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	<title>AssurX Blog&#187; Michael Causey</title>
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	<link>http://blog.assurx.com</link>
	<description>Compliance, quality and risk: Straight talk for regulated industries</description>
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		<title>FDA Inspectors Crave a Good Hot Cup of CAPA</title>
		<link>http://blog.assurx.com/2012/02/09/fda-inspectors-crave-a-good-hot-cup-of-capa/</link>
		<comments>http://blog.assurx.com/2012/02/09/fda-inspectors-crave-a-good-hot-cup-of-capa/#comments</comments>
		<pubDate>Thu, 09 Feb 2012 16:19:58 +0000</pubDate>
		<dc:creator>Michael Causey</dc:creator>
				<category><![CDATA[FDA Regulated]]></category>
		<category><![CDATA[Featured]]></category>
		<category><![CDATA[Michael Causey]]></category>
		<category><![CDATA[Quality Management]]></category>
		<category><![CDATA[Audits]]></category>
		<category><![CDATA[CAPA]]></category>
		<category><![CDATA[FDA]]></category>
		<category><![CDATA[Medical Devices]]></category>
		<category><![CDATA[Regulatory Compliance]]></category>

		<guid isPermaLink="false">http://blog.assurx.com/?p=3717</guid>
		<description><![CDATA[One of my favorite all-time bands, The Kinks, have a fantastic tongue-in-cheek song called “Have a Cuppa Tea” that satirizes the British belief that a good hot cup of tea will solve all of the world’s problems. I think the FDA misread “Cuppa” and instead decided that if it focused on CAPA it, too, would solve all [...]]]></description>
			<content:encoded><![CDATA[<div>
<div id="attachment_323" class="wp-caption alignleft" style="width: 160px"><a href="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg"><img class="size-full wp-image-323" title="mcausey" src="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg" alt="" width="150" height="150" /></a><p class="wp-caption-text">Michael Causey, Editor &amp; Publisher, eDataIntegrityReport.com</p></div>
<p>One of my favorite all-time bands, The Kinks, have a fantastic tongue-in-cheek song called “<a href="http://en.wikipedia.org/wiki/Have_a_Cuppa_Tea" target="_blank">Have a Cuppa Tea</a>” that satirizes the British belief that a good hot cup of tea will solve all of the world’s problems.</p>
</div>
<div></div>
<div>I think the FDA misread “Cuppa” and instead decided that if it focused on <a href="http://www.assurx.com/CAPA.html">CAPA</a> it, too, would solve all the of the [medical device] world’s problems.</p>
<div></div>
</div>
<div></div>
<div>An analysis of 2011 and 2010 FDA inspection observations in 483s shows clearly that CAPA remains at the top of the charts for the FDA (see charts below).  FDA’s own analysis of its 3,434 483 observations in 2010 found that CAPA was the number one, with a total of 1058 citations. Number for 2011 aren’t yet available, but there’s no indication they are going anywhere but up.</p>
<div></div>
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<div></div>
<div>And that’s probably not going to change in 2012, either.</p>
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<div></div>
<div>Why is CAPA so important? Melissa Torres, part of the Center for Devices and Radiological Health’s Quality System Team in the Office of Compliance, put it clearly. CAPA matters because it is “linked to so many other requirements.”</p>
<div></div>
</div>
<div></div>
<div>Consider this, CAPA touches on:</div>
<div></div>
<ul>
<li>820.198 Complaint files</li>
<li>820.90 Nonconforming Product</li>
<li>820.80 Acceptance Activities</li>
<li>820.200 Servicing</li>
<li>820.22 Audits</li>
<li>803 Medical Device Reporting (MDR)</li>
<li>806 Reports of Corrections and Recalls…</li>
</ul>
<div></div>
<div>“…and many more,” Torres emphasizes. Plus, dealing with CAPA effectively helps FDA inspectors relax because they get the sense you have detected and resolved any significant problems.</p>
<div></div>
</div>
<div></div>
<div>On the flip side, if you don’t have CAPA in control, you’re going to need <a href="http://www.drinksmixer.com/cat/1/" target="_blank">a lot stiffer drink</a> than a cup of tea.</p>
<div></div>
</div>
<div></div>
<div></div>
<div>
<div><span style="color: #800000;"><strong>The top 10 observations for 2011 were:</strong></span></div>
</div>
<div>
<div>
<ul>
<li>21 CFR 820.100(a) – Procedures for Corrective and Preventative Action (CAPA) have not been adequately established;</li>
<li>21 CFR 803.17 – Written Medical Device Report (MDR) procedures have not been developed/maintained/implemented;</li>
<li>21 CFR 820.198(a) – Complaint handling procedures for receiving/reviewing/evaluating  complaints have not been established/defined/documented/completed/implemented;</li>
<li>21 CFR 820.100(b) – Corrective and Preventative Action activities and/or results have not been adequately documented;</li>
<li>21 CFR 820.75(a) – A process whose results cannot be fully verified by subsequent inspection and test has not been adequately validated according to established procedures;</li>
<li>21 CFR 820.22 – Quality audits/reaudits have not been performed;</li>
<li>21 CFR 820.22 – Procedures for quality audits have not been adequately established;</li>
<li>21 CFR 820.30(a) – Procedures for design control have not been established;</li>
<li>21 CFR 820.30(i) – Procedures for design change have not been adequately established;</li>
<li>21 CFR 820.20 – Management with executive responsibility has not ensured that an adequate and effective quality system has been fully implemented and maintained at all levels of the organization.
