83_FR_23 83 FR 22 - Medical Devices; General and Plastic Surgery Devices; Classification of the Irrigating Wound Retractor Device

83 FR 22 - Medical Devices; General and Plastic Surgery Devices; Classification of the Irrigating Wound Retractor Device

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Federal Register Volume 83, Issue 1 (January 2, 2018)

Page Range22-24
FR Document2017-28255

The Food and Drug Administration (FDA or we) is classifying the irrigating wound retractor device into class II (special controls). The special controls that apply to the device type are identified in this order and will be part of the codified language for the irrigating wound retractor device's classification. We are taking this action because we have determined that classifying the device into class II (special controls) will provide a reasonable assurance of safety and effectiveness of the device. We believe this action will also enhance patients' access to beneficial innovative devices, in part by reducing regulatory burdens.

Federal Register, Volume 83 Issue 1 (Tuesday, January 2, 2018)
[Federal Register Volume 83, Number 1 (Tuesday, January 2, 2018)]
[Rules and Regulations]
[Pages 22-24]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-28255]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

21 CFR Part 878

[Docket No. FDA-2017-N-6596]


Medical Devices; General and Plastic Surgery Devices; 
Classification of the Irrigating Wound Retractor Device

AGENCY: Food and Drug Administration, HHS.

[[Page 23]]


ACTION: Final order.

-----------------------------------------------------------------------

SUMMARY: The Food and Drug Administration (FDA or we) is classifying 
the irrigating wound retractor device into class II (special controls). 
The special controls that apply to the device type are identified in 
this order and will be part of the codified language for the irrigating 
wound retractor device's classification. We are taking this action 
because we have determined that classifying the device into class II 
(special controls) will provide a reasonable assurance of safety and 
effectiveness of the device. We believe this action will also enhance 
patients' access to beneficial innovative devices, in part by reducing 
regulatory burdens.

DATES: This order is effective January 2, 2018. The classification was 
applicable on December 16, 2016.

FOR FURTHER INFORMATION CONTACT: Terrell Cunningham, Center for Devices 
and Radiological Health, Food and Drug Administration, 10903 New 
Hampshire Ave., Bldg. 66, Rm. 2502, Silver Spring, MD 20993-0002, 301-
796-6299, [email protected].

SUPPLEMENTARY INFORMATION:

I. Background

    Upon request, FDA has classified the irrigating wound retractor 
device as class II (special controls), which we have determined will 
provide a reasonable assurance of safety and effectiveness. In 
addition, we believe this action will enhance patients' access to 
beneficial innovation, in part by reducing regulatory burdens by 
placing the device into a lower device class than the automatic class 
III assignment.
    The automatic assignment of class III occurs by operation of law 
and without any action by FDA, regardless of the level of risk posed by 
the new device. Any device that was not in commercial distribution 
before May 28, 1976, is automatically classified as, and remains 
within, class III and requires premarket approval unless and until FDA 
takes an action to classify or reclassify the device (see 21 U.S.C. 
360c(f)(1)). We refer to these devices as ``postamendments devices'' 
because they were not in commercial distribution prior to the date of 
enactment of the Medical Device Amendments of 1976, which amended the 
Federal Food, Drug, and Cosmetic Act (FD&C Act).
    FDA may take a variety of actions in appropriate circumstances to 
classify or reclassify a device into class I or II. We may issue an 
order finding a new device to be substantially equivalent under section 
513(i) of the FD&C Act (21 U.S.C. 360c(i)) to a predicate device that 
does not require premarket approval. We determine whether a new device 
is substantially equivalent to a predicate by means of the procedures 
for premarket notification under section 510(k) of the FD&C Act and 
part 807 (21 U.S.C. 360(k) and 21 CFR part 807, respectively).
    FDA may also classify a device through ``De Novo'' classification, 
a common name for the process authorized under section 513(f)(2) of the 
FD&C Act. Section 207 of the Food and Drug Administration Modernization 
Act of 1997 established the first procedure for De Novo classification 
(Pub. L. 105-115). Section 607 of the Food and Drug Administration 
Safety and Innovation Act modified the De Novo application process by 
adding a second procedure (Pub. L. 112-144). A device sponsor may 
utilize either procedure for De Novo classification.
    Under the first procedure, the person submits a 510(k) for a device 
that has not previously been classified. After receiving an order from 
FDA classifying the device into class III under section 513(f)(1) of 
the FD&C Act, the person then requests a classification under section 
513(f)(2).
    Under the second procedure, rather than first submitting a 510(k) 
and then a request for classification, if the person determines that 
there is no legally marketed device upon which to base a determination 
of substantial equivalence, that person requests a classification under 
section 513(f)(2) of the FD&C Act.
    Under either procedure for De Novo classification, FDA shall 
classify the device by written order within 120 days. The 
classification will be according to the criteria under section 
513(a)(1) of the FD&C Act. Although the device was automatically placed 
within class III, the De Novo classification is considered to be the 
initial classification of the device.
    We believe this De Novo classification will enhance patients' 
access to beneficial innovation, in part by reducing regulatory 
burdens. When FDA classifies a device into class I or II via the De 
Novo process, the device can serve as a predicate for future devices of 
that type, including for 510(k)s (see 21 U.S.C. 360c(f)(2)(B)(i)). As a 
result, other device sponsors do not have to submit a De Novo request 
or premarket approval application in order to market a substantially 
equivalent device (see 21 U.S.C. 360c(i), defining ``substantial 
equivalence''). Instead, sponsors can use the less-burdensome 510(k) 
process, when necessary, to market their device.

