張明正 工程師 工研院量測中心/醫療器材驗證室 歐盟對醫療器材之管理 張明正 工程師 工研院量測中心/醫療器材驗證室 1999/5/14

European Council Regulations Brief in European Council Directive CE Marking Conformity Assessment EC Medical Devices Classification Medical Device Standards 1999/5/14

European Council Directives 90/385/EEC: Active implantable medical devices directive. 93/42/EEC: Medical devices directive. 98/79/EC: In vitro medical devices directive. 93/86/EEC: CE marking Directive. 1999/5/14

AIMD 90/385/EEC Cover all powered implants or partial implants that are left in the human body. Adopted by the European Council in June 1990. Came into effect on 1st January 1993. 1999/5/14

AIMD 90/385/EEC Article 1 ~17 Definitions and Clarification Member States’ Responsibility Free Marketing Policy Custom-Made and Clinical Investigation Devices 1999/5/14

MD Directive 93/42/EEC Cover most other products. Took effect on 1st January 1995. A transitional period in force until 13th Jane 1998. 1999/5/14

MD Directive 93/42/EEC Does not apply to: In vitro diagnostic devices; Active implantable devices; Medical products covered by directive 65/65/EEC; Cosmetic products covered by 76/786/EEC. 1999/5/14

IVD Directive 98/79/EC Cover in vitro diagnostic medical devices. Took effect on 7th December 1998. A transitional period in force until December 2003. 1999/5/14

IVD Directive 98/79/EC In vitro diagnostic medical devices should provide patients, users, and third parties with a high level of health protection and attain the performance levels by the manufacturer. Maintenance of improvement of the level of health protection attained in the Member States is one of the main objectives of it. 1999/5/14

IVD Directive 98/79/EC Council directive 90/385 EEC and 93/42/EEC concerning medical devices with the exclusion of in vitro diagnostic medical devices. Seeks to extend the harmonization to in vitro medical devices Based largely on the provision of 90/385 & 93/42 EEC. 1999/5/14

CE Marking Directive 93/86/EEC Came into force on the 1st January 1995. Will be compulsory for all medical devices as the directives relating to them come into force. The only exceptions are custom-made and clinical investigation devices. 1999/5/14

AIMD 90/385/EEC ANNEX 1~6 (CE marking Procedures) Essential Requirements EC Declaration of Conformity EC Type-Examination EC Verification EC Declaration of Conformity to Type Device Intended for Special Purpose 1999/5/14

EC Declaration of Conformity ( 90/385/EEC Annex 2) Complete quality assurance (EN 46001) from design to final control 1999/5/14

EC Type-Examination (90/385/EEC Annex 3) Notified bodied certification. The application shall be made by the manufacturer or by his authorized representative in the community. The application must make it possible to understand the design, the manufacture and the performances of the product. 1999/5/14

EC Verification (90/385/EEC Annex 4) The act by which a notified body verifies and certifies that products conform to the type describe in the EC type-examination certificate and satisfy the relevant requirements. The manufacturer shall undertake to institute and keep up-dated a post- marketing surveillance system. 1999/5/14

Declaration of Conformity to Type ( 90/385/EEC Annex 5) Assurance of production quality (EN 46002) from manufacture to final inspection. 1999/5/14

Conformity Assessment (90/385/EEC ) The manufacturer must, in order to affix the CE mark, at his own choice: Annex 2 ; or Annex 3, coupled with: Annex 4 ( EC verification) Annex 5 (Declaration of Conformity to type) Annex 6, for Custom-made devices 1999/5/14

Custom-made Devices (Declaration of Conformity 90/385 EEC) Data allowing the device in question to be identified. A statement affirming that the device is intended for exclusion use by a particular patient, together use his/her name. The name of doctor who drew up the prescription and, if applicable, the name of the clinic concerned, The particular features of the device as described by the medical prescription concerned, A statement affirming the device complies with essential requirements and, where applicable, indicating which have not been wholly met, together with the ground. 1999/5/14

Custom-made Devices (90/385/EEC ) Documentation enabling the design, Manufacture and performances of the product, including the expected performances, Manufacturer shall take all necessary measure to see the manufacturing process ensures the products conform to the documentation referred to in the above paragraph. 1999/5/14

Conformity Assessment (90/385/EEC ) Devices for clinical investigations: At least 60 days before the commencement of the investigations, submit the statement referred to in Annex 6 to the competent authorities of the Member State. The Member States shall, if necessary, take the appropriate steps to ensure public health and order. 1999/5/14

Devices Intended for Clinical Investigations (90/385/EEC) Data allowing the device in question to be identified, An investigation plan giving in particular the purpose, scope and number of the devices concerned, The name of doctor and of the institution responsible for the investigation, The place, date of commencement and duration scheduled for the investigation, A statement affirming the device complies with essential requirements apart from the aspects constituting the object of the investigations and that, with regard to these aspects, every precaution has been taken to protect the health and safety of the patient. 1999/5/14

Clinical Evaluation(Annex 7) General provision As referred to Annex 2, sec. 4.2 and Annex 3, sec. 3 Clinical investigation Purpose Ethical consideration Methods 1999/5/14

