Directive 2007/47/EC of the European Parliament and of the Council of 5 September 2007 amending Council Directive 90/385/EEC on the approximation of the laws of the Member States relating to active implantable medical devices, Council Directive 93/42/EEC concerning medical devices and Directive 98/8/EC concerning the placing of biocidal products on the market (Text with EEA relevance)
Date: 2007-09-05
Institutions: Council of the European Union, European Parliament
Subjects: approximation of laws, health control, market approval, medical device, medicinal product, product safety

21.9.2007

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Official Journal of the European Union

L 247/21

DIRECTIVE 2007/47/EC OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL

of 5 September 2007

amending Council Directive 90/385/EEC on the approximation of the laws of the Member States
relating to active implantable medical devices, Council Directive 93/42/EEC concerning medical
devices and Directive 98/8/EC concerning the placing of biocidal products on the market

(Text with EEA relevance)

THE EUROPEAN PARLIAMENT AND THE COUNCIL OF THE
EUROPEAN UNION,

was also discussed by the European Parliament which on
3 June 2003 adopted a
resolution on the health
implications of Directive 93/42/EEC (6).

Having regard to the Treaty establishing the European Commu-
nity, and in particular Article 95 thereof,

Having regard to the proposal from the Commission,

Having regard to the opinion of the European Economic and
Social Committee (1),

(4)

Following from the conclusions drawn in that Commu-
nication it is necessary and appropriate to amend Council
Directive 90/385/EEC (7), Directive 93/42/EEC and Direc-
the
tive 98/8/EC of
Council (8).

the European Parliament and of

Acting in accordance with the procedure laid down in Article 251
of the Treaty (2),

(5)

Whereas:

implementation of

(1) Council Directive 93/42/EEC (3) requires the Commission
to submit a report to the Council, no later than five years
from the date of
that Directive,
concerning: (i) information on incidents occurring follow-
ing the placing of devices on the market,
(ii) clinical
investigation carried out in accordance with the procedure
set out in Annex VIII to Directive 93/42/EEC, and (iii)
design examination and EC type examination of medical
devices that incorporate, as an integral part, a substance
which,
if used separately, may be considered to be a
medicinal product as defined in Directive 2001/83/EC of
the European Parliament and of the Council of 6 November
2001 on the Community code relating to medicinal
products for human use (4) and which is liable to act upon
the body with action ancillary to that of the device.

(2)

The Commission brought forward the conclusions of that
report
in its Communication to the Council and the
European Parliament on medical devices which, at the
request of the Member States, was expanded to cover all
aspects of
the Community regulatory framework for
medical devices.

(3)

This Communication was welcomed by the Council in its
Conclusions on medical devices of 2 December 2003 (5). It

(1) OJ C 195, 18.8.2006, p. 14.
(2) Opinion of the European Parliament of 29 March 2007 (not yet
published in the Official Journal) and Council Decision of 23 July
2007.

(3) OJ L 169, 12.7.1993, p. 1. Directive as last amended by Regulation
(EC) No 1882/2003 of the European Parliament and of the Council
(OJ L 284, 31.10.2003, p. 1).

(4) OJ L 311, 28.11.2001, p. 67. Directive as last amended by
Regulation (EC) No 1901/2006 of the European Parliament and of
the Council (OJ L 378, 27.12.2006, p. 1).

To ensure consistency of interpretation and implementation
between Directives 93/42/EEC and 90/385/EEC the legal
framework related to issues such as authorised representa-
tive, the European databank, health protection measures,
and the application of Directive 93/42/EEC as regards
medical devices incorporating stable derivates of human
blood or human plasma, as introduced by Directive 2000/
70/EC (9), should be extended to Directive 90/385/EEC. The
application of the provisions on medical devices incorpor-
ating stable derivates of human blood or human plasma
includes application of Directive 2002/98/EC of
the
European Parliament and of the Council of 27 January
2003 setting standards of quality and safety for
the
collection, testing, processing, storage and distribution of
human blood and blood components and amending
Directive 2001/83/EC (10).

It is necessary to clarify that software in its own right, when
specifically intended by the manufacturer to be used for one
or more of the medical purposes set out in the definition of
a medical device, is a medical device. Software for general
purposes when used in a healthcare setting is not a medical
device.

the
Particular care should be taken to ensure that
reprocessing of medical devices does not endanger patients’
safety or health.
is therefore necessary to provide
clarification on the definition of the term ‘single use’, as
well as to make provision for uniform labelling and

It

(6)

(7)

(6) OJ C 68 E, 18.3.2004, p. 85.
(7) OJ L 189, 20.7.1990, p. 17. Directive as last amended by Regulation

(EC) No 1882/2003.

(8) OJ L 123, 24.4.1998, p. 1. Directive as last amended by Commission

Directive 2007/20/EC (OJ L 94, 4.4.2007, p. 23).

(9) Directive 2000/70/EC of

the
Council of 16 November 2000 amending Council Directive 93/42/
EEC as regards medical devices incorporating stable derivates of
human blood or human plasma (OJ L 313, 13.12.2000, p. 22).

the European Parliament and of

(5) OJ C 20, 24.1.2004, p. 1.

(10) OJ L 33, 8.2.2003, p. 30.

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Official Journal of the European Union

21.9.2007

instructions for use. Moreover, the Commission should
engage in further analysis in order to see if additional
measures are appropriate to ensure a high level of
protection for patients.

(15) To further ensure public health and safety it is necessary to
provide for a more consistent application of the provisions
on health protection measures. Particular care should be
taken to ensure that, when in use, the products do not
endanger patients’ health or safety.

(8)

(9)

level

In the light of technical innovation and the development of
is necessary to
initiatives at
the international
enhance the provisions on clinical evaluation,
including
clarification that clinical data is generally required for all
devices regardless of classification and the possibility to
centralise data on clinical investigations in the European
databank.

it

In order to provide clearer evidence of the compliance of
custom-made device manufacturers, an explicit requirement
for a post market production review system involving
incident reporting to authorities should be introduced, as is
already in place for other devices, and to enhance patient
information, a requirement should be introduced that the
to Directive 93/42/EEC
‘Statement’ under Annex VIII
should be available to the patient and that
it should
contain the name of the manufacturer.

(10)

In the light of technical progress in information technology
and medical devices, a process should be provided to allow
information supplied by the manufacturer to be available
by other means.

(16)

In support of
transparency in Community legislation,
certain information related to medical devices and their
conformity with Directive 93/42/EEC, in particular infor-
mation on registration, on vigilance reports and on
certificates, should be available to any interested party
and the general public.

(17) To better coordinate the application and efficiency of
national
related to
resources when applied to issues
Directive 93/42/EEC, the Member States should cooperate
with each other and at international level.

(18) As design for patient safety initiatives play an increasing
role in public health policy, it is necessary to expressly set
out the need to consider ergonomic design in the essential
requirements. In addition the level of training and knowl-
edge of the user, such as in the case of a lay user, should be
further emphasised within the essential requirements. The
manufacturer should place particular emphasis on the
consequences of misuse of the product and its adverse
effects on the human body.

(11) Manufacturers of Class I sterile and/or measuring medical
devices should be given the option of using the full quality
assurance conformity assessment module in order
to
provide them with more flexibility in the choice of
compliance modules.

(19)

In the light of experience gained regarding activities of both
the notified bodies and the authorities in the assessment of
devices which require intervention of
the appropriate
authorities for medicines and human blood derivatives
their duties and tasks should be clarified.

(12)

In order
to support market surveillance activities by
Member States it is necessary and appropriate, in the case
of implantable devices, to increase the time period for the
retention of documents for administrative purposes to at
least 15 years.

(20) Taking account of the growing importance of software in
the field of medical devices, be it as stand alone or as
software incorporated in a device, validation of software in
accordance with the state of the art should be an essential
requirement.

(13) For the appropriate and efficient functioning of Directive
93/42/EEC as regards regulatory advice on classification
issues arising at national level, in particular on whether or
not a product falls under the definition of a medical device,
it is in the interest of national market surveillance and the
health and safety of humans to establish a procedure for
decisions on whether or not a product falls under the
medical device definition.

(21)

In the light of the increased use of third Parties to carry out
the design and manufacture of devices on behalf of the
the manufacturer
manufacturer,
demonstrates that he applies adequate controls to the third
party to continue to ensure the efficient operating of the
quality system.

important

that

is

it

a

single

(14) To ensure that, where a manufacturer does not have a
registered place of business in the Community, authorities
individual person authorised by the
have
manufacturer whom they can address in matters relating
to the compliance of the devices with the Directives it is
necessary to introduce an obligation for such manufacturers
to designate an authorised representative for a device. This
designation should be effective at least for all devices of the
same model.

the potential

(22) The classification rules are based on the vulnerability of the
human body taking account of
risks
associated with the technical design and manufacture of
the devices. Explicit prior authorisation with regard to
conformity,
the design
including an assessment of
documentation,
is required for Class III devices to be
placed on the market. In performing its duties under the
quality assurance and verification conformity assessment
modules for all other classes of devices, it is essential and
necessary for a notified body, in order to be assured of the

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compliance of the manufacturer with Directive 93/42/EEC,
to review the design documentation for the medical device.
The depth and extent of this review should be commensu-
rate with the classification of the device, the novelty of the
intended treatment, the degree of intervention, the novelty
the technology or construction materials, and the
of
complexity of the design and/or technology. This review
can be achieved by taking a representative example of
design documentation of one or more type(s) of devices
from those being manufactured. Further review(s), and in
particular the assessment of changes to the design that
could affect conformity with the essential requirements,
should be part of the surveillance activities of the notified
body.

(23)

is necessary to remove

It
in the
classification rules as a result of which invasive devices
with respect to body orifices intended for connection to an
active Class I medical device were not classified.

incoherence

the

(24) The measures necessary for

the

implementation of
Directive 90/385/EEC and Directive 93/42/EEC should be
adopted in accordance with Council Decision 1999/468/EC
of 28 June 1999 laying down the procedures for the
exercise of
conferred on the
Commission (1).

implementing powers

(25)

set out

to adapt

in certain Annexes,

In particular, power should be conferred on the Commis-
sion to adapt classification rules for medical devices, to
adapt the means by which the information needed to use
medical devices safely and properly may be set out, to
for making certain information
determine conditions
the provisions on clinical
publicly available,
investigations
to adopt
particular requirements for placing certain medical devices
on the market or putting them into service, and to take
decisions to withdraw such devices from the market for
reasons of protection of health or safety. Since those
measures are of general scope and are designed to amend or
supplement Directive 90/385/EEC and Directive 93/42/EEC
by the modification or addition of non-essential elements,
they must be adopted in accordance with the regulatory
procedure with scrutiny provided for in Article 5a of
Decision 1999/468/EC.

(27) The Commission should give a mandate to CEN and/or
Cenelec to specify technical requirements and a suitable
specific label for phthalate-containing devices within 12
months after entry into force of this Directive.

(28) Many Member States have established recommendations
with the aim of reducing or limiting the use of medical
devices containing critical phthalates on children, pregnant
and nursing women and other patients at risk. To enable
medical professionals to avoid such risks, devices which
possibly release phthalates to the body of the patient should
be labelled accordingly.

(29)

(30)

(31)

In accordance with the essential requirements on the design
and manufacture of medical devices, manufacturers should
avoid the use of substances that may possibly compromise
the health of patients, in particular of substances which are
carcinogenic, mutagenic or toxic to reproduction, and
should, as appropriate,
strive to develop alternative
substances or products with a lower risk potential.

It should be clarified that alongside Directives 90/385/EEC
and 93/42/EEC, in vitro diagnostic medical devices, which
are the subject of Directive 98/79/EC of the European
Parliament and of the Council of 27 October 1998 on in
vitro diagnostic medical devices (2), should also be excluded
from the scope of Directive 98/8/EC.

In accordance with point 34 of
the Interinstitutional
agreement on better law-making (3), Member States are
encouraged to draw up, for themselves and in the interests
of the Community, their own tables illustrating, as far as
possible, the correlation between this Directive and the
transposition measures, and to make them public.

