Congratulations – after years of pouring your heart, soul and ingenuity into the project, you’ve developed a brilliant medical device with the potential to improve countless lives. Well done you!
But hold off on the celebratory tequila shots for just a little longer, because before your amazing creation can reach patients, it needs to navigate – and survive – the byzantine labyrinth of FDA submission pathways and requirements.
Fear not – this is not your cue to find a wall against which to bang your head. There are multiple FDA submission pathways available, and with a little clarity and some strategic thinking you’ll be well equipped to make the right submission choice for your device. Let’s get started.
Charting the Course – Defining Your Device’s Intended Use
Every device’s regulatory journey begins with the Intended Use statement. The Intended Use refers to the objective intent (or purpose) of the device that can be demonstrated via labeling, advertising materials, oral and written statements, and implied or expressed claims (including marketing claims). It’s a precise description of what your device is designed to accomplish – and what it isn’t. In this case, more just might be better, and every word matters.
Close on the heels of your Intended Use statement is your Indications for Use, and no, they are not the same thing.
The Indications for Use is like a subparagraph of your Intended Use, and clearly articulates:
The Target Population: Who will benefit from your device? Is it designed for adults, children, or a specific patient demographic with a particular medical condition?
Duration of Use: How long is the device intended to be used? Is it a single-use disposable, a device worn for hours or days, or a long-term implant?
Anatomical Sites: Where on the body will the device be used? Understanding the intended use in this context is crucial for pinpointing relevant safety considerations.
Take time to craft robust Intended Use and Indications for Use statements, because they set the stage for all applicable regulatory requirements and help determine the specific FDA submission pathway your device should follow.
Identifying Your Device’s Classification
The next big question to answer is does your snazzy new technology even qualify as a medical device?
The FDA describes a medical device as “an instrument, apparatus, machine, implant, in vitro reagent, component, part, or accessory that diagnoses, cures, mitigates, treats, or prevents disease or condition; affects structure or function of body; and doesn’t achieve purpose as a drug.”
This definition excludes certain software functions such as data storage, administrative support, and electronic patient records.
But not all medical devices are created equal. The FDA categorizes medical devices into various classes based on the level of risk they pose to patients, and this in turn dictates the regulatory hurdles you’ll need to overcome to gain market approval.
You’ll also need to determine the best product code for your device, so start with the FDA Product Code Classification Database to be sure you end up on the right path.
Here’s a breakdown of the three main classifications:
Class I: These are the lowest-risk devices, often simple in design and function. Examples include tongue depressors or bandages. A streamlined registration process typically applies.
Class II: These devices pose a moderate risk and may require premarket notification (510(k)) to demonstrate substantial equivalence to a predicate device – a similar product already on the market.
Class III: These are the highest-risk devices, often crucial for life support or sustaining critical bodily functions. They require the most rigorous approval process, typically involving a Premarket Approval (PMA) application with extensive clinical trials and animal data analysis.
The good news is the FDA offers a wealth of resources to help you navigate this step, starting with the 510(k) database.
Building a Tower of Evidence with Valid Scientific Support
Here’s where the science comes in! To convince the FDA of your device’s safety and effectiveness, you’ll need to construct a robust foundation of scientific evidence supporting the claims you make about your device’s safety and effectiveness. This might involve some or all of these testing options:
Benchtop Testing: Here, you’ll meticulously evaluate your device’s performance under controlled laboratory conditions.
Comparative Analysis: For Class II devices, comparing your device to a predicate device is often crucial. This demonstrates how your device measures up to an existing, FDA-approved product.
Animal Testing: In some cases, depending on the risk profile and complexity of your device, animal testing might be necessary to assess safety and efficacy before progressing to human trials.
Clinical Trials: For Class III devices and some high-risk Class II devices, well-designed clinical trials with human subjects are critical. These trials evaluate your device’s safety and effectiveness in a real-world setting. Special attention is paid to user interface and human factors to ensure the device is not only safe but also intuitive for patients and healthcare providers to use.
Choosing the Right Path – Navigating Pre-Market Submission Options
So you’ve determined that your product is a medical device, you’ve finalized your Intended Use statement, you’ve chosen a product code and identified the right classification, AND you’ve amassed a boatload of data in alignment with FDA requirements.
Now it’s time to choose your submission pathway, which can be as simple as a walk in the park or as challenging as an Ironman Triathlon, depending on the path you choose.
510(k) Premarket Notification: This is the most common route for Class II devices. By demonstrating substantial equivalence to a predicate device, you can leverage the existing safety and effectiveness data of that product.
De Novo Classification Request: For truly innovative devices with no existing equivalent, a de novo request might be necessary. This establishes a new classification category for your device, paving the way for groundbreaking technology. Expect a more detailed data submission compared to a 510(k). However, it can sometimes make better business sense to go the 510(k) route first, and then work your way up to a de novo submission, so choose carefully.
Premarket Approval (PMA) Application: This is the most rigorous and data-intensive process, reserved for Class III devices. Expect to submit comprehensive clinical trial data and animal testing results to support your PMA application.
Don’t Ignore the Power of the Pre-Sub!
Pre-submissions are your friend. Take advantage of the FDA’s free pre-submission consultations before requesting a formal meeting or in-depth clinical data review. Don’t wait until your final application to connect with the FDA. Pre-submissions allow you to discuss your device’s specifics and get valuable feedback from regulatory experts, which will save you time and frustration down the road.
Beyond the Basics: Pro Tips for a Smoother Journey
513(g) requests for hard-to-classify devices: If finding a suitable predicate device proves challenging, a 513(g) request can help. However, keep in mind that despite the user fee, response times can be lengthy.
Combination products require extra attention: If your device involves drugs or biologics, you may need to involve the Office of Combination Products for a more comprehensive review.
Pediatric applications: Fee waivers and specialized support: The FDA recognizes the importance of innovation in pediatric care. Fee waivers and specific initiatives can be available to help bring your pediatric device to market.
This is a simplified roadmap, obviously, and there is a LOT more to consider. The intricacies of the FDA submission pathways can vary depending on your specific device, so it’s a good idea to consult with a regulatory professional familiar with your device type.
There are some big no-nos to remember as well. Check out this blog to find out what you shouldn’t do when selecting an FDA submission path: https://leanraqa.com/fda-submission-pathways-4/
But with careful planning, a well-defined strategy, and a clear understanding of the steps involved, you can successfully navigate the maze and bring your life-changing medical device to the world.