MD Directive 93/42/EEC Article 1 ~ 23. Annex 1~7 (CE marking procedures): Essential Requirements Full Quality Assurance System EC Type-Examination EC Verification Production Quality Assurance Product Quality Assurance Annex 7, Declaration of Conformity 1999/5/14

EC Declaration of Conformity ( 93/42/EEC Annex 2) Full quality assurance (EN 46001) from design to final inspection. 1999/5/14

EC Type-Examination (93/42/EEC Annex 3) Notified bodied certification. The application shall be made by the manufacturer or by his authorized representative in the community. The application must make it possible to understand the design, the manufacture and the performances of the product. 1999/5/14

EC Verification (93/42/EEC Annex 4) The act by which a notified body verifies and certifies that products conform to the type describe in the EC type-examination certificate and satisfy the relevant requirements. The manufacturer shall undertake to institute and keep up-dated a post- marketing surveillance system. 1999/5/14

Declaration of Conformity ( 93/42/EEC Annex 5) Assurance of production quality (EN 46002) from manufacture to final inspection. 1999/5/14

Declaration of Conformity ( 93/42/EEC Annex 6) Product quality assurance Final inspection and testing of the product. 1999/5/14

Declaration of Conformity ( 93/42/EEC Annex 7) Technical documents, and including the declaration of conformity statement, The technical documents must allow assessment of the conformity of the product with the requirements of the directive. 1999/5/14

Technical Documents A general description of the product, Design drawings. Methods of manufacture envisaged and diagrams of components, sub-assemblies, circuit, etc., Risk analysis activities, Sterilization methods, Test report and clinical data( if any) Labeling 1999/5/14

Conformity Assessment (93/42/EEC ) Class III devices: Annex 2 ; or Annex 3, coupled with: Annex 4 ( EC verification); Annex 5 (Production quality assurance). 1999/5/14

Conformity Assessment (93/42/EEC ) Class IIa devices: Annex 7 coupled with either: Annex 4 (EC verification); Annex 5 (Production quality assurance) ; Annex 6 (Product quality assurance). 1999/5/14

Conformity Assessment (93/42/EEC ) Class IIb devices: Annex 2 ( sec.4 is not applicable); Annex 3, coupled with: Annex 4 (EC verification) Annex 5 (Production quality assurance) Annex 6 (Product quality assurance) 1999/5/14

Conformity Assessment (93/42/EEC ) Class I devices: CE marking procedure referred to Annex 7. Draw up the EC declaration of conformity required before placing the device on the market. 1999/5/14

Conformity Assessment (93/42/EEC ) Custom-made and devices for clinical investigation : CE marking procedure follows Annex 8. Draw up the EC declaration of conformity required before placing the device on the market 1999/5/14

Registration (93/42/EEC) To whom places devices on the market referred to in Article 11(5) and (6), and; Any other natural or legal person engaged in the activities referred to in Article 12 . Manufacturer, or Persons responsible for marketing. 1999/5/14

Notified Bodies (93/42/EEC) Carry out the tasks pertaining to the procedures referred to in Article 11 and other specific tasks. The commission shall assign identification numbers to these bodies, hereinafter referred to as ‘notified bodies’. Member States shall apply the criteria set out in Annex 11 for the designation of bodies. 1999/5/14

IVD Directive 98/79/EC Annex 1~8 (CE marking procedures) Essential Requirements Devices Referred to in Article 9(2) & (3) EC Declaration of Conformity Full Quality Assurance System EC Type-Examination EC Verification Production Quality Assurance Product Quality Assurance 1999/5/14

EC Declaration of Conformity (98/79/EC Annex 3) Manufacturer must prepare the technical documentation and ensure the manufacturing process follows the principles of quality assurance. Devices for self-testing, the manufacturer shall lodge an application for examination of the design with a notified body. Notified body shall examine the application. 1999/5/14

Conformity Assessment(1) (98/79/EC ) All devices except for listed in Annex 2 and devices for performance evaluation: Annex 3, and declaration for conformity. Devices for self-testing other than in Annex2 and devices for performance evaluation: Annex 3, point 6, or Annex 2, or referred to (2) or (3) 1999/5/14

Conformity Assessment (2) (98/79/EC ) Annex 2, list A devices: Annex 4 ( full quality assurance), or EC Type-Examination, coupled with: Annex 7 (production quality assurance) 1999/5/14

Conformity Assessment (3) (98/79/EC ) Annex 2, list B devices: Annex 4 ( full quality assurance), or EC Type-Examination, coupled with: Annex 6 (EC verification), or Annex 7 (production quality assurance) 1999/5/14

Performance Evaluation 98/79/EC(Annex 8) Data allowing identification of the device in question, An evaluation plan stating in the purpose, scientific, technical or medical ground, scope, and number of devices concerned. List of labs or institute taking part in, Starting date and scheduled duration, A statement of conformity to the Directive. 1999/5/14

