82_FR_51799 82 FR 51585 - General Hospital and Personal Use Devices; Reclassification of Sharps Needle Destruction Device

82 FR 51585 - General Hospital and Personal Use Devices; Reclassification of Sharps Needle Destruction Device

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Federal Register Volume 82, Issue 214 (November 7, 2017)

Page Range51585-51589
FR Document2017-24191

The Food and Drug Administration (FDA) is issuing this proposed order to reclassify the needle destruction device, renaming the device to ``sharps needle destruction device,'' a postamendments class III device (regulated under product code MTV), into class II (special controls), subject to premarket notification. FDA is also identifying the proposed special controls that the Agency believes are necessary to provide a reasonable assurance of safety and effectiveness of the device. FDA is proposing this reclassification on its own initiative based on new information. If finalized, this order will reclassify these types of devices from class III to class II and reduce regulatory burdens on industry as these types of devices will no longer be required to submit a premarket approval application (PMA) but can instead submit a less burdensome premarket notification (510(k)) before marketing their device.

Federal Register, Volume 82 Issue 214 (Tuesday, November 7, 2017)
[Federal Register Volume 82, Number 214 (Tuesday, November 7, 2017)]
[Proposed Rules]
[Pages 51585-51589]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-24191]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

21 CFR Part 880

[Docket No. FDA-2017-N-6216]


General Hospital and Personal Use Devices; Reclassification of 
Sharps Needle Destruction Device

AGENCY: Food and Drug Administration, HHS.

ACTION: Proposed order.

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SUMMARY: The Food and Drug Administration (FDA) is issuing this 
proposed order to reclassify the needle destruction device, renaming 
the device to ``sharps needle destruction device,'' a postamendments 
class III device (regulated under product code MTV), into class II 
(special controls), subject to premarket notification. FDA is also 
identifying the proposed special controls that the Agency believes are 
necessary to provide a reasonable assurance of safety and effectiveness 
of the device. FDA is proposing this reclassification on its own 
initiative based on new information. If finalized, this order will 
reclassify these types of devices from class III to class II and reduce 
regulatory burdens on industry as these types of devices will no longer 
be required to submit a premarket approval application (PMA) but can 
instead submit a less burdensome premarket notification (510(k)) before 
marketing their device.

DATES: Submit either electronic or written comments on the proposed 
order by January 8, 2018. Please see section XI of this document for 
the proposed effective date when the new requirements apply and for the 
proposed effective date of a final order based on this proposed order.

ADDRESSES: You may submit comments as follows. Please note that late, 
untimely filed comments will not be considered. Electronic comments 
must be submitted on or before January 8, 2018. The https://www.regulations.gov electronic filing system will accept comments until 
midnight Eastern Time at the end of January 8, 2018. Comments received 
by mail/hand delivery/courier (for written/paper submissions) will be 
considered timely if they are postmarked or the delivery service 
acceptance receipt is on or before that date.

Electronic Submissions

    Submit electronic comments in the following way:
     Federal Rulemaking Portal: https://www.regulations.gov. 
Follow the instructions for submitting comments. Comments submitted 
electronically, including attachments, to https://www.regulations.gov 
will be posted to the docket unchanged. Because your comment will be 
made public, you are solely responsible for ensuring that your comment 
does not include any confidential information that you or a third party 
may not wish to be posted, such as medical information, your or anyone 
else's Social Security number, or confidential business information, 
such as a manufacturing process. Please note that if you include your 
name, contact information, or other information that identifies you in 
the body of your comments, that information will be posted on https://www.regulations.gov.
     If you want to submit a comment with confidential 
information that you do not wish to be made available to the public, 
submit the comment as a written/paper submission and in the manner 
detailed (see ``Written/Paper Submissions'' and ``Instructions'').

Written/Paper Submissions

    Submit written/paper submissions as follows:
     Mail/Hand delivery/Courier (for written/paper 
submissions): Dockets Management Staff (HFA-305), Food and Drug 
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
     For written/paper comments submitted to the Dockets 
Management Staff, FDA will post your comment, as well as any 
attachments, except for information submitted, marked and identified, 
as confidential, if submitted as detailed in ``Instructions.''
    Instructions: All submissions received must include the Docket No. 
FDA-2017-N-6216 for ``General Hospital and Personal Use Devices; 
Reclassification

[[Page 51586]]

of Sharps Needle Destruction Device.'' Received comments, those filed 
in a timely manner (see ADDRESSES), will be placed in the docket and, 
except for those submitted as ``Confidential Submissions,'' publicly 
viewable at https://www.regulations.gov or at the Dockets Management 
Staff between 9 a.m. and 4 p.m., Monday through Friday.
     Confidential Submissions--To submit a comment with 
confidential information that you do not wish to be made publicly 
available, submit your comments only as a written/paper submission. You 
should submit two copies total. One copy will include the information 
you claim to be confidential with a heading or cover note that states 
``THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.'' The Agency will 
review this copy, including the claimed confidential information, in 
its consideration of comments. The second copy, which will have the 
claimed confidential information redacted/blacked out, will be 
available for public viewing and posted on https://www.regulations.gov. 
Submit both copies to the Dockets Management Staff. If you do not wish 
your name and contact information to be made publicly available, you 
can provide this information on the cover sheet and not in the body of 
your comments and you must identify this information as 
``confidential.'' Any information marked as ``confidential'' will not 
be disclosed except in accordance with 21 CFR 10.20 and other 
applicable disclosure law. For more information about FDA's posting of 
comments to public dockets, see 80 FR 56469, September 18, 2015, or 
access the information at: https://www.thefederalregister.org/fdsys/pkg/FR-2015-09-18/pdf/2015-23389.pdf.
    Docket: For access to the docket to read background documents or 
the electronic and written/paper comments received, go to https://www.regulations.gov and insert the docket number, found in brackets in 
the heading of this document, into the ``Search'' box and follow the 
prompts and/or go to the Dockets Management Staff, 5630 Fishers Lane, 
Rm. 1061, Rockville, MD 20852.

FOR FURTHER INFORMATION CONTACT: Christopher K. Dugard, Center for 
Devices and Radiological Health, Food and Drug Administration, 10903 
New Hampshire Ave., Bldg. 66, Rm. 2561, Silver Spring, MD 20993, 240-
402-6031, [email protected].

SUPPLEMENTARY INFORMATION: 