<div></div>
</li>
</ul>
<p><span style="color: #800000;"><strong>The top 10 observations for 2010 were:<br />
</strong></span></p>
<ul>
<li>21 CFR 803.17 – Written Medical Device Report (MDR) procedures have not been developed/maintained/implemented;</li>
<li>21 CFR 820.100(a) – Procedures for corrective and preventive action have not been adequately established;</li>
<li>21 CFR 820.100(b) – Corrective and preventive action activities and/or results have not been adequately documented;</li>
<li>21 CFR 820.75(a) – A process whose results cannot be fully verified by subsequent inspection and test has not been adequately validated according to established procedures;</li>
<li>21 CFR 820.198(a) – Complaint handling procedures for receiving/reviewing/evaluating  complaints have not been established/defined/documented/completed/implemented;</li>
<li>21 CFR 820.50 – Purchasing controls,. Lack of or inadequate procedures Procedures to ensure that all purchased or otherwise received product and services conform to specified requirements have not been adequately established;</li>
<li>21 CFR 820.198(a) – Procedures for receiving, reviewing, and evaluating complaints by a formally designated unit have not been adequately established;</li>
<li>21 CFR 820.198(c) – Complaints involving the possible failure of a device/labeling/packaging to meet any of its specifications were not reviewed/evaluated/investigated where necessary;</li>
<li>21 CFR 820.22 – Procedures for quality audits have not been adequately established;</li>
<li>(tie) 21 CFR 820.22 – Conducted quality audits/reaudits have not been performed;</li>
<li>(tie) 21 CFR 820.30(i) – Design changes &#8211; lack of, or inadequate procedures.</li>
</ul>
<div></div>
</div>
</div>
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		<title>CDRH 2012 Strategic Priorities Emphasize QA, Life Cycle Management</title>
		<link>http://blog.assurx.com/2012/02/01/cdrh-2012-strategic-priorities-emphasize-qa-life-cycle-management/</link>
		<comments>http://blog.assurx.com/2012/02/01/cdrh-2012-strategic-priorities-emphasize-qa-life-cycle-management/#comments</comments>
		<pubDate>Wed, 01 Feb 2012 15:52:07 +0000</pubDate>
		<dc:creator>Michael Causey</dc:creator>
				<category><![CDATA[FDA Regulated]]></category>
		<category><![CDATA[Featured]]></category>
		<category><![CDATA[Medical Devices]]></category>
		<category><![CDATA[Michael Causey]]></category>
		<category><![CDATA[Quality Management]]></category>
		<category><![CDATA[Regulatory]]></category>
		<category><![CDATA[Risk Management]]></category>
		<category><![CDATA[FDA]]></category>
		<category><![CDATA[Regulatory Compliance]]></category>

		<guid isPermaLink="false">http://blog.assurx.com/?p=3694</guid>
		<description><![CDATA[Deciphering the FDA is a bit like trying to understand what the old USSR was up to in the days of the Cold War.  In those days, it was called Kremlinology, or the study of a complex, secretive organization.  We need a catchphrase for those of us today who try to figure out what the [...]]]></description>
			<content:encoded><![CDATA[<div id="attachment_323" class="wp-caption alignleft" style="width: 160px"><a href="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg"><img class="size-full wp-image-323" title="mcausey" src="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg" alt="" width="150" height="150" /></a><p class="wp-caption-text">Michael Causey, Editor &amp; Publisher, eDataIntegrityReport.com</p></div>
<p>Deciphering the <a href="http://www.fda.gov" target="_blank">FDA</a> is a bit like trying to understand <a href="http://geography.about.com/od/countryinformation/a/ussr.htm" target="_blank">what the old USSR was up</a> to in the days of the <a href="http://www.history.com/topics/cold-war" target="_blank">Cold War</a>.  In those days, it was called <a href="http://en.wikipedia.org/wiki/Kremlinology" target="_blank">Kremlinology</a>, or the study of a complex, secretive organization.  We need a catchphrase for those of us today who try to figure out what the FDA means when it says something, or what it means when it says nothing, or what it means when it tells you what it means. You get the idea.</p>
<p>The FDA has been talking a lot of late about transparency. Its <a href="http://www.fda.gov/AboutFDA/Transparency/TransparencyInitiative/default.htm" target="_blank">2011 initiative</a> is an agency attempt, it says, to open up about how it does business. FDA is accepting comments on it until February 28.  The jury is still out on whether this initiative will accomplish much.</p>
<p>Our latest piece of FDA evidence is <a href="http://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDRH/CDRHVisionandMission/ucm288735.htm" target="_blank">CDRH’s 2012 Strategic Priorities</a>.</p>
<p><a href="http://www.fda.gov/MedicalDevices/default.htm" target="_blank">CDRH</a> devotes the Introduction of the document about looking ahead to patting itself on the back for its 2011 achievements, e.g. its report, &#8220;<a href="http://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDRH/CDRHReports/ucm277272.htm" target="_blank">Understanding Barriers to Medical Device Quality</a>,&#8221; that reviews the challenges that the FDA and industry face in supporting well‐integrated, best‐quality manufacturing practices and strategies that industry and the FDA can take to overcome these barriers.</p>
<p>CDRH also reminds us that “to complete this work [in 2011] our staff went above and beyond their already demanding workload. This is a remarkable achievement.”</p>
<p>Good to know.</p>
<p>In 2012, CDRH says it will continue to emphasize four priority areas:</p>
<ol>
<li>Fully Implement a Total Product Life Cycle Approach</li>
<li>Enhance Communication and Transparency</li>
<li>Strengthen Its Workforce and Workplace</li>
<li>Proactively Facilitate Innovation to Address Unmet Public Health Needs</li>
</ol>
<p>CDRH promises in 2012 to “improve” its premarket programs. By April 1, it pledges to begin its Triage of Pre-market Submissions Pilot to “increase submission review efficiency and better manage the pre-market review workload.”</p>
<p>And by the end of the year, CDRH pledges to publish a proposed rule to clarify the circumstances under which it could rely on clinical studies conducted in and for other countries. CDRH also says it will finalize all guidance documents it has issued as part of its overall plan to improve its premarket programs.</p>
<p>We’ll keep an eye on these and other promises throughout the year and report back as FDA hits or misses its own targets.</p>
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		<title>FDA Offers Salty Recipe for Increased Food Regulation in 2012</title>
		<link>http://blog.assurx.com/2012/01/03/fda-offers-salty-recipe-for-increased-food-regulation-in-2012/</link>
		<comments>http://blog.assurx.com/2012/01/03/fda-offers-salty-recipe-for-increased-food-regulation-in-2012/#comments</comments>
		<pubDate>Tue, 03 Jan 2012 17:49:08 +0000</pubDate>
		<dc:creator>Michael Causey</dc:creator>
				<category><![CDATA[FDA Regulated]]></category>
		<category><![CDATA[Food]]></category>
		<category><![CDATA[Michael Causey]]></category>
		<category><![CDATA[Regulatory]]></category>
		<category><![CDATA[FDA]]></category>
		<category><![CDATA[Food Safety]]></category>
		<category><![CDATA[Regulatory Compliance]]></category>

		<guid isPermaLink="false">http://blog.assurx.com/?p=3630</guid>
		<description><![CDATA[To salt or not to salt? That is the question. Well, it’s one of the questions. It’s actually bigger than a battle over a popular condiment, according to some folks who oppose what they say is the FDA overplaying its regulatory hand. We’re not going to settle this controversy here, but some experts suggest you [...]]]></description>
			<content:encoded><![CDATA[<div id="attachment_323" class="wp-caption alignleft" style="width: 160px"><a href="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg"><img class="size-full wp-image-323" title="mcausey" src="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg" alt="" width="150" height="150" /></a><p class="wp-caption-text">Michael Causey, Editor &amp; Publisher, eDataIntegrityReport.com</p></div>