Notified Bodies (98/79/EC) Carry out the tasks pertaining to the procedures referred to in Article 9 and other specific tasks. Member States shall apply the criteria set out in Annex 11 for the designation of bodies and apply continual surveillance. Notified Bodies shall, on request, supply all relevant information and documents, including budgetary documents. 1999/5/14

Criteria to Be Met for Notified Bodies Sound vocational training covering all the assessment and verification operations, Satisfactory knowledge of the rules on the inspections which they carry out and adequate experience of such inspection, The ability required to draw up the certificates, records and reports to demonstrate that the inspections have been carried out 1999/5/14

Purpose of the EC Directives Not to create trade barriers against the free marketing of any CE-marked product within the EU; To indicate the product should complies with its relevant directive, and to be applied to any product imported from outside the EU. 1999/5/14

EC MD Classification For feasible economically and justifiable in practice. A graduated system of control is more appropriate. To channel medical devices into the proper conformity assessment route. 1999/5/14

Four Class Classification vs. AIMD & IVD Active Implantable Device Medical Devices Class I (Low risk) Class IIa and IIb (Medium risk) Class III (High risk) In Vitro Diagnostic Devices 1999/5/14

Philosophy of EC Medical Device Classification Technical features and potential hazard. Duration of contact with the body. Degree of invasiveness and local vs. system effect. The human body is a relatively unchanging element of the equation. 1999/5/14

Medical Devices Standards EN 46001/2:1996 ( application standard ) BS EN 724: 1995 ( guidance standard ) Non-active medical devices. BS EN 928: 1996 ( guidance standard ) In vitro diagnostics. BS EN 50103: 1996 ( guidance standard ) Active medical devices. 1999/5/14

BS EN 50103: 1996 Provides active medical device examples of how to meet the requirements, recognizing that other methods which achieve the same ends are equally acceptable; Gives general advice on how to meet the requirement; Draws attention to the aspects of requirements that may not be readily apparent to those unfamiliar with quality systems for the active medical device industry. 1999/5/14

BS EN 50103 Definition of ‘should’ and ‘may’ indicates that a certain course of action is preferred but not necessarily required. May: indicates a course of action often followed by established SUPPLIERS of similar ACTIVE MEDICAL DEVICCES. 1999/5/14

BS EN 50103: 1996 Details additional information and GMP. For the benefit of the industry, suppliers, regulatory authorities, and auditors. They assist in the understanding and interpretation of the requirement. 1999/5/14

BS EN 724: 1996 Provides guidance on the establishment and maintenance of the quality systems defined in EN 46001/2 for the manufacture of non-active medical devices. Seeks to assist in the transition from GMP to quality systems by presenting familiar concepts under the relevant paragraphs of EN 46001/2. 1999/5/14

BS EN 724: 1996 Provides non-active medical device examples of how to meet the requirements, recognizing that other methods which achieve the same ends are equally acceptable; Gives general advice on how to meet the requirement; Draws attention to the aspects of requirements that may not be readily apparent to those unfamiliar with quality systems for non-active medical device industry. 1999/5/14

BS EN 928: 1996 Intended to provide guidance to IVD manufacturers and also for certifying and regulatory bodies. Attempts to explain what should be done to fulfil customer needs and is not only a guide for quality assessors. The combination of standards embrace the principles of GMP. 1999/5/14

Sterilization Standards ISO 11134 ( BS EN 554):1994 requirement for validation and routine control of moist heat sterilization. ISO 11135 ( BS EN 550) :1994 requirement for validation and routine control of ethylene oxide sterilization. ISO 11137 ( BS EN 552):1995 requirement for validation and routine control of radiation sterilization 1999/5/14

TC 198 Sterilization of health care products ISO 13408-1: 1998 Aseptic processing of health care products 1999/5/14

Software for Medical Devices EN 60601-1-4:1997 ( BS 5724 1.4:1997) Medical electrical equipment; part1: general requirements for safety; 4. Collateral standard, safety requirements for programmable electrical medical systems. 1999/5/14

Risk Analysis EN 1441: 1998 (BSI 96506771DC) risk analysis for medical devices. 1999/5/14

Environmental Standard ISO 14001:1996 Environmental management systems -- Specification with guidance for use 1999/5/14

Collateral Directives Electrical Safety (Low Voltage Directive) (73/23/EEC) mandatory since 1-1-1997 Electromagnetic Compatibility (EMC) (89/336/EEC) mandatory since 1-1-1996 Terminal equipment (91/263/EEC) mandatory since 1-1-1992 1999/5/14

CE Marking for Medical Device A IMD Directive (90/385/EEC) MDD Directive (93/42/EEC) IVD Directive 98/76/EC CE Marking Conformity Assessment Vigilance System Third Party Review 1999/5/14

Vigilance System Manufacturers Incident Competent Authority 1. Inform Informed of incident 1. Inform Informed of incident 2. Assess Informed by manufacturer within 10(30)days Initial assessment report Propose/Implement action 3. Review Monitor initial action 4. Investigate Full investigation Informed of progress Propose/Implement action 5. Action Informed consultation Final report issued 6. Conclusion Receive or prepare final report 7. Information Inform other European CAs File report File report 8. File 1999/5/14