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AcknowledgementsThanks to the following organizations for their invaluable assistance in preparing this report:
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Table of Contents
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Part 1 Advances in Patient Care
FETAL OXYGEN MONITOR
MIDDLE EAR SURGICAL IMPLANT
ROBOT-ASSISTED SURGERY
DIGITAL MAMMOGRAPHY
MAPPING THE HEART AND TREATING ARRHYTHMIA
LASER-BASED EYE SURGERY
TREATING GASTROESOPHAGEAL REFLUX DISEASE
FDA Consumer Web Sites
Device Databases
Consumer Information
Original PMA/HDE Approvals for Fiscal Year 2000
Significant Medical Device Breakthroughs
Devices Approved via PMA/HDE
510(k) Clearances or Automatic Evaluations of Class III
Designation Devices (AE)
ODE Guidance Documents
Draft Guidance Documents on the Internet for Comment Purposes
Only
Part 3 Key Performance Indices
Premarket Approval Applications (PMAs)
Figure 1. Average Review Time for PMA Decision Cohort
Approvals
Figure 2. Original Receipt Cohort PMAs Received and Filed
Figure 3. Receipt Cohort PMA Average Elapsed
Figure 4. Annual Receipts and Actions for PMA Supplement Decision
Cohort
Figure 5. Average Review Time for PMA Supplements
Real-Time Review of PMA Supplements
Product Development Protocols (PDPs)
Modular PMA Review
Humanitarian Device Exemption (HDE) Applications
Investigational Device Exemptions (IDE)
Premarket Notification (510(k)s)
Figure 7. Average 510(k) Review Time for Decision Cohort
Figure 8. Receipts and Actions for 510(k) Receipt Cohorts*
Figure 9. FDA Days from Receipt to Final Action for 510(k)
Receipt Cohorts*
Third-Party Review of 510(k)s
Special 510(k)s
Abbreviated 510(k)s
Significant Medical Device Breakthroughs
Classification Actions
Automatic Evaluation of Class III Designation
Final Reclassification Actions
Class II Exemption Petitions
Final 515(b) Calls for PMAs
Guidance for Industry and Reviewers
Least Burdensome
Significant Jurisdictional Issues Involving Devices in FY 2000
Advisory Panel Activities
ODE Integrity Program
Freedom of Information Requests
Congressional Inquiries
Publications
ODE Vendor Day
Site Visits
In-House Training
Mentoring Program
Other Employee Programs
Minority Recruitment
Computer Tracking Systems
Office Automation
Electronic Submissions
Video Conferencing
World Wide Web Activity
Device Databases
Consumer Information
Table 3. PMA/HDE/IDE/510(k) Submissions Received
Table 4. Original PMA Decision Cohort Performance
Table 5. Original PMA Receipt Cohort Performance
Table 6. PMA Supplement Decision Cohort Performance
Table 7. PMA Supplement Receipt Cohort Performance
Table 8. HDE Submissions Received FY97 FY00
Table 9. Original HDE Decision Cohort Performance FY97
FY00
Table 10. HDE Supplement Decision Cohort Performance FY97
FY00
Table 11. Original IDEs FY 96 - FY 00
Table 12. IDE AmendmentsFY 96 - FY 00
Table 13. IDE Supplements FY 96 - FY 00
Table 14. 510(k) Decision Cohort Performance FY 96 - FY 00
Table 15. 510(k) Receipt Cohort Performance FY 96 - FY 00
Appendix A Summary of Major ODE Programs
Premarket Approval Applications (PMAs)
Product Development Protocols (PDPs)
Humanitarian Device Exemptions (HDEs)
PMA Supplements
Investigational Device Exemptions (IDEs)
IDE Amendments
IDE Supplements
Premarket Notifications (510(k))
Appendix C Selected FDA Websites
Last year the Office of Device Evaluation (ODE) approved and cleared thousands of devices used to diagnose and treat a wide variety of medical conditions. For a complete listing of newly approved devices, please see Part 2 INDUSTRY INFORMATION. A new Premarket Approval Application (PMA) approval website describing recently approved devices with patient information is now available at http://www.fda.gov/cdrh/mda/index.html. Below we highlight several medical devices approved during this past fiscal year that we believe will have a major impact on patient care.
FETAL
OXYGEN MONITOR -- The OxiFirst Fetal Oxygen Saturation Monitoring System,
Mallinckrodt, Nellcor Perinatal Business, is a new type of fetal monitor that
measures oxygen saturation in the babys blood as a sign of fetal health during labor
and delivery. The OxiFirst sensor is inserted into the mothers uterus and
placed against the temple or cheek of the fetus. The monitor displays fetal oxygen
saturation as percent of oxygen in the fetuss blood. Oxifirst is used along
with conventional electronic fetal monitoring when the fetal heart rate is
"non-reassuring," that is, when the rate indicates that the baby may be in
distress due to lack of adequate oxygen. It is intended for use only on single (not
multiple) fetuses of at least 36 weeks gestation, where the "mothers
water" has broken and the fetal head is in the normal, head down position for
delivery.
MIDDLE EAR SURGICAL IMPLANT -- The Vibrant Soundbridge, Symphonix
Devices, Inc., is a
surgically implanted hearing device
intended to help adults with moderate to severe nerve hearing loss. The device is
implanted behind the ear in the temporal (skull) bone. It converts sound to mechanical
energy that is transferred to the middle ear. This energy vibrates delicate structures in
the middle ear very much the way normal sound does. The brain interprets the vibrations as
sound. During implant surgery, the surgeon implants a receiver behind the ear. A wire
leads from the receiver to a small electromagnet attached to one of the middle ear bones.
As an alternative to traditional hearing aids, adults with a moderate to severe
sensorineural hearing loss may choose this device. Adults who choose this device should
have already tried using appropriately fitting external hearing aids.
ROBOT-ASSISTED
SURGERY -- The Intuitive Surgical da Vinci Surgical System, Intuitive
Surgical Inc., is a robotic device that enables a surgeon to perform certain types of
surgery while seated at a console with a computer and video monitor. The surgeon uses
handgrips and foot pedals attached to the computer console to control three robotic arms
that perform the surgery using a variety of surgical tools. The robotic arms, which have a
"wrist" built into the end of the surgical tools, give surgeons additional
manipulation ability during minimal invasive laparoscopic surgery, enabling easier, more
intricate motion and better control of surgical tools. The device is an alternative to
traditional open surgery or minimally invasive manual laparoscopic surgery in an operating
room environment for procedures such as gall bladder disease or gastro-esophageal reflux
disease (severe heartburn).
DIGITAL MAMMOGRAPHY -- The
Senographe 2000D Full Field Digital Mammography
System, General
Electric Medical Systems, is an x-ray mammography system that employs a digital
receptor to capture images of the breast. These images can then be printed to film or
displayed on a high-resolution workstation for interpretation by a qualified mammographer.
The device passes x-rays through the breast to a receptor. In this case the receptor
converts the received x-rays into digital signals that can be stored for subsequent
retrieval and display. A mammographer then interprets the displayed image of the breast to
determine whether the breast is normal or whether additional testing is required. This is
an alternative to traditional screening and diagnostic mammography. It can be used
whenever a traditional mammography examination is indicated.
MAPPING
THE HEART AND TREATING ARRHYTHMIA The NAVI-STAR®
Diagnostic/Ablation Deflectable Tip Catheter, Biosense Webster, Inc., is a
steerable, multi-electrode catheter with a deflectable tip. The catheter provides
information for electrophysiological mapping of the heart and transmits RF
(radiofrequency) current through the catheter tip electrode for ablation purposes. When
used with the CARTO® system and REF-STAR® reference device, a
real-time 3D reconstruction of the heart chamber is provided. For ablation, the catheter
is used in conjunction with a compatible RF generator and a commercially available
dispersive pad. The NAVI-STAR® catheter is available with either a
thermocouple or thermistor temperature sensor embedded in the tip electrode. A magnetic
field location sensor (location sensor) embedded in the tip transmits location information
to the CARTOsystem. Thermal energy is delivered at the site of application, which produces
a lesion that interrupts a defective electrical conduction pathway in the cardiac wall.