<p>To salt or not to salt? That is the question. Well, it’s one of the questions.</p>
<p>It’s actually bigger than a battle over a popular condiment, according to some folks who oppose what they say is the FDA overplaying its regulatory hand.</p>
<p>We’re not going to settle this controversy here, but <a href="http://www.scientificamerican.com/article.cfm?id=review-adds-salt-to-a-familiar" target="_blank">some experts suggest you may be able to sprinkle a little salt on your food without feeling guilty</a> about increasing your risk of heart disease and high blood pressure.</p>
<p>However, some say the FDA has gotten too activist and one-sided in its approach to the condiment – and that it’s just another sign that the FDA in 2012 will be more strident with regulatory overreach that won’t help food consumers and will harm food manufacturers.</p>
<p><a href="http://blog.assurx.com/wp-content/uploads/2012/01/salt.jpg"><img class="alignright size-full wp-image-3634" title="salt" src="http://blog.assurx.com/wp-content/uploads/2012/01/salt.jpg" alt="salt" width="126" height="87" /></a>The <a href="http://www.iom.edu/Reports/2010/Strategies-to-Reduce-Sodium-Intake-in-the-United-States.aspx" target="_blank">FDA is generally following the lead of a 2010 report from the IOM</a> that says salt contributes to serious health problems. The agency is working on a guidance now that would promote ways to reduce salt consumption by Americans in their diet.</p>
<p>“I think the FDA is adding unnecessary bureaucratic layers” that aren’t improving food safety and are in fact making it harder for food manufacturers to do business, says <a href="http://www.iwf.org/about/julie-gunlock" target="_blank">Julie Gunlock</a>, a senior fellow at the <a href="http://www.iwf.org" target="_blank">Independent Women&#8217;s Forum</a>, a non-partisan research and educational institution that seeks to combat what they say is the too-common presumption that women want and benefit from big government. In the case of salt, for example, Gunlock says the FDA is ignoring more recent studies that at least question the strong connection between salt and the health problems.</p>
<p>Gunlock has written extensively about what she calls “the damage” caused by intrusive FDA regulations. She focuses on the harm to food processors and manufacturers, and the role of parents in making dietary decisions on behalf of their children.</p>
<p>For Gunlock, it’s more than just a battle over salt. She sees this issue as just another example of the FDA taking authority away from state regulators and telling consumers what they can eat. “Unfortunately, I think we’ll see tougher FDA actions in 2012 against a food supply chain that is already safe and probably doesn’t need additional regulation like this.”</p>
<p>When trying to predict what will happen in 2012, it’s important to recall that the <a href="http://www.fda.gov/food/foodsafety/fsma/default.htm" target="_blank">Food Safety Modernization Act</a>, signed in January 2011, ushered in a new era of increased security measures, processes and controls for food safety officials; most orchestrated by the FDA, notes <a href="http://www.adt.com/wps/wcm/connect/3c562d80477dd73bad9cff457aa67d7c/30311_ADT_L8516-01_COMM.pdf?MOD=AJPERES" target="_blank">Don Hsieh, director of commercial and industrial marketing with ADT Security Services</a>. He works to educate brands on how to build a proactive food defense program and how food officials can effectively comply with FDA regulations.</p>
<p>Simply put, the FSMA is the” most significant expansion of food safety requirements and FDA food safety authority in over 70 years, since the original Food Drug &amp; Cosmetic Act in 1938,” Hsieh says.</p>
<p>And FDA is clear on its intent. “The historic FSMA is aimed at transforming our food safety efforts toward prevention and based on risk analysis” said LeeAnne Jackson, PhD, Health Science Policy Adviser, FDA.</p>
<p>Hsieh reminds us that recalls are bad for business, to put it mildly. One of the largest food recalls was the recall of peanut products produced by Peanut Corporation of America. What resulted from this mass distribution of contaminated product were 714 confirmed infections, nine deaths and $1 billion in losses to the United States peanut industry. The Peanut Corporation of America filed for Chapter 7 bankruptcy and its owner and CEO appeared before Congress under Congressional subpoena. Although the cause of the outbreak was one firm and did not involve major peanut butter brands, consumers reacted by avoiding the peanut butter category and sales plunged 25% after the recall announcement. “This points out the importance of not only protecting the food supply chain for your company’s products but being able to prove that your supply chain was not impacted by a specific incident,” he sums up.</p>
<p>But are food processors ready for 2012? Doesn’t sound like it. As Hsieh points out, for most food manufacturers, “documentation is typically done by a person with a clipboard checking off items on a paper check-off list. Given FDA’s mandate of providing documentation of compliance, these documents may not accurately reflect compliance and are difficult to access and compile.”</p>
<p>Looking ahead to 2012, that’s probably an understatement.</p>
<p>&nbsp;</p>
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		<title>Companies Struggle to Harness Business Intelligence</title>
		<link>http://blog.assurx.com/2011/12/16/companies-struggle-to-harness-business-intelligence/</link>
		<comments>http://blog.assurx.com/2011/12/16/companies-struggle-to-harness-business-intelligence/#comments</comments>
		<pubDate>Fri, 16 Dec 2011 15:57:08 +0000</pubDate>
		<dc:creator>Michael Causey</dc:creator>
				<category><![CDATA[Michael Causey]]></category>

		<guid isPermaLink="false">http://blog.assurx.com/?p=3615</guid>
		<description><![CDATA[Business Intelligence (BI), the process of transforming the raw data companies collect from various operations and sources into usable and actionable information, is an often under-utilized and misunderstood tool in the strategic arsenal. A new white paper from Information Builders by Kevin R. Quinn notes that companies are increasingly leveraging BI software to help them [...]]]></description>
			<content:encoded><![CDATA[<div>
<div id="attachment_323" class="wp-caption alignleft" style="width: 160px"><a href="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg"><img class="size-full wp-image-323" title="mcausey" src="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg" alt="" width="150" height="150" /></a><p class="wp-caption-text">Michael Causey, Editor &amp; Publisher, eDataIntegrityReport.com</p></div>
<p>Business Intelligence (BI), the process of transforming the raw data companies collect from various operations and sources into usable and actionable information, is an often under-utilized and misunderstood tool in the strategic arsenal.</p>
<p>A new white paper from Information Builders by Kevin R. Quinn notes that companies are increasingly leveraging BI software to help them aggregate, manipulate, and display data to further inform their decision-making. Harnessed properly, this can improve the way companies do business if they utilize the proper business intelligence improvement cycle (BIIC).</p>
<p>But many companies fall short of their BI potential for several reasons, including:</p>
<ul>
<li>Users’ skills and desires are misinterpreted.</li>
<li>An emphasis is put on the wrong stage of the cycle (plan, improve, measure, and analyze).</li>
<li>No information self-sufficiency.</li>
<li>No culture of established measurement.</li>
<li>Disparate tactical BI solutions gain footholds.</li>
</ul>
<p>Let’s look a little more in-depth at how these common pitfalls trip up companies.<br />
SKILLS MISINTERPRETED: There are four categories of information workers. Nontechnical business users, who tend to make up 80 to 90 percent of the workforce, business analysts, power users, and IT developers. Quinn says that too many organizations focus all of their BI resources and tactics on the business analysts and power users, this prevents “the majority of users from using the tools and becoming part of the information culture.”</p>