(32) Directives 90/385/EEC, 93/42/EEC and 98/8/EC should

therefore be amended accordingly,

HAVE ADOPTED THIS DIRECTIVE:

Article 1

Directive 90/385/EEC is hereby amended as follows:

1.

Article 1 shall be amended as follows:

(a)

paragraph 2 shall be amended as follows:

(26) When, on imperative grounds of urgency, the normal time
limits for the regulatory procedure with scrutiny cannot be
complied with, the Commission should be able to use the
urgency procedure provided for in Article 5a(6) of Decision
1999/468/EC for taking decisions on withdrawal of certain
medical devices from the market and for the adoption of
particular requirements for placing such devices on the
market or putting them into service for
reasons of
protection of health or safety.

(i)

point (a) shall be replaced by the following:

‘(a)

“medical device” means any instrument,
apparatus, appliance, software, material or
other article, whether used alone or in
combination, together with any accessories,
including the software intended by its

(1) OJ L 184, 17.7.1999, p. 23. Decision as amended by Decision 2006/

(EC) No 1882/2003.

512/EC (OJ L 200, 22.7.2006, p. 11).

(3) OJ C 321, 31.12.2003, p. 1.

(2) OJ L 331, 7.12.1998, p. 1. Directive as last amended by Regulation

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21.9.2007

manufacturer to be used specifically for
diagnostic and/or therapeutic purposes and
necessary
application,
intended by the manufacturer to be used
for human beings for the purpose of:

its proper

for

— diagnosis, prevention, monitoring,
treatment or alleviation of disease,

— diagnosis, monitoring, treatment, alle-
viation of or compensation for an
injury or handicap,

— investigation, replacement or modifi-
the anatomy or of a

cation of
physiological process,

— control of conception,

and which does not achieve its principal
intended action in or on the human body
by pharmacological,
immunological or
metabolic means, but which may be
assisted in its function by such means;’

(ii)

points (d), (e) and (f) shall be replaced by the
following:

‘(d)

(e)

“custom-made device” means any device
specifically made in accordance with a duly
qualified medical practitioner's written pre-
scription which gives, under his responsi-
bility, specific design characteristics and is
intended for the sole use of a particular
patient. Mass-produced devices which need
to be adapted to meet the specific require-
ments of the medical practitioner or any
other professional user shall not be con-
sidered to be custom-made devices;

“device intended for clinical investigation”
means any device intended for use by a
duly qualified medical practitioner when
as
conducting
referred to in Section 2.1 of Annex 7 in
an adequate human clinical environment.

investigations

clinical

the purpose of conducting clinical
For
investigation, any other person who, by
virtue of his professional qualifications, is
authorised to carry out such investigation
shall be accepted as equivalent to a duly
qualified medical practitioner;

(f)

“intended purpose” means
the use for
which the device is intended according to
the data supplied by the manufacturer on

the labelling, in the instructions and/or in
promotional material;’

(iii)

the following points shall be added:

‘(j)

“authorised representative” means any nat-
ural or legal person established in the
Community who, explicitly designated by
and may be
the manufacturer,
addressed by authorities and bodies in the
Community instead of
the manufacturer
with regard to the latter's obligations under
this Directive;

acts

(k)

“clinical data” means the safety and/or
performance information that is generated
from the use of a device. Clinical data are
sourced from:

— clinical investigation(s) of the device

concerned, or

— clinical

investigation(s) or other stu-
dies reported in the scientific litera-
ture, of a similar device for which
equivalence to the device in question
can be demonstrated, or

— published and/or unpublished reports
on other clinical experience of either
the device in question or a similar
device for which equivalence to the
device in question can be demon-
strated.’;

(b)

paragraph 3 shall be replaced by the following:

‘3. Where an active implantable medical device is
intended to administer a substance defined as a
medicinal product within the meaning of Article 1 of
Directive 2001/83/EC (*), that device shall be gov-
erned by this Directive, without prejudice to the
provisions of Directive 2001/83/EC with regard to the
medicinal product.

(*) OJ L 311, 28.11.2001, p. 67. Directive as last
amended by Regulation (EC) No 1901/2006 (OJ
L 378, 27.12.2006, p. 1)’

(c)

paragraph 4 shall be replaced by the following:

‘4. Where an active implantable medical device
incorporates, as an integral part, a substance which,
if used separately, may be considered to be a medicinal
product within the meaning of Article 1 of Directive
2001/83/EC and which is liable to act upon the

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human body with action that is ancillary to that of the
device, that device shall be evaluated and authorised in
accordance with this Directive.’;

2.

Article 2 shall be replaced by the following:

‘Article 2

(d)

the following paragraph shall be inserted:

‘4a. Where a device incorporates, as an integral part,
if used separately, may be
a substance which,
considered to be a medicinal product constituent or
a medicinal product derived from human blood or
human plasma within the meaning of Article 1 of
Directive 2001/83/EC and which is liable to act upon
the human body with action that is ancillary to that of
the device, hereinafter referred to as a “human blood
derivative”,
assessed and
authorised in accordance with this Directive.’;

that device

shall be

(e)

paragraph 5 shall be replaced by the following:

‘5. This Directive constitutes a specific Directive
within the meaning of Article 1(4) of Directive 2004/
108/EC (*).

(*) Directive 2004/108/EC of the European Parlia-
ment and of the Council of 15 December 2004
on the approximation of the laws of the Member
States relating to electromagnetic compatibility
(OJ L 390, 31.12.2004, p. 24).’;

(f)

the following paragraph shall be added:

‘6. This Directive shall not apply to:

(a) medicinal products covered by Directive 2001/
83/EC. In deciding whether a product falls under
that Directive or
this Directive, particular
account shall be taken of the principal mode
of action of the product;

(b)

(c)

(d)

human blood, blood products, plasma or blood
to devices which
cells of human origin or
incorporate at the time of placing on the market
such blood products, plasma or cells with the
exception of devices referred to in paragraph 4a;

transplants or tissues or cells of human origin or
to products
incorporating or derived from
tissues or cells of human origin, with the
exception of devices referred to in paragraph 4a;

transplants or tissues or cells of animal origin,
unless a device is manufactured utilising animal
tissue which is rendered non-viable or non-
viable products derived from animal tissue.’;

Member States shall take all necessary steps to ensure that
the devices may be placed on the market and/or put into
service only if they comply with the requirements laid
down in this Directive when duly supplied, properly
implanted and/or properly installed, maintained and used
in accordance with their intended purposes.’;

3.

Article 3 shall be replaced by the following:

‘Article 3

The active implantable medical devices referred to in
referred to as
(d) and (e), hereinafter
Article 1(2)(c),
“devices”, shall satisfy the essential requirements set out in
Annex 1 which apply to them, account being taken of the
intended purpose of the devices concerned.

Where a relevant hazard exists, devices which are also
machinery within the meaning of Article 2(a) of Directive
2006/42/EC of the European Parliament and of the Council
of 17 May 2006 on machinery (*) shall also meet the
essential health and safety requirements set out in Annex I
to that Directive to the extent to which those essential
health and safety requirements are more specific than the
essential requirements set out in Annex 1 to this Directive.

(*) OJ L 157, 9.6.2006, p. 24.’;

4.

in Article 4, paragraphs 1, 2 and 3 shall be replaced by the
following:

‘1. Member States shall not create any obstacle to the
placing on the market or the putting into service within
their territory of devices complying with the provisions of
this Directive and bearing the CE marking provided for in
Article 12, which indicates that they have been the subject
of an assessment of their conformity in accordance with
Article 9.

2. Member States shall not create any obstacles to:

— devices intended for clinical investigations being made
available to duly qualified medical practitioners or
authorised persons for that purpose if they satisfy the
conditions laid down in Article 10 and in Annex 6,

— custom-made devices being placed on the market and
put into service if they satisfy the conditions laid
down in Annex 6 and are accompanied by the
statement, which shall be available to the particular
identified patient, referred to in that Annex.

These devices shall not bear the CE marking.

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fairs,

trade

exhibitions, demonstrations,

etc.,
3. At
Member States shall not create any obstacle to the showing
of devices which do not conform to this Directive, provided
that a visible sign clearly indicates that such devices do not
conform and cannot be marketed or put into service until
they have been made to comply by the manufacturer or his
authorised representative.’;

5.

Article 5 shall be replaced by the following:

‘Article 5

1. Member States shall presume compliance with the
essential requirements referred to in Article 3 in respect of
devices which are in conformity with the relevant national
standards adopted pursuant to the harmonised standards
the references of which have been published in the Official
Journal of the European Union; Member States shall publish
the references of such national standards.

For

this Directive,

the purposes of

2.
reference to
harmonised standards also includes the monographs of
the European Pharmacopoeia notably on interaction
between medicinal products and materials used in devices
containing such medicinal products,
the references of
which have been published in the Official Journal of the
European Union.’;

6.

Article 6 shall be amended as follows:

(a)

in paragraph 1 the reference ‘83/189/EEC’ shall be
replaced by the reference

‘98/34/EC (*)

(*) Directive 98/34/EC of the European Parliament
and of the Council of 22 June 1998 laying down
a procedure for the provision of information in
the field of technical standards and regulations
and of rules on Information Society services (OJ
L 204, 21.7.1998, p. 37). Directive as last
amended by the 2003 Act of Accession.’;

(b)

paragraph 2 shall be replaced by the following:

Decision 1999/468/EC shall apply, having regard to
the provisions of Article 8 thereof.’;

7.

Article 8 shall be replaced by the following:

‘Article 8

1. Member States shall take the necessary steps to ensure
that information brought to their knowledge regarding the
incidents mentioned below involving a device is recorded
and evaluated in a centralised manner:

(a)

(b)

any malfunction of or deterioration in the character-
istics and performances of a device, as well as any
inadequacy in the labelling or in the instructions for
use which might lead to or might have led to the death
of a patient or user or to a serious deterioration in his
state of health;

any technical or medical reason in relation to the
characteristics or performances of a device for the
reasons referred to in point (a), leading to systematic
recall of devices of the same type by the manufacturer.

the medical

2. Where a Member State requires medical practitioners
institutions to inform the competent
or
authorities of any incidents referred to in paragraph 1, it
shall
the
manufacturer of the device concerned, or his authorised
representative, is also informed of the incident.

the necessary steps

to ensure

take

that

3. After carrying out an assessment, if possible together
with the manufacturer or his authorised representative,
Member States
shall, without prejudice to Article 7,
immediately inform the Commission and the other
Member States of measures that have been taken or are
contemplated to minimise the recurrence of the incidents
referred to in paragraph 1, including information on the
underlying incidents.

4. The measures necessary for the implementation of this
Article shall be adopted in accordance with the regulatory
procedure referred to in Article 6(3).’;

‘2. The Commission shall be assisted by a standing
committee (hereinafter referred to as the Committee).

8.

Article 9 shall be amended as follows:

3. Where reference is made to this paragraph,
Articles 5 and 7 of Decision 1999/468/EC shall
apply, having regard to the provisions of Article 8
thereof.

The period laid down in Article 5(6) of Decision
1999/468/EC shall be set at three months.

4. Where reference is made to this paragraph,
Article 5a(1) to (4) and Article 7 of Decision 1999/
468/EC shall apply, having regard to the provisions of
Article 8 thereof.

5. Where reference is made to this paragraph,
(4) and (6), and Article 7 of
Article 5a(1),

(2),

(a)

paragraph 8 shall be replaced by the following:

taken by the notified bodies

‘8. Decisions
in
accordance with Annexes 2, 3 and 5 shall be valid
for a maximum of five years and may be extended on
application, made at a time agreed in the contract
signed by both Parties,
for further periods of a
maximum length of five years.’;

(b)

the following paragraph shall be added:

‘10. The measures designed to amend non-essential
elements of this Directive, inter alia by supplementing
it, relating to the means by which, in the light of

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technical progress and considering the intended users
of the devices concerned, the information laid down
in Annex 1 Section 15 may be set out shall be adopted
in accordance with the regulatory procedure with
scrutiny referred to in Article 6(4).’;

9.