The device and its related accessory devices are indicated for catheter-based atrial and
ventricular cardiac mapping, and for cardiac ablation procedures
LASER-BASED EYE SURGERY
The Hyperion LTK System, Sunrise Technologies, International, Inc., is a
new type of refractive surgical laser used in the temporary reduction of hyperopia
(farsightedness). Its benefit is temporary because the amount of farsightedness correction
decreases over time. However, some patients may retain some or all of the correction. LTK
(Laser Thermal Keratoplasty) is a surgical treatment for farsightedness performed using a
holmium YAG laser. The laser produces a beam that is positioned outside of the optical
zone of the eye. The beam heats the tissue in the cornea, causing it to shrink slightly.
When the tissue shrinks, the cornea angle becomes steeper. This allows incoming light to
focus on the retina, giving clearer images. The goal of LTK is to improve the
patients ability to see objects at a distance.
This device may be used to treat
patients who have farsightedness between +0.75 to +2.5 diopters (D), who are at least 40
years of age, and whose visual acuity has changed very little over time (that is, the
patients glasses prescription has changed no more than 0.50 diopter in the previous
six months). Treatment using this device will allow hyperopes (farsighted persons) who
have difficulty seeing clearly at a distance without glasses to have improved distance
vision without needing glasses.
TREATING GASTROESOPHAGEAL REFLUX DISEASE -- The
CSM Stretta System, Conway Stuart Medical, Inc., is an electrosurgical system
that includes a generator, electrosurgical catheter and a dispersive electrode. The
electrosurgical catheter has a tip with individual needle prongs, which can be placed
interstially into soft tissue to produce soft tissue coagulation. This system is intended
for the treatment of Gastroesophageal Reflux Disease (GERD). The catheter tip needles are
inserted into the soft tissue of the esophagus at the junction of the esophagus and
stomach. Controlled energy is applied for a predetermined amount of time to produce soft
tissue coagulation at the insertion site. This coagulation results in a shrinkage of the
esophageal tissue at this site resulting in a narrowing of the junction which causes a
reduction or elimination of stomach reflux of stomach acid up into the esophagus. This
treatment can be used as an alternative to the previous surgical option of fundoplication.
Fundoplication requires use of general anesthesia, a long recovery period and an extended
hospital stay since it is major abdominal surgery. The Stretta process does not require
general anesthesia and has significantly less recovery time or hospital stay time. Both of
these procedures are used only after patients have failed more conservative treatments for
GERD such as lifestyle changes, changes in diet, and use of medication to reduce
production of stomach acid. Use of this surgical procedure can, in some patients, result
in total elimination of reflux and use of GERD medications, and in other patients, surgery
can result in improved pH values showing reduced acid problems and consequently allowing
patients to use less costly or less potent GERD medications.
Center for Devices and Radiological Health (CDRH) maintains searchable databases of devices previously approved for marketing or declared substantially equivalent to a legally marketed device at http://www.fda.gov/cdrh/mda/mda-databases.html.
The Consumer Staff in FDAs Center for Devices and Radiological Health, Division of Small Manufacturers Assistance also provides information to consumers regarding medical devices and radiation-emitting products to enhance their ability to avoid risk, achieve maximum benefit, and make informed decisions about the use of such products.
| Website: | http://www.fda.gov/cdrh/consumer/index.html |
| E-Mail: | dsma@cdrh.fda.gov |
| Phone: | Toll Free 1-888-463-6332 or 301-827-3990 directly between
the hours of 8:00 a.m. 4:30 p.m. EST |
The FDA Breast Implant website for consumer information is available at http://www.fda.gov/cdrh/breastimplants/index.html.
A new CDRH website entitled LASIK Eye Surgery: Learning About LASIK is available at http://www.fda.gov/cdrh/lasik/.
ODE reviews four types of marketing applications: Premarket Notification (or a 510(k) submission), Premarket Approval Application (PMA), Product Development Protocol (PDP), and Humanitarian Device Exemption (HDE). Most devices are cleared for marketing through the 510(k) process. PMAs apply to the highest risk and newly developed devices.
During Fiscal Year 2000, ODE approved 43 PMAs and 6 HDEs. These are listed below. We recommend turning to the new PMA approval website, which is available at http://www.fda.gov/cdrh/mda/index.html, for easy-to-understand one pagers for each PMA approved.
| 25-Oct-99 | P990033 | Ceramed Corp. | PEPGEN P-15 Bone Filling Augmentation Material |
| 12-Nov-99 | P980008 | LaserSight | LaserScan LSX for PRK myopia |
| 12-Nov-99 | P990014 | Bausch & Lomb Surgical, Inc. |
Hydroview Composite Hydrogel Foldable Ultraviolet (UV) -Absorbing Posterior Chamber Intraocular Lens (IOL) |
| 19-Nov-99 | P990010 | VISX | VISX Star S2 for LASIK myopia plus astigmatism |
| 03-Dec-99 | P990019 | DUSA Pharmaceuticals, Inc. |
Photodynamic Therapy |
| 03-Dec-99 | P990009 | Fusion Medical Technologies, Inc. |
Hemostatic Agent |
| 07-Dec-99 | H990007 | CryoLife, Inc. | BioGlue®Surgical Adhesive |
| 10-Dec-99 | H980006 | DataMedix Corp. | Therasphere® |
| 16-Dec-99 | P970049 | Dishler | Dishler Excimer for LASIK myopia plus astigmatism |
| 07-Jan-00 | P990016 | McCue Corp., Inc. | Ultrasonic Bone Sonometry System |
| 20-Jan-00 | P990035 | Sunlight Ultrasound Technologies, Inc. |
Ultrasonic Bone Sonometry System |
| 28-Jan-00 | P990066 | GE Medical System | Senographe 2000D (1st digital mammography) |
| 01-Feb-00 | H990011 | Nitinol Medical. Technologies, Inc |
CardioSEAL® Septal Occlusion System |
| 03-Feb-00 | P980040 | Allergan, Inc. | Sensar Soft Acrylic UV-Absorbing Posterior Chamber IOL |
| 23-Feb-00 | P990027 | Bausch & Lomb | Technolas 217A for LASIK myopia |
| 24-Feb-00 | P990023 | Alcon Laboratories | Cellugel Ophthalmic Viscosurgical Device |
| 09-Mar-00 | H990008 | Interpore Cross International |
Telescopic Plate Spacer (TPS) Spinal System |
| 17-Mar-00 | P990054 | Cardiac Pathways Corp. | CHILLI COOLED ABLATION SYSTEM with Tracking |
| 31-Mar-00 | H990014 | Medtronic, Inc. | Gastric Electrical Stimulation System (Now known as Enterraä Therapy System) |
| 02-Apr-00 | P990013 | Star Surgical, Co. | IOL |
| 12-Apr-00 | P990048 | Carl Zeiss | VISULAS 690s Laser and VISULINK PDT adapter |
| 12-Apr-00 | P990049 | Coherent Medical Group | Coherent Opal Photoactivator and modified Coherent LaserLink |
| 18-Apr-00 | P950020 | Interventional Technologies, Inc. | Cutting Balloon |
| 10-May-00 | P990074 | McGhan Medical Corp. | RTV Saline-Filled Breast Implant |