I. Background--Regulatory Authorities

    The Federal Food, Drug, and Cosmetic Act (the FD&C Act), as 
amended, establishes a comprehensive system for the regulation of 
medical devices intended for human use. Section 513 of the FD&C Act (21 
U.S.C. 360c) established three categories (classes) of devices, 
reflecting the regulatory controls needed to provide reasonable 
assurance of their safety and effectiveness. The three categories of 
devices are class I (general controls), class II (special controls), 
and class III (premarket approval).
    Devices that were not in commercial distribution prior to May 28, 
1976 (generally referred to as postamendments devices) are 
automatically classified by section 513(f)(1) of the FD&C Act into 
class III without any FDA rulemaking process. Those devices remain in 
class III and require premarket approval unless, and until, the device 
is reclassified into class I or II, or FDA issues an order finding the 
device to be substantially equivalent, in accordance with section 
513(i) of the FD&C Act, to a predicate device that does not require 
premarket approval. The Agency determines whether new devices are 
substantially equivalent to predicate devices by means of premarket 
notification procedures in section 510(k) of the FD&C Act (21 U.S.C. 
360(k)) and 21 CFR part 807.
    A postamendments device that has been initially classified in class 
III under section 513(f)(1) of the FD&C Act may be reclassified into 
class I or class II under section 513(f)(3) of the FD&C Act. Section 
513(f)(3) of the FD&C Act provides that FDA acting by order can 
reclassify the device into class I or class II on its own initiative, 
or in response to a petition from the manufacturer or importer of the 
device. To change the classification of the device, the proposed new 
class must have sufficient regulatory controls to provide reasonable 
assurance of the safety and effectiveness of the device for its 
intended use.
    Reevaluation of the data previously before the Agency is an 
appropriate basis for subsequent action where the reevaluation is made 
in light of newly available regulatory authority (see Bell v. Goddard, 
366 F.2d 177, 181 (7th Cir. 1966); Ethicon, Inc. v. FDA, 762 F. Supp. 
382, 388-391 (D.D.C. 1991)) or in light of changes in ``medical 
science'' (Upjohn v. Finch, 422 F.2d 944, 951 (6th Cir. 1970)). Whether 
data before the Agency are old or new, the ``new information'' to 
support reclassification under 513(f)(3) must be ``valid scientific 
evidence'', as defined in section 513(a)(3) of the FD&C Act and 21 CFR 
860.7(c)(2). (See, e.g., General Medical Co. v. FDA, 770 F.2d 214 (D.C. 
Cir. 1985); Contact Lens Assoc. v. FDA, 766 F.2d 592 (D.C. Cir.1985), 
cert. denied, 474 U.S. 1062 (1986)).
    FDA relies upon ``valid scientific evidence'' in the classification 
process to determine the level of regulation for devices. To be 
considered in the reclassification process, the ``valid scientific 
evidence'' upon which the Agency relies must be publicly available. 
Publicly available information excludes trade secret and/or 
confidential commercial information, e.g., the contents of a pending 
PMA (see section 520(c) of the FD&C Act (21 U.S.C. 360j(c)). Section 
520(h)(4) of the FD&C Act provides that FDA may use, for 
reclassification of a device, certain information in a PMA 6 years 
after the application has been approved. This includes information from 
clinical and preclinical tests or studies that demonstrate the safety 
or effectiveness of the device, but does not include descriptions of 
methods of manufacture or product composition and other trade secrets.
    Section 510(m) of the FD&C Act provides that a class II device may 
be exempted from the 510(k) premarket notification requirements, if the 
Agency determines that premarket notification is not necessary to 
reasonably assure the safety and effectiveness of the device.

II. Regulatory History of the Devices

    On February 3, 1994, FDA issued a Memorandum to manufacturers and 
initial distributors of sharps containers and destroyers used by health 
care manufacturers to clarify the regulatory status of sharps destroyer 
devices (Ref. 1).
    On March 6, 1997, FDA approved its first needle destruction device 
through its PMA process under section 515 of the FD&C Act (21 U.S.C. 
360e). In the June 11, 1997, Federal Register notice (62 FR 31831), FDA 
announced a PMA approval order for Millenium Medical Supply's 
Incorporated Needle-EaseTM 2501\1\ device and the 
availability of the Summary of Safety and Effectiveness Data for the 
Device (SSED) (Ref. 2). As of the date of issuance of this proposed 
order, FDA has approved 18 original PMAs for this device type.\2\
---------------------------------------------------------------------------

    \1\ FDA approved a modified needle destruction device on 
February 11, 1998. The device, as modified, is marketed under the 
trade name Needle-Ease[supreg]3500.
    \2\ See PMA database for original PMAs regulated under the 
product code MTV: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMA/pma.cfm.

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[[Page 51587]]

    On March 2, 2001, FDA finalized guidance entitled, ``Premarket 
Approval Applications (PMA) for Sharps Needle Destruction Devices,'' 
describing the Agency's recommendations for information to include in 
PMA applications for sharps needle destruction devices intended for use 
in health care settings (Ref. 3).

III. Device Description

    A sharps needle destruction device is a postamendments device 
classified into class III under section 513(f)(1) of the FD&C Act. A 
sharps needle destruction device is a prescription device intended for 
home use or in professional health care facilities to destroy sharps or 
needles used for medical purposes by incineration or mechanical means. 
Sharps needle destruction devices are typically electrical devices that 
can destruct sharps and/or needles in a variety of methods (grinding, 
incinerating, etc.) that can be either portable or stationary. Some of 
these devices may also employ software to provide the user with greater 
control. Please note these devices were originally identified as needle 
destruction devices (product code MTV) in FDA SSEDs and product code 
database; however, FDA believes the identification of sharps needle 
destruction device more accurately describes this device type as it can 
be used to destroy devices other than needles (e.g., sharps).

IV. Proposed Reclassification

    As part of the Center for Devices and Radiological Health's 2014-
2015 strategic priority ``Strike the Right Balance Between Premarket 
and Postmarket Data Collection,'' a retrospective review of class III 
devices subject to PMA was completed to determine whether or not, based 
on our current understanding of the technology, reclassification may be 
appropriate. On August 8, 2016, FDA published a document in the Federal 
Register entitled ``Retrospective Review of Premarket Approval 
Application Devices; Striking the Balance Between Premarket and 
Postmarket Data Collection'' in which FDA announced plans to reclassify 
sharps needle destruction devices identified with the MTV product code 
from class III to class II (81 FR 52445). FDA has found that sufficient 
information exists to establish special controls that, together with 
general controls, can provide a reasonable assurance of safety and 
effectiveness for sharps needle destruction devices.
    In accordance with section 513(f)(3) of the FD&C Act and 21 CFR 
part 860, subpart C, FDA is proposing to reclassify this postamendments 
class III device into class II. FDA believes that there is sufficient 
information available to FDA through FDA's accumulated experience with 
these devices from review submissions, peer-reviewed literature, and 
knowledge of similar devices to establish special controls that 
effectively mitigate the risks to health identified in section V. 
Absent the special controls identified in this proposed order, general 
controls applicable to the device are insufficient to provide 
reasonable assurance of the safety and effectiveness of the device.
    FDA is proposing to create a separate classification regulation for 
sharps needle destruction devices that will be reclassified from class 
III to II. Under this proposed order, if finalized, the sharps needle 
destruction devices will be identified as a prescription device. As 
such, the prescription device must satisfy prescription labeling 
requirements (see Sec.  801.109 (21 CFR 801.109), Prescription 
devices). Prescription devices are exempt from the requirement for 
adequate directions for use for the layperson under section 502(f)(1) 
of the FD&C Act (21 U.S.C. 352(f)(1)) and Sec.  801.5 (21 CFR 801.5), 
as long as the conditions of Sec.  801.109 are met. In this proposed 
order, if finalized, the Agency has identified the special controls 
under section 513(a)(1)(B) of the FD&C Act that, together with general 
controls, will provide a reasonable assurance of the safety and 
effectiveness for sharps needle destruction devices.
    Section 510(m) of the FD&C Act provides that FDA may exempt a class 
II device from the premarket notification requirements under section 
510(k) of the FD&C Act if FDA determines that premarket notification is 
not necessary to provide reasonable assurance of the safety and 
effectiveness of the device. For this type of device, FDA has 
determined that premarket notification is necessary for sharps needle 
destruction devices to provide reasonable assurance of the safety and 
effectiveness. Therefore, the Agency does not intend to exempt these 
proposed class II devices from 510(k) requirements. Persons who intend 
to market this type of device must submit to FDA a 510(k) and receive 
clearance prior to marketing the device.

V. Risks to Health

    After considering the information available to FDA through review 
submissions, peer-reviewed literature, and knowledge of similar 
devices, FDA determined the probable risks to health associated with 
the use of sharps needle destruction devices are as follows:
     Patient/user exposure to environmental contaminants. 
Destroying a used sharp or needle may generate hazardous emissions from 
the device that may result in infection or respiratory problems for the 
patient and/or user. Contamination of the patient environment can occur 
through emission of toxic fumes or infectious aerosol when the device 
destroys a sharp by incineration or mechanical means, and may result 
from device malfunction (mechanical and/or software). The device may 
also become contaminated through regular usage and may cause cross-
contamination.
     Patient/user burns as a result of excessive heat discharge 
or spark formation. Excessive heat or sparks may be generated and 
discharged from the device during destruction of sharps that may burn 
the user.
     Electromagnetic interference. While in operation, the 
device may interfere with other electrically powered devices, causing 
them to malfunction.
     Electrical shock. While in operation, the device may 
discharge electricity that could shock the user.
     Sharps injury. Incompletely destroyed sharps, physical 
device instability, device malfunctions, or use error may pose a risk 
for a sharps injury to the user.