II. De Novo Classification

    On August 13, 2015, Prescient Surgical submitted a request for De 
Novo classification of the CleanCisionTM Wound Retraction 
and Protection System. FDA reviewed the request in order to classify 
the device under the criteria for classification set forth in section 
513(a)(1) of the FD&C Act.
    We classify devices into class II if general controls by themselves 
are insufficient to provide reasonable assurance of safety and 
effectiveness, but there is sufficient information to establish special 
controls that, in combination with the general controls, provide 
reasonable assurance of the safety and effectiveness of the device for 
its intended use (see 21 U.S.C. 360c(a)(1)(B)). After review of the 
information submitted in the request, we determined that the device can 
be classified into class II with the establishment of special controls. 
FDA has determined that these special controls, in addition to the 
general controls, will provide reasonable assurance of the safety and 
effectiveness of the device.
    Therefore, on December 16, 2016, FDA issued an order to the 
requester classifying the device into class II. FDA is codifying the 
classification of the device by adding 21 CFR 878.4371. We have named 
the generic type of device irrigating wound retractor device, and it is 
identified as a prescription device intended to be used by a surgeon to 
retract the surgical incision, to provide access to the surgical wound, 
to protect and irrigate the surgical wound, and to serve as a conduit 
for removal of fluid from the surgical wound.
    FDA has identified the following risks to health associated 
specifically with this type of device and the measures required to 
mitigate these risks in table 1.

Table 1--Irrigating Wound Retractor Device Risks and Mitigation Measures
------------------------------------------------------------------------
            Identified risks                   Mitigation measures
------------------------------------------------------------------------
Adverse tissue reaction................  Biocompatibility evaluation.
Tissue or wound damage.................  Non-clinical performance
                                          testing, Shelf life testing,
                                          and Labeling.

[[Page 24]]

 
Infection..............................  Sterilization validation, Non-
                                          clinical performance testing,
                                          Shelf life testing, and
                                          Labeling.
------------------------------------------------------------------------

    FDA has determined that special controls, in combination with the 
general controls, address these risks to health and provide reasonable 
assurance of safety and effectiveness. For a device to fall within this 
classification, and thus avoid automatic classification in class III, 
it would have to comply with the special controls named in this final 
order. The necessary special controls appear in the regulation codified 
by this order. This device is subject to premarket notification 
requirements under section 510(k) of the FD&C Act.
    At the time of classification, irrigating wound retractor devices 
are for prescription use only. 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 21 CFR 
801.5, as long as the conditions of 21 CFR 801.109 are met (referring 
to 21 U.S.C. 352(f)(1)).

