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Please note: as of October 1, 2002, FDA charges fees for review of Premarket Notification 510(k)s and Premarket Approvals
The current Good Manufacturing Practice (GMP) requirements set forth in the Quality System (QS) regulation are promulgated under section 520 of the Food, Drug and Cosmetic (FD&C) Act. They require that domestic or foreign manufacturers have a quality system for the design, manufacture, packaging, labeling, storage, installation, and servicing of finished medical devices intended for commercial distribution in the United States. The regulation requires that various specifications and controls be established for devices; that devices be designed under a quality system to meet these specifications; that devices be manufactured under a quality system; that finished devices meet these specifications; that devices be correctly installed, checked and serviced; that quality data be analyzed to identify and correct quality problems; and that complaints be processed. Thus, the QS regulation helps assure that medical devices are safe and effective for their intended use. The Food and Drug Administration (FDA) monitors device problem data and inspects the operations and records of device developers and manufacturers to determine compliance with the GMP requirements in the QS regulation.
The QS Regulation is contained in Title 21 Part
820 of the Code of Federal Regulations. This regulation covers quality management
and organization, device design, buildings, equipment, purchase and handling
of components, production and process controls, packaging and labeling control,
device evaluation, distribution, installation, complaint handling, servicing,
and records. The preamble describes the public comments received during the
development of the QS regulation and describes the FDA Commissioner's resolution
of the comments. Thus, the preamble contains valuable insight into the meaning
and intent of the QS regulation.
The Good Manufacturing Practice (GMP) / Quality System Regulation page has a link to the Medical Device Quality Systems Manual: A Small Entity Compliance Guide, First Edition which details the requirements of the new QS regulation and provides detailed guidance in the following areas:
Manufacturers should use good judgment when developing their quality system and apply those sections of the QS regulation that are applicable to their specific products and operations, 21 CFR 820.5 of the QS regulation. Operating within this flexibility, it is the responsibility of each manufacturer to establish requirements for each type or family of devices that will result in devices that are safe and effective, and to establish methods and procedures to design, produce, and distribute devices that meet the quality system requirements. FDA has identified in the QS regulation the essential elements that a quality system shall embody for design, production and distribution, without prescribing specific ways to establish these elements. Because the QS regulation covers a broad spectrum of devices and production processes, it allows some leeway in the details of quality system elements. It is left to manufacturers to determine the necessity for, or extent of, some quality elements and to develop and implement specific procedures tailored to their particular processes and devices. For example, if it is impossible to mix up labels at a manufacturer because there is only one label or one product, then there is no necessity for the manufacturer to comply with all of the GMP requirements under device labeling.
The medical device QS regulation requires an "umbrella" quality system intended to cover the design, production, and distribution of all medical devices from simple surgical hand tools to very complex computerized axial tomography (CAT) scanners. It is not practical for a regulation to specify details of quality system elements for such a wide range of products. Rather, the QS regulation specifies general objectives such as use of trained employees, design reviews, design validation, calibrated equipment, process controls, etc., rather than methods, because a specific method would not be appropriate to all operations.
In most cases, it is left to the manufacturer to determine the best methods to attain quality objectives. In some cases, however, the QS regulation does specify the particular type of method to be used, such as written procedures or written instructions. This does not mean, however, that manufacturers cannot vary from the method specified if the intent of the GMP requirement can be met by another method such as using an engineering drawing plus a model device as manufacturing instructions. Written procedures are not restricted to paper copies. Written procedures may be filed and distributed by automated data processing equipment. This flexibility is allowed by section 21 CFR 820.180.
Typically, large manufacturers will have a quality system that exceeds the medical device QS regulation. Small manufacturers will typically have a proportionally simpler system. FDA recognizes that a small manufacturer may not need the same amount of documentation that a large manufacturer does in order to achieve a state?of?control; and, that some of the records maintained to fulfill the GMP requirements for written procedures may not be as long and complex for a small manufacturer.
After a manufacturer establishes a quality system, it should be maintained. Each manufacturer should assure that with growth and process or product changes their quality system is still adequate. This assurance is obtained through change control, day?to?day observance of operations, and by periodic audits of the quality system. The auditor should first identify the elements of the company's quality system. Next the audit should determine how well each element is functioning, and then determine its adequacy with respect to the intent of the device GMP requirements and meeting the company's quality claims.
The QS regulation applies to finished devices intended to be commercially distributed for human use unless there is an approved exemption in effect. GMP exemptions are codified in the Classification Regulations 21 CFR 862 to 892. The exemption of most Class I devices from design controls is in section 21 CFR 820.30 (a).