Article 9a shall be replaced by the following:

‘Article 9a

1. A Member State shall submit a duly substantiated
request to the Commission and ask it to take the necessary
measures in the following situations:

— that Member State considers that the conformity of a
device or family of devices should be established, by
way of derogation from the provisions of Article 9, by
applying solely one of the given procedures chosen
from among those referred to in Article 9,

— that Member State considers that a decision is required
as to whether a particular product or product group
falls within the definition of Article 1(2)(a), (c), (d) or
(e).

Where measures are deemed necessary pursuant to the first
subparagraph of this paragraph they shall be adopted in
accordance with the regulatory procedure referred to in
Article 6(3).

2. The Commission shall inform the Member States of the
measures taken.’;

10. Article 10 shall be amended as follows:

(a)

(b)

in paragraph 1, the word ‘his’ shall be replaced by the
word ‘the’.

the second subparagraph of paragraph 2 shall be
replaced by the following:

‘Member States may, however, authorise manufac-
turers to start the clinical investigations in question
before the expiry of the 60-day period, provided that
the ethics committee concerned has issued a favour-
able opinion with respect
investigation
programme in question including its review of the
clinical investigation plan.’;

to the

(c)

paragraph 3 shall be replaced by the following:

‘3. The Member States shall, if necessary, take the
appropriate steps to ensure public health and public
policy. Where a clinical
investigation is refused or
halted by a Member State, that Member State shall
communicate its decision and the grounds therefor to
all Member States and the Commission. Where a
Member State has called for a significant modification
or temporary interruption of a clinical investigation,
that Member State shall inform the Member States
concerned about its actions and the grounds for the
actions taken.’;

(d)

the following paragraphs shall be added:

‘4. The manufacturer or his authorised representa-
tive shall notify the competent authorities of
the
Member States concerned of the end of the clinical
investigation, with a justification in case of early
termination. In the case of early termination of the
clinical investigation on safety grounds this notifica-
tion shall be communicated to all Member States and
the Commission. The manufacturer or his authorised
representative shall keep the report referred to in
point 2.3.7 of Annex 7 at
the
competent authorities.

the disposal of

investigations

5. Clinical
shall be conducted in
accordance with the provisions of Annex 7. The
measures designed to amend non-essential elements
of this Directive relating to the provisions on clinical
investigation in Annex 7 shall be adopted in
accordance with the
regulatory procedure with
scrutiny referred to in Article 6(4).’;

11.

the following Articles shall be inserted:

‘Article 10a

1. Any manufacturer who, under his own name, places
devices on the market in accordance with the procedure
referred to in Article 9(2) shall
inform the competent
authorities of
the Member State in which he has his
registered place of business of the address of the registered
place of business and the description of
the devices
concerned.

Member States may request to be informed of all data
allowing for the devices to be identified together with the
label and the instructions for use when the devices are put
into service within their territory.

2. Where a manufacturer who places a device on the
market under his own name does not have a registered
place of business in a Member State, he shall designate a
single authorised representative in the European Union.

referred to in the first

subparagraph of
For devices
paragraph 1 the authorised representative shall
inform
the competent authority of the Member State in which he
has his registered place of business of all details as referred
to in paragraph 1.

3. The Member States shall on request inform the other
Member States and the Commission of the details referred
to in the first subparagraph of paragraph 1 given by the
manufacturer or authorised representative.

Article 10b

1. Regulatory data in accordance with this Directive shall
be stored in a European databank accessible to the
competent authorities to enable them to carry out their
tasks relating to this Directive on a well-informed basis.

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The databank shall contain the following:

(b)

(a)

(b)

(c)

data relating to certificates issued, modified, supple-
mented, suspended, withdrawn or refused according
to the procedures as laid down in Annexes 2 to 5;

data obtained in accordance with the vigilance
procedure as defined in Article 8;

data relating to clinical investigations referred to in
Article 10.

2. Data shall be forwarded in a standardised format.

3. The measures necessary for the implementation of
paragraphs 1 and 2 of this Article, in particular paragraph 1
(c), shall be adopted in accordance with the regulatory
procedure referred to in Article 6(3).

Article 10c

Where a Member State considers in relation to a given
product or group of products that,
in order to ensure
protection of health and safety and/or to ensure that public
health requirements are observed, such products should be
withdrawn from the market, or their placing on the market
and putting into service should be prohibited, restricted or
subjected to particular
it may take any
necessary and justified transitional measures.

requirements,

The Member State shall then inform the Commission and
all the other Member States of the transitional measures,
giving the reasons for its decision.

in paragraph 4, the words ‘agent established in the
Community’
the words
‘authorised representative’;

replaced by

shall be

(c)

the following paragraphs shall be added:

inform its competent
‘5. The notified body shall
authority about all certificates
issued, modified,
supplemented, suspended, withdrawn or refused and
the other notified bodies within the scope of this
Directive about certificates suspended, withdrawn or
refused and, on request, about certificates issued. The
notified body shall also make available, on request, all
additional relevant information.

6. Where a notified body finds
that pertinent
requirements of this Directive have not been met or
are no longer met by the manufacturer or that a
certificate should not have been issued, it shall, taking
account of the principle of proportionality, suspend
or withdraw the certificate issued or place any
restrictions on it unless compliance with such
requirements is ensured by the implementation of
appropriate corrective measures by the manufacturer.

the
In the case of suspension or withdrawal of
certificate or of any restriction placed on it or in cases
where an intervention of the competent authority
may become necessary, the notified body shall inform
its competent authority thereof.

The Member State shall
States and the Commission.

inform the other Member

The Commission shall, whenever possible, consult
the
interested Parties and the Member States. The Commission
shall adopt its opinion,
indicating whether the national
measures are justified or not. The Commission shall inform
all the Member States and the consulted interested Parties.

7. The notified body shall, on request, supply all
relevant information and documents, including bud-
getary documents, required to enable the Member
State to verify compliance with the criteria laid down
in Annex 8.’;

When appropriate, the necessary measures designed to
this Directive, by
elements of
amend non-essential
supplementing it, relating to withdrawal from the market,
prohibition of placing on the market and putting into
service of a certain product or group of products or to
restrictions or
requirements
introduction of particular
therefor, shall be adopted in accordance with the regulatory
procedure with scrutiny referred to in Article 6(4). On
imperative grounds of urgency, the Commission may use
the urgency procedure referred to in Article 6(5).’;

12. Article 11 shall be amended as follows:

(a)

in paragraph 2, the following subparagraph shall be
‘When appropriate in the light of technical
added:
progress, the detailed measures necessary to ensure a
consistent application of
in
Annex 8 to this Directive for the designation of
bodies by the Member States shall be adopted in
accordance with the regulatory procedure referred to
in Article 6(3).’;

the criteria set out

13. Article 13 shall be replaced by the following:

‘Article 13

Without prejudice to Article 7

(a) where a Member State establishes that the CE marking
has been affixed unduly or is missing in violation of
the manufacturer or his authorised
this Directive,
representative established within the Community shall
be obliged to end the infringement under conditions
imposed by the Member State;

(b) where non-compliance continues, the Member State
must
take all appropriate measures to restrict or
prohibit the placing on the market of the device in
question or to ensure that it is withdrawn from the
market in accordance with the procedures laid down
in Article 7.

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Those provisions shall also apply where the CE marking has
been affixed in accordance with the procedures in this
Directive, but inappropriately, on products that are not
covered by this Directive.’;

14. Article 14 shall be amended as follows:

(a)

the first paragraph shall be replaced by the following:

‘Any decision taken pursuant to this Directive

3. The measures designed to amend non-essential
elements of this Directive, inter alia by supplementing it,
relating to the determination of the conditions under which
information other than that referred to in paragraph 2, and
in particular concerning any obligation for manufacturers
the
to prepare and make available a summary of
information and data related to the device, may be made
publicly available shall be adopted in accordance with the
regulatory procedure with scrutiny referred to in Article 6
(4).’;

(a)

to refuse or restrict the placing on the market or
the putting into service of a device or the
carrying out of clinical investigations;

‘Article 15a

16.

the following Article shall be inserted:

or

(b)

to withdraw devices from the market

shall state the exact grounds on which it is based. Such
a decision shall be notified without delay to the party
concerned, who shall at the same time be informed of
the remedies available to him under the laws in force
in the Member State in question and of the time limits
to which such remedies are subject.’;

the competent authorities of

Member States shall take appropriate measures to ensure
that
the Member States
cooperate with each other and with the Commission and
transmit to each other the information necessary to enable
this Directive to be applied uniformly.

The Commission shall provide for the organisation of an
exchange of experience between the competent authorities
responsible for market surveillance in order to coordinate
the uniform application of this Directive.

(b)

in the second paragraph the words ‘established in the
Community’ shall be deleted;

Without prejudice to the provisions of
this Directive,
cooperation may be part of initiatives developed at an
international level.’;

15. Article 15 shall be replaced by the following:

‘Article 15

1. Without prejudice to the existing national provisions
and practices on medical confidentiality, Member States
shall ensure that all the Parties involved in the application
of this Directive are bound to observe confidentiality with
regard to all
information obtained in carrying out their
tasks.

This does not affect the obligations of Member States and
notified bodies with regard to mutual information and the
dissemination of warnings, nor the obligations of
the
persons concerned to provide information under criminal
law.

2. The following information shall not be treated as
confidential:

(a)

(b)

information on the registration of persons responsible
for placing devices on the market in accordance with
Article 10a;

information to users sent out by the manufacturer,
authorised representative or distributor in relation to a
measure in accordance with Article 8;

17. Annexes 1 to 7 shall be amended in accordance with

Annex I to this Directive.

Article 2

Directive 93/42/EEC is hereby amended as follows:

1.

Article 1 shall be amended as follows:

(a)

paragraph 2 shall be amended as follows:

(i)

in point (a) the introductory phrase shall be
replaced by the following:

‘“medical device” means any instrument, appar-
software, material or other
atus, appliance,
article, whether used alone or in combination,
including the software intended by its manufac-
turer to be used specifically for diagnostic and/or
therapeutic purposes and necessary for
its
intended by the manufac-
proper application,
turer to be used for human beings for the
purpose of:’;

(c)

information contained in certificates issued, modified,
supplemented, suspended or withdrawn.

(ii)

in the third paragraph of point (d) the words ‘are
not’ shall be replaced by the words ‘shall not be’;

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(iii)

the following points shall be added:

shall apply as far as safety and performance-related
device features are concerned.

‘(k)

“clinical data” means the safety and/or
performance information that is generated
from the use of a device. Clinical data are
sourced from:

— clinical investigation(s) of the device

concerned; or

— clinical

investigation(s) or other stu-
dies reported in the scientific litera-
ture, of a similar device for which
equivalence to the device in question
can be demonstrated; or

— published and/or unpublished reports
on other clinical experience of either
the device in question or a similar
device for which equivalence to the
device in question can be demon-
strated;

(l)

“device subcategory” means a set of devices
having common areas of intended use or
common technology;

(m)

“generic device group” means a set of
devices having the same or similar intended
uses or commonality of technology allow-
ing them to be classified in a generic
manner not reflecting specific characteris-
tics;

(n)

“single use device” means a device intended
to be used once only for a single patient.’;

(b)

paragraph 3 shall be replaced by the following:

‘3. Where a device is intended to administer a
medicinal product within the meaning of Article 1 of
Directive 2001/83/EC (*), that device shall be gov-
erned by this Directive, without prejudice to the
provisions of Directive 2001/83/EC with regard to the
medicinal product.