| 10-May-00 | P990075 | Mentor Corporation | Saline-Filled and Spectrum® Mammary Prosthesis |
| 11-May-00 | H990012 | Cardiovascular Diagnostics, Inc. | TAS Ecarin Clotting Time Test |
| 12-May-00 | P990053 | Nellcor Puritan Bennett, Inc. | Oxifirst Fetal Oxygen Saturation Monitor |
| 26-May-00 | P990028 | Focal Inc. | FocalSeal-L Synthetic Absorbable Surgical Sealant |
| 31-May-00 | P990071 | Biosense Webster, Inc. | Stockert 70 RF Generator for Cardiac Ablation |
| 13-Jun-00 | P990030 | Cohesion Technologies, Inc. | CoStasis Surgical Hemostar |
| 14-Jun-00 | P980050 | Medtronic, Inc. | Medtronic® Jewel® AF 7250 Dual Chamber Implantable Cardioverter Defibrillator, Model 9961 Programmer Application Software and Medtronic® Sprint Model 6943 Steroid Eluting, Screw-in, Atrial/Ventricular Lead |
| 15-Jun-00 | P990025 | Biosense Webster, Inc. | NAVI-STAR® Diagnostic/Ablation Deflectable Tip Catheter |
| 22-Jun-00 | P990037 | Vascular Solutions, Inc | Vascular Solutions Duett Sealing Device |
| 30-Jun-00 | P990021 | QLT Photo Therapeutics, Inc. | Diomed 630 PDT Laser, Model T |
| 30-Jun-00 | P990078 | Sunrise | Hyperion LTK for hyperopia |
| 11-Jul-00 | P990018 | Menicon U.S.A. | Minicon (tisilfocon A) Rigid |
| 14-Jul-00 | P990064 | Medtronic, Inc. | MOSAIC® Porcine Bioprosthesis, Models 301 and 310 |
| 21-Jul-00 | P990034 | Medtronic, Inc. | Medtronic Isomed Infusion System |
| 24-Jul-00 | P000006 | Mentor Corp. | Alpha I Inflatable Penile Prosthesis |
| 01-Aug-00 | P990039 | Metra Biosystems | QUS-2 Calcaneal Ultrasonometer |
| 22-Aug-00 | P990072 | Westcon Contact Lens Co., Inc. | Horizon 55 EW and Horizon 55 |
| 31-Aug-00 | P990052 | Symphonix Devices, Inc. | Vibrant P Soundbridge System |
| 05-Sep-00 | P970042 | Medstone International, Inc. | Medstone STS Lithotripter |
| 08-Sep-00 | P990055 | Bayer Corp. | Bayer Immuno 1 Complexed PSA Assay |
| 19-Sep-00 | P980010 | Ostenometer MediTech, Inc. | DTU-one Ultrasound Scanner |
| 25-Sep-00 | P990040 | Cordis Neuro- vascular Inc. | TRUFILL®n-Butyl Cyanoacrylate (nBCA) Liquid Embolic System |
| 29-Sep-00 | P000014 | Ortho-Clinical Diagnostics, Inc. | VITROS Immunodiagnostic Products:Anti-HBS Reagent Pack/Anti-HBS Calibrators |
| 29-Sep-00 | P000009 | Biotronik, Inc. | Phylax AV Implantable Cardioverter Defibrillator with Program Software (I-GAV.2.U) |
| 29-Sep-00 | P000011 | Biocompatibles Cardiovascular, Inc. | BiodivYsio AS PC (phosphorylcholine) Coated
Stent and Delivery System |
The following devices were approved via PMAs, PMA Supplements, and HDEs or cleared via 510(k)s or classified via the Automatic Evaluation of Class III Designation process during FY 00. They represent significant medical breakthroughs because they are first-of-a-kind, e.g., they use a new technology or energy source, or they provide a major diagnostic or therapeutic advancement, such as reducing hospital stays, replacing the need for surgical intervention, reducing the time needed for a diagnostic determination, etc. The information for each device includes the trade name and/or classification name, firm, and date of approval or clearance.
Medtronic® Jewel® AF 7250 Dual Chamber Implantable Cardioverter Defibrillator by Medtronic, Inc. (June 14, 2000)
NAVI-STAR® Diagnostic/Ablation Deflectable Tip Catheter by Biosense Webster, Inc. (June 15, 2000)
TAS Ecarin Clotting Time Test by Cardiovascular Diagnostics, Inc. (May 11, 2000)
RTV Saline-Filled Breast Implant by McGhan Medical Corp. (May 10, 2000)
Saline-Filled and Spectrum® Mammary Prosthesis by Mentor Corporation (May 10, 2000)
FocalSeal-L Synthetic Absorbable Surgical Sealant by Focal Inc. (May 26, 2000)
Apligraf® (Graftskin) by Organogenesis Inc. (June 20, 2000)
TRUFILL® n-Butyl Cyanoacrylate (n-BCA) Liquid Embolic System by Cordis Neurovascular Inc. (September 25, 2000)
Hyperion® for Laser Thermal Keratoplasty for Hyperopia (+0.75 to +2.5 diopters) by Sunrise Technologies (June 30, 2000)
Vibrant Soundbridge by Symphonix Devices, Inc. (August 31, 2000)
Senographe 2000D (1st digital mammography) by GE Medical System (January 28, 2000)
Gastric Electrical Stimulation System by Medtronic, Inc. (March 31, 2000)
Oxifirst Fetal Oxygen Saturation Monitor by Nellcor Puritan Bennett, Inc. (May 12, 2000)
Alpha I Inflatable Penile Prosthesis by Mentor Corp. (July 14, 2000)
Medstone STS Lithotripter by Medstone International, Inc. (September 5, 2000)
510(k) Clearances or Automatic Evaluations of Class III Designation Devices (AE)
Becton, Dickinson & Co.s Probetec ET System for Chlamydia Trachomatis and Gonorrhea (November 4, 1999)
Wallac Neonatal Biotinidase Test Kit by Perkin Elmer Inc. (November 22, 1999)
Axix %CDT Turbidometric Immunoassay by Axis (December 21, 1999)
MTM Bioscanner HDL Test Strips (Over-the-Counter) by Polymer Technology Systems, Inc. (January 13, 2000)
CDCs Synthetic VDRL Antigen Slide for Syphilis (February 23, 2000)
Cedia Dau Amphassure Assay by Microgenics Corporation (May 2, 2000)
BV Blue by Gryphus Diagnostics, L.L.C. (May 15, 2000)
Bioscanner Triglycerides Test Strips by Polymer Technology Systems, Inc. (May 24, 2000)
Microwave Delivery System (MDS), Model MMC-3000 by Microwave Medical, Inc. (October 1, 1999)
600 C Laser Keratome by IntraLase Corporation (December 17, 1999)
Excimer Laser Phototherapy System AL7000 by AccuLase, Inc. (January 27, 2000)
Visage Cosmetic Surgery Model V5000 by ArthroCare Corporation (March 20, 2000)
CSM Stretta System by Conway Stuart Medical Inc. (April 18, 2000)
Laser Photolysis System and Pharo Opthalmic Surgery System by A.R.C. Laser Corporation (June 29, 2000)
da Vinci Endoscopic Instrument Control System and Endoscopic Instruments by Intuitive Surgical, Inc. (July 11, 2000)
Purilens System contact lens cleaning and disinfection system by Purilens, Inc. (October 1, 1999)
Ocu-flex-38 Keratoconus (polymacon) soft contact lens by Ocu-Ease Optical Products, (October 4, 1999)
Hylashield CL contact lens lubricating eye drop by Biomatrix, Inc. (March 2, 2000)
Hylasine, hylan B Gel by Biomatrix, Inc. (March 13, 2000)
VISX WaveScan Wavefront Analysis System Refractometer (April 28, 2000)
Autononmous Technologies CustomCornea Wavefront Analysis Refractometer (May 16, 2000)
Sportsight GP rigid gas permeable contact lens by Paragon Vision Sciences, (May 22, 2000)
Option care system for cleaning and disinfecting non-UV absorbing contact lenses by Optisonic, Inc. (June 5, 2000)
MeroGel Otologic pack by Medtronic Xomed (July 3, 2000)
LifeSite® Hemodialysis Access System by Vasca, Inc. (August 24, 2000)
The following guidance documents were adopted by ODE and its operating divisions during FY 00 and are available from the Division of Small Manufacturers Assistance (DSMA, HFZ-200). To contact DSMA, call 800-638-2041 or 301-443-6597; fax 301-443-8818; Email dsma@cdrh.fda.gov or write to DSMA (HFZ-200, Food and Drug Administration, 1350 Piccard Drive, Rockville, Maryland 20850-4307.)