Certain components such as blood tubing and major diagnostic x?ray components are considered by FDA to be finished devices because they are accessories to finished devices. The manufacturer of such accessories is subject to the QS regulation when the accessory device is labeled and sold separately from the primary device for a health?related purpose to a hospital, physician, or other user.
The designation of a device as a "custom" or "customized" device does not confer a GMP exemption.
Contract manufacturers and specification developers shall comply with the sections of the QS regulation that apply to the functions they perform.
Contract test laboratories are considered an extension of a manufacturer's quality system and presently are not routinely scheduled for GMP inspections. The finished device manufacturer shall meet the requirement of the QS regulation, particularly 21 CFR 820.50, Purchasing, when they obtain products or services. Internal test laboratories, however, that are part of a corporate manufacturer that provides services to individual corporation factories should meet GMP requirements. Internal laboratories are inspected as part of the FDA GMP inspection of the member factories.
Situations are discussed in the remainder of this chapter where various manufacturers are exempt from the QS regulation or are not routinely inspected. However, these manufacturers are still subject to the FD&C Act. If these manufacturers or any manufacturer render devices unsafe or ineffective, the devices are adulterated and/or misbranded and the manufacturers are subject to the penalties of the FD&C Act.
FDA has determined that certain types of establishments are exempt from GMP requirements; and FDA has defined GMP responsibilities for others. Exemption from the GMP requirements does not exempt manufacturers of finished devices from keeping complaint files ( 21 CFR 820.198) or from general requirements concerning records 21 CFR 820.180. Sterile devices are never exempted from GMP requirements. Medical devices manufactured under an investigational device exemption (IDE) are not exempt from design control requirements under 21 CFR 820.30. A device that normally would be subject to GMP requirements may be exempt under the following conditions:
When FDA has issued an exemption order in response to a citizen's petition for exemption;
When FDA, in the absence of a petition, has exempted the device and published the exemption in the Federal Register;
When the device is exempted by FDA classification regulations published in the Federal Register and codified in 21 CFR 862 to 892;
When the device is an intraocular lens (IOL) under an IDE and meets the requirements of the IDE regulation for IOL's (except for design controls 21 CFR 820.30); and
Through a policy statement, FDA may decide not to apply GMP requirements to some types of devices and processes although the devices may not have been exempted from GMP requirements.
Manufacturers should be aware of the GMP exemption status of their devices. In addition, manufacturers should keep on file records of any specific GMP exemption granted to them by FDA. Upon request during a factory visit, the exemption records need to be shown during normal business hours to the FDA investigator in order to verify that an exemption has been granted.
Component Manufacturers
A "component" is defined by 21 CFR 820.3 (c) as "any raw material, substance, piece, part, software, firmware, labeling, or assembly which is intended to be included as part of the finished, packaged, and labeled device." Component manufacturers are excluded from the QS regulation by 21 CFR 820.1 (a)(1). Current FDA policy is to rely upon the finished device manufacturer to assure that components are acceptable for use. Component manufacturers are not routinely scheduled for GMP inspections; however, FDA encourages them to use the QS regulation as guidance for their quality system.
When finished device manufacturers produce components specifically for use in medical devices they produce, whether in the same building or another location, such production of components is considered part of the device manufacturing operations, and the production should comply with the QS regulation as detailed under Manufacturers of Accessories .
A remanufacturer as defined in 21 CFR 820.3 (w) is any person who processes, conditions, renovates, repackages, restores, or does any other act to a finished device that changes the finished device's performance or safety specifications or intended use. Remanufacturers are considered manufacturers. As such, these manufacturers are subject to inspection by FDA and shall meet the applicable requirements of the medical device QS regulation. These manufacturers shall establish and implement quality systems to assure the safety and effectiveness of the devices that are distributed. Such activities include drafting of device master records, rebuilding per the device master records, inspection and testing, calibration of measurement equipment, control of components, updating of labeling, processing of complaints, and any other GMP requirement applicable to the activities being performed.
Remanufacturers are also required to comply with the labeling requirements of 21 CFR 801.1 (c). This labeling regulation requires that where the person or manufacturer named on the label of the device is not the original manufacturer, the name shall be qualified by an appropriate phrase which reveals the connection that person has with the device, e.g., remanufactured by XYZ Company.
Section 520(b) of the FD&C Act and the IDE regulation (21 CFR 812.3 (b)) defines a custom device. Custom devices are exempt from certain statutory requirements. For example, manufacturers of custom devices are not required to comply with premarket approval requirements (Section 515) and are exempt from premarket notification requirements [Section 510(k)]. Custom devices are NOT exempt from the GMP requirements. Manufacturers of custom devices should comply with the GMP requirements while considering the flexibility allowed.