If, however, such a device is placed on the market in
such a way that the device and the medicinal product
form a single integral product which is intended
exclusively for use in the given combination and
which is not reusable, that single product shall be
governed by Directive 2001/83/EC. The relevant
essential requirements of Annex I to this Directive

(*) Directive 2001/83/EC of the European Parlia-
ment and of the Council of 6 November 2001
on the Community code relating to medicinal
products for human use (OJ L 311, 28.11.2001,
p. 67). Directive as last amended by Regulation
(EC) No 1901/2006 (OJ L 378, 27.12.2006,
p. 1).’;

(c)

in paragraph 4:

(i)

the reference ‘65/65/EEC’ shall be replaced by the
reference ‘2001/83/EC’;

(ii)

the words ‘that device must’ shall be replaced by
the words ‘that device shall’;

(d)

in paragraph 4a:

(i)

the reference ‘89/381/EEC’ shall be replaced by
the reference ‘2001/83/EC’;

(ii)

the words ‘that device must’ shall be replaced by
the words ‘that device shall’;

(e)

paragraph 5 shall be amended as follows:

(i)

The introductory phrase shall be replaced by the
following:

‘This Directive shall not apply to:’;

(ii)

point (c) shall be replaced by the following:

‘(c) medicinal products covered by Directive
2001/83/EC. In deciding whether a product
falls under that Directive or this Directive,
particular account shall be taken of the
principal mode of action of the product;’;

(iii) point (f) shall be replaced by the following:

‘(f)

transplants or tissues or cells of human
origin nor to products incorporating or
derived from tissues or cells of human
origin, with the
exception of devices
referred to in paragraph 4a.’;

(f)

paragraph 6 shall be replaced by the following:

‘6. Where a device is intended by the manufacturer
to be used in accordance with both the provisions on
personal protective equipment in Council Directive

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89/686/EEC (*) and this Directive, the relevant basic
health and safety requirements of Directive 89/686/
EEC shall also be fulfilled.

4.

in Article 6(1) the reference ‘83/189/EEC’ shall be replaced
by the reference ‘98/34/EC (*)

(*)

Council Directive 89/686/EEC of 21 December
1989 on the approximation of the laws of the
Member States relating to personal protective
equipment
(OJ L 399, 30.12.1989, p. 18).
Directive as last amended by Regulation (EC)
No 1882/2003 of the European Parliament and
of the Council (OJ L 284, 31.10.2003, p. 1).’

the provision of

(*) Directive 98/34/EC of the European Parliament and of
the Council of 22 June 1998 laying down a procedure
for
information in the field of
technical standards and regulations and of rules on
Information Society services (OJ L 204, 21.7.1998,
p. 37). Directive as last amended by the 2003 Act of
Accession.’

5.

Article 7 shall be replaced by the following:

(g)

paragraphs 7 and 8 shall be replaced by the following:

‘Article 7

‘7. This Directive is a specific Directive within the
meaning of Article 1(4) of Directive 2004/108/EC of
the European Parliament and of the Council (*).

8. This Directive shall not affect the application of
Council Directive 96/29/Euratom of 13 May 1996
laying down basic safety standards for the protection
of the health of workers and the general public against
the dangers arising from ionising radiation (**), nor of
Council Directive 97/43/Euratom of 30 June 1997 on
health protection of individuals against the dangers of
ionising radiation in relation to medical expo-
sure (***).

(*) Directive 2004/108/EC of the European Parlia-
ment and of the Council of 15 December 2004
on the approximation of the laws of the Member
States relating to electromagnetic compatibility
(OJ L 390, 31.12.2004, p. 24).

(**) OJ L 159, 29.6.1996, p. 1.
(***) OJ L 180, 9.7.1997, p. 22.’

2.

in Article 3 the following paragraph shall be added:

‘Where a relevant hazard exists, devices which are also
machinery within the meaning of Article 2(a) of Directive
2006/42/EC of the European Parliament and of the Council
of 17 May 2006 on machinery (*) shall also meet the
essential health and safety requirements set out in Annex I
to that Directive to the extent to which those essential
health and safety requirements are more specific than the
essential requirements set out in Annex I to this Directive.

(*) OJ L 157, 9.6.2006, p. 24.’

3.

the second indent of Article 4(2) shall be replaced by the
following:

‘— custom-made devices being placed on the market and
put into service if they meet the conditions laid down
in Article 11 in combination with Annex VIII; Class
IIa, IIb and III devices shall be accompanied by the
statement referred to in Annex VIII, which shall be
available to the particular patient identified by name,
an acronym or a numerical code.’;

1. The Commission shall be assisted by the Committee set
up by Article 6(2) of Directive 90/385/EEC, hereinafter
referred to as “the Committee”.

2. Where reference is made to this paragraph, Articles 5
and 7 of Decision 1999/468/EC shall apply, having regard
to the provisions of Article 8 thereof.

The period laid down in Article 5(6) of Decision 1999/468/
EC shall be set at three months.

3. Where reference is made to this paragraph, Article 5a
(1) to (4) and Article 7 of Decision 1999/468/EC shall
apply, having regard to the provisions of Article 8 thereof.

4. Where reference is made to this paragraph, Article 5a
(1), (2), (4) and (6) and Article 7 of Decision 1999/468/EC
shall apply, having regard to the provisions of Article 8
thereof.’;

6.

In Article 8 paragraph 2 shall be replaced by the following:

‘2. The Commission shall enter into consultation with the
Parties concerned as soon as possible. Where, after such
consultation, the Commission finds that:

(a)

the measures are justified:

(i)

it shall immediately so inform the Member State
which took the measures and the other Member
States. Where
the decision referred to in
paragraph 1 is attributed to shortcomings in
the standards,
the Commission shall, after
consulting the Parties concerned, bring the
matter before the Committee referred to in
Article 6(1) within two months if the Member
State which has taken the decision intends to
maintain it and shall
initiate the advisory
procedure referred to in Article 6(2);

(ii) when necessary in the interests of public health,
appropriate measures designed to amend non-
essential elements of this Directive relating to
withdrawal from the market of devices referred
to in paragraph 1 or to prohibition or restriction
of their placement on the market or being put
into service or to introduction of particular
requirements in order for such products to be
adopted in
put on the market,

shall be

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accordance with the regulatory procedure with
scrutiny referred to in Article 7(3). On impera-
tive grounds of urgency, the Commission may
use the urgency procedure referred to in Article 7
(4);

(b)

the measures are unjustified, it shall immediately so
inform the Member State which took the measures
and the manufacturer or his authorised representa-
tive.’;

(c)

the following paragraph shall be added:

‘14. The measures designed to amend non-essential
elements of
this Directive, by supplementing it,
in the light of
relating to the means by which,
technical progress and considering the intended users
of the devices concerned, the information laid down
in Annex I Section 13.1 may be set out, shall be
adopted in accordance with the regulatory procedure
with scrutiny referred to in Article 7(3).’;

7.

In Article 9 paragraph 3 shall be replaced by the following:

10. Article 12 shall be amended as follows:

‘3. Where a Member State considers that the classification
rules set out in Annex IX require adaptation in the light of
technical progress and any information which becomes
available under the information system provided for in
Article 10, it may submit a duly substantiated request to the
Commission and ask it to take the necessary measures for
adaptation of classification rules. The measures designed to
amend non-essential elements of this Directive relating to
adaptation of classification rules shall be adopted in
accordance with the regulatory procedure with scrutiny
referred to in Article 7(3).’;

8.

Article 10 shall be amended as follows:

(a)

in paragraph 2,
Community’ shall be deleted;

the words

‘established in the

(b)

paragraph 3 shall be replaced by the following:

if possible
‘3. After carrying out an assessment,
together with the manufacturer or his authorised
representative, Member States shall, without prejudice
to Article 8, immediately inform the Commission and
the other Member States of measures that have been
taken or are contemplated to minimise the recurrence
of the incidents referred to in paragraph 1, including
information on the underlying incidents.’;

(c)

the following paragraph shall be added:

‘4. Any appropriate measures to adopt procedures
this Article shall be adopted in
to implement
accordance with the regulatory procedure referred to
in Article 7(2).’;

(a)

the title shall be replaced by ‘Particular procedure for
systems and procedure packs and procedure for
sterilisation’;

(b)

paragraph 3 shall be replaced by the following:

‘3. Any natural or legal person who sterilises, for the
purpose of placing on the market,
systems or
procedure packs referred to in paragraph 2 or other
CE-marked medical devices designed by their manu-
facturers to be sterilised before use, shall, at his choice,
follow one of the procedures referred to in Annex II or
V. The application of the abovementioned Annexes
and the intervention of the notified body are limited
to the aspects of
the procedure relating to the
the sterile package is
obtaining of sterility until
opened or damaged. The person shall draw up a
declaration stating that sterilisation has been carried
out in accordance with the manufacturer's instruc-
tions.’;

(c)

in paragraph 4, the third sentence shall be replaced by
the following:

‘The declarations referred to in paragraphs 2 and 3
shall be kept at
the competent
authorities for a period of five years.’;

the disposal of

11. The following Article shall be inserted:

‘Article 12a

Reprocessing of medical devices

9.

Article 11 shall be amended as follows:

(a)

(b)

in paragraphs 8 and 9 the words ‘established in the
Community’ shall be deleted;

in paragraph 11, the words ‘Annexes II and III’ shall be
replaced by the words ‘Annexes II, III, V and VI’ and
the words ‘for further periods of five years’ shall be
replaced by the words ‘for further periods of a
maximum length of five years’;

The Commission shall, no later than 5 September 2010,
submit a report to the European Parliament and to the
Council on the issue of the reprocessing of medical devices
in the Community.

In the light of the findings of this report, the Commission
shall submit to the European Parliament and to the Council
any additional proposal it may deem appropriate in order
to ensure a high level of health protection.’

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12. Article 13 shall be replaced by the following:

14. Article 14a shall be amended as follows:

‘Article 13

Decisions with regard to classification and derogation
clause

1. A Member State shall submit a duly substantiated
request to the Commission and ask it to take the necessary
measures in the following situations:

(a)

(b)

(c)

(d)

that Member State considers that the application of
the classification rules set out in Annex IX requires a
decision with regard to the classification of a given
device or category of devices;

that Member State considers that a given device or
family of devices should, by way of derogation from
the provisions of Annex IX, be classified in another
class;

family of devices

that Member State considers that the conformity of a
device or
should, by way of
established by
derogation from Article 11, be
applying solely one of the given procedures chosen
from among those referred to in Article 11;

that Member State considers that a decision is required
as to whether a particular product or product group
falls within one of the definitions in Article 1(2)(a) to
(e).

The measures referred to in the first subparagraph of this
paragraph shall, as appropriate, be adopted in accordance
with the procedure referred to in Article 7(2).

2. The Commission shall inform the Member States of the
measures taken.’;

(a)

the second subparagraph of paragraph 1 shall be
amended as follows:

(i)

point (a) shall be replaced by the following:

‘(a) data relating to registration of manufac-
turers and authorised representatives and
devices
in accordance with Article 14
excluding data related to custom-made
devices;’;

(ii)

the following point shall be added:

‘(d) data

relating to clinical

investigations

referred to in Article 15;’;

(b)

paragraph 3 shall be replaced by the following:

‘3. The measures necessary for the implementation
of paragraphs 1 and 2 of this Article, in particular
paragraph 1(d), shall be adopted in accordance with
the regulatory procedure referred to in Article 7(2).’

(c)

the following paragraph shall be added:

‘4. The provisions of this Article shall be imple-
mented no later
than 5 September 2012. The
Commission shall, no later than 11 October 2012,
evaluate the operational functioning and the added
value of the databank. On the basis of this evaluation,
the Commission shall, if appropriate, present propo-
sals to the European Parliament and the Council or
present draft measures in accordance with para-
graph 3.’;

13. Article 14 shall be amended as follows:

15. Article 14b shall be replaced by the following:

(a)

in the second subparagraph of paragraph 1, the words
‘Classes IIb and III’ shall be replaced by the words
‘Classes IIa, IIb and III’;

‘Article 14b

Particular health monitoring measures

(b)

paragraph 2 shall be replaced by the following:

‘2. Where a manufacturer who places a device on
the market under his own name does not have a
registered place of business in a Member State, he shall
designate a single authorised representative in the
European Union. For devices referred to in the first
subparagraph of paragraph 1, the authorised repre-
sentative shall inform the competent authority of the
Member State in which he has his registered place of
business of the details referred to in paragraph 1.’;

Where a Member State considers, in relation to a given
product or group of products, that,
in order to ensure
protection of health and safety and/or to ensure that public
health requirements are observed, such products should be
withdrawn from the market, or their placing on the market
and putting into service should be prohibited, restricted or
subjected to particular
it may take any
necessary and justified transitional measures.

requirements,

The Member State shall then inform the Commission and
all other Member States, giving the reasons for its decision.

