits mandatory for new designations and re-designations of notified bodies. Five such audits have been carried out until April 2014. About 20 mandatory joint audits are foreseen for 2014; 
• Most Member States have reported on their market surveillance activities. This information is used as a base for assessing the need for further improvement; 
• Monthly vigilance teleconferences with Member States, chaired by the Commission services, have been launched and become regular. The teleconferences have proved to be a very efficient means of ensuring/improving coordination between Member States; 
• The Commission Joint Research Centre (JRC) has started a metadata analysis in the field of vigilance reporting and is conducting a screening of publicly available sources with regard to the safety of medical devices relevant for the European Market;
• A Commission Recommendation on the use of a specific system for traceability of medical devices (UDI) was adopted in April 2013; 
• Dialogues with Member States are on-going on product registers; 
• With regard to incident reporting from medical practitioners and patients, Member States however prefer to develop systems at national level.

The positive progress in the implementation of the plan has been discussed between Health Ministers in several EPSCO Councils.

Many Member States and stakeholders have underlined the importance to continue and intensify the work on certain aspects of the Joint Plan. The focus should be on problematic issues identified during the implementation of this plan that are not yet resolved, such as:

• Market surveillance

The information received under the Joint Plan and the national market surveillance programmes indicate great divergences between the Member States with regard to resources attributed and how market surveillance is carried out. Many Member States recognise that because of a shortage of resources, market surveillance is only reactive and that no proactive surveillance is carried out.

These differences in approaches influence decisions on which products are concretely checked and on which aspects they are checked. Experience has shown that national competent authorities sometimes react in different ways to the same problems. A consequence is that whilst in some Member States the placing on the market or putting into service of a given device is banned or restricted, it may freely circulate in other Member States.

Some of the 20 actions for safer and compliant products for Europe outlined in a Commission communication of last year can be a source of inspiration for the concrete actions to be undertaken, in order to address those issues and to develop best practices (for example, a best practice would be to develop a common understanding of market surveillance and better co-ordination and communication on surveillance data, as set out in paragraph 3 of that Communication).

On the international level, the activities carried out within IMDRF could contribute to an increased coordination.

• Functioning of notified bodies

•  Communication and transparency

The next steps on UDI and reporting of incidents from healthcare professionals are foreseen to be taken following the adaption of the new legislation.

The work on making best use of registers for providing data and identifying problems with devices that has been launched under the Joint Plan should be pursued under the current PARENT Joint Action and in follow up actions envisaged.

The proposals of the JRC project on identifying and developing recommendations for mechanisms to detect signals, trends and increased incident frequency more effectively should allow reducing the number of problems at the source and thus more effectively allocate the scarce resources attributed to market surveillance and vigilance. The results, that should become available mid-2014, should allow for discussions with Member States and stakeholders on the improvements in this respect.

•  Sharing of knowledge and good practices

This could have a huge impact on the EU market place including the patients, medical device manufacturers (especially the smaller medical device companies), and put jobs at risk, as well.  See the article from Eucamed on a survey they did of medical device companies in Europe to get an idea of the costs involved with these proposed changes.  On 25 Sept 2013 Eucamed said they expressed “…disappointment and strong concern at the outcome of a vote in the European Parliament’s Committee for Environment, Public Health and Food Safety (ENVI)….” in their Article titled Rushed deal leaves patient and jobs in second place.

There are several sources I rely on a regular basis to keep up to date on this changing landscape and the next two websites are some of my favorite blogs as they have very reliable information that is on point, sometimes they will even make a predication here or there (with decent odds of being right, but not always) and always helpful for the medical device manufacturer.

The first of the 2 websites I read regularly is Medical Device Academy.  The article provides analysis and interpretation of how the EU took the next step in approving the proposed medical device regulations. This article covers a lot of ground including the EU Commission Press Release about two new documents in relation to Notified Bodies, Eucamed’s Political Positioning, Next Steps in the Proposed Medical Device Regulations Approval Process (important to read), and lastly Why is there a Rush?

The second website I am always checking up on is MedicalDeviceslegal written by a lawyer that works at a boutique life sciences law firm Axon Lawyers located in the Netherlands who is able to keep a really good pulse of the industry and the development of these types of regulations, laws, directives, and such.  He has written many articles on this specific subject and has been following the process closely.  His latest article indicates that the “ENVI vote result worst of all worlds”.   He gives you the bad news straight up.