VI. Summary of Reasons for Reclassification

    FDA believes that the sharps needle destruction devices intended 
for home use or in professional health care facilities to reduce the 
incidence of needlesticks by destroying sharps and/or needles in a 
variety of methods (grinding, incinerating, etc.) should be 
reclassified from class III to class II in light of new information 
about the effectiveness of these devices. There is sufficient 
information to establish special controls for sharps needle destruction 
devices, in addition to general controls, which can provide reasonable 
assurance of safety and effectiveness of the device, as general 
controls themselves are insufficient to provide reasonable assurance of 
its safety and effectiveness. FDA believes that the risks to health 
associated with sharps needle destruction devices intended for home use 
or in professional health care facilities to reduce the incidence of 
needlesticks can be mitigated with special controls and that these 
mitigations will provide a reasonable assurance of its safety and 
effectiveness.
    Based on a reconsideration of the available information and data, 
FDA believes that there is valid scientific evidence of effectiveness 
for sharps

[[Page 51588]]

needle destruction devices to reduce the incidence of needlesticks.

VII. Summary of Data Upon Which the Reclassification Is Based

    FDA believes that the identified special controls, in addition to 
general controls, are necessary to provide reasonable assurance of 
safety and effectiveness of these devices. Taking into account the 
probable health benefits of the use of the device and the nature and 
known incidence of the risks of the device, FDA, on its own initiative, 
is proposing to reclassify this postamendments class III device into 
class II. FDA has considered and analyzed the following information: An 
inclusive search of the Agency's Manufacturer and User Facility Device 
Experience (MAUDE) database, which shows no adverse events for sharps 
needle destruction devices; data contained in PMAs approved 6 or more 
years before the date of this proposal (reviewed under section 
520(h)(4) of the FD&C Act, also known as the 6-year rule); a review of 
sharps containers regulated under 21 CFR 880.5570, which have similar 
intended uses, but different technology, and are currently regulated as 
class II devices; and one relevant article found from a literature 
search that discussed the benefits and the probable risks of these 
devices (Ref. 4).

VIII. Proposed Special Controls

    FDA believes that the following special controls, together with 
general controls, are sufficient to mitigate the risks to health 
described in section V and provide a reasonable assurance of safety and 
effectiveness for sharps needle destruction devices.
     Performance testing will demonstrate:
    [cir] The device's ability to contain or ventilate aerosols or 
fumes from device operation that may result in environmental 
contamination and cross-contamination. Performance testing will 
demonstrate that harmful fumes, such as ozone, are not emitted by the 
device during destruction of sharps needles.
    [cir] Excessive heat or sparks are not generated during device 
operation that may injure users or patients through characterization of 
the heat dissipation profile from the heat source to the enclosure 
surface, and the point of contact between the held syringe and the 
user. Performance testing will ensure the heat generated through normal 
operation of the device will not harm users or patients or affect 
circuit performance and useful life of the device.
    [cir] Complete destruction of sharps intended to be destructed to 
mitigate user injuries from incomplete sharps destruction by conducting 
performance testing such as simulated use demonstrating complete 
destruction of the sharps and/or needles intended to be destroyed.
    [cir] Mitigation of injuries from device instability through 
characterization of the vibrations and movement generated by the device 
to ensure device stability in the use environment.
     Validation of cleaning and disinfection instructions to 
demonstrate that the device can be safely and effectively reprocessed 
after use to minimize the risk of patient/user cross-contamination.
     Performance testing ensures electromagnetic compatibility 
with other devices under conditions which are consistent with the 
intended environment of device use.
     Electrical safety testing ensures the risk of shock to the 
patient/user is minimized.
     Software hazard analysis, as well as software verification 
and validation, ensures that software performs as intended and 
potential software malfunctions do not impact the performance of the 
device.
     Labeling to ensure proper use of the device, including 
warnings of the generation of excessive heat, potential for needle 
stick injuries, instructions for reprocessing, and instructions for 
installation (e.g., on a stable surface, adequate ventilation).
    Table 1 shows how FDA believes these special controls will mitigate 
each risk to health described in section V.

   Table 1--Risks to Health and Mitigation Measures for Sharps Needle
                           Destruction Devices
------------------------------------------------------------------------
         Identified risk to health               Mitigation measures
------------------------------------------------------------------------
Patient/user exposure to environmental      Performance testing.
 contaminants.                              Reprocessing validation.
                                            Software verification,
                                             validation, and hazard
                                             analysis.
                                            Labeling.
Patient/user burns........................  Performance testing.
                                            Labeling.
Electrical shock..........................  Electrical Safety Testing.
                                            Labeling.
Electromagnetic interference..............  Electromagnetic
                                             Compatibility (EMC)
                                             Testing.
                                            Labeling.
Sharps injury.............................  Performance testing.
                                            Software verification,
                                             validation, and hazard
                                             analysis.
                                            Labeling.
------------------------------------------------------------------------

    In addition, FDA is proposing to limit these devices to 
prescription use under Sec.  801.109. Prescription devices are exempt 
from the requirement for adequate directions for use for the layperson 
under section 502(f)(1) of the FD&C Act and Sec.  801.5, as long as the 
conditions of Sec.  801.109 are met (referring to 21 U.S.C. 352(f)(1)). 
Under 21 CFR 807.81, the device would continue to be subject to 510(k) 
notification requirements. FDA does not believe that clinical data is 
necessary to mitigate the identified risks to health for sharps needle 
destruction devices. FDA may request clinical data to evaluate 
substantial equivalence when a manufacturer includes new indications 
for use, such as indications for disease prevention or organism 
destruction.
    This reclassification order and the identified special controls, if 
finalized, would provide sufficient detail regarding FDA's requirements 
to reasonably assure safety and effectiveness of sharps needle 
destruction devices. FDA intends to withdraw the final guidance 
entitled, ``Premarket Approval Applications (PMA) for Sharps Needle 
Destruction Devices; Final Guidance for Industry and FDA'' issued in 
2001 upon finalization of this proposed reclassification order (Ref. 
3).

IX. Analysis of Environmental Impact

    The Agency has determined under 21 CFR 25.34(b) that this action is 
of a type that does not individually or cumulatively have a significant 
effect on the human environment. Therefore, neither an environmental 
assessment nor an environmental impact statement is required.

X. Paperwork Reduction Act of 1995

    FDA tentatively concludes that this proposed order contains no new 
collections of information. Therefore, clearance by the Office of 
Management and Budget (OMB) under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520) is not required. This proposed order refers 
to previously approved collections of information

[[Page 51589]]

found in FDA regulations. These collections of information are subject 
to review by OMB under the PRA. The collections of information in 21 
CFR part 807, subpart E have been approved under OMB control number 
0910-0120 and the collections of information under 21 CFR part 801 have 
been approved under OMB control number 0910-0485.

XI. Proposed Effective Date

    FDA proposes that any final order based on this proposal become 
effective 30 days after the date of its publication in the Federal 
Register.

XII. References

    The following references are on display in the Dockets Management 
Staff (see ADDRESSES) and are available for viewing by interested 
persons between 9 a.m. and 4 p.m., Monday through Friday; they are also 
available electronically at https://www.regulations.gov. FDA has 
verified the Web site addresses, as of the date this document publishes 
in the Federal Register, but Web sites are subject to change over time.

    1. FDA memorandum ``To Manufacturers and Initial Distributors of 
Sharps Containers and Destroyers Used by Health Care 
Professionals,'' February 3, 1994, available at: https://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm070679.pdf.
    2. FDA ``Premarket Approval of Millenium Medical Supply 
Incorporated Needle-EaseTM 2501-ACTION,'' March 6, 1997, 
available at: https://www.accessdata.fda.gov/cdrh_docs/pdf/p960044.pdf.
    3. ``Premarket Approval Applications (PMA) for Sharps Needle 
Destruction Devices; Final Guidance for Industry and FDA,'' March 2, 
2001, available at: https://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm073601.pdf.
    4. Tamplin S.A., D. Davidson, B. Powis, and Z. O'Leary, ``Issues 
and Options for the Safe Destruction and Disposal of Used Injection 
Materials,'' Waste Management, vol. 25, pp. 655-665, 2005.