Many are also available through the CDRH Facts-On-Demand (faxback service at 800-899-0381 or 301-837-0111) and the World Wide Web (CDRH homepage: http://www.fda.gov/cdrh) which provide easy access to the latest information and operating policies and procedures.
ODE
Use of Standards in Substantial Equivalence Determinations (March 13, 2000)
Guidance for Over-the-Counter (OTC) Human Chorionic Gonadotropin (hCG) 510(k)s (July 22, 2000)
Guidance for Over-the-Counter (OTC) Ovulation Predictor 510(k)s (July 22, 2000)
Class II Special Control Guidance Document for Anti-Saccharomyces cerevisia (S. cerevisiae) Antibody (ASCA) Premarket Notification (August 23, 2000)
DCRD
Guidance for Cardiovascular Intravascular Filter Submissions (November 26, 1999)
Guidance for Annuloplasty Rings 510(k) Submissions (November 26,1999)
Guidance for Premarket Notification Submissions for Nitric Oxide Delivery Apparatus, Nitric Oxide Analyzer and Nitrogen Dioxide Analyzer (January 24, 2000)
Guidance for Indwelling Blood Gas Analyzer 510(k) Submissions (February 21, 2000)
Guidance for Electrical Safety, Electromagnetic Compatibility, Mechanical Testing for Indwelling Blood Gas Analyzer Premarket Notification Submissions (June 28, 2000)
Class II Special Control Guidance for Acute Upper Airway Obstruction Devices (July 3, 2000)
One Consolidated Annual Report for a Device Product Line (1-CARD): Pilot for Preparation of Annual Reports for Pacemaker Premarket Approval Applications (July 6, 2000)
Draft Guidance for Infant/Child Apnea Monitor 510(k) Submissions (September 22, 2000)
DGRND
Guidance on Preclinical and Clinical Data and Labeling for Breast Prostheses (October 5, 1999)
Guidance for Resorbable Adhesion Barrier Devices for Use in Abdominal and/or Pelvic Surgery (December 16, 1999)
Guidance Document for the Preparation of IDEs for Spinal Systems (January 13, 2000)
Guidance for Surgical Suture 510(k)s (August 10, 2000)
Guidance for Spinal System 510(k)s (September 27, 2000)
DOED
Intraocular Lens Guidance Document (draft) (October 14, 1999)
Guidance for Premarket Submissions of Orthokeratology Rigid Gas Permeable Contact Lenses (April 10, 2000)
Refractive Implants: Guidance for Investigational Device Exemptions (IDE) and Premarket Approval (PMA) Applications (draft) (August 1, 2000)
DRARD
Draft Guidance for Resorbable Adhesion Barrier Devices for Use in Abdominal and/or Pelvic Surgery (December 16, 1999)
Guidance for the Content of Premarket Notifications for Penile Rigidity Implants; Final (January 16, 2000)
Class II Special Controls Guidance Document for Clinical Engorgement Devices (July 3, 2000)
Guidance for the Submission of Premarket Notifications for Medical Image Management Devices (July 27, 2000) (update of PACS guidance, DSMA FOD#416)
Guidance for the Submission of Premarket Notifications for Photon-Emitting Brachytherapy Sources (August 2, 2000)
Guidance on Premarket Approval Applications for Assays Pertaining to Hepatitis C Viruses (HCV) that are Indicated for Diagnosis or Monitoring of HCV Infection or Associated Disease (October 8, 1999)
Guidance on the Labeling for Over-the-Counter Sample Collection Systems for Drugs of Abuse Testing (December 21, 1999)
Guidance on Review Criteria for Assessment of Antimicrobial Susceptibility Devices (March 8, 2000)
Revision to the Extracorporeal Shockwave Lithotripter Guidance (August 9, 2000)
Guidance for Administrative Procedures for CLIA Categorization (August 14, 2000)
ODE is responsible for protecting the rights, safety and welfare of patients participating in clinical studies of significant risk medical device research and for evaluating the safety and effectiveness of medical devices before these devices enter the U.S. market place.
Following are the details of ODEs review activities and performance for Fiscal Year 2000 (FY 00). Most of the data below can be found in the tables in Part 5 -- the Operational Summary section of this report. First, we present the major submissions received and completed. Next, we review the Premarket Approval Applications (PMAs) in terms of review time as well as volume. This same analysis is done for PMA supplements. The remainder of this section deals with Humanitarian Device Exemptions (HDEs), Investigational Device Exemptions (IDEs), and Premarket Notifications (510(k)s).
During FY 00, ODE received a total of 16,919 submissions, compared to 16,812 in FY 99; 9,774 were major submissions compared to 9,792 last fiscal year [see Table 1]. Major submissions include: IDEs -- originals, amendments and supplements; PMAs -- originals and supplements; HDEs -- originals and supplements; and 510(k)s. Other submissions include PMA amendments and reports; master files; and 510(k) amendments and supplements.
Table 1. Major
Submissions Received
FY 90 FY 00
| Type of Submission |
|
|
|
|
|
|
|
|
|
|
|
Orig. PMAs |
79 |
75 |
65 |
40 |
43 |
39 |
44 |
66 |
47 |
60 |
67 |
| PMA Supp. | 660 | 593 | 606 | 395 | 372 | 499 | 415 | 409 | 513 | 552 | 545 |
| Orig. IDEs | 252 | 213 | 229 | 241 | 171 | 214 | 253 | 297 | 322 | 304 | 311 |
| IDE Amend. | 288 |
283 |
297 |
320 |
254 |
210 |
219 |
223 |
226 |
275 |
240 |
| IDE Supp. | 3,043 | 3,647 | 3,644 | 3,668 | 3,020 | 3,171 | 3,189 | 3,776 | 4,277 | 4,127 | 4,388 |
| 510(k)s | 5,831 | 5,770 | 6,509 | 6,288 | 6,434 | 6,056 | 5,297 | 5,049 | 4,623 | 4,458 | 4,202 |
| Orig. HDE | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4 | 8 | 12 | 11 |
| HDE Supp. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4 | 10 |
| _____ | _____ | _____ | _____ | _____ | _____ | _____ | _____ | _____ | _____ | _____ | |
| Total | 10,153 | 10,581 | 11,350 | 10,952 | 10,293 | 10,189 | 9,417 | 9,824 | 10,016 | 9,792 | 9,774 |
On the decision side, ODE completed the processing of 9,994 major submissions, compared to 9,881 major submissions in FY 99. [See Table 2 for major submissions completed.]