<p>WRONG EMPHASIS: Quinn argues that companies often neglect the first stage, planning or gathering information, in their haste to get to the good stuff. As the old computer adage goes, “garbage in, garbage out.” Planning and collecting information may not be as fun as working with the data, but it’s the foundation for the success of any big BI project.</p>
<p>LACK OF SELF-SUFFICIENCY: A common pitfall when setting the BIIC in motion is that the IT department is relied on as the sole information-producers in the company, while of course they aren’t the only group that generates data. “This causes an imbalance that leads to a heavier burden on IT because as more and more information consumers need information, more and more requests are made of IT.” Making matters worse, IT personnel frequently don’t understand the underlying nature of the business questions that data users are looking to answer, so their responses are often incorrect or incomplete in practical terms.</p>
<p><a href="http://blog.assurx.com/wp-content/uploads/2011/06/USMedDeviceLeadership.jpg"><img class="alignright  wp-image-3182" title="USMedDeviceLeadership" src="http://blog.assurx.com/wp-content/uploads/2011/06/USMedDeviceLeadership-150x150.jpg" alt="" width="120" height="120" /></a>NO MEASUREMENT CULTURE: We’ve emphasized this before. If there is not buy-in at the top, any initiative is most likely going to fail. No exception here, Quinn says. “If executives are the only people who are about measurement and the improvement of those measurements’ outcomes, the motivation to improve will not be established among the ranks of workers who have the capability to make the necessary changes.”</p>
<p>DISPARATE SOLUTIONS: Quinn writes that many organizations purchase BI tools without a clear strategic plan for using them to truly make changes within the organization. When reports are generated at the behest of a Big Cheese, for example, rather than being part of a bigger BI plan, key reports and key information is often locked in figurative silos without contributing to a smooth-flowing BIIC.</p>
<p>Quinn advocates a simple method of information access and distribution along with open communication within an organization to ensure that everyone understands the value of BI and why an intelligent BIIC is a critical component of success in today’s marketplace.</p>
<p>Editor’s Note: To read the full white paper, <a href="http://searchbusinessanalytics.bitpipe.com/data/document.do?res_id=1063730808_5&amp;li=481248&amp;asrc=EM_DWP_15744074&amp;uid=1615506" target="_blank">click here</a>. Note: Registration is required.</p>
<p>&nbsp;</p>
</div>
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		<title>Lilly CEO Calls on FDA to Lighten Up</title>
		<link>http://blog.assurx.com/2011/11/08/lilly-ceo-calls-on-fda-to-lighten-up/</link>
		<comments>http://blog.assurx.com/2011/11/08/lilly-ceo-calls-on-fda-to-lighten-up/#comments</comments>
		<pubDate>Tue, 08 Nov 2011 14:04:33 +0000</pubDate>
		<dc:creator>Michael Causey</dc:creator>
				<category><![CDATA[FDA Regulated]]></category>
		<category><![CDATA[Michael Causey]]></category>
		<category><![CDATA[Pharma/Biotech]]></category>
		<category><![CDATA[Regulatory]]></category>
		<category><![CDATA[Risk Management]]></category>
		<category><![CDATA[FDA]]></category>
		<category><![CDATA[Pharma]]></category>
		<category><![CDATA[Regulatory Compliance]]></category>

		<guid isPermaLink="false">http://blog.assurx.com/?p=3564</guid>
		<description><![CDATA[The FDA has to speed up adoption of a &#8220;Benefit-Risk Framework&#8221; to improve decision-making in the regulatory process, said John Lechleiter, Ph.D., chairman, president and CEO of Eli Lilly and Company. Speaking at recent industry conference, the CEO of the drug giant called for a regulatory process that focuses both on recognizing and appreciating benefits while [...]]]></description>
			<content:encoded><![CDATA[<div id="attachment_323" class="wp-caption alignleft" style="width: 160px"><a href="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg"><img class="size-full wp-image-323" title="mcausey" src="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg" alt="" width="150" height="150" /></a><p class="wp-caption-text">Michael Causey, Editor &amp; Publisher, eDataIntegrityReport.com</p></div>
<p>The FDA has to speed up adoption of a &#8220;Benefit-Risk Framework&#8221; to improve decision-making in the regulatory process, said John Lechleiter, Ph.D., chairman, president and CEO of <a href="http://www.lilly.com/Pages/home.aspx" target="_blank">Eli Lilly and Company</a>.</p>
<p>Speaking at recent industry conference, the CEO of the drug giant called for a regulatory process that focuses both on recognizing and appreciating benefits while identifying and minimizing risks. Such a balanced approach would help increase the flow of needed medicines to patients and reverse a trend of fewer new drugs getting approved, he said.</p>
<p>&#8220;The stakes are high,&#8221; Lechleiter said. &#8220;The only way to make inroads against [chronic and other] diseases is to sustain the pace of medical progress.&#8221;</p>
<p>The FDA appears to be a bit on the defensive here. It recently issued a report <a href="http://www.nytimes.com/2011/11/04/health/policy/drug-approvals-rise-for-fda.html" target="_blank">touting its record approving drugs</a> it says demonstrates it isn&#8217;t stifling innovation at all thank you very much.</p>
<p>The backdrop to this battle is the upcoming reauthorization of the <a href="http://www.fda.gov/forindustry/userfees/prescriptiondruguserfee/default.htm" target="_blank">Prescription Drug User Fee Act</a> (PDUFA) V. Originally enacted in 1992, PDUFA and its iterations set the foundation for how FDA will manage the drug review process for five years, beginning in October 2012.</p>
<p>Lilly&#8217;s Lechleiter stressed the importance of a non-partisan course for reauthorization. &#8220;As a basis for the drug review process, PDUFA is too important to get bogged down in partisan politics,&#8221; Lechleiter said. &#8220;As Congress considers reauthorization next year, we hope to see a &#8216;clean&#8217; bill &#8211; one free of extraneous and controversial provisions that would politicize the bill and further complicate matters for all parties.&#8221;Lechleiter said the regulatory system must continue to evolve to meet 21st century needs.</p>
<blockquote><p>Lechleiter offered five key characteristics of a &#8220;state of the art&#8221; regulatory approval system:</p>
<ol>
<li>Timely &#8211; &#8220;There are far too many conditions for which therapy is inadequate or nonexistent. We need a system that is not only effective, but efficient as well.&#8221;</li>
<li>Predictable &#8211; &#8220;The system must be predictable in its judgments, its decisions, and the criteria on which those decisions were based &#8211; whether scientific, ethical, legal, etc.&#8221;</li>
<li>Consistent &#8211; &#8220;The system must be consistent across review divisions using standardization and repeatable processes &#8211; so that an innovator clearly understands the regulatory requirements and so that institutional learning can be harnessed to replace time-consuming one-off learning by review groups and division.&#8221;</li>
<li>Transparent &#8211; &#8220;The system needs to be transparent in its judgments and criteria so [stakeholders] understand the rationale for its decisions.&#8221;</li>
<li>Scientifically rigorous &#8211; &#8220;This requires scientific expertise within the agency &#8211; or access to the expertise &#8211; that understands, engages in, and influences the constantly evolving external scientific environment and ensures that standards are up-to-date.&#8221;</li>
</ol>
</blockquote>
<p>Lechleiter also discussed ways to strengthen a medicine&#8217;s benefit and lower its risk, including calling for greater emphasis on improved outcomes for individual patients, through the development of tailored therapeutics.</p>