(c)

paragraph 3 shall be replaced by the following:

The Commission shall, whenever possible, consult
interested Parties and the Member States.

the

‘3. The Member States shall on request inform the
other Member States and the Commission of
the
details
subparagraph of
paragraph 1 given by the manufacturer or authorised
representative.’;

referred to in the first

The Commission shall adopt
indicating
whether the national measures are justified or not. The
Commission shall inform all the Member States and the
consulted interested Parties thereof.

its opinion,

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When appropriate, the necessary measures designed to
amend non-essential elements of this Directive, relating to
withdrawal from the market, prohibition of placing on the
market and putting into service of a certain product or
group of products or to restrictions or introduction of
particular requirements in order for such products to be put
on the market, shall be adopted in accordance with the
regulatory procedure with scrutiny referred to in Article 7
(3). On imperative grounds of urgency, the Commission
may use the urgency procedure referred to in Article 7(4).’;

16. Article 15 shall be amended as follows:

(a)

paragraphs 1, 2 and 3 shall be replaced by the
following:

In the case of devices intended for clinical
‘1.
investigations,
the manufacturer or the authorised
representative, established in the Community, shall
follow the procedure referred to in Annex VIII and
notify the competent authorities of the Member States
in which the investigations are to be conducted by
means of the statement mentioned in Section 2.2 of
Annex VIII.

IIb,

IIa or

2.
In the case of devices falling within Class III and
implantable and long-term invasive devices falling
within Class
the manufacturer may
investigation at the
commence the relevant clinical
end of a period of 60 days after notification, unless
the competent authorities have notified him within
that period of a decision to the contrary based on
considerations of public health or public policy.

Member States may however authorise manufacturers
to commence the relevant clinical
investigations
before the expiry of the period of 60 days, insofar
issued a
as
favourable opinion on the programme of investigation
in question,
the clinical
investigation plan.

the relevant ethics committee has

including its

review of

3.
In the case of devices other than those referred to
in paragraph 2, Member States may authorise
manufacturers to commence clinical
investigations
immediately after the date of notification, provided
that the ethics committee concerned has issued a
favourable opinion on the programme of investigation
in question including its
the clinical
investigation plan.’;

review of

(b)

paragraphs 5, 6 and 7 shall be replaced by the
following:

this Directive,

‘5. The clinical investigations must be conducted in
accordance with the provisions of Annex X. The
measures designed to amend non-essential elements
of
inter alia by supplementing it,
relating to the provisions on clinical investigation in
Annex X shall be adopted in accordance with the
regulatory procedure with scrutiny referred to in
Article 7(3).

halted by a Member State, that Member State shall
communicate its decision and the grounds therefor to
all Member States and the Commission. Where a
Member State has called for a significant modification
or temporary interruption of a clinical investigation,
that Member State shall inform the Member States
concerned about its actions and the grounds for the
actions taken.

7. The manufacturer or his authorised representative
shall notify the competent authorities of the Member
States concerned of the end of the clinical investiga-
tion, with a justification in case of early termination.
In the case of early termination of
the clinical
investigation on safety grounds this notification shall
be communicated to all Member States and the
Commission. The manufacturer or his authorised
representative shall keep the report referred to in
Section 2.3.7 of Annex X at the disposal of
the
competent authorities.’;

17. Article 16 shall be amended as follows:

(a)

following subparagraph shall be

the
paragraph 2:

added to

‘When appropriate in the light of technical progress,
the detailed measures necessary to ensure a consistent
application of the criteria set out in Annex XI for the
designation of bodies by the Member States shall be
adopted in accordance with the regulatory procedure
referred to in Article 7(2).’;

(b)

in paragraph 4,
Community’ shall be deleted;

the words

‘established in the

(c)

paragraph 5 shall be replaced by the following:

inform its competent
‘5. The notified body shall
authority about all certificates
issued, modified,
supplemented, suspended, withdrawn or refused and
the other notified bodies within the scope of this
Directive about certificates suspended, withdrawn or
refused and, on request, about certificates issued. The
notified body shall also make available, on request, all
additional relevant information.’;

18.

in Article 18 point (a) shall be replaced by the following:

‘(a) where a Member State establishes that the CE marking
has been affixed unduly or is missing in violation of
the manufacturer or his authorised
the Directive,
representative shall be obliged to end the infringement
under conditions imposed by the Member State;’;

19.

in Article 19(2), the words ‘established in the Community’
shall be deleted;

20. Article 20 shall be replaced by the following:

‘Article 20

Confidentiality

6. The Member States shall, if necessary, take the
appropriate steps to ensure public health and public
investigation is refused or
policy. Where a clinical

1. Without prejudice to the existing national provisions
and practices on medical confidentiality, Member States
shall ensure that all the Parties involved in the application

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of this Directive are bound to observe confidentiality with
regard to all
information obtained in carrying out their
tasks.

This does not affect the obligation of Member States and
notified bodies with regard to mutual information and the
dissemination of warnings, nor the obligations of
the
persons concerned to provide information under criminal
law.

2. The following information shall not be treated as
confidential:

(a)

(b)

information on the registration of persons responsible
for placing devices on the market in accordance with
Article 14;

information to users sent out by the manufacturer,
authorised representative or distributor in relation to a
measure according to Article 10(3);

(c)

information contained in certificates issued, modified,
supplemented, suspended or withdrawn.

3. The measures designed to amend non-essential
elements of this Directive, inter alia by supplementing it,
relating to determination of the conditions under which
other information may be made publicly available, and in
particular
for Class IIb and Class III devices to any
obligation for manufacturers to prepare and make available
a summary of the information and data related to the
device, shall be adopted in accordance with the regulatory
procedure with scrutiny referred to in Article 7(3).’;

21.

the following Article shall be inserted:

‘Article 20a

Cooperation

the competent authorities of

Member States shall take appropriate measures to ensure
the Member States
that
cooperate with each other and with the Commission and
transmit to each other the information necessary to enable
this Directive to be applied uniformly.

The Commission shall provide for the organisation of an
exchange of experience between the competent authorities
responsible for market surveillance in order to coordinate
the uniform application of this Directive.

Without prejudice to the provisions of
this Directive,
cooperation may be part of initiatives developed at an
international level.’;

22. Annexes I to X shall be amended in accordance with

Annex II to this Directive.

Article 3

In Article 1(2) of Directive 98/8/EC the following point shall be
added:

‘(s) Directive 98/79/EC of the European Parliament and of the
Council of 27 October 1998 on in vitro diagnostic medical
devices (*).

(*) OJ L 331, 7.12.1998, p. 1. Directive as last amended by
Regulation (EC) No 1882/2003 (OJ L 284, 31.10.2003,
p. 1).’

Article 4

1. Member States shall adopt and publish by 21 December
2008 the laws,
regulations and administrative provisions
necessary to comply with this Directive. They shall forthwith
communicate to the Commission the text of those measures.

They shall apply those measures from 21 March 2010.

When Member States adopt those measures, they shall contain a
reference to this Directive or be accompanied by such a reference
on the occasion of their official publication. The methods of
making such reference shall be laid down by Member States.

2. Member States shall communicate to the Commission the
text of the main provisions of national law which they adopt in
the field covered by this Directive.

Article 5

This Directive shall enter into force on the 20th day following its
publication in the Official Journal of the European Union.

Article 6

This Directive is addressed to the Member States.

Done at Strasbourg, 5 September 2007.

For the European Parliament

For the Council

The President

The President

H.-G. PÖTTERING

M. LOBO ANTUNES

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ANNEX I

Annexes 1 to 7 to Directive 90/385/EEC shall be amended as follows:

1.

Annex 1 shall be amended as follows:

(a)

the following Section shall be inserted:

‘5a. Demonstration of conformity with the essential requirements must include a clinical evaluation in

accordance with Annex 7.’;

(b)

in Section 8, the fifth indent shall be replaced by the following:

‘— risks connected with ionising radiation from radioactive substances included in the device, in compliance
with the protection requirements laid down in Council Directive 96/29/Euratom of 13 May 1996 laying
down basic safety standards for the protection of the health of workers and the general public against the
dangers arising from ionising radiation (*) and Council Directive 97/43/Euratom of 30 June 1997 on
health protection of individuals against the dangers of ionising radiation in relation to medical expo-
sure (**).

(*) OJ L 159, 29.6.1996, p. 1.
(**) OJ L 180, 9.7.1997, p. 22.’;

(c)

in Section 9, seventh indent, the following phrase shall be added:

‘For devices which incorporate software or which are medical software in themselves, the software must be
validated according to the state of the art taking into account the principles of development lifecycle, risk
management, validation and verification.’;

(d)

Section 10 shall be replaced by the following:

‘10. Where a device incorporates, as an integral part, a substance which, if used separately, may be considered
to be a medicinal product as defined in Article 1 of Directive 2001/83/EC, and which is liable to act upon
the body with action ancillary to that of the device, the quality, safety and usefulness of the substance
must be verified by analogy with the methods specified in Annex I to Directive 2001/83/EC.

For the substances referred to in the first paragraph, the notified body shall, having verified the usefulness
of the substance as part of the medical device and taking account of the intended purpose of the device,
seek a scientific opinion from one of the competent authorities designated by the Member States or the
European Medicines Agency (EMEA) acting particularly through its committee in accordance with
Regulation (EC) No 726/2004 (*) on the quality and safety of the substance including the clinical benefit/
risk profile of the incorporation of the substance into the device. When issuing its opinion, the competent
authority or the EMEA shall take into account the manufacturing process and the data related to the
usefulness of incorporation of the substance into the device as determined by the notified body.

Where a device incorporates, as an integral part, a human blood derivative, the notified body shall, having
verified the usefulness of the substance as part of the device and taking account of the intended purpose
of the device, seek a scientific opinion from the EMEA, acting particularly through its committee, on the
quality and safety of the substance, including the clinical benefit/risk profile of the incorporation of the
human blood derivative into the device. When issuing its opinion, the EMEA shall take into account the
manufacturing process and the data related to the usefulness of incorporation of the substance into the
device as determined by the notified body.

Where changes are made to an ancillary substance incorporated in a device, in particular related to its
manufacturing process, the notified body shall be informed of the changes and shall consult the relevant
medicines competent authority (i.e. the one involved in the initial consultation), in order to confirm that
the quality and safety of the ancillary substance are maintained. The competent authority shall take into
account the data related to the usefulness of the incorporation of the substance into the device as
determined by the notified body, in order to ensure that the changes have no negative impact on the
established benefit/risk profile of the addition of the substance in the device.

When the relevant medicines competent authority (i.e. the one involved in the initial consultation) has
obtained information on the ancillary substance, which could have an impact on the established benefit/
risk profile of the addition of the substance to the device, it shall provide the notified body with advice,

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whether this information has an impact on the established benefit/risk profile of the addition of the
substance to the device or not. The notified body shall take the updated scientific opinion into account in
reconsidering its assessment of the conformity assessment procedure.

(*)

Regulation (EC) No 726/2004 of the European Parliament and of the Council of 31 March 2004 laying
down Community procedures for the authorisation and supervision of medicinal products for human and
veterinary use and establishing a European Medicines Agency (OJ L 136, 30.4.2004, p. 1). Regulation as
last amended by Regulation (EC) No 1901/2006.’;

(e)

Section 14.2 shall be amended as follows:

(i)

the first indent shall be replaced by the following:

‘— the name and address of

the authorised
representative, where the manufacturer does not have a registered place of business in the
Community,’;

the manufacturer and the name and address of

(ii)

the following indent shall be added:

‘— in the case of a device within the meaning of Article 1(4a), an indication that the device contains a

human blood derivative.’;

(f)

the following indent shall be added to the second paragraph of Section 15:

‘— date of issue or the latest revision of the instructions for use.’;

2.