Table 2. Major
Submissions Completed
FY 90 - FY 00
| Type of Submission |
|
|
|
|
|
|
|
|
|
|
|
Orig. PMAs |
47 |
27 |
12 |
24 |
26 |
27 |
43 |
48 |
46 |
45 |
43 |
| PMA Supp. | 700 | 479 | 394 | 354 | 385 | 435 | 462 | 401 | 421 | 437 | 474 |
| Orig. IDEs | 248 | 220 | 215 | 248 | 174 | 210 | 260 | 272 | 325 | 305 | 320 |
| IDE Amend. | 270 |
287 |
297 |
324 |
256 |
213 |
218 |
220 |
225 |
268 |
251 |
| IDE Supp. | 2,968 | 3,705 | 3,469 | 3,814 | 3,070 | 3,181 | 3,121 | 3,777 | 4,209 | 4,224 | 4,335 |
| 510(k)s | 6,197 | 5,367 | 4,862 | 5,073 | 7,135 | 7,948 | 5,563 | 5,155 | 5,229 | 4,593 | 4,397 |
| Orig. HDE | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 4 | 6 | 6 |
| HDE Supp. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3 | 10 |
| _____ | _____ | _____ | _____ | _____ | _____ | _____ | _____ | _____ | _____ | _____ | |
| Total | 10,430 | 10,085 | 9,249 | 9,837 | 11,045 | 12,014 | 9,667 | 9,875 | 10,459 | 9,881 | 9,994 |
ODE ended the fiscal year with 359 employees. During the year, 27 full-time employees (12 scientific reviewers, 1 medical officer, 13 clericals and 1 program analyst) left through resignation or retirement. During FY 00, 52 new employees (30 scientific reviewers, 6 medical officers, 1 program analyst, 11 clericals, and 4 summer students) joined our office.
Premarket Approval Applications (PMAs)
[NOTE: In previous annual reports, the PMA data included data for Humanitarian Device Exemption (HDE) Applications. This annual report contains a separate section for HDEs (see page 19). We also added new statistical Tables 8, 9 and 10 that contain HDE data.]
ODE received 67 complete original PMAs (7 more than the number received in FY 99) and 55 modular submissions representing 48 PMA shells.
The total number of PMAs in inventory (active and on hold) at the end of this fiscal year decreased from 77 in FY 99 to 76. The number of active PMAs under review decreased at the end of FY 00 to 35 compared to 47 last year, and those on hold increased from 30 in FY 99 to 41 in FY 00. This means that we took action on more PMAs and thus reduced the number under active review. For the third consecutive year, there were no active and overdue PMAs at the end of the fiscal year.
The total number of PMA actions increased from 229 to 321 actions. These actions included 68 filing decisions, 173 review determinations, and 80 approval/approvable/not approvable decisions.
The 80 original PMA decisions were comprised of 43 approved PMAs, 33 approvable PMAs, and 4 not approvable PMAs. None of the 43 approvals were expedited PMAs. See Part 2 (INDUSTRY INFORMATION) for a complete list of PMA approvals.
Average FDA review time for original PMAs reaching approval increased from 149 days in FY 99 to 158 days in FY 00. The non-FDA component of review time increased from 26 days in FY 99 to 40 days this fiscal year. Thus, the total average review time increased to 198 days. Of greater significance to industry is the total elapsed time from submission to decision.
Figure 1. Average Review Time for PMA Decision Cohort Approvals

In FY 00, the total average elapsed time for PMA decision cohort performance decreased from 380 days in FY 99 to 362 days in FY 00. (Please refer to Table 4.)
Figure 2. Original Receipt Cohort PMAs Received and Filed

Figure 3. Receipt
Cohort PMA Average Elapsed
Time from Filing to Final Action

For the first 6 months of FY 00 for PMA receipt cohort performance, the average FDA days from filing to first action decreased from 145 in FY 99 to 139 days.
The average FDA (total) elapsed time to an approval or to a denial decreased from 244(293) in FY 99 to 164(214) days in FY 00. The median FDA (total) elapsed time to an approval or denial decision decreased from 240(269) in FY 99 to 178(211) days in FY 00. This means that all of the statistics of the PMA receipt cohort for FY 00 indicate that we are making decisions faster.
The number of PMA supplements received decreased from last years 552 to 545. There were 747 PMA supplement actions which is up from last years 608 total actions. These actions included 17 panel track PMA supplement filing decisions, 98 scientific review decisions, and 632 approval decisions.
Figure 4. Annual Receipts and Actions for PMA Supplement Decision Cohort

For PMA supplements reaching final action, the average elapsed FDA review time increased from 92 days in FY 99 to 94 days in FY 00, and the total average elapsed time increased from 118 days to 122 days.
Figure 5. Average Review Time for PMA Supplements

Just as in FY 97, FY 98 and FY 99, there were no PMA supplements active and overdue at the end of this fiscal year. The number of active supplements decreased to 98 in FY 00 from 158 in FY 99, while the number of supplements on hold increased from 69 to 84. This means that although we are receiving about the same number of PMA supplements, we are reaching final decisions on more, but we are taking an average of 3 extra days for the decisions.
For the first 6 months of FY 00 for PMA supplements receipt cohort performance, the first action and final action as follows. The average FDA days from filing to first decision decreased from 74 in FY 99 to 67 days in FY 00. The average FDA (total) elapsed time to an approval or denial decreased from 79(95) in FY 99 to 66(76) in FY 00. The median FDA (total) elapsed time to an approval or denial remained the same from 35(47) in FY 99 to 35(43) days in FY 00.
Real-Time Review of PMA Supplements
A total of 146 requests were received and processed for real time PMA supplements in FY 00 which represents 27% of all supplements received. Of those submissions, 134 were approved. Most applicants chose telephone conferencing versus a face-to-face meeting or a videoconference. The majority of these applications were reviewed in DCRND (54%) followed by DGRD (23%), DOD (11%), DRAERD (8%), DDIGD (2%) and DCLD (1%). Overall, average review time from "receipt" to first action (approvable, not approvable or approval order) was 34 days, and was 38 days from receipt to approval.
Product Development Protocols (PDPs)
Two PDPs have been approved in FY 00, and reports are being received on their progress for the clinical study. No original Notices of Completion were declared complete. In addition, five "Real Time" supplements, and three routine PDP supplements were approved. Note that a PDP that has been declared complete is considered to have an approved PMA. ODE continues to encourage the use of the PDP process and will work with the interested applicants to fully evaluate their PMA options.
ODE received a total of 48 PMA shells and 55 modules. A total of 17 modules were found to be acceptable while 12 received deficiency letters. A number of modules were rolled into PMA review during FY 00 because they were under review or on hold at the time the PMA was received. Applicants with modular submissions that were under review or deficient when the PMA was received continued to receive feedback under the PMA for those modules. Review times for PMAs that had modular submissions were approximately half that for traditional PMAs. However, this is based on a small number of submissions achieving PMA approval since modular review was implemented. A tracking system with modular PMA query capability became available during FY 99.
Humanitarian Device Exemption (HDE) Applications
ODE received 11 original HDEs, 1 less than the number received in FY 99. The total number of original HDE actions decreased from 37 in FY 99 to 36 in FY 00. These actions included 12 filing decisions, 16 review determinations, 7 approval decisions and 1 other final decision.
A total of 8 first actions were made this fiscal year, a decrease from 13 made last year. The average time from filing to first action decreased from 87 days in FY 99 to 61 days in FY 00.
One hundred percent of the first actions made in FY 00 occurred within 75 days.
The 7 approval decisions were comprised of 6 approved HDEs and 1 approvable HDE.
In FY 00, the average elapsed time (from filing to final approval) for original HDEs was 216 days, an increase from 163 days in FY 99. The average FDA time was 112 days, a decrease from 113 days in FY 99. The average non-FDA time was 104 days, a significant increase from 50 days last year.
The total number of original HDEs in inventory (active and on hold) at the end of this fiscal year was 10, the same as last fiscal year. Of these, 2 were under review and 8 were on hold. There was no active HDEs that were overdue at the end of the fiscal year.
The number of HDE supplements received increased from 4 in FY 99 to 10 in FY 00. There were 11 HDE supplement actions in FY 00, up from 7 in FY 99. These actions included 10 approval decisions and 1 not approvable decision.
A total of 10 first actions for HDE supplements were made this fiscal year, an increase from 4 last year. The average time from filing to first action decrease from 57 days in FY 99 to 44 days in FY 00. One hundred percent of the first actions were made within 75 days.