List of Subjects in 21 CFR Part 880

    Medical devices.

    Therefore, under the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 321 et seq., as amended) and under authority delegated to the 
Commissioner of Food and Drugs, it is proposed that 21 CFR part 880 be 
amended as follows:

PART 880--GENERAL HOSPITAL AND PERSONAL USE DEVICES

0
1. The authority citation for part 880 continues to read as follows:

    Authority:  21 U.S.C. 351, 360, 360c, 360e, 360j, 371.

0
2. Add Sec.  880.6210 to subpart G to read as follows:


Sec.  880.6210  Sharps needle destruction device.

    (a) Identification. A sharps needle destruction device is a 
prescription device that is intended to destroy needles or sharps used 
for medical purposes by incineration or mechanical means.
    (b) Classification. Class II (special controls). The special 
controls for this device are:
    (1) Performance testing must demonstrate the following during 
operation of the device:
    (i) The device safely contains or ventilates aerosols or fumes from 
device operation.
    (ii) Excessive heat or sparks are not generated that may injure 
users or patients.
    (iii) Simulated use testing must demonstrate sharps and/or needles 
are completely destroyed using a range of types and sizes of sharps 
sufficient to represent actual use.
    (iv) Simulated use testing must demonstrate that the device is 
physically stable on the surface for which it is intended to be mounted 
to ensure the risk of harm to the patient/user as a result of the 
device falling is minimized.
    (2) Validation of cleaning and disinfection instructions must 
demonstrate that the device can be safely and effectively reprocessed 
after use per the recommended cleaning and disinfection protocol in the 
instructions for use.
    (3) Analysis and/or testing must validate electromagnetic 
compatibility (EMC) and electrical safety, including the safety of any 
battery used in the device, under conditions which are consistent with 
the intended environment of device use.
    (4) Software verification, validation, and hazard analysis must be 
performed.
    (5) Labeling must include:
    (i) A clear description of the device and its technological 
features;
    (ii) How the device is to be used, including validated cleaning and 
disinfection instructions;
    (iii) Relevant precautions and warnings based on performance and 
in-use testing to ensure proper use of the device; and
    (iv) Instructions to install device in adequately ventilated area 
and stable area.

    Dated: November 2, 2017.
Anna K. Abram,
Deputy Commissioner for Policy, Planning, Legislation, and Analysis.
[FR Doc. 2017-24191 Filed 11-6-17; 8:45 am]
 BILLING CODE 4164-01-P



                                                                       Federal Register / Vol. 82, No. 214 / Tuesday, November 7, 2017 / Proposed Rules                                          51585

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                                                  on the lower skin of the left wing and the              on the availability of this material at the           at the end of January 8, 2018. Comments
                                                  right wing using Piper SB No. 1304, dated               FAA, call (816) 329–4148.
                                                  August 23, 2017.                                                                                              received by mail/hand delivery/courier
                                                                                                            Issued in Kansas City, Missouri, on                 (for written/paper submissions) will be
                                                  (i) Inspect for Corrosion                               October 30, 2017.                                     considered timely if they are
                                                     Within the next 100 hours TIS after the              Melvin J. Johnson,                                    postmarked or the delivery service
                                                  effective date of this AD or within the next            Acting Deputy Director, Policy & Innovation           acceptance receipt is on or before that
                                                  12 months after the effective date of this AD,          Division, Aircraft Certification Service.             date.
                                                  whichever occurs first, inspect the left and
                                                                                                          [FR Doc. 2017–24083 Filed 11–6–17; 8:45 am]
                                                  the right main wing spar for any evidence of                                                                  Electronic Submissions
                                                  corrosion using Part I of the Instructions              BILLING CODE 4910–13–P
                                                                                                                                                                  Submit electronic comments in the
                                                  section of Piper SB No. 1304, dated August
                                                  23, 2017.                                                                                                     following way:
                                                                                                                                                                  • Federal Rulemaking Portal: https://
                                                  (j) Corrective Actions                                  DEPARTMENT OF HEALTH AND                              www.regulations.gov. Follow the
                                                     Before further flight after the inspection
                                                                                                          HUMAN SERVICES                                        instructions for submitting comments.
                                                  required in paragraph (i) of this AD, if
                                                                                                          Food and Drug Administration                          Comments submitted electronically,
                                                  evidence of corrosion is found, take all                                                                      including attachments, to https://
                                                  necessary corrective actions to remove the                                                                    www.regulations.gov will be posted to
                                                  corrosion using Part I of the Instructions              21 CFR Part 880
                                                                                                                                                                the docket unchanged. Because your
                                                  section of Piper SB No. 1304, dated August
                                                  23, 2017, and/or make all necessary repairs
                                                                                                          [Docket No. FDA–2017–N–6216]                          comment will be made public, you are
                                                  using Part II of the Instructions section of                                                                  solely responsible for ensuring that your
                                                  Piper SB No. 1304, dated August 23, 2017.
                                                                                                          General Hospital and Personal Use                     comment does not include any
                                                                                                          Devices; Reclassification of Sharps                   confidential information that you or a
                                                  (k) Alternative Methods of Compliance                   Needle Destruction Device
                                                  (AMOCs)
                                                                                                                                                                third party may not wish to be posted,
                                                                                                          AGENCY:    Food and Drug Administration,              such as medical information, your or
                                                     (1) The Manager, Atlanta ACO Branch,                                                                       anyone else’s Social Security number, or
                                                  FAA, has the authority to approve AMOCs                 HHS.
                                                  for this AD, if requested using the procedures
                                                                                                                                                                confidential business information, such
                                                                                                          ACTION:   Proposed order.                             as a manufacturing process. Please note
                                                  found in 14 CFR 39.19. In accordance with
                                                  14 CFR 39.19, send your request to your                 SUMMARY:   The Food and Drug                          that if you include your name, contact
                                                  principal inspector or local Flight Standards           Administration (FDA) is issuing this                  information, or other information that
                                                  District Office, as appropriate. If sending             proposed order to reclassify the needle               identifies you in the body of your
                                                  information directly to the manager of the                                                                    comments, that information will be
                                                                                                          destruction device, renaming the device
                                                  certification office, send it to the attention of                                                             posted on https://www.regulations.gov.
                                                                                                          to ‘‘sharps needle destruction device,’’ a
                                                  the person identified in paragraph (l)(1) of
                                                                                                          postamendments class III device                         • If you want to submit a comment
                                                  this AD.                                                                                                      with confidential information that you
                                                     (2) Before using any approved AMOC,                  (regulated under product code MTV),
                                                  notify your appropriate principal inspector,            into class II (special controls), subject to          do not wish to be made available to the
                                                  or lacking a principal inspector, the manager           premarket notification. FDA is also                   public, submit the comment as a
                                                  of the local flight standards district office/          identifying the proposed special                      written/paper submission and in the
                                                  certificate holding district office.                    controls that the Agency believes are                 manner detailed (see ‘‘Written/Paper
                                                     (3) For service information that contains
                                                                                                          necessary to provide a reasonable                     Submissions’’ and ‘‘Instructions’’).
                                                  steps that are labeled as Required for
                                                  Compliance (RC), the provisions of                      assurance of safety and effectiveness of              Written/Paper Submissions
                                                  paragraphs (g) through (j) of this AD apply.            the device. FDA is proposing this                       Submit written/paper submissions as
                                                     (i) The steps labeled as RC, including               reclassification on its own initiative                follows:
                                                  substeps under an RC step and any figures               based on new information. If finalized,                 • Mail/Hand delivery/Courier (for
                                                  identified in an RC step, must be done to               this order will reclassify these types of             written/paper submissions): Dockets
                                                  comply with the AD. An AMOC is required                 devices from class III to class II and
                                                  for any deviations to RC steps, including                                                                     Management Staff (HFA–305), Food and
                                                                                                          reduce regulatory burdens on industry                 Drug Administration, 5630 Fishers
                                                  substeps and identified figures.
                                                                                                          as these types of devices will no longer              Lane, Rm. 1061, Rockville, MD 20852.
                                                     (ii) Steps not labeled as RC may be
                                                  deviated from using accepted methods in                 be required to submit a premarket                       • For written/paper comments
                                                  accordance with the operator’s maintenance              approval application (PMA) but can                    submitted to the Dockets Management
                                                  or inspection program without obtaining                 instead submit a less burdensome                      Staff, FDA will post your comment, as
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                                                  approval of an AMOC, provided the RC steps,             premarket notification (510(k)) before                well as any attachments, except for
                                                  including substeps and identified figures, can          marketing their device.                               information submitted, marked and
                                                  still be done as specified, and the airplane            DATES: Submit either electronic or                    identified, as confidential, if submitted
                                                  can be put back in an airworthy condition.
                                                                                                          written comments on the proposed                      as detailed in ‘‘Instructions.’’
                                                  (l) Related Information                                 order by January 8, 2018. Please see                    Instructions: All submissions received
                                                     (1) For more information about this AD,              section XI of this document for the                   must include the Docket No. FDA–
                                                  contact Dan McCully, Aerospace Engineer,                proposed effective date when the new                  2017–N–6216 for ‘‘General Hospital and
                                                  FAA, Atlanta ACO Branch, 1701 Columbia                  requirements apply and for the                        Personal Use Devices; Reclassification