<p>&#8220;From the point of view of patients and their doctors, a tailored therapy will provide a better benefit/risk trade-off, because they can have a higher degree of confidence that it will work effectively and with minimal harmful side-effects relative to the benefit obtained,&#8221; said Lechleiter. &#8220;From a value-for-money standpoint, tailored medicines should also reduce the heavy costs associated with non-responders. In other words, payers will get what they are paying for.&#8221;</p>
<p>Cry havoc and let slip the dogs of war. This one isn&#8217;t over by a long-shot.</p>
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		<title>FDA Promises &#8216;Sea Change&#8217; in Food Regulation</title>
		<link>http://blog.assurx.com/2011/11/02/fda-promises-sea-change-in-food-regulation/</link>
		<comments>http://blog.assurx.com/2011/11/02/fda-promises-sea-change-in-food-regulation/#comments</comments>
		<pubDate>Wed, 02 Nov 2011 15:01:59 +0000</pubDate>
		<dc:creator>Michael Causey</dc:creator>
				<category><![CDATA[FDA Regulated]]></category>
		<category><![CDATA[Food]]></category>
		<category><![CDATA[Michael Causey]]></category>
		<category><![CDATA[Quality Management]]></category>
		<category><![CDATA[Regulatory]]></category>
		<category><![CDATA[Food Safety]]></category>
		<category><![CDATA[Regulatory Compliance]]></category>

		<guid isPermaLink="false">http://blog.assurx.com/?p=3541</guid>
		<description><![CDATA[The new mantra for food manufacturers better be prevention, prevention, prevention according to current and former FDAers commenting on the January 2011 passage of the mammoth Food Safety and Modernization Act. &#8220;This law represents a sea [of] change for food safety in America, bringing a new focus on prevention&#8230;&#8221; FDA Commissioner Margaret Hamburg says. But [...]]]></description>
			<content:encoded><![CDATA[<div id="attachment_323" class="wp-caption alignleft" style="width: 160px"><a href="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg"><img class="size-full wp-image-323" title="mcausey" src="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg" alt="" width="150" height="150" /></a><p class="wp-caption-text">Michael Causey, Editor &amp; Publisher, eDataIntegrityReport.com</p></div>
<p>The new mantra for food manufacturers better be prevention, prevention, prevention according to current and former FDAers commenting on the January 2011 passage of the mammoth <a href="http://www.fda.gov/food/foodsafety/fsma/default.htm" target="_blank">Food Safety and Modernization Act</a>.</p>
<p>&#8220;This law represents a sea [of] change for food safety in America, bringing a new focus on prevention&#8230;&#8221; FDA Commissioner Margaret Hamburg says.</p>
<p>But former FDA Commissioner of Foods Dr. David Acheson takes it further in a new white paper from <a href="http://www.plex.com" target="_blank">Plex Online</a>. The new law &#8220;will result in significant changes for FDA-regulated food manufacturers and processors.&#8221; FDA&#8217;s emphasis on prevention will require registered facilities to develop and maintain a written food safety plan, for starters, Acheson stresses in a new white paper &#8220;<a href="http://erp.plex.com/forms/DMFoodSafetyPlans-1011?elq=9d05affee7094af8a2cca3348ad8529b" target="_blank">Food Safety plans: New Requirements for Registered Facilities.</a>&#8221;</p>
<p>As <a href="http://blog.assurx.com/2011/10/20/former-fdaer-‘sweeping’-food-regulations-will-challenge-entire-industry/" target="_blank">we&#8217;ve blogged before</a>, most registered food facilities will be required to develop a clear, detailed safety plan that documents the facility&#8217;s:</p>
<ul>
<li>Prerequisite programs are in place to ensure food is produced in a safe and sanitary manner;</li>
<li>Hazard analysis that identifies all potential risks throughout processing;</li>
<li>Preventive controls that are implemented to mitigate risks;</li>
<li>Monitoring of preventive controls to ensure they are properly implemented;</li>
<li>Verification that the preventive controls have the intended reduction in risk; and</li>
<li>Re-analysis of the hazards and preventive controls when there are significant changes in the process or every three years.</li>
</ul>
<p><a href="http://blog.assurx.com/wp-content/uploads/2009/12/foodsafety150.png"><img class="alignright size-full wp-image-1251" title="foodsafety150" src="http://blog.assurx.com/wp-content/uploads/2009/12/foodsafety150.png" alt="" width="150" height="150" /></a>Acheson, now with <a href="http://www.leavittpartners.com/" target="_blank">Leavitt Partners</a>, notes that regulated entities must soon be &#8220;able to quickly access records and demonstrate compliance with the food safety plan requirements.&#8221; They&#8217;ll also be expected to have &#8220;implemented a robust food safety program&#8221; if they want to maintain a position as a food safety leader.</p>
<p>He advises regulated entities to develop well-documented safety plans with strong monitoring procedures and <a href="http://www.assurx.com/CAPA.html">corrective actions</a>, for nine key areas:</p>
<ol>
<li>Facility Information: Facilities will need to document a description of the food, the methods of distribution and storage, the intended use and intended customer for all products produced.</li>
<li>Prerequisite Programs: These programs will require a written plan, established monitoring procedures, established corrective action procedures, and an established recordkeeping system.</li>
<li>Hazard Analysis: Facilities will be required to conduct and document these to identify potential product-related hazards, including biological, chemical, and other hazards such as terrorism.</li>
<li>Preventive Controls: Once identified, each hazard must be evaluated to determine the significance of the hazard if it isn&#8217;t controlled, the likely occurrence of the hazards, and if it constitutes a &#8220;critical control point&#8221; that must be addressed.</li>
<li>Monitoring: Each critical control point must be then monitored to ensure compliance with the critical limits.</li>
<li>Corrective Actions: Beyond on-going monitoring, facilities must establish and document procedures for taking proper and effective corrective actions when critical limits aren&#8217;t met.</li>
<li>Verification: Facilities will then need to verify that the preventive control and critical limits result in the intended control and reduction of hazard.</li>
<li>Record-keeping: The new legislation authorizes the FDA to request access to a regulated entities&#8217; Food Safety Plan. Each entity must establish a record-keeping system that documents their hazard analysis, critical control points, monitoring, verification, and corrective action plans and follow-up.</li>
<li>Re-analysis: facilities are required to conduct one of their food safety plan and hazard assessment whenever they implement significant changes or every three years.</li>
</ol>
<p>It will take some time for the FDA to decide exactly how it will enforce the new law, and its interpretation will clearly have some impact on food manufacturers and other regulated entities. But it&#8217;s equally clear that the new law means big changes for companies that make food for a living.</p>
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		<title>Former FDAer: ‘Sweeping’ Food Regulations Will Challenge Entire Industry</title>
		<link>http://blog.assurx.com/2011/10/20/former-fdaer-%e2%80%98sweeping%e2%80%99-food-regulations-will-challenge-entire-industry/</link>
		<comments>http://blog.assurx.com/2011/10/20/former-fdaer-%e2%80%98sweeping%e2%80%99-food-regulations-will-challenge-entire-industry/#comments</comments>
		<pubDate>Thu, 20 Oct 2011 15:38:55 +0000</pubDate>
		<dc:creator>Michael Causey</dc:creator>
				<category><![CDATA[FDA Regulated]]></category>
		<category><![CDATA[Food]]></category>
		<category><![CDATA[Michael Causey]]></category>
		<category><![CDATA[Regulatory]]></category>
		<category><![CDATA[FDA]]></category>
		<category><![CDATA[Food Safety]]></category>
		<category><![CDATA[Regulatory Compliance]]></category>

		<guid isPermaLink="false">http://blog.assurx.com/?p=3527</guid>