The average elapsed time (from filing to final approval) for HDE supplements decreased from 94 days in FY 99 to 76 days in FY 00. The average FDA time decreased from 70 days in FY 99 to 43 days in FY 00. Non-FDA time increased from 24 days in FY 99 to 33 days in FY 00.
The number of HDE supplements in inventory (active and on hold) at the end of this fiscal year was 1, the same as last fiscal year.
Investigational Device Exemptions (IDE)
During FY 00, ODE reviewed 244 pre-IDEs. Based on these reviews, guidance for the pre-original IDE submissions were provided through meetings with the sponsors, letters, fax, or by phone phone.
ODE received 311 original IDEs, an increase from 304 received in FY 99. There were 320 decisions made on original IDEs, an increase from 305 last year.
Ninety-nine percent of all original IDE decisions were issued within 30 days in FY 00. The average review time was 28 days.
Figure 6. Percentage of IDEs Approved on First Review Cycle*

*Based on those IDEs complete enough to permit substantial review.
Of the IDEs which were complete enough to support substantive review, the percentage of IDEs approved on the first review cycle increased from 68% in FY 99 to 76% in FY 00.
During this fiscal year, 240 IDE amendments were received. Decisions were made on 251 amendments: 107 approvals (43%); 34 disapprovals (13%); and 110 other administrative actions (44%). One hundred percent of these decisions were made within 30 days.
It took an average total time of 136 days to approve IDEs that were initially disapproved, down from 145 days in FY 99. This average approval time consisted of 70 days for FDA time, up from 57 days last year, and 66 days for non-FDA time, down from 88 days in FY 99.
ODE received 4,388 IDE supplements during FY 00. There were no overdue supplements at the end of the year, and the percentage of supplements reviewed within the 30-day statutory timeframe was 100 percent in FY 00. The average review time for IDE supplements stayed the same at 20 days.
Premarket Notification (510(k)s)
ODE received 4,202 original 510(k)s, as well as 1,742 510(k) supplements (responses to hold letters, the receipt of which restart the 90-day review clock), and 2,953 510(k) amendments (additional information received while the 510(k) is under review, the receipt of which does not affect the review clock).
The total average review time remained at 102 days in FY 00, and the average FDA review time was 77 days, down from 80 days in FY 99. The median review time, i.e., the time it took to review 50% of the 510(k)s, has been falling from a high of 164 days in FY 93 to a current low of 72 days in FY 00.
Figure 7. Average 510(k) Review Time for Decision Cohort

There were 1,220 510(k)s in inventory (those under active review or on hold) at the end of this fiscal year, which is 184 less than the 1,404 in FY 99s end-of-year inventory. The number on hold decreased from 461 at the end of FY 99 to 370. Most important, for the fifth consecutive fiscal year there was no 510(k)s active and overdue at the end of the reporting period.
For the first 9 months of FY 00 for receipt cohort performance, the FDA time from receipt to final decision decreased to 60 days compared to 66 days for the first 9 months in FY 99.
Figure 8. Receipts and Actions for 510(k) Receipt Cohorts*

*Cut off Date of 8/30/00 for all receipt cohorts.
**12 months projection based on first 9 months of receipts.
For the first 9 months of FY 00 for receipt cohort performance, the total time from receipt to final decision decreased to 75 days compared to 77 days for the first 9 months in FY 99.
Figure 9. FDA Days from Receipt to Final Action for 510(k) Receipt Cohorts*

*Cut Off Date as of 9/30/00 for all
receipt cohorts.
**For the first 9 months of FY 00. 90th percentile data not available for FY 00.
During FY 00, ODE received 47 510(k)s reviewed by third-party organizations under the Accredited Persons provisions (section 523) of the Federal Food, Drug, and Cosmetic Act. This is a small percentage of all 510(k)s that were eligible for third-party review, but is a 47% increase over the number of such submissions received by ODE last fiscal year. ODE made final decisions on 46 "third-party" 510(k)s in FY 00, an increase from the 29 final decisions in FY 99. The average total elapsed time from a third partys receipt of a 510(k) to ODEs issuance of a substantial equivalence decision was 68 days, as compared to the average total elapsed time of 99 days for ODEs decision on comparable 510(k)s that did not have a third-party review.
In June 2000, to encourage greater industry use of Accredited Persons, the Center expanded the list of Class I and Class II devices that are eligible for review from 154 devices to 211 devices. In the Federal Register on July 18, 2000 (65 FR 44540), the Center also proposed an expansion pilot that would permit third-party review of a greatly expanded list of devices. The pilot would allow-subject to certain specified conditions-third-party review of Class II devices for which device-specific guidance does not exist.
Until now, device-specific guidance had existed for each Class II device that is eligible for third-party review. The Federal Register notice established a 45-day public comment period, which ended September 1, 2000. The Center has reviewed the public comments and intends to finalize the proposal in FY 01. Information on the expansion pilot is available on the Centers third party web page at http://www.fda.gov/cdrh/thirdparty.
From October 1, 1999 to September 30, 2000 ODE received 615 Special 510(k)s out of the 4,202 total number of 510(k)s received, and 583 have received final decisions with the average FDA review time of 27 days and the average total time of 32 days, and 551 were found substantially equivalent and the remaining 32 had other decisions such as withdrawn or deleted.
During the same timeframe ODE received 150 Abbreviated 510(k)s out of the 4,202 total number of 510(k)s received. One hundred eighteen received final decisions (104 substantially equivalent and 12 other decisions, and 2 NSEs) with a FDA average review time of 83 days and total time of 103 days. None of the Abbreviated 510(k)s went over 90 days.
Significant Medical Device Breakthroughs
During FY 00, ODE approved 15 PMAs and cleared 25 510(k)s that represented significant medical device breakthroughs. See INDUSTRY INFORMATION for a complete listing.
Automatic Evaluation of Class III Designation
Final Reclassification Actions
Guidance for Industry and Reviewers
In FY 00, ODE published 25 final guidance documents and published 5 draft guidance documents for comment. See INDUSTRY INFORMATION for a complete listing of all ODE guidance documents published in FY 00.
The FDA Modernization Act of 1997 contains a charge to FDA to require only clinical data or information necessary to establish device effectiveness or to confer substantial equivalence. FDA must consider the least burdensome means of demonstrating effectiveness or equivalence in the review of premarket applications. Pursuant to this congressional mandate, ODE has taken the lead in implementing the concept of "least burdensome." As part of this effort, ODE actively participated in a CDRH-wide working group on least burdensome issues. As part of the efforts to implement the least burdensome provisions of FDAMA, ODE's internal tracking documents and correspondence with companies have been modified to highlight least burdensome efforts. Working collaboratively with an Industry Task Force, ODE participated in the preparation of a draft "Concepts and Principles" document. Efforts are continuing, both internally and with the Industry Task Force, to implement the least burdensome provisions in all of our activities. Information related to the least burdensome provisions of the FDA Modernization Act of 1997 can be accessed on the CDRH website: http://www.fda.gov/cdrh/modact/leastburdensome.html.
Significant Jurisdictional Issues Involving Devices in FY 2000
Title 21 of the Code of Federal Regulations Part 3 - PRODUCT JURISDICTION describes the procedure the agency uses to assign Center jurisdiction over medical products whose jurisdiction is not clear or is in dispute. Requests for Designations (RFDs) over such products are made in writing to the FDA Office of the Chief Mediator and Ombudsman. These formal submissions contain the material describing the requester's product and their proposal regarding which Center should be given the lead designation over the product and whose authorities (Biological, Device or Drug) should apply.
In FY 2000, CDRH participated in the review of 21 out of 23 RFDs (two were assigned wholly to CDER and CBER only) in addition to completing the review of 2 RFDs received in FY 99. The reviews of the 21 new requests were assigned to the ODE Divisions as follows; DGRND was assigned to review seven and shared an additional review with DOED, DDIGD and DCRD were assigned five each, DOED was assigned one and shared one with DGRND, and DCLD was assigned one RFD. Finally, one was not assigned to any division as it was handled by the Centers coordinator for incoming RFDs.
