The major thrust of the FDA has been in the oversight of the manufacture of medical devices, with specific requirements based on categories of perceived risks. The 1976 Act (Section 513) establishes three classes of medical devices intended for human use: Class I. General controls regulate devices for which controls other than performance standards or premarket approvals are sufficient to assure safety and effectiveness. Such controls include regulations that (1) prohibit adulterated or misbranded devices; (2) require domestic device manufacturers and initial distributors to register their establishments and list their devices; (3) grant FDA authority to ban certain devices; (4) provide for notification of risks and of repair, replacement, or refund; (5) restrict the sale, distribution, or use of certain devices; and (6) govern Good Manufacturing Practices, records, and reports, and inspections. These minimum requirements apply also to Class II and Class III devices. Class II. Performance Standards apply to devices for which general controls alone do not provide reasonable assurance of safety and efficacy, and for which existing information is sufficient to establish a performance standard that provides this assurance. Class II devices must comply not only with general controls, but also with an applicable standard developed under Section 514 of the Act. Until performance standards are developed by regulation, only general controls apply.
Class III. Premarket Approval applies to devices for which general
controls do not suffice or for which insufficient information is available to
write a performance standard to provide reasonable assurance of safety
and effectiveness. Also, devices that are used to support or sustain human
life or to prevent impairment of human health, devices implanted in the
body, and devices that present a potentially unreasonable risk of illness or
injury. New Class III devices, those not “substantially equivalent” to a
device on the market prior to enactment (May 28, 1976), must have
approved Premarket Approval Applications (Section 510 k).
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