Annex 2 shall be amended as follows:

(a)

in Section 2, the third paragraph shall be replaced by the following:

‘This declaration shall cover one or more clearly identified devices by means of product name, product code or
other unambiguous reference and must be kept by the manufacturer.’;

(b)

in the second paragraph of Section 3.1, the first sentence of the fifth indent shall be replaced by the following:

‘— an undertaking by the manufacturer to institute and keep updated a post-marketing surveillance system

including the provisions referred to in Annex 7.’;

(c)

Section 3.2 shall be amended as follows:

(i)

the following sentence shall be added to the second subparagraph:

‘It shall
procedures referred to in point (c).’;

include in particular the corresponding documentation, data and records arising from the

(ii)

the following indent shall be added to point (b):

‘— where the design, manufacture and/or final inspection and testing of the products, or elements
thereof, is carried out by a third party, the methods of monitoring the efficient operation of the
quality system and in particular the type and extent of control applied to the third party.’;

(iii)

the following indents shall be added to point (c):

‘— a statement indicating whether or not the device incorporates, as an integral part, a substance or a
human blood derivative referred to in Section 10 of Annex 1 and the data on the tests conducted in
this connection required to assess the safety, quality and usefulness of that substance or human
blood derivative, taking account of the intended purpose of the device,

— the pre-clinical evaluation,

— the clinical evaluation referred to in Annex 7.’;

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(d)

in Section 3.3, the last sentence of the second subparagraph shall be replaced by the following:

‘The evaluation procedure shall include an inspection on the manufacturer's premises and, in duly substantiated
cases, on the premises of the manufacturer's suppliers and/or subcontractors to inspect the manufacturing
processes.’;

(e)

Section 4.2 shall be amended as follows:

(i)

the first paragraph shall be replaced by the following:

‘The application shall describe the design, manufacture and performances of the product in question, and
it must include the documents needed to assess whether the product conforms to the requirements of this
Directive, and in particular Annex 2, Section 3.2, third paragraph, points (c) and (d).’;

(ii)

in the fourth indent of the second paragraph, the word ‘data’ shall be replaced by the word ‘evaluation’;

(f)

in Section 4.3, the following paragraphs shall be added:

‘In the case of devices referred to in Annex 1, Section 10, second paragraph, the notified body shall, as regards
the aspects referred to in that section, consult one of the competent authorities designated by the Member States
in accordance with Directive 2001/83/EC or the EMEA before taking a decision. The opinion of the competent
national authority or the EMEA shall be drawn up within 210 days after receipt of valid documentation. The
scientific opinion of the competent national authority or the EMEA must be included in the documentation
concerning the device. The notified body will give due consideration to the views expressed in this consultation
when making its decision. It will convey its final decision to the competent body concerned.

In the case of devices referred to in Annex 1, Section 10, third paragraph, the scientific opinion of the EMEA
must be included in the documentation concerning the device. The opinion shall be drawn up within 210 days
after receipt of valid documentation. The notified body will give due consideration to the opinion of the EMEA
when making its decision. The notified body may not deliver the certificate if the EMEA's scientific opinion is
unfavourable. It will convey its final decision to the EMEA.’;

(g)

in Section 5.2, the second indent shall be replaced by the following:

‘— the data stipulated in the part of the quality system relating to design, such as the results of analyses,
calculations, tests, pre-clinical and clinical evaluation, post-market clinical follow-up plan and the results
of the post-market clinical follow-up, if applicable, etc.’;

(h)

Section 6.1 shall be replaced by the following:

‘6.1. For at least 15 years from the last date of manufacture of the product, the manufacturer or his authorised

representative shall keep available for the national authorities:

— the declaration of conformity,

— the documentation referred to in the second indent of Section 3.1, and in particular the

documentation, data and records referred to in the second paragraph of Section 3.2,

— the amendments referred to in Section 3.4,

— the documentation referred to in Section 4.2,

— the decisions and reports of the notified body referred to in Sections 3.4, 4.3, 5.3 and 5.4.’;

(i)

(j)

Section 6.3 shall be deleted;

the following Section shall be added:

‘7.

Application to the devices referred to in Article 1(4a):

Upon completing the manufacture of each batch of devices referred to in Article 1(4a), the manufacturer
shall inform the notified body of the release of the batch of devices and send to it the official certificate

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concerning the release of the batch of human blood derivative used in the device, issued by a State
laboratory or a laboratory designated for that purpose by a Member State in accordance with Art-
icle 114(2) of Directive 2001/83/EC.’;

3.

Annex 3 shall be amended as follows:

(a)

Section 3 shall be amended as follows:

(i)

the first indent shall be replaced by the following:

‘— a general description of the type, including any variants planned, and its intended use(s),’;

(ii)

the fifth to eighth indents shall be replaced by the following:

‘— the results of design calculations, risk analysis, investigations and technical tests carried out, etc.,

— a declaration stating whether or not the device incorporates, as an integral part, a substance or a
human blood derivative as referred to in Section 10 of Annex 1 and the data on the tests conducted
in this connection required to assess the safety, quality and usefulness of that substance or human
blood derivative, taking account of the intended purpose of the device,

— the pre-clinical evaluation,

— the clinical evaluation referred to in Annex 7,

— the draft instruction leaflet.’;

(b)

the following paragraphs shall be added to Section 5:

‘In the case of devices referred to in Annex 1, Section 10, second paragraph, the notified body shall, as regards
the aspects referred to in that section, consult one of the competent authorities designated by the Member States
in accordance with Directive 2001/83/EC or the EMEA before taking a decision. The opinion of the competent
national authority or the EMEA shall be drawn up within 210 days after receipt of valid documentation. The
scientific opinion of the competent national authority or the EMEA must be included in the documentation
concerning the device. The notified body will give due consideration to the views expressed in this consultation
when making its decision. It will convey its final decision to the competent body concerned.

In the case of devices referred to in Annex 1, Section 10, third paragraph, the scientific opinion of the EMEA
must be included in the documentation concerning the device. The opinion shall be drawn up within 210 days
after receipt of valid documentation. The notified body will give due consideration to the opinion of the EMEA
when making its decision. The notified body may not deliver the certificate if the EMEA's scientific opinion is
unfavourable. It will convey its final decision to the EMEA.’;

(c)

in Section 7.3, the words ‘five years from the manufacture of the last appliance’ shall be replaced by the words
‘15 years from the manufacture of the last product’;

(d)

Section 7.4 shall be deleted;

4.

Annex 4 shall be amended as follows:

(a)

in Section 4, the words ‘post-marketing surveillance system’ shall be replaced by the words ‘post-marketing
surveillance system including the provisions referred to in Annex 7’;

(b)

Section 6.3 shall be replaced by the following:

‘6.3. Statistical control of products will be based on attributes and/or variables, entailing sampling schemes
with operational characteristics which ensure a high level of safety and performance according to the state
of the art. The sampling schemes will be established by the harmonised standards referred to in Article 5,
taking account of the specific nature of the product categories in question.’;

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(c)

the following Section shall be added:

‘7.

Application to the devices referred to in Article 1(4a):

Upon completing the manufacture of each batch of devices referred to in Article 1(4a), the manufacturer
shall inform the notified body of the release of the batch of devices and send to it the official certificate
concerning the release of the batch of human blood derivative used in the device, issued by a State
laboratory or a laboratory designated for that purpose by a Member State in accordance with Art-
icle 114(2) of Directive 2001/83/EC.’;

5.

Annex 5 shall be amended as follows:

(a)

in Section 2, second paragraph, the words ‘identified specimens of the product and shall be kept by the
manufacturer’ shall be replaced by the words ‘devices manufactured, clearly identified by means of product
name, product code or other unambiguous reference and must be kept by the manufacturer’;

(b)

in the sixth indent of Section 3.1, the words ‘post-marketing surveillance system’ shall be replaced by the words
‘post-marketing surveillance system including the provisions referred to in Annex 7’;

(c)

in Section 3.2(b), the following indent shall be added:

‘— where the manufacture and/or final inspection and testing of the products, or elements thereof, are carried
out by a third party, the methods of monitoring the efficient operation of the quality system and in
particular the type and extent of control applied to the third party.’;

(d)

in Section 4.2, the following indent shall be inserted after the first indent:

‘— the technical documentation,’;

(e)

the following Section shall be added:

‘6.

Application to the devices referred to in Article 1(4a):

Upon completing the manufacture of each batch of devices referred to in Article 1(4a), the manufacturer
shall inform the notified body of the release of the batch of devices and send to it the official certificate
concerning the release of the batch of human blood derivative used in the device, issued by a State
laboratory or a laboratory designated for that purpose by a Member State in accordance with Art-
icle 114(2) of Directive 2001/83/EC.’;

6.

Annex 6 shall be amended as follows:

(a)

Section 2.1 shall be amended as follows:

(i)

the first indent shall be replaced by the following two indents:

‘— the name and address of the manufacturer,

— the information necessary for the identification of the product in question,’;

(ii)

in the third indent, the word ‘doctor’ shall be replaced by the words ‘duly qualified medical practitioner’;

(iii)

the fourth indent shall be replaced by the following:

‘— the specific characteristics of the product revealed by the prescription,’;

(b)

Section 2.2 shall be replaced by the following:

‘2.2. For devices intended for clinical investigations covered in Annex 7:

— data allowing the devices in question to be identified,

— the clinical investigation plan,

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— the investigator's brochure,

— the confirmation of insurance of subjects,

— the documents used to obtain informed consent,

— a statement indicating whether or not the device incorporates, as an integral part, a substance or

human blood derivative referred to in Section 10 of Annex 1,

— the opinion of the ethics committee concerned and details of the aspects covered by its opinion,

— the name of the duly qualified medical practitioner or other authorised person and of the institution

responsible for the investigations,

— the place, date of commencement and duration scheduled for the investigations,

— a statement affirming that the device in question complies with the essential requirements apart
from the aspects constituting the object of the investigations and that, with regard to these aspects,
every precaution has been taken to protect the health and safety of the patient.’;

(c)

in Section 3.1, the first paragraph shall be replaced by the following:

‘For custom-made devices, documentation,
indicating manufacturing site(s) and enabling the design,
manufacture and performances of the product, including the expected performances, to be understood, so as
to allow conformity with the requirements of this Directive to be assessed.’;

(d)

in Section 3.2, the first paragraph shall be amended as follows:

(i)

the first indent shall be replaced by the following:

‘— a general description of the product and its intended use,’;

(ii)

in the fourth indent, the words ‘a list of the standards’ shall be replaced by the words ‘the results of the risk
analysis and a list of the standards’;

(iii)

the following indent shall be inserted after the fourth indent:

‘— if the device incorporates, as an integral part, a substance or human blood derivative referred to in
Section 10 of Annex 1, the data on the tests conducted in this connection which are required to
assess the safety, quality and usefulness of that substance, or human blood derivative, taking account
of the intended purpose of the device,’;

(e)

the following two sections shall be added:

‘4.

5.

The information included in the declarations covered by this Annex shall be kept for a period of at least
15 years from the date of manufacture of the last product.

For custom-made devices, the manufacturer must undertake to review and to document experience gained
in the post-production phase,
including the provisions referred to in Annex 7, and to implement
appropriate means to apply any necessary corrective action. This undertaking must include an obligation
for the manufacturer to notify the competent authorities of the following incidents immediately on
learning of them and the relevant corrective actions:

(i)

(ii)

any malfunction or deterioration in the characteristics and/or performance of a device, as well as
any inadequacy in the labelling or the instructions for use which might lead to or might have led to
the death of a patient or user or to a serious deterioration in his state of health;

any technical or medical reason connected with the characteristics or performance of a device for
the reasons referred to in point (i) leading to systematic recall of devices of the same type by the
manufacturer.’;

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7.

Annex 7 shall be amended as follows:

(a)

Section 1 shall be replaced by the following:

‘1.

1.1.

General provisions

As a general rule, confirmation of conformity with the requirements concerning the characteristics and
performances referred to in Sections 1 and 2 of Annex 1 under the normal conditions of use of the
device and the evaluation of the side-effects and of the acceptability of the benefit/risk ratio referred to in
Section 5 of Annex 1, must be based on clinical data. The evaluation of this data (hereinafter referred to
as clinical evaluation), where appropriate taking account of any relevant harmonised standards, must
follow a defined and methodologically sound procedure based on:

1.1.1. Either a critical evaluation of the relevant scientific literature currently available relating to the safety,

performance, design characteristics and intended purpose of the device where:

— there is demonstration of equivalence of the device to the device to which the data relates and,

— the data adequately demonstrate compliance with the relevant essential requirements;

1.1.2. Or a critical evaluation of the results of all the clinical investigations made,

1.1.3. Or a critical evaluation of the combined clinical data provided in 1.1.1 and 1.1.2.

1.2.