Out of the 21 RFDs assigned to CDRH for review, seven were not due for completion until FY 2001. Of the 16 RFDs whose reviews were completed, CDRH was assigned the lead center in 10 of those requests and one was withdrawn before its review could be completed. Of the remaining five the lead center designation was to either CDER or CBER.
The Center's Medical Devices Advisory Committee (MDAC) provides advice to FDA on the safety and effectiveness of marketed and investigational devices, the classification of devices into one of three regulatory categories, the possible risks to health associated with the use of devices, the formulation of product development protocols, the review of premarket approval applications, and the content of guidelines or guidance documents designed to improve the interaction between the Agency and sponsors of medical devices. The MDAC consists of 18 panels divided according to medical device specialties.
In FY 00, ODE held 27 panel meetings, 12 open meetings and 15 partially closed. Of the 18 panels, four met at least once, four met twice, and five met three times during the fiscal year. The panels collectively considered 28 PMA submissions, five PMA Supplements, four Reclassifications, two PDPs, one 510k, and two guidance documents. The panels discussed and provided advice on a number of issues. Topics ranged, for example, from the design of clinical trials to support claims for reduced posterior capsular opacification for intraocular lenses, devices used in atrial fibrillation therapies, to assessing the performance of in vitro diagnostic tests for hepatitis infection. Further information about government-wide advisory committees is available at the Federal Advisory Committee Act Database on the GSA website: http://www.gsa.gov/Portal/policy.jsp?detail=longDesc&OID=116001.
There were 25 formal training sessions for new panel members (special government employees known as SGEs). The two-hour training for SGEs covered the laws and regulations with respect to medical devices, organizational structure of the Agency, ODE's operations, the roles and responsibilities of panel members, the elements of a panel meeting, and conflict of interest.
Panel members are leading authorities in a broad range of medical areas and have current experience in medical practice, teaching and/or research. Each panel has a consumer representative, an industry representative, and when appropriate, a patient representative; these panel members do not vote but provide valuable input into panel discussions. Patient representatives served on two panels during the fiscal year the Clinical Chemistry and Clinical Toxicology Devices Panel meeting on December 6 and 7, 1999, and the Neurological Devices Panel on March 31, 2000. During the past fiscal year, females made up 43% of the ODE panel membership and minorities approximately 31%.
ODE continuously recruits highly qualified experts to serve as consultants and panel members. Potential candidates are asked to provide detailed information concerning financial holdings, employment, and research grants and contracts to identify any potential conflict of interest. Interested individuals should send their resume to the Advisory Panel Coordinator, Office of Device Evaluation, 9200 Corporate Boulevard, Rockville, Maryland 20850.
Announcements of panel meetings are publicized in several ways: voice information via the FDA Advisory Committee Information Line (1-800-741-8138), printed information in the Federal Register, and on the Internet (http://www.fda.gov/cdrh/panelmtg.html). This website also includes summaries of the most recent advisory panel meetings.
The Guidance on Amended Procedures for Advisory Panel Meetings was revised on July 22, 2000, to clarify the standard operating procedures that apply to advisory panel meetings where a specific submission is being considered by the panel or to device classification panel meetings on issues involving more than one sponsor. The clarification addresses timeframes for when and what types of information/new data analyses might be submitted to the panel. The revised guidance is available at http://www.fda.gov/cdrh/modact/amendpan.html.
During this fiscal year, ODE investigated about 62 cases concerning the integrity of data submitted to the agency in premarket applications. Under the Application Integrity Program (AIP), two firms were placed on the AIP list and AIP restrictions applied against these firms.
ODE handled 37 instances related to questions arising under the standards of conduct for employees. During FY 00, as in years past, the ODE staff received several unsolicited gifts from the regulated industry. Both the offering of gifts and their acceptance in general, are prohibited under applicable laws and regulations. The regulated industry, their agents and representatives should not send gifts to staff members. (See Standards of Ethical Conduct for Employees of the Executive Branch on the internet at http://www.usoge.gov/pages/forms_pubs_otherdocs/fpo_files/reference/rfsoc_99.pdf).
Freedom of Information Requests
ODE staff received 1,080 FOI requests during FY 00, a decrease from 1,355 last fiscal year. During FY 00, the number of FOI requests closed was 1,146 compared to 834 in FY 99. The total number of FOI requests pending in ODE at the end of FY 00 is 621 compared to 771 in FY 99.
Congressional interest in ODE programs continued to be strong in FY 00. ODE staff responded to inquiries and participated in briefings on such topics as hearing aids, breast implants, drug test kits, dental amalgam/illness, hemodialysis, and reuse. ODE also participated in Congressional hearings held during FY 00 dealing with FDAs budget, FDAMA, reuse, and genetic testing.
During FY 00, ODE staff authored 20 manuscripts for publication in professional and scientific journals and delivered 58 presentations at professional, scientific and trade association meetings. See Appendix B for a bibliography of publications.
In FY 00, ODE, in conjunction with the regulatory industry, sponsored one Vendor Day - an informative exhibit and exchange seminar with device manufacturers on cardiovascular, general and restorative, clinical laboratory and other devices.
In FY 00, ODE continued its Site Visit Program that was developed to enhance reviewer knowledge of how specific medical devices are designed, manufactured, and tested. The program continued to include not only visits to medical device manufacturing firms but also hospitals for the observation of certain devices in use. As a result, 11 firms and/or hospitals were visited to learn about orthopedic products, blood-glucose products, endovascular grafts, dialysis systems, IVD products, condoms, and other devices.
ODE employees attended many courses, lecturers, and grand rounds sponsored by the CDRH Staff College. Supervisors continued to participate in monthly meetings to discuss current management issues, and all employees attended all-hands meetings to learn about new FDAMA polices and procedures.
ODE sponsored three in-house training courses for employees and managers: Media Relations Workshop, Congressional Hearings Workshop and Interviewing Techniques.
ODE continues to improve and enhance its mentoring program. The program is designed to orient new employees to their job responsibilities and their workplace. The program matches new employees with a mentor who is expected to provide technical, informational and career guidance to the employee in an effort to ensure appropriate employee development. The ODE PMO Office has served as an informal mentoring agent for minorities to facilitate their assimilation into the workforce.
In FY 2000, ODE continued and expanded the ODE Intern Program. The program allows 4-5 college students to work in a practical work environment, gain entry level professional "real work" experience and work alongside some the Agencys top healthcare authorities. Special attention is given to minority candidates. ODE continues to expand the program to include American and foreign professionals.
ODE, along with a sister organization, the Office of Health Industry Programs, continued the DSMA/ODE Exchange Program, an internal program that allows scientific reviewers from each Office to exchange places for a period of 60-90 days. Each participant is expected to learn about the operations and integral workings of the other Office.
ODE established the ODE Employee Exchange Program. The primary purpose of the program is to allow staff members the opportunity to work in other Offices and Centers within FDA to keep abreast of current advances and practices in sister organizations, as well as changes in legislation, regulations, scientific and legislative literature in other medical fields.
In an effort to increase the hiring of minorities within the Center, ODE participated in various recruitment and job fairs including the Presidents Committee on the Employment of People with Disabilities Job Fair and the Hispanic Association of Colleges and Universities (HACU) Employment Fair.
ODE tracking system changes included premarket database enhancements, revised query programs and performance reports, and the development and implementation of the CLIA categorization tracking system, the 510(k) Exempt CLIA submission tracking system, and the 513(g) (device determination) tracking system. In addition, revisions were made in the Classification database for the expanded third party review and to the PMA modular review tracking system. The ODE division tracking system was updated to accommodate CLIA and 513(g) submissions and to produce new reports. All tracking systems were modified to reflect the division reorganizations of ODE.