Other resources I rely on a pretty regular basis that also have articles on this subject are: 

• RAPS Regulatory Focus which has 2 articles for today 26 Sept 2013 on the subject:
• European Parliament Passes Landmark Medical Device, IVD Reform Proposals
• European Commission Strengthens Oversight of CE-Marking Process
• MASS DEVICE article I saw today on the topic but with other related articles from other days:
• EU panel approves FDA-like requirements for medical devices
• Fierce Medical Devices one article I saw today but with other related articles from other times:
• EU committee backs tougher, U.S.-style device approval system

Past posts to refer to includes:

• Electronic IFUs for EU MDD & AIMDD Devices
• EC publishes draft regulation on electronic IFUs of Medical Devices

On 30 April 2013 the Medicaldeviceslegal.com website via Axon Lawyers posted a really helpful new document for your use (free of charge and no request for info about you or your company).   The RAPS Dutch/Flanders chapter has been active in defining a list of EU legislation that does not directly regulate medical devices but covers them in its scope, like environmental design requirements for electronic devices.  From this listing Axon Lawyers expanded the document into an English language document that includes active links to the underlying legislative texts, the EU law summaries in the ScadPlus database, if available, and to the EU Commission web pages with explanation about the rules concerned.

Axon Lawyers mentioned that this list will always be in constant flux because these rules tend to be amended a lot.  So, the best place to download this chart is directly from their blog posting.  If you want to just download this version of the chart click here for now but check back with their website (Medicaldeviceslegal.com) to look for updates.  At this point they haven’t decided how they will distribute updates to this chart but I am sure they will figure something out and disseminate, as appropriate.  Stand tuned for more updates on this valuable resource and let’s again thank both the RAPS Dutch/Flanders chapter and Medicaldeviceslegal.com website for this resource they are sharing with us.

The EU Commission has advised that the disappearance of EN 980 was a mistake and it is still Harmonized and will be corrected at the next release of the updated Harmonized Standards Listing, hopefully in the next few months.   The EU Commission didn’t Harmonize the EN ISO 15223-1 because they saw issues in relation to the Directives (MDD, AIMDD, & IVDD) and Annex Z’s (e.g. Annex ZA, ZB, ZC) of the standard EN ISO 15223-1:2012.  Because the standard EN ISO 15223-1 wasn’t Harmonized under this last round by the EU Commission CEN extended the date of withdrawal of EN ISO 15223-1:2012 from Jan 31, ‘13 to Jul 1, ’15.

For access to the current list of Harmonized Standards, published Jan 24, ’13, they are available thru our previous post FDA & EU MDD / AIMDD / IVDD Updated Standards Lists.

Christine Ruther, an Eisner Safety Consultants Associate reminded us

“The directives already allows the use of symbols from non-harmonized standards with the stipulation that the symbols and colours must be described in the documentation supplied with the device (e.g., MDD Annex I item 13.2).  As most manufacturers define all symbols, regardless of origin, this gap in a harmonized standard for symbols should not be an issue.

In any event, manufacturers are expected to take a common sense approach to managing the situation.  This will likely entail writing a short quality plan that acknowledges the situation and defines what actions will be taken.  Actions might include waiting for the next update of harmonized standards to confirm which standards are harmonized, reviewing existing use of symbols to confirm compliance with EN ISO 15223-1 in anticipation of the change, or other actions.”  NOTE: It is not clear, at this point, if the EU Commission will Harmonize EN ISO 15223-1:2012 for the next publication of the List of Harmonized Standards for the MDD, AIMDD, & IVDD.

For Christine’s part of this post we should also thank NSAI for forwarding information on this momentary vacuum.

The Emergo blog posting says “While the European medical device regulatory system remains largely intact, greater detail has been added, and new mechanisms exist to bolster the weaknesses.” An example, is that in the existing MDD there are only 14 definitions while in the proposed Regulation there are now 50 definitions.  As you can see from this example the intent is to clarify the regulation so it is better understood. The Emergo blog post summarizes the high level primary changes while the Emergo White Paper goes into a much deeper analysis.

If you are interested in consulting support  from Eisner Safety Consultants to help you through this transition, closer to when finalized, or for current MDD or AIMDD please feel free to contact us via the information at our contact us webpage.