Presentation on theme: "FDA Human Factors of Medical Devices"— Presentation transcript:
1FDA Human Factors of Medical Devices Ensuring a safe,user friendlydevice-user interfaceI will be speaking to you today about some of the opportunities and problems Plug-N-Play present us in dealing with dangerous use error and patient safety. I will tell what FDA is doing to try to see that medical devices more user friendly and safer. We see real promise in the Plug-N-Play scheme and we also see some possible problems. But the promise looks like it may far out weigh the problems.
2Medical Errors in U.S. each Year Result In: Up to 98,000 deaths5th leading case of death: exceeds auto accidents, breast cancer and AIDS$29 Billion added costAn Institute of Medicine report cites studies that show that as many as 98,000 people die every year from medical error. That’s equivalent to an overloaded jumbo jet falling out of the sky every other day of the year. In addition, thousands more are injured.Medical errors attributable to device use is not the major cause. Non-the-less, we have every reason to believe it’s a significant contributor.
3FDA Medical Device Incident Reports: 100,000 reports per yearMore than 1/3 involve use errorTip of the IcebergFDA receives about 100,000 medical device incident reports every year.More than than 1/3 of these reports can be attributed primarily to use error.This is a small fraction of all the incidents that actually occur. Really only a few percent of the total.
4FDA Recall Study 44% of medical device recalls due to design problems. Use error often linked to design.An internal FDA study some years ago showed that 44% of medical device recalls were the result of design problems and more than 1/3 involved the device-user interface (device, it’s labeling or instructions for use).
5More user friendly Design Operations - don’t exceed user capabilitiesInformation - Sufficient, legible and intelligibleProcedures - logical and intuitiveOperations - consistent with conventionsDangerous error - designed outConditions of use - considered and addressedHere’s some advice to help avoid these mistakes?
6Key safety concepts in design make things visiblesimplify the operationavoid reliance on memoryavoid reliance on vigilanceuse natural mappingsuse forcing functionsmake it easy to reverse an error
7FDA’s authorityQuality Systems Regulation/ CGMP - Design Controls (1996)The FDA Quality Systems Regulation is the basis for FDA authority to require proper attention to the design of the device user interface.FDA wants to make sure manufacturers know how to achieve good design and this authority provides us a means for educating slow learners. Nothing like the threat of a little jail time to get their attention.
8Design Controls Regulatory Language: “… design requirements … intended use … needs of the user and patient.”“… testing production units under actual or simulated use conditions.”“… conduct risk analysis.”The Design Control provisions of the FDA regulation require manufacturers to address the user's needs and those needs certainly include a safe user interface.Design validation calls for testing under actual or simulated use conditions and for a risk analysis to be carried out.
9Design Controls Preamble Language: “… conduct appropriate human factors studies, analyses, and tests …”“… human interface includes both the hardware and software characteristics…”The preamble to the FDA regulation speaks, in some detail, to the need for human factors studies, analysis and tests.Preambles to FDA regulations have legal standing and are used to clarify and provide the rationale for the regulation.
10Design Controls - Human Factors Engineering (HFE) Process HFE applied from concept stage to final designEarly Involvement of typical users is criticalThe process is iterativeIncorporating HFE into the design process is the only way to reliably ensure that the needs of the user are adequately addressed in the final product.
11Human Factors Engineering Process ConceptPhaseDesignInputDesignOutputVerificationValidationPerformStudies &AnalysesDevelopRequire-mentsSpecs.Test OutputAgainstInputTest AgainstPatient &UserNeeds*HF ElementsAnalysesExpertEvaluationRapidPrototypingLiteratureComplaintsObservationInterviewsHFE is conducted throughout the design process from beginning to end.It's also a process that must be fully integrated into the overall design activities.HFE starts early, involves typical users, is iterative just like the rest of the design process.SafetyEnvironmentUsersPerformanceDrawingsMockupsComputerPrototypesProductionUnitsFull UsabilityTestRisk Assessment*Design and Development Planning Important Here
12Human Factors Engineering - Summary of Methodology Study the user population and use conditionsAnalyze function, tasks, and hazardsIncorporate findings in requirementsTo summarize the HFE methodology.All this information has been provided to manufacturers via our FDA website and in a number of voluntary consensus standards that FDA has recognized.
13Human Factors Engineering - Summary of Methodology Test and analyze prototypes against requirementsTest production models in simulated environmentConduct a risk assessmentRead screen
14HFE StandardsANSI/AAMI HE74:2001 Human factors design process for medical devicesIEC , Ed1, UsabilityHere is one of those voluntary consensus standards that FDA has recognized to give guidance to manufacturers. We highly recommend it. FDA staff worked closely with the AAMI HFE Committee and medical device manufacturers to write this standard. A survey of manufacturers was carried out to determine what information they needed and what question they wanted answered. It’s a user friendly guidance document designed for the HFE novice as well as the HFE experts. It served as the basis for the new IEC , Collateral Standard: Usability which is currently being balloted as an FDIS.
15ANSI/AAMI HE74:2001 Overview of the HFE process Planning the HFE processHFE process: a systems approachMethods and techniquesRisk & cost benefit analysisThis is an overview of contents of that standard.
16ANSI/AAMI HE74:2001 Need for user input Scaling the HFE work Documenting the HFE activitiesDesign evaluation: verification & validationMore content.
17ANSI/AAMI HE74:2001 Relevant FDA regulations Practical tips Bibliography General HFE references - Human error Human computer interface - Usability testingMore useful content. That is – useful according to the feed back from manufacturers.
18FDA Web Site http://www. fda.gov/cdrh/humanfactors.html fda.gov/cdrh/usererror.html