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                                                  51586                Federal Register / Vol. 82, No. 214 / Tuesday, November 7, 2017 / Proposed Rules

                                                  of Sharps Needle Destruction Device.’’                  I. Background—Regulatory Authorities                  evidence’’, as defined in section
                                                  Received comments, those filed in a                        The Federal Food, Drug, and Cosmetic               513(a)(3) of the FD&C Act and 21 CFR
                                                  timely manner (see ADDRESSES), will be                  Act (the FD&C Act), as amended,                       860.7(c)(2). (See, e.g., General Medical
                                                  placed in the docket and, except for                    establishes a comprehensive system for                Co. v. FDA, 770 F.2d 214 (D.C. Cir.
                                                  those submitted as ‘‘Confidential                       the regulation of medical devices                     1985); Contact Lens Assoc. v. FDA, 766
                                                  Submissions,’’ publicly viewable at                     intended for human use. Section 513 of                F.2d 592 (D.C. Cir.1985), cert. denied,
                                                  https://www.regulations.gov or at the                   the FD&C Act (21 U.S.C. 360c)                         474 U.S. 1062 (1986)).
                                                  Dockets Management Staff between 9                      established three categories (classes) of                FDA relies upon ‘‘valid scientific
                                                  a.m. and 4 p.m., Monday through                         devices, reflecting the regulatory                    evidence’’ in the classification process
                                                  Friday.                                                 controls needed to provide reasonable                 to determine the level of regulation for
                                                                                                                                                                devices. To be considered in the
                                                     • Confidential Submissions—To                        assurance of their safety and
                                                                                                          effectiveness. The three categories of                reclassification process, the ‘‘valid
                                                  submit a comment with confidential
                                                                                                          devices are class I (general controls),               scientific evidence’’ upon which the
                                                  information that you do not wish to be                                                                        Agency relies must be publicly
                                                  made publicly available, submit your                    class II (special controls), and class III
                                                                                                          (premarket approval).                                 available. Publicly available information
                                                  comments only as a written/paper                                                                              excludes trade secret and/or
                                                  submission. You should submit two                          Devices that were not in commercial
                                                                                                          distribution prior to May 28, 1976                    confidential commercial information,
                                                  copies total. One copy will include the                                                                       e.g., the contents of a pending PMA (see
                                                                                                          (generally referred to as
                                                  information you claim to be confidential                                                                      section 520(c) of the FD&C Act (21
                                                                                                          postamendments devices) are
                                                  with a heading or cover note that states                                                                      U.S.C. 360j(c)). Section 520(h)(4) of the
                                                                                                          automatically classified by section
                                                  ‘‘THIS DOCUMENT CONTAINS                                513(f)(1) of the FD&C Act into class III              FD&C Act provides that FDA may use,
                                                  CONFIDENTIAL INFORMATION.’’ The                         without any FDA rulemaking process.                   for reclassification of a device, certain
                                                  Agency will review this copy, including                 Those devices remain in class III and                 information in a PMA 6 years after the
                                                  the claimed confidential information, in                require premarket approval unless, and                application has been approved. This
                                                  its consideration of comments. The                      until, the device is reclassified into class          includes information from clinical and
                                                  second copy, which will have the                        I or II, or FDA issues an order finding               preclinical tests or studies that
                                                  claimed confidential information                        the device to be substantially                        demonstrate the safety or effectiveness
                                                  redacted/blacked out, will be available                 equivalent, in accordance with section                of the device, but does not include
                                                  for public viewing and posted on                        513(i) of the FD&C Act, to a predicate                descriptions of methods of manufacture
                                                  https://www.regulations.gov. Submit                     device that does not require premarket                or product composition and other trade
                                                  both copies to the Dockets Management                   approval. The Agency determines                       secrets.
                                                  Staff. If you do not wish your name and                 whether new devices are substantially                    Section 510(m) of the FD&C Act
                                                  contact information to be made publicly                 equivalent to predicate devices by                    provides that a class II device may be
                                                  available, you can provide this                         means of premarket notification                       exempted from the 510(k) premarket
                                                  information on the cover sheet and not                  procedures in section 510(k) of the                   notification requirements, if the Agency
                                                  in the body of your comments and you                    FD&C Act (21 U.S.C. 360(k)) and 21 CFR                determines that premarket notification
                                                  must identify this information as                       part 807.                                             is not necessary to reasonably assure the
                                                  ‘‘confidential.’’ Any information marked                   A postamendments device that has                   safety and effectiveness of the device.
                                                  as ‘‘confidential’’ will not be disclosed               been initially classified in class III                II. Regulatory History of the Devices
                                                  except in accordance with 21 CFR 10.20                  under section 513(f)(1) of the FD&C Act
                                                  and other applicable disclosure law. For                may be reclassified into class I or class                On February 3, 1994, FDA issued a
                                                  more information about FDA’s posting                    II under section 513(f)(3) of the FD&C                Memorandum to manufacturers and
                                                  of comments to public dockets, see 80                   Act. Section 513(f)(3) of the FD&C Act                initial distributors of sharps containers
                                                  FR 56469, September 18, 2015, or access                 provides that FDA acting by order can                 and destroyers used by health care
                                                  the information at: https://www.gpo.gov                 reclassify the device into class I or class           manufacturers to clarify the regulatory
                                                  /fdsys/pkg/FR-2015-09-18/pdf/2015-                      II on its own initiative, or in response              status of sharps destroyer devices (Ref.
                                                  23389.pdf.                                              to a petition from the manufacturer or                1).
                                                                                                          importer of the device. To change the                    On March 6, 1997, FDA approved its
                                                     Docket: For access to the docket to                  classification of the device, the                     first needle destruction device through
                                                  read background documents or the                        proposed new class must have sufficient               its PMA process under section 515 of
                                                  electronic and written/paper comments                   regulatory controls to provide                        the FD&C Act (21 U.S.C. 360e). In the
                                                  received, go to https://                                reasonable assurance of the safety and                June 11, 1997, Federal Register notice
                                                  www.regulations.gov and insert the                      effectiveness of the device for its                   (62 FR 31831), FDA announced a PMA
                                                  docket number, found in brackets in the                 intended use.                                         approval order for Millenium Medical
                                                  heading of this document, into the                         Reevaluation of the data previously                Supply’s Incorporated Needle-EaseTM
                                                  ‘‘Search’’ box and follow the prompts                   before the Agency is an appropriate                   25011 device and the availability of the
                                                  and/or go to the Dockets Management                     basis for subsequent action where the                 Summary of Safety and Effectiveness
                                                  Staff, 5630 Fishers Lane, Rm. 1061,                     reevaluation is made in light of newly                Data for the Device (SSED) (Ref. 2). As
                                                  Rockville, MD 20852.                                    available regulatory authority (see Bell              of the date of issuance of this proposed
                                                                                                          v. Goddard, 366 F.2d 177, 181 (7th Cir.               order, FDA has approved 18 original
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                                                  FOR FURTHER INFORMATION CONTACT:
                                                  Christopher K. Dugard, Center for                       1966); Ethicon, Inc. v. FDA, 762 F.                   PMAs for this device type.2
                                                  Devices and Radiological Health, Food                   Supp. 382, 388–391 (D.D.C. 1991)) or in
                                                  and Drug Administration, 10903 New                      light of changes in ‘‘medical science’’                 1 FDA approved a modified needle destruction