Clinical investigations shall be performed unless it is duly justified to rely on existing clinical data.

1.3.

1.4.

The clinical evaluation and its outcome shall be documented. This documentation shall be included
and/or fully referenced in the technical documentation of the device.

The clinical evaluation and its documentation must be actively updated with data obtained from the
post-market surveillance. Where post-market clinical follow-up as part of the post-market surveillance
plan for the device is not deemed necessary, this must be duly justified and documented.

1.5. Where demonstration of conformity with essential requirements based on clinical data is not deemed
appropriate, adequate justification for any such exclusion has to be given based on risk management
output and under consideration of the specifics of the device/body interaction, the clinical performances
intended and the claims of the manufacturer. Adequacy of demonstration of conformity with the
essential requirements by performance evaluation, bench testing and pre-clinical evaluation alone has to
be duly substantiated.

1.6.

All data must remain confidential unless it is deemed essential that they be divulged.’

(b)

Section 2.3.5 shall be replaced by the following:

‘2.3.5. All serious adverse events must be fully recorded and immediately notified to all competent authorities of

the Member States in which the clinical investigation is being performed.’

(c)

In Section 2.3.6, the words ‘appropriately qualified medical specialist’ shall be replaced by the words ‘duly
qualified medical practitioner or authorised person’.

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ANNEX II

Annexes I to X to Directive 93/42/EEC shall be amended as follows:

1.

Annex I shall be amended as follows:

(a)

Section 1 shall be replaced by the following:

‘1.

The devices must be designed and manufactured in such a way that, when used under the conditions and
for the purposes intended, they will not compromise the clinical condition or the safety of patients, or the
safety and health of users or, where applicable, other persons, provided that any risks which may be
associated with their intended use constitute acceptable risks when weighed against the benefits to the
patient and are compatible with a high level of protection of health and safety.

This shall include:

— reducing, as far as possible, the risk of use error due to the ergonomic features of the device and the

environment in which the device is intended to be used (design for patient safety), and

— consideration of the technical knowledge, experience, education and training and where applicable
the medical and physical conditions of intended users (design for lay, professional, disabled or other
users).’;

(b)

the following Section shall be inserted:

‘6a.

Demonstration of conformity with the essential requirements must include a clinical evaluation in
accordance with Annex X.’;

(c)

in Section 7.1, the following indent shall be added:

‘— where appropriate, the results of biophysical or modelling research whose validity has been demonstrated

beforehand.’;

(d)

Section 7.4. shall be replaced by the following:

‘7.4. Where a device incorporates, as an integral part, a substance which, if used separately, may be considered
to be a medicinal product as defined in Article 1 of Directive 2001/83/EC and which is liable to act upon
the body with action ancillary to that of the device, the quality, safety and usefulness of the substance
must be verified by analogy with the methods specified in Annex I to Directive 2001/83/EC.

For the substances referred to in the first paragraph, the notified body shall, having verified the usefulness
of the substance as part of the medical device and taking account of the intended purpose of the device,
seek a scientific opinion from one of the competent authorities designated by the Member States or the
European Medicines Agency (EMEA) acting particularly through its committee in accordance with
Regulation (EC) No 726/2004 (*) on the quality and safety of the substance including the clinical benefit/
risk profile of the incorporation of the substance into the device. When issuing its opinion, the competent
authority or the EMEA shall take into account the manufacturing process and the data related to the
usefulness of incorporation of the substance into the device as determined by the notified body.

Where a device incorporates, as an integral part, a human blood derivative, the notified body shall, having
verified the usefulness of the substance as part of the medical device and taking into account the intended
purpose of the device, seek a scientific opinion from the EMEA, acting particularly through its committee,
on the quality and safety of the substance including the clinical benefit/risk profile of the incorporation of
the human blood derivative into the device. When issuing its opinion, the EMEA shall take into account
the manufacturing process and the data related to the usefulness of incorporation of the substance into
the device as determined by the notified body.

Where changes are made to an ancillary substance incorporated in a device, in particular related to its
manufacturing process, the notified body shall be informed of the changes and shall consult the relevant
medicines competent authority (i.e. the one involved in the initial consultation), in order to confirm that
the quality and safety of the ancillary substance are maintained. The competent authority shall take into

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account the data related to the usefulness of incorporation of the substance into the device as determined
by the notified body, in order to ensure that the changes have no negative impact on the established
benefit/risk profile of the addition of the substance in the medical device.

When the relevant medicines competent authority (i.e. the one involved in the initial consultation) has
obtained information on the ancillary substance, which could have an impact on the established benefit/
risk profile of the addition of the substance in the medical device, it shall provide the notified body with
advice, whether this information has an impact on the established benefit/risk profile of the addition of
the substance in the medical device or not. The notified body shall take the updated scientific opinion into
account in reconsidering its assessment of the conformity assessment procedure.

(*)

Regulation (EC) No 726/2004 of the European Parliament and of the Council of 31 March 2004 laying
down Community procedures for the authorisation and supervision of medicinal products for human and
veterinary use and establishing a European Medicines Agency (OJ L 136, 30.4.2004, p. 1). Regulation as
last amended by Regulation (EC) No 1901/2006.’

(e)

Section 7.5 shall be replaced by the following:

‘7.5. The devices must be designed and manufactured in such a way as to reduce to a minimum the risks posed
by substances leaking from the device. Special attention shall be given to substances which are
carcinogenic, mutagenic or toxic to reproduction, in accordance with Annex I to Council Directive 67/
548/EEC of 27 June 1967 on the approximation of laws, regulations and administrative provisions
relating to the classification, packaging and labelling of dangerous substances (*).

If parts of a device (or a device itself) intended to administer and/or remove medicines, body liquids or
other substances to or from the body, or devices intended for transport and storage of such body fluids or
substances, contain phthalates which are classified as carcinogenic, mutagenic or toxic to reproduction, of
category 1 or 2, in accordance with Annex I to Directive 67/548/EEC, these devices must be labelled on
the device itself and/or on the packaging for each unit or, where appropriate, on the sales packaging as a
device containing phthalates.

If the intended use of such devices includes treatment of children or treatment of pregnant or nursing
women, the manufacturer must provide a specific justification for the use of these substances with regard
to compliance with the essential requirements,
in particular of this paragraph, within the technical
documentation and, within the instructions for use, information on residual risks for these patient groups
and, if applicable, on appropriate precautionary measures.

(*) OJ 196, 16.8.1967, p. 1. Directive as last amended by Directive 2006/121/EC of the European

Parliament and of the Council (OJ L 396, 30.12.2006, p. 850).’

(f)

in Section 8.2, the word ‘transferable’ shall be replaced by the word ‘transmissible’;

(g)

the following Section shall be inserted:

‘12.1a For devices which incorporate software or which are medical software in themselves, the software must
be validated according to the state of the art taking into account the principles of development lifecycle,
risk management, validation and verification.’;

(h)

in Section 13.1, the first paragraph shall be replaced by the following:

‘13.1. Each device must be accompanied by the information needed to use it safely and properly, taking account

of the training and knowledge of the potential users, and to identify the manufacturer.’;

(i)

Section 13.3 shall be amended as follows:

(i)

point (a) shall be replaced by the following:

‘(a)

the name or trade name and address of
the manufacturer. For devices imported into the
Community, in view of their distribution in the Community, the label, or the outer packaging, or
instructions for use, shall contain in addition the name and address of the authorised representative
where the manufacturer does not have a registered place of business in the Community;’

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(ii)

point (b) shall be replaced by the following:

‘(b)

the details strictly necessary to identify the device and the contents of the packaging especially for
the users;’

(iii)

point (f) shall be replaced by the following:

‘(f) where appropriate, an indication that the device is for single use. A manufacturer's indication of

single use must be consistent across the Community;’

(j)

Section 13.6 shall be amended as follows:

(i)

the following subparagraph shall be added to point (h):

‘If the device bears an indication that the device is for single use, information on known characteristics and
technical factors known to the manufacturer that could pose a risk if the device were to be re-used. If in
accordance with Section 13.1 no instructions for use are needed, the information must be made available
to the user upon request;’

(ii)

point (o) shall be replaced by the following:

‘(o) medicinal substances, or human blood derivatives incorporated into the device as an integral part in

accordance with Section 7.4;’

(iii)

the following point shall be added:

‘(q)

date of issue or the latest revision of the instructions for use.’;

(k)

Section 14 shall be deleted.

2.

Annex II shall be amended as follows:

(a)

Section 2 shall be replaced by the following:

‘2.

The EC declaration of conformity is the procedure whereby the manufacturer who fulfils the obligations
imposed by Section 1 ensures and declares that the products concerned meet the provisions of this
Directive which apply to them.

The manufacturer must affix the CE marking in accordance with Article 17 and draw up a written
declaration of conformity. This declaration must cover one or more medical devices manufactured, clearly
identified by means of product name, product code or other unambiguous reference and must be kept by
the manufacturer.’;

(b)

in Section 3.1, second paragraph, the introductory part of the seventh indent shall be replaced by the following:

‘— an undertaking by the manufacturer to institute and keep up to date a systematic procedure to review
experience gained from devices in the post-production phase, including the provisions referred to in
Annex X, and to implement appropriate means to apply any necessary corrective action. This undertaking
must include an obligation for the manufacturer to notify the competent authorities of the following
incidents immediately on learning of them:’;

(c)

Section 3.2 shall be amended as follows:

(i)

the following paragraph shall be inserted after the first paragraph:

‘It shall
procedures referred to in point (c).’;

include in particular the corresponding documentation, data and records arising from the

(ii)

in point (b), the following indent shall be added:

‘— where the design, manufacture and/or final inspection and testing of the products, or elements
thereof, is carried out by a third party, the methods of monitoring the efficient operation of the
quality system and in particular the type and extent of control applied to the third party;’

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(iii)

point (c) shall be replaced by the following:

‘(c)

the procedures
corresponding documentation, and in particular:

for monitoring and verifying the design of

the products,

including the

— a general description of the product, including any variants planned, and its intended use(s),

— the design specifications, including the standards which will be applied and the results of the
risk analysis, and also a description of
the essential
requirements which apply to the products if the standards referred to in Article 5 are not
applied in full,

the solutions adopted to fulfil

— the techniques used to control and verify the design and the processes and systematic

measures which will be used when the products are being designed,

— if the device is to be connected to other device(s) in order to operate as intended, proof must
be provided that it conforms to the essential requirements when connected to any such device
(s) having the characteristics specified by the manufacturer,

— a statement indicating whether or not the device incorporates, as an integral part, a substance
or a human blood derivative referred to in section 7.4 of Annex I and the data on the tests
conducted in this connection required to assess the safety, quality and usefulness of that
substance or human blood derivative, taking account of the intended purpose of the device,

— a statement indicating whether or not the device is manufactured utilising tissues of animal

origin as referred to in Commission Directive 2003/32/EC (*),

— the solutions adopted as referred to in Annex I, Chapter I, Section 2,

— the pre-clinical evaluation,

— the clinical evaluation referred to in Annex X,

— the draft label and, where appropriate, instructions for use.

(*)

Commission Directive 2003/32/EC of 23 April 2003 introducing detailed specifications as regards
the requirements laid down in Council Directive 93/42/EEC with respect to medical devices
manufactured utilising tissues of animal origin (OJ L 105, 26.4.2003, p. 18).’

(d)

the second paragraph of Section 3.3 shall be replaced by the following:

‘The assessment team must include at least one member with past experience of assessments of the technology
concerned. The assessment procedure must
the
documentation of the design of the product(s) concerned, an inspection on the manufacturer's premises and, in
duly substantiated cases, on the premises of the manufacturer's suppliers and/or subcontractors to inspect the
manufacturing processes.’;

include an assessment, on a representative basis, of

(e)

in Section 4.3, the second and third paragraphs shall be replaced by the following:

‘In the case of devices referred to in Annex I, Section 7.4, second paragraph, the notified body shall, as regards
the aspects referred to in that section, consult one of the competent authorities designated by the Member States
in accordance with Directive 2001/83/EC or the EMEA before taking a decision. The opinion of the competent
national authority or the EMEA must be drawn up within 210 days after receipt of valid documentation. The
scientific opinion of the competent national authority or the EMEA must be included in the documentation
concerning the device. The notified body will give due consideration to the views expressed in this consultation
when making its decision. It will convey its final decision to the competent body concerned.