III. 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.

IV. Paperwork Reduction Act of 1995

    This final order establishes special controls that refer to 
previously approved collections of information found in other FDA 
regulations. These collections of information are subject to review by 
the Office of Management and Budget (OMB) under the Paperwork Reduction 
Act of 1995 (44 U.S.C. 3501-3520). The collections of information in 
the guidance document ``De Novo Classification Process (Evaluation of 
Automatic Class III Designation)'' have been approved under OMB control 
number 0910-0844; the collections of information in 21 CFR part 814, 
subparts A through E, regarding premarket approval, have been approved 
under OMB control number 0910-0231; the collections of information part 
807, subpart E, regarding premarket notification submissions, have been 
approved under OMB control number 0910-0120, and the collections of 
information in 21 CFR part 801, regarding labeling, have been approved 
under OMB control number 0910-0485.

List of Subjects in 21 CFR Part 878

    Medical devices.

    Therefore, under the Federal Food, Drug, and Cosmetic Act and under 
authority delegated to the Commissioner of Food and Drugs, 21 CFR part 
878 is amended as follows:

PART 878--GENERAL AND PLASTIC SURGERY DEVICES

0
1. The authority citation for part 878 continues to read as follows:

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


0
2. Add Sec.  878.4371 to subpart E to read as follows:


Sec.  878.4371   Irrigating wound retractor device.

    (a) Identification. An irrigating wound retractor device is a 
prescription device intended to be used by a surgeon to retract the 
surgical incision, to provide access to the surgical wound, to protect 
and irrigate the surgical wound, and to serve as a conduit for removal 
of fluid from the surgical wound.
    (b) Classification. Class II (special controls). The special 
controls for this device are:
    (1) The patient-contacting components of the device must be 
demonstrated to be biocompatible and evaluated for particulate matter.
    (2) Performance data must demonstrate the sterility and 
pyrogenicity of the patient-contacting components of the device.
    (3) Performance data must support shelf life by demonstrating 
continued functionality and sterility of the device over the identified 
shelf life.
    (4) Non-clinical performance testing must demonstrate that the 
device performs as intended under anticipated conditions of use. 
Performance testing must:
    (i) Characterize the tear resistance, tensile strength, and 
elongation properties of the barrier material;
    (ii) Demonstrate that the liquid barrier material is resistant to 
penetration by blood, and is non-flammable;
    (iii) Characterize the forces required to deploy the device;
    (iv) Characterize the device's ranges of operation, including flow 
rates and maximum suction pressures;
    (v) Demonstrate the ability of the device irrigation apparatus to 
maintain a user defined or preset flow rate to the surgical wound; and
    (vi) Demonstrate the ability of the device to maintain user defined 
or preset removal rates of fluid from the surgical wound.
    (5) The labeling must include or state the following information:
    (i) Device size or incision length range;
    (ii) Method of sterilization;
    (iii) Flammability classification;
    (iv) Non-pyrogenic;
    (v) Shelf life; and
    (vi) Maximum flow rate and suction pressure.

    Dated: December 26, 2017.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2017-28255 Filed 12-29-17; 8:45 am]
BILLING CODE 4164-01-P



                                                                                                              Vol. 83                            Friday,
                                                                                                              No. 23                             February 2, 2018

                                                                                                              Pages 4831–5028


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                                                                                                                                                                                                        III

                                                        Contents                                                                              Federal Register
                                                                                                                                              Vol. 83, No. 23