                                                  Hampshire Ave., Bldg. 66, Rm. 2561,                     (Upjohn v. Finch, 422 F.2d 944, 951 (6th              device on February 11, 1998. The device, as
                                                                                                          Cir. 1970)). Whether data before the                  modified, is marketed under the trade name Needle-
                                                  Silver Spring, MD 20993, 240–402–                                                                             Ease®3500.
                                                                                                          Agency are old or new, the ‘‘new
                                                  6031, christopher.dugard@fda.hhs.gov.                                                                           2 See PMA database for original PMAs regulated
                                                                                                          information’’ to support reclassification             under the product code MTV: https://www.access
                                                  SUPPLEMENTARY INFORMATION:                              under 513(f)(3) must be ‘‘valid scientific            data.fda.gov/scripts/cdrh/cfdocs/cfPMA/pma.cfm.



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                                                                       Federal Register / Vol. 82, No. 214 / Tuesday, November 7, 2017 / Proposed Rules                                           51587

                                                    On March 2, 2001, FDA finalized                       subpart C, FDA is proposing to                          • Patient/user exposure to
                                                  guidance entitled, ‘‘Premarket Approval                 reclassify this postamendments class III              environmental contaminants.
                                                  Applications (PMA) for Sharps Needle                    device into class II. FDA believes that               Destroying a used sharp or needle may
                                                  Destruction Devices,’’ describing the                   there is sufficient information available             generate hazardous emissions from the
                                                  Agency’s recommendations for                            to FDA through FDA’s accumulated                      device that may result in infection or
                                                  information to include in PMA                           experience with these devices from                    respiratory problems for the patient
                                                  applications for sharps needle                          review submissions, peer-reviewed                     and/or user. Contamination of the
                                                  destruction devices intended for use in                 literature, and knowledge of similar                  patient environment can occur through
                                                  health care settings (Ref. 3).                          devices to establish special controls that            emission of toxic fumes or infectious
                                                                                                          effectively mitigate the risks to health              aerosol when the device destroys a
                                                  III. Device Description
                                                                                                          identified in section V. Absent the                   sharp by incineration or mechanical
                                                     A sharps needle destruction device is                special controls identified in this                   means, and may result from device
                                                  a postamendments device classified into                 proposed order, general controls                      malfunction (mechanical and/or
                                                  class III under section 513(f)(1) of the                applicable to the device are insufficient             software). The device may also become
                                                  FD&C Act. A sharps needle destruction                   to provide reasonable assurance of the                contaminated through regular usage and
                                                  device is a prescription device intended                safety and effectiveness of the device.               may cause cross-contamination.
                                                  for home use or in professional health                     FDA is proposing to create a separate                • Patient/user burns as a result of
                                                  care facilities to destroy sharps or                    classification regulation for sharps                  excessive heat discharge or spark
                                                  needles used for medical purposes by                    needle destruction devices that will be               formation. Excessive heat or sparks may
                                                  incineration or mechanical means.                       reclassified from class III to II. Under              be generated and discharged from the
                                                  Sharps needle destruction devices are                   this proposed order, if finalized, the                device during destruction of sharps that
                                                  typically electrical devices that can                   sharps needle destruction devices will                may burn the user.
                                                  destruct sharps and/or needles in a                     be identified as a prescription device.                 • Electromagnetic interference. While
                                                  variety of methods (grinding,                           As such, the prescription device must                 in operation, the device may interfere
                                                  incinerating, etc.) that can be either                  satisfy prescription labeling                         with other electrically powered devices,
                                                  portable or stationary. Some of these                   requirements (see § 801.109 (21 CFR                   causing them to malfunction.
                                                  devices may also employ software to                     801.109), Prescription devices).                        • Electrical shock. While in
                                                  provide the user with greater control.                  Prescription devices are exempt from                  operation, the device may discharge
                                                  Please note these devices were                          the requirement for adequate directions               electricity that could shock the user.
                                                  originally identified as needle                         for use for the layperson under section                 • Sharps injury. Incompletely
                                                  destruction devices (product code MTV)                  502(f)(1) of the FD&C Act (21 U.S.C.                  destroyed sharps, physical device
                                                  in FDA SSEDs and product code                           352(f)(1)) and § 801.5 (21 CFR 801.5), as             instability, device malfunctions, or use
                                                  database; however, FDA believes the                     long as the conditions of § 801.109 are               error may pose a risk for a sharps injury
                                                  identification of sharps needle                         met. In this proposed order, if finalized,            to the user.
                                                  destruction device more accurately                      the Agency has identified the special                 VI. Summary of Reasons for
                                                  describes this device type as it can be                 controls under section 513(a)(1)(B) of                Reclassification
                                                  used to destroy devices other than                      the FD&C Act that, together with general
                                                  needles (e.g., sharps).                                 controls, will provide a reasonable                      FDA believes that the sharps needle
                                                                                                          assurance of the safety and effectiveness             destruction devices intended for home
                                                  IV. Proposed Reclassification                                                                                 use or in professional health care
                                                                                                          for sharps needle destruction devices.
                                                     As part of the Center for Devices and                   Section 510(m) of the FD&C Act                     facilities to reduce the incidence of
                                                  Radiological Health’s 2014–2015                         provides that FDA may exempt a class                  needlesticks by destroying sharps and/
                                                  strategic priority ‘‘Strike the Right                   II device from the premarket notification             or needles in a variety of methods
                                                  Balance Between Premarket and                           requirements under section 510(k) of the              (grinding, incinerating, etc.) should be
                                                  Postmarket Data Collection,’’ a                         FD&C Act if FDA determines that                       reclassified from class III to class II in
                                                  retrospective review of class III devices               premarket notification is not necessary               light of new information about the
                                                  subject to PMA was completed to                         to provide reasonable assurance of the                effectiveness of these devices. There is
                                                  determine whether or not, based on our                  safety and effectiveness of the device.               sufficient information to establish
                                                  current understanding of the                            For this type of device, FDA has                      special controls for sharps needle
                                                  technology, reclassification may be                     determined that premarket notification                destruction devices, in addition to
                                                  appropriate. On August 8, 2016, FDA                     is necessary for sharps needle                        general controls, which can provide
                                                  published a document in the Federal                     destruction devices to provide                        reasonable assurance of safety and
                                                  Register entitled ‘‘Retrospective Review                reasonable assurance of the safety and                effectiveness of the device, as general
                                                  of Premarket Approval Application                       effectiveness. Therefore, the Agency                  controls themselves are insufficient to
                                                  Devices; Striking the Balance Between                   does not intend to exempt these                       provide reasonable assurance of its
                                                  Premarket and Postmarket Data                           proposed class II devices from 510(k)                 safety and effectiveness. FDA believes
                                                  Collection’’ in which FDA announced                     requirements. Persons who intend to                   that the risks to health associated with
                                                  plans to reclassify sharps needle                       market this type of device must submit                sharps needle destruction devices
                                                  destruction devices identified with the                 to FDA a 510(k) and receive clearance                 intended for home use or in professional
                                                  MTV product code from class III to class                prior to marketing the device.                        health care facilities to reduce the
                                                  II (81 FR 52445). FDA has found that                                                                          incidence of needlesticks can be
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                                                  sufficient information exists to establish              V. Risks to Health                                    mitigated with special controls and that
                                                  special controls that, together with                      After considering the information                   these mitigations will provide a
                                                  general controls, can provide a                         available to FDA through review                       reasonable assurance of its safety and
                                                  reasonable assurance of safety and                      submissions, peer-reviewed literature,                effectiveness.
                                                  effectiveness for sharps needle                         and knowledge of similar devices, FDA                    Based on a reconsideration of the
                                                  destruction devices.                                    determined the probable risks to health               available information and data, FDA
                                                     In accordance with section 513(f)(3) of              associated with the use of sharps needle              believes that there is valid scientific
                                                  the FD&C Act and 21 CFR part 860,                       destruction devices are as follows:                   evidence of effectiveness for sharps