		<description><![CDATA[The most sweeping food regulation since the days of Franklin Delano Roosevelt is about to catch some unsuspecting companies off guard, warns former FDA Associate Commissioner of Foods Dr. David Acheson. “Companies need to update their compliance systems to meet a new mindset and new regulations,” he stressed. The Food Safety Modernization Act, signed into law [...]]]></description>
			<content:encoded><![CDATA[<div id="attachment_323" class="wp-caption alignleft" style="width: 160px"><a href="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg"><img class="size-full wp-image-323" title="mcausey" src="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg" alt="" width="150" height="150" /></a><p class="wp-caption-text">Michael Causey, Editor &amp; Publisher, eDataIntegrityReport.com</p></div>
<p>The most sweeping food regulation <a href="http://en.wikipedia.org/wiki/New_Deal" target="_blank">since the days of Franklin Delano Roosevelt</a> is about to catch some unsuspecting companies off guard, warns former FDA Associate Commissioner of Foods <a href="http://blogs.wsj.com/washwire/2009/07/20/fda-food-safety-chief-heads-to-consulting-firm/" target="_blank">Dr. David Acheson</a>. “Companies need to update their compliance systems to meet a new mindset and new regulations,” he stressed.</p>
<p><a href="http://www.fda.gov/food/foodsafety/fsma/default.htm" target="_blank">The Food Safety Modernization Act</a>, signed into law in January, will go into effect in stages in the next few years. The final rule is expected to be enacted in July 2012, with a ramp up time for companies to comply. It’s worth noting that, unlike its work with, say, <a href="http://www.assurx.com/fda.html" target="_blank">21 CFR Part 11</a> and <a href="http://www.assurx.com/emdr.html" target="_blank">eMDR</a>, the FDA has in fact hit every regulatory deadline it has given itself. &#8220;That doesn’t give you very long to understand and navigate the change,&#8221; Acheson said.</p>
<p>But as with pharma and medical device industries, the bigger food companies tend to have a jumpstart in terms of compliance when compared with smaller companies, notes <a href="http://www.plex.com" target="_blank">Plex</a>’s Executive Vice President, Tom Mackey. Big companies had a hand in writing the law and are generally supportive of its provisions, he adds.</p>
<p>FDA, reacting to some high-profile recalls with cantaloupes, peanuts and other food products, is now preaching a mantra of “prevention, prevention, prevention,” Acheson said this week at a Webinar sponsored by <a href="http://www.plex.com" target="_blank">Plex Online</a>.</p>
<p>Acheson, now managing director food and import safety with <a href="http://leavittpartners.com/food-safety-modernization-act/" target="_blank">Leavitt Partners</a>, warned food industry players that “protecting the brand today is different than it was five years ago…and these new regulations are just icing on the cake.” New challenges for the food industry include higher consumer expectations and more aggressive social media that can damage a brand almost instantly.</p>
<p>We’re in a new world of global risk and supply chains, Acheson warned. Food companies that don’t get it, are going to get it from the FDA.</p>
<p>While he doesn’t expect FDA food inspections to increase for at least another year or two domestically, they are already on the rise internationally. He noted, too, that FDA inspectors today are focusing more on how well companies have a handle on <a href="http://www.assurx.com/CAPA.html" target="_blank">CAPA</a> and root cause analysis. “The FDA really expects you to understand what went wrong,” he said.</p>
<p><a href="http://blog.assurx.com/wp-content/uploads/2011/01/tomatoes.jpg"><img class="alignright size-thumbnail wp-image-2778" title="tomatoes" src="http://blog.assurx.com/wp-content/uploads/2011/01/tomatoes-150x150.jpg" alt="" width="150" height="150" /></a>For example, in a typical inspection, an FDA inspector will now ask to see your food safety plan. He won’t read it cover to cover, but he will focus on a particular point, then ask you to demonstrate what’s gone wrong in your system in the last six months and ask you to show your root cause analysis capability, too.</p>
<p>“This is a great way to inspect, and the FDA has a heavy emphasis on verification and knowing that your plan is working,” Acheson said. All components must be continuously documented.</p>
<p>Oh, and expect more warning letters and recall notices, too, as a result of the Act and FDA’s new emphasis.</p>
<p>“It’s a heavy lift [to comply] but there are many ways to make it easier, including staying informed and using technological innovations” to get a better handle on your supply chain and your operations, he said.</p>
<p>But don’t get complacent just because you have some time before you need to comply, he suggested. Instead, use this time to get ahead of the curve.</p>
<p>Start by identifying a team in your firm to spearhead compliance, conduct a gas assessment, determine the best way to close those gaps, examine if your current business practices conform to these new regulatory demands, set priorities based on risk and resources, and establish a system to stay informed internally and one that can be used to demonstrate to FDA inspectors that you are on top of it.</p>
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		<title>Medical Device Industry Warily Eyes More FDA Reorganization Plans</title>
		<link>http://blog.assurx.com/2011/10/10/medical-device-industry-warily-eyes-more-fda-reorganization-plans/</link>
		<comments>http://blog.assurx.com/2011/10/10/medical-device-industry-warily-eyes-more-fda-reorganization-plans/#comments</comments>
		<pubDate>Mon, 10 Oct 2011 16:15:03 +0000</pubDate>
		<dc:creator>Michael Causey</dc:creator>
				<category><![CDATA[FDA Regulated]]></category>
		<category><![CDATA[Medical Devices]]></category>
		<category><![CDATA[Michael Causey]]></category>
		<category><![CDATA[Regulatory]]></category>
		<category><![CDATA[510K]]></category>
		<category><![CDATA[FDA]]></category>
		<category><![CDATA[Regulatory Compliance]]></category>

		<guid isPermaLink="false">http://blog.assurx.com/?p=3503</guid>
		<description><![CDATA[That sound you heard last week was the device industry sighing and maybe even applauding lightly when the FDA announced  it was seeking the public’s input on a plan to identify and harness a web of outside experts who may help it speed device approval. As Reuters reported, FDA formed a pilot committee of experts, which [...]]]></description>
			<content:encoded><![CDATA[<div id="attachment_323" class="wp-caption alignleft" style="width: 160px"><a href="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg"><img class="size-full wp-image-323" title="mcausey" src="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg" alt="" width="150" height="150" /></a><p class="wp-caption-text">Michael Causey, Editor &amp; Publisher, eDataIntegrityReport.com</p></div>
<p>That sound you heard last week was the device industry sighing and maybe even applauding lightly when the <a href="http://www.reuters.com/article/2011/10/04/us-fda-approval-idUSTRE79373F20111004" target="_blank">FDA announced </a> it was seeking the public’s input on a plan to identify and harness a web of outside experts who may help it speed device approval.</p>
<p>As Reuters reported, FDA formed a pilot committee of experts, which will run through December 30 and expand the pool of vetted sources the agency already has on tap. It’s all part of the FDA’s effort to reform the <a href="http://www.fda.gov/medicaldevices/deviceregulationandguidance/howtomarketyourdevice/premarketsubmissions/premarketnotification510k/ucm070201.htm" target="_blank">510(k) medical device review process</a>. Some say the agency isn’t tough enough in protecting the safety of device users; others say the <a href="http://www.qmed.com/news/us-medical-innovation-risk-fewer-new-companies-and-therapies-receiving-funding-says-report#" target="_blank">agency is stifling innovation and sending more jobs overseas</a>.</p>