                                                                                                                                              Friday, February 2, 2018



                                                        Agriculture Department                                                                Education Department
                                                        See Food Safety and Inspection Service                                                NOTICES
                                                        See Rural Housing Service                                                             Agency Information Collection Activities; Proposals,
                                                                                                                                                 Submissions, and Approvals:
                                                        Centers for Disease Control and Prevention                                             Campus Safety and Security Survey, 4912
                                                        NOTICES
                                                        Agency Information Collection Activities; Proposals,
                                                           Submissions, and Approvals, 4917–4918                                              Employment and Training Administration
                                                                                                                                              NOTICES
                                                        Coast Guard                                                                           Agency Information Collection Activities; Proposals,
                                                        RULES                                                                                    Submissions, and Approvals:
                                                        2017 Quarterly Listings; Safety Zones, Security Zones,                                 Trade Adjustment Assistance Community College and
                                                            Special Local Regulations, Drawbridge Operation                                        Career Training Grant Program Reporting
                                                            Regulations and Regulated Navigation Areas, 4838–                                      Requirements, 4926–4927
                                                            4844
                                                        Drawbridge Operations:                                                                Energy Department
                                                          Anacostia River, Washington, DC, 4845                                               See Federal Energy Regulatory Commission
                                                        PROPOSED RULES                                                                        NOTICES
                                                        Anchorage Grounds:                                                                    Meetings:
                                                         Saint Lawrence Seaway, Cape Vincent, NY, 4882–4884                                    Methane Hydrate Advisory Committee, 4913
                                                        Commerce Department
                                                        See Economic Analysis Bureau                                                          Environmental Protection Agency
                                                        See Foreign-Trade Zones Board                                                         RULES
                                                        See Industry and Security Bureau                                                      Air Quality State Implementation Plans; Approvals and
                                                        See International Trade Administration                                                    Promulgations:
                                                        See National Oceanic and Atmospheric Administration                                     Indiana; Regional Haze Five-Year Progress Report, 4847–
                                                                                                                                                    4848
                                                        Committee for Purchase From People Who Are Blind or                                     Ohio; Infrastructure SIP Requirements for 2012 PM2.5
                                                           Severely Disabled                                                                        NAAQS; Multistate Transport, 4845–4847
                                                        NOTICES                                                                               PROPOSED RULES
                                                        Procurement List; Additions and Deletions, 4910–4911                                  Air Quality State Implementation Plans; Approvals and
                                                                                                                                                  Promulgations:
                                                        Comptroller of the Currency                                                             Regional Haze Plan and Prong 4 (Visibility) for 2012
                                                        NOTICES                                                                                     PM2.5, 2010 NO2, 2010 SO2, and 2008 Ozone
                                                        Agency Information Collection Activities; Proposals,                                        NAAQS; GA, 4886–4890
                                                           Submissions, and Approvals:                                                        NOTICES
                                                         Bank Activities and Operations; Investment in Bank                                   Environmental Impact Statements; Availability, etc.:
                                                              Premises, 4955–4956                                                               Weekly Receipts, 4914
                                                         Company-Run Annual Stress Test Reporting Template
                                                              and Documentation for Covered Institutions with                                 Equal Employment Opportunity Commission
                                                              Total Consolidated Assets of 50 Billion Dollars or                              NOTICES
                                                              More under Dodd-Frank Wall Street Reform and                                    Agency Information Collection Activities; Proposals,
                                                              Consumer Protection Act, 4957–4959                                                 Submissions, and Approvals, 4914–4915
                                                         Customer Complaint Form, 4959–4960
                                                         International Regulation, 4956–4957
                                                                                                                                              Federal Aviation Administration
                                                        Copyright Office, Library of Congress                                                 RULES
                                                        PROPOSED RULES                                                                        Amendment of Class E Airspace:
                                                        Public Hearings:                                                                       Millersburg and Coshocton, OH, 4833–4834
                                                          Exemptions to Permit Circumvention of Access Controls                               PROPOSED RULES
                                                              on Copyrighted Works, 4884–4886                                                 Amendment of Class D and Class E Airspace:
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                                                                                                                                                Atwater, CA, 4866–4868
                                                        Defense Department                                                                    Amendment of Class D and E Airspace:
                                                        See Navy Department                                                                     Casper, WY, 4865–4866
                                                                                                                                              Establishment of Class E Airspace, Amendment of Class D
                                                        Economic Analysis Bureau                                                                  Airspace, and Revocation of Class E Airspace:
                                                        RULES                                                                                   Tacoma, WA, 4863–4864
                                                        International Services Surveys:                                                       NOTICES
                                                          BE–120 Benchmark Survey of Transactions in Selected                                 Environmental Assessments; Availability, etc.:
                                                              Services and Intellectual Property with Foreign                                   Paulding Northwest Atlanta Airport, Dallas, GA, 4953–
                                                              Persons, 4834–4838                                                                    4954


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Document Created: 2017-12-29 23:38:32
Document Modified: 2017-12-29 23:38:32
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionRules and Regulations
ActionFinal order.
DatesThis order is effective January 2, 2018. The classification was applicable on December 16, 2016.
ContactTerrell Cunningham, Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 66, Rm. 2502, Silver Spring, MD 20993-0002, 301- 796-6299, [email protected]
FR Citation83 FR 22 

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