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                                                  51588                Federal Register / Vol. 82, No. 214 / Tuesday, November 7, 2017 / Proposed Rules

                                                  needle destruction devices to reduce the                   Æ Complete destruction of sharps                      TABLE 1—RISKS TO HEALTH AND MITI-
                                                  incidence of needlesticks.                              intended to be destructed to mitigate                     GATION MEASURES FOR SHARPS
                                                                                                          user injuries from incomplete sharps                      NEEDLE DESTRUCTION DEVICES—
                                                  VII. Summary of Data Upon Which the
                                                                                                          destruction by conducting performance                     Continued
                                                  Reclassification Is Based
                                                                                                          testing such as simulated use
                                                     FDA believes that the identified                     demonstrating complete destruction of                      Identified risk to
                                                  special controls, in addition to general                the sharps and/or needles intended to                                                  Mitigation measures
                                                                                                                                                                          health
                                                  controls, are necessary to provide                      be destroyed.
                                                  reasonable assurance of safety and                                                                              Sharps injury .............   Performance testing.
                                                                                                             Æ Mitigation of injuries from device                                               Software verification,
                                                  effectiveness of these devices. Taking                  instability through characterization of
                                                  into account the probable health                                                                                                                validation, and haz-
                                                                                                          the vibrations and movement generated                                                   ard analysis.
                                                  benefits of the use of the device and the               by the device to ensure device stability                                              Labeling.
                                                  nature and known incidence of the risks                 in the use environment.
                                                  of the device, FDA, on its own initiative,                                                    In addition, FDA is proposing to limit
                                                  is proposing to reclassify this                            • Validation of cleaning and
                                                                                                                                             these devices to prescription use under
                                                                                                          disinfection instructions to demonstrate
                                                  postamendments class III device into                                                       § 801.109. Prescription devices are
                                                  class II. FDA has considered and                        that the device can be safely and
                                                                                                                                             exempt from the requirement for
                                                                                                          effectively reprocessed after use to
                                                  analyzed the following information: An                                                     adequate directions for use for the
                                                  inclusive search of the Agency’s                        minimize the risk of patient/user cross-
                                                                                                          contamination.                     layperson under section 502(f)(1) of the
                                                  Manufacturer and User Facility Device                                                      FD&C Act and § 801.5, as long as the
                                                  Experience (MAUDE) database, which                         • Performance testing ensures   conditions of § 801.109 are met
                                                  shows no adverse events for sharps                      electromagnetic compatibility with (referring to 21 U.S.C. 352(f)(1)). Under
                                                  needle destruction devices; data                        other devices under conditions which
                                                                                                                                             21 CFR 807.81, the device would
                                                  contained in PMAs approved 6 or more                    are consistent with the intended   continue to be subject to 510(k)
                                                  years before the date of this proposal                  environment of device use.         notification requirements. FDA does not
                                                  (reviewed under section 520(h)(4) of the
                                                                                                             • Electrical safety testing ensures the
                                                                                                                                             believe that clinical data is necessary to
                                                  FD&C Act, also known as the 6-year                                                         mitigate the identified risks to health for
                                                                                                          risk of shock to the patient/user is
                                                  rule); a review of sharps containers                                                       sharps needle destruction devices. FDA
                                                                                                          minimized.
                                                  regulated under 21 CFR 880.5570,                                                           may request clinical data to evaluate
                                                  which have similar intended uses, but                      • Software hazard analysis, as well as
                                                                                                                                             substantial equivalence when a
                                                  different technology, and are currently                 software verification and validation,
                                                                                                                                             manufacturer includes new indications
                                                  regulated as class II devices; and one                  ensures that software performs as
                                                                                                                                             for use, such as indications for disease
                                                  relevant article found from a literature                intended and potential software
                                                                                                                                             prevention or organism destruction.
                                                  search that discussed the benefits and                  malfunctions do not impact the
                                                                                                                                                This reclassification order and the
                                                  the probable risks of these devices (Ref.               performance of the device.
                                                                                                                                             identified special controls, if finalized,
                                                  4).                                                        • Labeling to ensure proper use of the
                                                                                                                                             would provide sufficient detail
                                                  VIII. Proposed Special Controls                         device, including warnings of the  regarding FDA’s requirements to
                                                                                                          generation of excessive heat, potential
                                                                                                                                             reasonably assure safety and
                                                     FDA believes that the following                      for needle stick injuries, instructions for
                                                                                                                                             effectiveness of sharps needle
                                                  special controls, together with general                 reprocessing, and instructions for destruction devices. FDA intends to
                                                  controls, are sufficient to mitigate the                installation (e.g., on a stable surface,
                                                                                                                                             withdraw the final guidance entitled,
                                                  risks to health described in section V                  adequate ventilation).             ‘‘Premarket Approval Applications
                                                  and provide a reasonable assurance of                                                      (PMA) for Sharps Needle Destruction
                                                                                                             Table 1 shows how FDA believes
                                                  safety and effectiveness for sharps                                                        Devices; Final Guidance for Industry
                                                                                                          these special controls will mitigate each
                                                  needle destruction devices.                                                                and FDA’’ issued in 2001 upon
                                                                                                          risk to health described in section V.
                                                     • Performance testing will                                                              finalization of this proposed
                                                  demonstrate:
                                                                                                           TABLE 1—RISKS TO HEALTH AND MITI- reclassification order (Ref. 3).
                                                     Æ The device’s ability to contain or
                                                                                                            GATION MEASURES FOR SHARPS IX. Analysis of Environmental Impact
                                                  ventilate aerosols or fumes from device
                                                  operation that may result in                               NEEDLE DESTRUCTION DEVICES                              The Agency has determined under 21
                                                  environmental contamination and cross-                                                                          CFR 25.34(b) that this action is of a type
                                                  contamination. Performance testing will                       Identified risk to       Mitigation measures      that does not individually or
                                                                                                                     health
                                                  demonstrate that harmful fumes, such as                                                                         cumulatively have a significant effect on
                                                  ozone, are not emitted by the device                    Patient/user exposure         Performance testing.      the human environment. Therefore,
                                                  during destruction of sharps needles.                     to environmental            Reprocessing valida-      neither an environmental assessment
                                                     Æ Excessive heat or sparks are not                     contaminants.                 tion.                   nor an environmental impact statement
                                                  generated during device operation that                                                Software verification,    is required.
                                                  may injure users or patients through                                                    validation, and haz-
                                                  characterization of the heat dissipation                                                ard analysis.           X. Paperwork Reduction Act of 1995
                                                  profile from the heat source to the                                                   Labeling.                   FDA tentatively concludes that this
nshattuck on DSK9F9SC42PROD with PROPOSALS




                                                  enclosure surface, and the point of                     Patient/user burns .....      Performance testing.      proposed order contains no new
                                                                                                                                        Labeling.
                                                  contact between the held syringe and                                                                            collections of information. Therefore,
                                                                                                          Electrical shock .........    Electrical Safety Test-
                                                  the user. Performance testing will                                                      ing.
                                                                                                                                                                  clearance by the Office of Management
                                                  ensure the heat generated through                                                     Labeling.                 and Budget (OMB) under the Paperwork
                                                  normal operation of the device will not                 Electromagnetic inter-        Electromagnetic           Reduction Act of 1995 (PRA) (44 U.S.C.
                                                  harm users or patients or affect circuit                  ference.                      Compatibility           3501–3520) is not required. This
                                                  performance and useful life of the                                                      (EMC) Testing.          proposed order refers to previously
                                                  device.                                                                               Labeling.                 approved collections of information


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                                                                       Federal Register / Vol. 82, No. 214 / Tuesday, November 7, 2017 / Proposed Rules                                                 51589