ODE continued to upgrade equipment in order to improve the processing of applications and interactions with the regulated industry and the public. Speakerphones, Windows NT on all PCs, laptops, PCs, laser printers, uninterruptible power supplies, and facsimile machines were among the improvements. In addition, ODE contributed funds to upgrade the Centers telephone system to enable dial-in access speeds to approach 56K and to help with the development of a new storage system for archived documents.
In FY 00, ODE received 113 electronic submissions for PMAs, IDEs, and 510(k)s from 37 different sponsors. ODE reviewers received parts of submissions in electronic format such as additional information, summaries of safety and effectiveness, and proposed labeling and those submissions were recorded as electronic submissions. Prior contact with an ODE division is requested before developing and sending an electronic submission. Instructions for submitting electronic submissions can be found on the FDA home page at the address http://www.fda.gov/cdrh/elecsub.html.
The ODE use of videoconferencing to interact with the regulated industry continued to show limited use. In FY 00, 8 videoconferences were held involving industry, other Federal agencies and professional societies. CDRH has the ability to conduct Room and Desktop Video Conferences with outside parties that have H.320 compliant systems, a standard for video conferencing over ISDN lines and other narrowband transmission media.
ODE continues to provide information on the web that can be downloaded and searched through the CDRH home page at http://www.fda.gov/cdrh. Information on Premarket Approval Applications (PMAs) and Premarket Notifications (510(k)s) can be found under the Popular Items/New Device Information on the CDRH home page.
Anyone can search the Releasable 510(k) and PMA databases, download 510(k) or PMA files, obtain the monthly PMA, HDE and 510(k) listings and Summaries of Safety and Effectiveness Data, and read about the "Real-Time" program for PMA supplements. A database of guidance documents is available at the address http://www.fda.gov/cdrh/ggpmain.html. The database is searchable by words in the document title, office, division, or any combination of these elements. In FY00, ODE posted 39 guidance documents on the web. In addition, information on ODEs panel meeting schedules and summaries can be found on the internet at http://www.fda.gov/cdrh/panelmtg.html.
Center for Devices and Radiological Health (CDRH) maintains searchable databases of devices previously approved for marketing or declared substantially equivalent to a legally marketed device at http://www.fda.gov/cdrh/mda/mda-databases.html.
The Consumer Staff in FDAs Center for Devices and Radiological Health, Division of Small Manufacturers Assistance also provides information to consumers regarding medical devices and radiation-emitting products to enhance their ability to avoid risk, achieve maximum benefit, and make informed decisions about the use of such products.
| Website: | http://www.fda.gov/cdrh/consumer/index.html |
| E-Mail: | dsma@cdrh.fda.gov |
| Phone: | Toll Free 1-888-463-6332 or 301-827-3990 directly between the hours of 8:00 a.m. 4:30 p.m. EST |
The FDA Breast Implant website for consumer information is available at http://www.fda.gov/cdrh/breastimplants/index.html.
A new CDRH website entitled LASIK Eye Surgery: Learning About LASIK is available at http://www.fda.gov/cdrh/lasik/.
[NOTE: Although accurate at the time of publication, the data in the following tables may change slightly in subsequent reports to reflect changes in the regulatory status of submissions or verification of data entry. There are also likely to be changes in the previous years annual report numbers in tables representing receipt cohort data. For example, if an incoming PMA supplement is later converted to an original PMA, changes are made in the appropriate tables. Likewise, some data from earlier reporting periods may have been changed to reflect similar corrections in data entry. These adjustments are not likely to have a significant effect on conclusions based on these data. Percentages of actions are presented in some tables. They may not add up to 100% in all cases due to the rounding off of fractions.] Refer to Tables 1 (page 14) and 2 (page 15) for general summary of major submissions received and completed.
Table 3.
PMA/HDE/IDE/510(k) Submissions Received
FY 96 - FY 00
| Type of Submission | Number Received | ||||
FY 96 |
FY 97 |
FY 98 |
FY 99 |
FY 00 |
|
Premarket Approval (PMAs) |
|||||
| Original Applications | 44 | 66 | 47 | 60 | 67 |
| Amendments | 883 | 829 | 710 | 767 | 978 |
| Supplements | 415 | 409 | 513 | 552 | 545 |
| Amendments to Supplements | 823 | 819 | 863 | 924 | 932 |
| Reports for Orig. Applications | 435 | 435 | 431 | 406 | 419 |
| Reports for Supplements | 24 | 2 | 0 | 0 | 0 |
| Master Files | 65 | 130 | 94 | 25 | 44 |
| PMA Subtotal | 2,689 | 2,690 | 2,658 | 2,734 | 2,985 |
| Humanitarian Device Exemptions (HDEs) | |||||
| Original Applications | 0 | 4 | 8 | 12 | 11 |
| Amendments | 0 | 10 | 32 | 55 | 56 |
| Supplements | 0 | 0 | 0 | 4 | 10 |
| Amendments to Supplements | 0 | 0 | 0 | 3 | 12 |
| Reports for Orig. Applications | 0 | 0 | 0 | 6 | 9 |
| Reports for Supplements | 0 | 0 | 0 | 0 | 0 |
| HDE Subtotal | 0 | 14 | 40 | 80 | 98 |
| Investigational Device Exemptions (IDEs) | |||||
| Original Applications | 253 | 297 | 322 | 304 | 311 |
| Amendments | 219 | 223 | 226 | 275 | 240 |
| Supplements | 3,189 | 3,776 | 4,277 | 4,127 | 4,388 |
| IDE Subtotal | 3,661 | 4,296 | 4,825 | 4,706 | 4,939 |
| Premarket Notification (510(k)s) | |||||
| Original Notifications | 5,297 | 5,049 | 4,623 | 4,458 | 4,202 |
| Supplements | 3,246 | 2,785 | 2,023 | 1,872 | 1,742 |
| Amendments | 5,343 | 4,433 | 3,692 | 2,962 | 2,953 |
| 510(k) Subtotal | 13,886 | 12,267 | 10,338 | 9,292 | 8,897 |
| PMA/HDE/IDE/510(k) Total | 20,236 | 19,267 | 17,861 | 16,812 | 16,919 |
Table 4. Original
PMA Decision Cohort Performance*
FY 96 - FY 00
FY 96 |
FY 97 |
FY 98 |
FY 99 |
FY 00 |
|
Number Received |
44 |
0 |
55 |
72 |
67 |
| PMA Actions Filing Decisions | |||||
| Filed | 45 | 58 | 51 | 65 | 64 |
| Not Filed | 17 | 16 | 10 | 7 | 4 |
| Others | 0 | 0 | 0 | 0 | 0 |
| Filing Decision Subtotal | 62 | 74 | 61 | 72 | 68 |
| Scientific Review Decisions | |||||
| Major Deficiencies | 32 | 38 | 28 | 32 | 51 |
| Minor Deficiencies | 5 | 5 | 10 | 4 | 11 |
| Othera | 97 | 138 | 105 | 105 | 111 |
| Scientific Review Decisions Subtotal | 134 | 181 | 143 | 141 | 173 |
| Approval Decisions | |||||
| Approvals | 43 | 48 | 46 | 45 | 43 |
| Approvable | 27 | 14 | 7 | 7 | 33 |
| Not Approvable | 6 | 5 | 12 | 1 | 4 |
| Denials | 0 | 0 | 0 | 0 | 0 |
| Approval Decision Subtotal | 76 | 67 | 65 | 53 | 80 |
| Total PMA Actions | 272 | 322 | 269 | 266 | 321 |
| Average Review Time (Days) | |||||
| for Approvalsb | |||||
| FDA | 289 | 207 | 154 | 149 | 158 |
| Non-FDA |