A person(s) that manufactures a finished device under the terms of a contract with another manufacturer is a contract manufacturer. The agreement between the manufacturers should be documented in a written contract. Contract manufacturers of finished devices shall comply with applicable requirements of the quality system and shall register their establishment with FDA. Depending on the circumstances, both the contractor and manufacturer may be held jointly responsible by FDA for the activities performed.
Contract laboratories that designs or test components or finished devices for a manufacturer according to the manufacturer's specifications are considered an extension of the manufacturer's quality system. These laboratories may provide services to a number of customers, many of which are not medical device manufacturers. These contract laboratories are not subject to routine GMP inspections. Through the conduct of purchasing assessment, the finished device manufacturer is responsible for assuring that equipment and procedures used by a lab are adequate and appropriate (21 CFR 820.50). However, an internal test laboratory, if part of a manufacturer that does testing for various facilities within the corporation, is subject to inspection when FDA GMP inspections are conducted at the individual manufacturing facilities. That is, the test laboratory is simply a part of a medical device manufacturer of which all device-related divisions shall comply with the QS regulation.
Repackaging and relabeling of a device and specification development are defined as manufacturing in 21 CFR 820.3(o) and 21 CFR Part 807, Establishment Registration and Device Listing for Manufacturers of Devices. Some definitions from 21 CFR 807.3 (d) are reprinted below because they affect the applications of the QS regulation.
(d) "Manufacture, preparation, propagating, compounding, assembly, or processing" of a device means the making by chemical, physical, biological, or other procedures of any article that meets the definition of a device in section 201(h) of the Act. These terms include the following activities:
1. Repackaging or otherwise changing the container, wrapper, or labeling of any device package in furtherance of the distribution of the device from the original place of manufacture to the person who makes final delivery or sale to the ultimate consumer;
2.Distribution of domestic or imported devices; or
3. Initiation of specifications for devices that are manufactured by a second party for subsequent commercial distribution by the person initiating specifications".
As defined above, repackaging and relabeling are manufacturing operations. Further, a repacker, repackager or relabeler is a manufacturer per 21 CFR 820.3 (o) and subject to the applicable requirements of the QS regulation. Individuals are repackers or relabelers if they:
Individuals are not considered repackers or relabelers or a manufacturer for purposes of applying the QS regulation if they pack only previously packaged and labeled individual devices into packages for the convenience of the user. (Note that this activity is essentially the same as a drug store employee placing packaged items into a bag labeled with the name of the drug store.)
A distributor who only adds a label bearing their name and address is exempt from the GMP requirements. A manufacturer simply affixing a sticker label bearing the distributor's name and address would not require record keeping demonstrating compliance with labeling controls requirements.
Specification developers provide specifications to contract manufacturers, who produce devices to meet the specifications. The contract manufacturer may package and label the device, or the finished device may be shipped to the specification developer for packaging and labeling.
Specification developers are manufacturers and are subject to the GMP requirements that apply to the activities they conduct, such as various design controls including correct transfer of the design information to a contract manufacturer [21 CFR 820.30 (h)]. This activity, in turn, requires an adequate device master record (21 CFR 820.181) and adequate document change control [21 CFR 820.40 (b)]. Further, if the product carries the specification developer's label, the developer is responsible for maintaining a complaint file and processing complaints, plus maintaining the device specifications and other appropriate documents in the device master record.
When finished device manufacturers produce components specifically for use in medical devices they produce, whether in the same building or another location, such production of components is considered part of the device manufacturing operations, and the production should comply with the QS regulation.
Accessory devices are discussed in 21 CFR Part 807, Establishment Registration and Device Listing for Manufacturers of Devices [21 CFR 807.20 (a)(5)]. These devices, such as hemodialysis tubing or major diagnostic x?ray components, that are packaged, labeled, and distributed separately to a hospital, physician, etc., for health?related purposes are sometimes inappropriately referred to as components. However, FDA considers them finished devices because they are suitable for use or capable of functioning and are distributed for health-related purposes; and the QS regulation applies to their manufacture. Similarly, a device or component including software that is sold as an addition to a finished medical device to augment or supplement its performance is also termed an accessory. An accessory to a medical device is considered a finished device and, therefore, is subject to the QS regulation.
An initial importer (or initial distributor) takes first title to the devices imported into the U.S. and further distributes the product. With regards to the GMP, this initial distributor is responsible for maintaining complaint files and general record keeping requirements. A procedure shall be established and maintained for receiving, reviewing, and evaluating complaints. All complaints, including oral complaints, are to be processed in a uniform and timely manner. These complaints shall be evaluated to determine whether or not they require reporting to FDA under Medical Device Reporting, 21 CFR Part 804 or 803. The initial distributor is also required to evaluate all complaints to determine whether an investigation is necessary, as well as complying with all other requirements in 21 CFR 820.198, Complaint Files.
Updated January 28, 2004
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