<p>Device manufacturers we spoke to were guardedly optimistic about this and other recent FDA moves. “We support the creation of such a network, providing that the FDA ensures that the experts do not have any personal or professional ties or conflicts of interest with the products / manufacturers / specific device industries they oversee,” Kelly Roman, Vice President at <a href="http://www.fisherwallace.com/" target="_blank">Fisher Wallace Laboratories</a>, told us.</p>
<p>“We are aware that current Panel members that the FDA works with on PMA and reclassification matters may have these types of ties and conflicts,” Kelly continues. “It is difficult to retain top experts who have no vested interest in the fate of the industries they oversee, but ensuring that the process is completely free of bias is essential to the FDA’s mission and to public health.”</p>
<p>She suggests that, as with Panel members, FDA should “provide the full professional biographies of network experts. “ She also called on the agency to provide a forum by which the public may raise concerns over potential conflicts of interest on a case by case basis, and provide some process by which these concerns are officially addressed.</p>
<p>“This will help provide transparency and resolution to conflicts of interest that will inevitably arise. As of now, there is no clear, prescribed way to address such issues.</p>
<p>But Charlie Chi, Ph.D., former CEO and co-founder of <a href="http://www.otismed.com/" target="_blank">OtisMed</a> (now part of Stryker Orthopaedics), is a medical device industry entrepreneur and inventor flat out thinks it’s a bad idea for the FDA to get involved in new medical technologies.</p>
<p>Chi doesn’t think any company would want the FDA to get involved in every step of the product development cycle. In addition, he thinks it would take longer and be more costly for companies to develop new medical devices even though the approval process might be faster.</p>
<p>Chi noted that most U.S. companies are now going to Europe/Asia first to launch their new products because the approval process is quicker and less stringent than in the U.S. Yet, the failure rate is actually less than here in the U.S. He thinks the FDA should follow a review and approval process similar to other countries around the world.</p>
<div id="attachment_3507" class="wp-caption alignright" style="width: 119px"><a href="http://www.accenture.com/us-en/blogs/accenture-medical-technology-blog/default.aspx"><img class="size-full wp-image-3507 " title="Doug Mowen_resize" src="http://blog.assurx.com/wp-content/uploads/2011/10/Doug-Mowen_resize.jpg" alt="Doug Mowen" width="109" height="130" /></a><p class="wp-caption-text">Doug Mowen, Accenture</p></div>
<p><a href="http://www.accenture.com/us-en/blogs/accenture-medical-technology-blog/FullBiography.aspx?name=Doug%20Mowen" target="_blank">Accenture’s Doug Mowen</a> feels the pain of both sides and urged the medical device industry to take a “wait and watch” approach. “There has been so much noise around FDA and these issues, but I believe the FDA has now heard everyone loud and clear.” He and his team work with medical device firms to handle 483s and other FDA-related dealings.</p>
<p>Doug sees some reasons for optimism because the FDA does seem to finally understand the medical device industries concerns. “If the FDA is able to reform a few things in the 510(k) process and make it more transparent, that will be such a positive thing.”</p>
<p>With over 15 years of experience in the Life Sciences industry, Doug has worked broadly across the medical technology industry, assisting major MedTech companies with compliance in key areas including emerging markets, supply chain, and pricing and customer profitability. Most recently Doug developed a research paper <a href="http://www.accenture.com/SiteCollectionDocuments/PDF/Accenture-Med-Tech-HPB-Research-2011-Final.pdf" target="_blank">“Achieving High Performance: Reinventing Medical Technology for a Dramatically Different Future,”</a> addressing how global regulatory issues are changing the overall business landscape for MedTech.</p>
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		<title>IOM Report Calls for Gutting Current 510(k) Review Process, Angers Everyone</title>
		<link>http://blog.assurx.com/2011/08/03/iom-report-calls-for-gutting-current-510k-review-process-angers-everyone/</link>
		<comments>http://blog.assurx.com/2011/08/03/iom-report-calls-for-gutting-current-510k-review-process-angers-everyone/#comments</comments>
		<pubDate>Wed, 03 Aug 2011 13:52:36 +0000</pubDate>
		<dc:creator>Michael Causey</dc:creator>
				<category><![CDATA[FDA Regulated]]></category>
		<category><![CDATA[Medical Devices]]></category>
		<category><![CDATA[Michael Causey]]></category>
		<category><![CDATA[Regulatory]]></category>
		<category><![CDATA[510K]]></category>
		<category><![CDATA[FDA]]></category>
		<category><![CDATA[Regulatory Compliance]]></category>

		<guid isPermaLink="false">http://blog.assurx.com/?p=3347</guid>
		<description><![CDATA[Tyra Banks aside, not many 35 year olds look as pristine and buff as they did in younger days. But if the new Institute of Medicine (IOM) report has its way, the FDA’s 35 year-old 510(k) process should be put out to pasture entirely. I suppose there’s something to be said for the fact that [...]]]></description>
			<content:encoded><![CDATA[<div id="attachment_323" class="wp-caption alignleft" style="width: 160px"><a href="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg"><img class="size-full wp-image-323" title="mcausey" src="http://blog.assurx.com/wp-content/uploads/2009/04/mcausey.jpg" alt="" width="150" height="150" /></a><p class="wp-caption-text">Michael Causey, Editor &amp; Publisher, eDataIntegrityReport.com</p></div>
<p><a href="http://www.examiner.com/celebrity-fitness-and-health-in-national/top-model-tyra-banks-still-rocks-model-body-at-35" target="_blank">Tyra Banks</a> aside, not many 35 year olds look as pristine and buff as they did in younger days.</p>
<p>But if the new <a href="http://www.iom.edu/" target="_blank">Institute of Medicine (IOM)</a> report has its way, the FDA’s 35 year-old <a href="http://www.fda.gov/medicaldevices/productsandmedicalprocedures/deviceapprovalsandclearances/510kclearances/default.htm" target="_blank">510(k) process</a> should be put out to pasture entirely.</p>
<p>I suppose there’s something to be said for the fact that <a href="http://www.iom.edu/~/media/Files/Report%20Files/2011/Medical-Devices-and-the-Publics-Health-The-FDA-510k-Clearance-Process-at-35-Years/510k%20Clearance%20Process%202011%20Report%20Brief.pdf" target="_blank">IOM’s controversial new report</a> seems to have made almost everyone mad.</p>
<p>FDA is reportedly not happy and surprised that it calls for scrapping the current 510(k) system.</p>
<p>Stephen J. Ubl, president and CEO of the <a href="http://www.advamed.org" target="_blank">Advanced Medical Technology Association</a> (AdvaMed), said industry isn’t happy with it, either. &#8220;The report’s conclusions do not deserve serious consideration from the Congress or the Administration. It proposes abandoning efforts to address the serious problems with the administration of the current program by replacing it at some unknown date with an untried, unproven and unspecified new legal structure. This would be a disservice to patients and the public health.&#8221;</p>
<p>Ulb goes on, &#8220;Numerous academic studies have shown that the 510(k) process is overwhelmingly safe. The IOM committee itself acknowledges that there is no evidence that the 510(k) process is failing to assure safety and effectiveness. Yet the report recommends entirely scrapping this proven process with a vague new plan that contains no useful guidance. It even goes so far as to say that further investment in 510(k) process improvements would not be ‘a wise use of FDA resources.&#8221;</p>
<p>But IOM’s report seems to have surprised everyone with its stark view of the situation.</p>
<p>&#8220;The committee concludes that the 510(k) process lacks the legal basis to be a reliable premarket screen of the safety and effective­ness of moderate-risk devices and, furthermore, that it cannot be transformed into one,&#8221; the report says.</p>