                                                  found in FDA regulations. These                         ■ 2. Add § 880.6210 to subpart G to read                Dated: November 2, 2017.
                                                  collections of information are subject to               as follows:                                           Anna K. Abram,
                                                  review by OMB under the PRA. The                                                                              Deputy Commissioner for Policy, Planning,
                                                  collections of information in 21 CFR                    § 880.6210    Sharps needle destruction               Legislation, and Analysis.
                                                                                                          device.
                                                  part 807, subpart E have been approved                                                                        [FR Doc. 2017–24191 Filed 11–6–17; 8:45 am]
                                                  under OMB control number 0910–0120                        (a) Identification. A sharps needle                 BILLING CODE 4164–01–P
                                                  and the collections of information under                destruction device is a prescription
                                                  21 CFR part 801 have been approved                      device that is intended to destroy
                                                  under OMB control number 0910–0485.                     needles or sharps used for medical                    LIBRARY OF CONGRESS
                                                                                                          purposes by incineration or mechanical
                                                  XI. Proposed Effective Date
                                                                                                          means.                                                Copyright Royalty Board
                                                    FDA proposes that any final order                       (b) Classification. Class II (special
                                                  based on this proposal become effective                 controls). The special controls for this              37 CFR Part 381
                                                  30 days after the date of its publication               device are:                                           [Docket No. 16–CRB–0002–PBR (2018–
                                                  in the Federal Register.
                                                                                                            (1) Performance testing must                        2022)]
                                                  XII. References                                         demonstrate the following during
                                                                                                          operation of the device:                              Determination of Rates and Terms for
                                                    The following references are on                                                                             Public Broadcasting (PB III)
                                                  display in the Dockets Management                         (i) The device safely contains or
                                                  Staff (see ADDRESSES) and are available                 ventilates aerosols or fumes from device              AGENCY:  Copyright Royalty Board (CRB),
                                                  for viewing by interested persons                       operation.                                            Library of Congress.
                                                  between 9 a.m. and 4 p.m., Monday                         (ii) Excessive heat or sparks are not               ACTION: Proposed rule.
                                                  through Friday; they are also available                 generated that may injure users or
                                                  electronically at https://                              patients.                                             SUMMARY:    The Copyright Royalty Judges
                                                  www.regulations.gov. FDA has verified                                                                         solicit comments on proposed rates and
                                                                                                            (iii) Simulated use testing must                    terms for use of certain works in
                                                  the Web site addresses, as of the date
                                                                                                          demonstrate sharps and/or needles are                 connection with noncommercial
                                                  this document publishes in the Federal
                                                                                                          completely destroyed using a range of                 broadcasting for the period commencing
                                                  Register, but Web sites are subject to
                                                                                                          types and sizes of sharps sufficient to               January 1, 2018, and ending on
                                                  change over time.
                                                                                                          represent actual use.                                 December 31, 2022.
                                                    1. FDA memorandum ‘‘To Manufacturers
                                                  and Initial Distributors of Sharps Containers
                                                                                                            (iv) Simulated use testing must                     DATES: Comments and objections, if any,
                                                  and Destroyers Used by Health Care                      demonstrate that the device is                        are due on or before November 27, 2017.
                                                  Professionals,’’ February 3, 1994, available at:        physically stable on the surface for                  ADDRESSES: You may submit comments
                                                  https://www.fda.gov/downloads/medical                   which it is intended to be mounted to                 and objections, identified by docket
                                                  devices/deviceregulationandguidance/                    ensure the risk of harm to the patient/               number 16–CRB–0002–PBR (2018–
                                                  guidancedocuments/ucm070679.pdf.                        user as a result of the device falling is
                                                    2. FDA ‘‘Premarket Approval of Millenium
                                                                                                                                                                2022), by any of the following methods:
                                                                                                          minimized.                                              CRB’s electronic filing application:
                                                  Medical Supply Incorporated Needle-EaseTM
                                                  2501–ACTION,’’ March 6, 1997, available at:               (2) Validation of cleaning and                      Submit comments online in eCRB at
                                                  https://www.accessdata.fda.gov/cdrh_docs/               disinfection instructions must                        https://app.crb.gov/.
                                                  pdf/p960044.pdf.                                        demonstrate that the device can be                      U.S. mail: Copyright Royalty Board,
                                                    3. ‘‘Premarket Approval Applications                  safely and effectively reprocessed after              P.O. Box 70977, Washington, DC 20024–
                                                  (PMA) for Sharps Needle Destruction                     use per the recommended cleaning and                  0977; or
                                                  Devices; Final Guidance for Industry and                disinfection protocol in the instructions               Overnight service (only USPS Express
                                                  FDA,’’ March 2, 2001, available at: https://            for use.                                              Mail is acceptable): Copyright Royalty
                                                  www.fda.gov/downloads/MedicalDevices/
                                                  DeviceRegulationandGuidance/Guidance                      (3) Analysis and/or testing must                    Board, P.O. Box 70977, Washington, DC
                                                  Documents/ucm073601.pdf.                                validate electromagnetic compatibility                20024–0977; or
                                                    4. Tamplin S.A., D. Davidson, B. Powis,               (EMC) and electrical safety, including                  Commercial courier: Address package
                                                  and Z. O’Leary, ‘‘Issues and Options for the            the safety of any battery used in the                 to: Copyright Royalty Board, Library of
                                                  Safe Destruction and Disposal of Used                   device, under conditions which are                    Congress, James Madison Memorial
                                                  Injection Materials,’’ Waste Management, vol.           consistent with the intended                          Building, LM–403, 101 Independence
                                                  25, pp. 655–665, 2005.                                  environment of device use.                            Avenue SE., Washington, DC 20559–
                                                  List of Subjects in 21 CFR Part 880                                                                           6000. Deliver to: Congressional Courier
                                                                                                            (4) Software verification, validation,
                                                                                                                                                                Acceptance Site, 2nd Street NE. and D
                                                     Medical devices.                                     and hazard analysis must be performed.
                                                                                                                                                                Street NE., Washington, DC; or
                                                     Therefore, under the Federal Food,                     (5) Labeling must include:                            Hand delivery: Library of Congress,
                                                  Drug, and Cosmetic Act (21 U.S.C. 321                     (i) A clear description of the device               James Madison Memorial Building, LM–
                                                  et seq., as amended) and under                          and its technological features;                       401, 101 Independence Avenue SE.,
                                                  authority delegated to the Commissioner                   (ii) How the device is to be used,                  Washington, DC 20559–6000.
                                                  of Food and Drugs, it is proposed that                  including validated cleaning and                        Instructions: Unless submitting
                                                  21 CFR part 880 be amended as follows:                                                                        online, commenters must submit an
nshattuck on DSK9F9SC42PROD with PROPOSALS




                                                                                                          disinfection instructions;
                                                                                                                                                                original, five paper copies, and an
                                                  PART 880—GENERAL HOSPITAL AND                             (iii) Relevant precautions and                      electronic version on a CD. All
                                                  PERSONAL USE DEVICES                                    warnings based on performance and in-                 submissions must include the CRB’s
                                                                                                          use testing to ensure proper use of the               name and docket number. All
                                                  ■ 1. The authority citation for part 880                device; and                                           submissions will be posted without
                                                  continues to read as follows:                             (iv) Instructions to install device in              change to eCRB on https://www.crb.gov
                                                    Authority: 21 U.S.C. 351, 360, 360c, 360e,            adequately ventilated area and stable                 including any personal information
                                                  360j, 371.                                              area.                                                 provided.


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Document Created: 2018-10-25 10:25:29
Document Modified: 2018-10-25 10:25:29
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionProposed Rules
ActionProposed order.
DatesSubmit either electronic or written comments on the proposed order by January 8, 2018. Please see section XI of this document for the proposed effective date when the new requirements apply and for the proposed effective date of a final order based on this proposed order.
ContactChristopher K. Dugard, Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 66, Rm. 2561, Silver Spring, MD 20993, 240- 402-6031, [email protected]
FR Citation82 FR 51585 

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