<p>IOM believes &#8220;the current 510(k) process is flawed based on its legislative foundation. Rather than continuing to modify the 35-year-old 510(k) process, the IOM concludes that the FDA’s finite resources would be better invested in developing an integrated premarket and postmarket regulatory framework that provides a reasonable assurance of safety and effectiveness throughout the device life cycle.&#8221;</p>
<p>In other words, junk it. Start over.</p>
<p><a href="http://blog.assurx.com/wp-content/uploads/2009/04/fda-logo1.jpg"><img class="alignright size-full wp-image-281" title="fda-logo" src="http://blog.assurx.com/wp-content/uploads/2009/04/fda-logo1.jpg" alt="" width="54" height="26" /></a>Has the FDA’s 510(k) process hindered innovation (as much of the medical device industry maintains), or has it struck the best balance between protecting patients and spurring new ideas?</p>
<p>Sorry, IOM punted on that one. &#8220;It is unclear—and the committee concludes that it is indeterminable, given current information— whether the 510(k) process over the last 35 years has had a positive or negative effect on innovation. To answer this question, the FDA should commission an assessment to determine this effect.&#8221;</p>
<p>In other words, do another study.</p>
<p>Respected industry attorney and <a href="http://www.hoganlovells.com/john-smith/" target="_blank">Hogan Lovells Partner John Smith</a> tells us, &#8220;the report is extremely disappointing given the time and effort that has been dedicated to this process. The assumptions underlying the IOMs conclusions are fundamentally flawed and those conclusions are vague and highly questionable.&#8221;</p>
<p>Specifically, he faults the IOM report for saying the 510(k) process does not evaluate safety and effectiveness. &#8220;This is simply not true in FDA&#8217;s application of the 510(k) paradigm to new medical devices. Although the standard for clearance is ‘substantial equivalence,’ the agency routinely integrates an evaluation of both safety and effectiveness into its substantial equivalence determinations. In other words, the IOM analysis lacks a ‘real world’ perspective and appears to have relied upon on a very conservative reading of the <a href="http://www.fda.gov/regulatoryinformation/legislation/federalfooddrugandcosmeticactfdcact/default.htm" target="_blank">Federal Food, Drug, and Cosmetic Act</a>, and its implementing regulations to reach this conclusion.&#8221;</p>
<p>IOM says scrap the 510(k) system, but some say scrap the IOM report.</p>
<p>&#8220;The Institute&#8217;s primary conclusion that the 510(k) process should be abandoned completely ignores the considerable debate that lead to its creation and the successful applicable of the 510(k) paradigm over 35 years,&#8221; Smith says. &#8220;No specific, systemic shortcomings that would justify such a radical restructuring were convincingly identified. Simply put, establishing the 510(k) paradigm was a thorough, thoughtful process and the process served both FDA and industry well since its inception. The Institute also fails to offer concrete recommendations as to potential alternatives, likely reflecting how difficult it will be to improve on the existing 510(k) paradigm.&#8221;</p>
<p>Watch the IOM’s webcast <a href="http://www.tvworldwide.com/events/iom/110729/default.cfm" target="_blank">unveiling the report here.</a></p>
<p>Comment period ends September 30. <a href="http://www.federalregister.gov/articles/2011/08/01/2011-19353/center-for-devices-and-radiological-health-510k-clearance-process-institute-of-medicine-report" target="_blank">To comment, go here</a>:</p>
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		<title>Book Review: Former FDA Inspector Calls for Revitalized Agency, Focus</title>
		<link>http://blog.assurx.com/2011/08/01/book-review-former-fda-inspector-calls-for-revitalized-agency-focus/</link>
		<comments>http://blog.assurx.com/2011/08/01/book-review-former-fda-inspector-calls-for-revitalized-agency-focus/#comments</comments>
		<pubDate>Mon, 01 Aug 2011 14:12:34 +0000</pubDate>
		<dc:creator>Michael Causey</dc:creator>
				<category><![CDATA[FDA Regulated]]></category>
		<category><![CDATA[Michael Causey]]></category>
		<category><![CDATA[Quality Management]]></category>
		<category><![CDATA[Regulatory]]></category>
		<category><![CDATA[FDA]]></category>
		<category><![CDATA[Regulatory Compliance]]></category>

		<guid isPermaLink="false">http://blog.assurx.com/?p=3330</guid>
		<description><![CDATA[In a book he says is neither a “toasting or a roasting,” former inspector Patrick Stone clearly loves the FDA he worked at from August 1998 until March 2011, but hates some of what he’s seen happen at the agency. “Bubble Gum Badge” is invaluable for regulated companies because, among other things, it shows the [...]]]></description>
			<content:encoded><![CDATA[<div id="attachment_2963" class="wp-caption alignleft" style="width: 160px"><a href="http://www.tradestoneqa.com"><img class="size-full wp-image-2963" title="Patrick Stone" src="http://blog.assurx.com/wp-content/uploads/2009/04/PatrickStone.jpg" alt="" width="150" height="150" /></a><p class="wp-caption-text">Patrick Stone, President, TradeStone QA</p></div>
<p>In a book he says is neither a “toasting or a roasting,” former inspector Patrick Stone clearly loves the <a href="http://www.fda.gov" target="_blank">FDA</a> he worked at from August 1998 until March 2011, but hates some of what he’s seen happen at the agency.</p>
<p><a href="http://www.bubblegumbadge.com" target="_blank">“Bubble Gum Badge”</a> is invaluable for regulated companies because, among other things, it shows the importance of gauging the human side of FDA inspectors. As Stone notes, they have different approaches and interpretations to how they do their work, including what they look for on inspections and what they consider problems. It’s incumbent on regulated companies to have best practices in place, but also to be prepared to explain their rationale to inspectors.</p>
<p>“FDA investigators, the good ones, at least, can read individuals like a book; and your lack of experience is on the front page. Good leaders listen to the experts in the field and are willing to learn from a subordinate,” Stone advises higher-ups at regulated companies. His book is full of such practical, nuts and bolts advice.</p>
<p><a href="http://www.bubblegumbadge.com"><img class="alignright size-full wp-image-3333" title="bubblegumbadge" src="http://blog.assurx.com/wp-content/uploads/2011/08/bubblegumbadge.jpg" alt="Bubble Gum Badge" width="126" height="190" /></a>Stone also calls for both industry and the FDA to do a better job with electronic data integrity and electronic record keeping. There’s lots of room for improvement on both sides. He lays out several areas where each needs to raise the bar, but for industry it boils down to taking it seriously, using common sense, and not trying to hide violations. For the FDA, it’s about practicing what it preaches, and issuing some vastly overdue new guidances for <a href="http://www.fda.gov/regulatoryinformation/guidances/ucm125067.htm" target="_blank">21 CFR Part 11</a>, among other electronic record areas. Fuzzy FDA directives aren’t helping anyone, Stone maintains.</p>
<p>This isn’t a rough hatchet job, but more of a carefully considered critique of an agency Stone loves, but wishes could be better. “I am not a disgruntled employee… I have nothing but respect for the field investigators, laboratory staff, support staff, and frontline workers as well as the center reviewers.”</p>
<p>I hope some current senior FDA staff read this book and take it to heart.</p>
<p>Click here to <a href="http://www.amazon.com/Bubble-Gum-Badge/dp/1462872581/ref=sr_1_1?ie=UTF8&amp;qid=1311816525&amp;sr=8-1" target="_blank">purchase his book</a>.</p>
<p>Connect with Stone, and to read a book excerpt visit <a href="http://www.bubblegumbadge.com" target="_blank">http://www.bubblegumbadge.com</a> or email him at <a href="mailto:patrick@tradestoneqa.com" target="_blank">patrick@tradestoneqa.com</a>.</p>
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