In the case of devices referred to in Annex I, Section 7.4, third paragraph, the scientific opinion of the EMEA
must be included in the documentation concerning the device. The opinion of the EMEA must be drawn up
within 210 days after receipt of valid documentation. The notified body will give due consideration to the
opinion of the EMEA when making its decision. The notified body may not deliver the certificate if the EMEA's
scientific opinion is unfavourable. It will convey its final decision to the EMEA.

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In the case of devices manufactured utilising tissues of animal origin as referred to in Directive 2003/32/EC, the
notified body must follow the procedures referred to in that Directive.’;

(f)

in Section 5.2, the second indent shall be replaced by the following:

‘— the data stipulated in the part of the quality system relating to design, such as the results of analyses,
calculations, tests, the solutions adopted as referred to in Annex I, Chapter I, Section 2, pre-clinical and
clinical evaluation, post-market clinical follow-up plan and the results of the post-market clinical follow-
up, if applicable, etc.,’;

(g)

Section 6.1 shall be amended as follows:

(i)

the introductory part shall be replaced by the following:

‘The manufacturer or his authorised representative must, for a period ending at least five years, and in the
case of implantable devices at least 15 years, after the last product has been manufactured, keep at the
disposal of the national authorities:’;

(ii)

the following phrase shall be added to the second indent:

‘and in particular the documentation, data and records referred to in the second paragraph of Section 3.2,’;

(h)

Section 6.3 shall be deleted;

(i)

Section 7 shall be replaced by the following:

‘7.

Application to devices in Classes IIa and IIb.

7.1.

In line with Article 11(2) and (3), this Annex may apply to products in Classes IIa and IIb. Section 4,
however, does not apply.

7.2. For devices in Class IIa the notified body shall assess, as part of the assessment in Section 3.3, the technical
documentation as described in Section 3.2(c) for at least one representative sample for each device
subcategory for compliance with the provisions of this Directive.

7.3. For devices in Class IIb the notified body shall assess, as part of the assessment in Section 3.3, the
technical documentation as described in Section 3.2(c) for at least one representative sample for each
generic device group for compliance with the provisions of this Directive.

7.4.

In choosing representative sample(s) the notified body shall take into account the novelty of the
technology, similarities in design, technology, manufacturing and sterilisation methods, the intended use
and the results of any previous relevant assessments (e.g. with regard to physical, chemical or biological
properties) that have been carried out in accordance with this Directive. The notified body shall document
and keep available to the competent authority its rationale for the sample(s) taken.

7.5. Further samples shall be assessed by the notified body as part of the surveillance assessment referred to in

Section 5.’;

(j)

in Section 8, the words ‘Article 4(3) of Directive 89/381/EEC’ shall be replaced by the words ‘Article 114(2) of
Directive 2001/83/EC’;

3.

Annex III shall be amended as follows:

(a)

Section 3 shall be replaced by the following:

‘3.

The documentation must allow an understanding of the design, the manufacture and the performances of
the product and must contain the following items in particular:

— a general description of the type, including any variants planned, and its intended use(s),

— design drawings, methods of manufacture envisaged,
diagrams of components, sub-assemblies, circuits, etc.,

in particular as regards sterilisation, and

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— the descriptions and explanations necessary to understand the abovementioned drawings and

diagrams and the operation of the product,

— a list of the standards referred to in Article 5, applied in full or in part, and descriptions of the
solutions adopted to meet the essential requirements if the standards referred to in Article 5 have
not been applied in full,

— the results of the design calculations, risk analysis, investigations, technical tests, etc. carried out,

— a statement indicating whether or not the device incorporates, as an integral part, a substance, or
human blood derivative, referred to in Section 7.4 of Annex I, and the data on the tests conducted
in this connection which are required to assess the safety, quality and usefulness of that substance,
or human blood derivative, taking account of the intended purpose of the device,

— a statement indicating whether or not the device is manufactured utilising tissues of animal origin as

referred to in Directive 2003/32/EC,

— the solutions adopted as referred to in Annex I, Chapter I, Section 2,

— the pre-clinical evaluation,

— the clinical evaluation referred to in Annex X,

— the draft label and, where appropriate, instructions for use.’;

(b)

in Section 5, the second and third paragraphs shall be replaced by the following:

‘In the case of devices referred to in Annex I, Section 7.4, second paragraph, the notified body shall, as regards
the aspects referred to in that section, consult one of the authorities designated by the Member States in
accordance with Directive 2001/83/EC or the EMEA before taking a decision. The opinion of the competent
national authority or the EMEA must be drawn up within 210 days after receipt of valid documentation. The
scientific opinion of the competent national authority or the EMEA must be included in the documentation
concerning the device. The notified body will give due consideration to the views expressed in this consultation
when making its decision. It will convey its final decision to the competent body concerned.

In the case of devices referred to in Annex I, Section 7.4, third paragraph, the scientific opinion of the EMEA
must be included in the documentation concerning the device. The opinion of the EMEA must be drawn up
within 210 days after receipt of valid documentation. The notified body will give due consideration to the
opinion of the EMEA when making its decision. The notified body may not deliver the certificate if the EMEA's
scientific opinion is unfavourable. It will convey its final decision to the EMEA.

In the case of devices manufactured utilising tissues of animal origin as referred to in Directive 2003/32/EC, the
notified body must follow the procedures referred to in that Directive.’;

(c)

Section 7.3 shall be replaced by the following:

‘7.3. The manufacturer or his authorised representative must keep with the technical documentation copies of
EC type-examination certificates and their additions for a period ending at least five years after the last
device has been manufactured. In the case of implantable devices, the period shall be at least 15 years after
the last product has been manufactured.’;

(d)

Section 7.4 shall be deleted;

4.

Annex IV shall be amended as follows:

(a)

in Section 1, the words ‘established in the Community’ shall be deleted;

(b)

in Section 3, the first paragraph shall be replaced by the following:

‘3.

The manufacturer must undertake to institute and keep up to date a systematic procedure to review
experience gained from devices in the post-production phase, including the provisions referred to in

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Annex X, and to implement appropriate means to apply any necessary corrective action. This undertaking
must include an obligation for the manufacturer to notify the competent authorities of the following
incidents immediately on learning of them:’;

(c)

Section 6.3 shall be replaced by the following:

‘6.3. Statistical control of products will be based on attributes and/or variables, entailing sampling schemes
with operational characteristics which ensure a high level of safety and performance according to the state
of the art. The sampling schemes will be established by the harmonised standards referred to in Article 5,
taking account of the specific nature of the product categories in question.’;

(d)

in Section 7, the introductory part shall be replaced by the following:

‘The manufacturer or his authorised representative must, for a period ending at least five years, and in the case of
implantable devices at least 15 years, after the last product has been manufactured, make available to the
national authorities:’;

(e)

in the introductory part of Section 8 the word ‘exemptions’ shall be deleted;

(f)

in Section 9, the words ‘Article 4(3) of Directive 89/381/EEC’ shall be replaced by the words ‘Article 114(2) of
Directive 2001/83/EC’;

5.

Annex V shall be amended as follows:

(a)

Section 2 shall be replaced by the following:

‘2.

The EC declaration of conformity is the part of the procedure whereby the manufacturer who fulfils the
obligations imposed by Section 1 ensures and declares that the products concerned conform to the type
described in the EC type-examination certificate and meet the provisions of this Directive which apply to
them.

The manufacturer must affix the CE marking in accordance with Article 17 and draw up a written
declaration of conformity. This declaration must cover one or more medical devices manufactured, clearly
identified by means of product name, product code or other unambiguous reference, and must be kept by
the manufacturer.’;

(b)

in the eighth indent of the second paragraph of Section 3.1, the introductory part shall be replaced by the
following:

‘— an undertaking by the manufacturer to institute and keep up to date a systematic procedure to review
experience gained from devices in the post-production phase, including the provisions referred to in
Annex X, and to implement appropriate means to apply any necessary corrective action. This undertaking
must include an obligation for the manufacturer to notify the competent authorities of the following
incidents immediately on learning of them;’;

(c)

in point (b) of the third paragraph of Section 3.2, the following indent shall be added:

‘— where the manufacture and/or final inspection and testing of the products, or elements thereof, are carried
out by a third party, the methods of monitoring the efficient operation of the quality system and in
particular the type and extent of control applied to the third party;’

(d)

in Section 4.2, the following indent shall be inserted after the first indent:

‘— the technical documentation,’;

(e)

in Section 5.1, the introductory part shall be replaced by the following:

‘The manufacturer or his authorised representative must, for a period ending at least five years, and in the case of
implantable devices at least 15 years, after the last product has been manufactured, make available to the
national authorities:’;

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(f)

Section 6 shall be replaced by the following:

‘6. Application to devices in Class IIa

In line with Article 11(2), this Annex may apply to products in Class IIa, subject to the following:

6.1. By way of derogation from Sections 2, 3.1 and 3.2, by virtue of the declaration of conformity the
manufacturer ensures and declares that the products in Class IIa are manufactured in conformity with the
technical documentation referred to in Section 3 of Annex VII and meet the requirements of this Directive
which apply to them.

6.2. For devices in Class IIa the notified body shall assess, as part of the assessment in Section 3.3, the technical
documentation as described in Section 3 of Annex VII for at least one representative sample for each
device subcategory for compliance with the provisions of this Directive.

6.3.

In choosing representative sample(s) the notified body shall take into account the novelty of the
technology, similarities in design, technology, manufacturing and sterilisation methods, the intended use
and the results of any previous relevant assessments (e.g. with regard to physical, chemical or biological
properties) that have been carried out in accordance with this Directive. The notified body shall document
and keep available to the competent authority its rationale for the sample(s) taken.

6.4. Further samples shall be assessed by the notified body as part of the surveillance assessment referred to in

Section 4.3.’;

(g)

in Section 7, the words ‘Article 4(3) of Directive 89/381/EEC’ shall be replaced by the words ‘Article 114(2) of
Directive 2001/83/EC’;

6.

Annex VI shall be amended as follows:

(a)

Section 2 shall be replaced by the following:

‘2.

The EC declaration of conformity is the part of the procedure whereby the manufacturer who fulfils the
obligations imposed by Section 1 ensures and declares that the products concerned conform to the type
described in the EC type-examination certificate and meet the provisions of this Directive which apply to
them.

The manufacturer affixes the CE marking in accordance with Article 17 and draws up a written
declaration of conformity. This declaration must cover one or more medical devices manufactured, clearly
identified by means of product name, product code or other unambiguous reference, and be kept by the
manufacturer. The CE marking must be accompanied by the identification number of the notified body
which performs the tasks referred to in this Annex.’;

(b)

in the eighth indent of the second paragraph of Section 3.1, the introductory part shall be replaced by the
following:

‘— an undertaking by the manufacturer to institute and keep up to date a systematic procedure to review
experience gained from devices in the post-production phase, including the provisions referred to in
Annex X, and to implement appropriate means to apply any necessary corrective action. This undertaking
must include an obligation for the manufacturer to notify the competent authorities of the following
incidents immediately on learning of them:’;

(c)

in Section 3.2, the following indent shall be added:

‘— where the final inspection and testing of the products, or elements thereof, are carried out by a third party,
the methods of monitoring the efficient operation of the quality system and in particular the type and
extent of control applied to the third party;’

(d)

in Section 5.1, the introductory part shall be replaced by the following:

‘The manufacturer or his authorised representative must, for a period ending at least five years, and in the case of
implantable devices at least 15 years, after the last product has been manufactured, make available to the
national authorities:’;

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(e)

Section 6 shall be replaced by the following:

‘6. Application to devices in Class IIa

In line with Article 11(2), this Annex may apply to products in Class IIa, subject to the following:

6.1. By way of derogation from Sections 2, 3.1 and 3.2, by virtue of the declaration of conformity the
manufacturer ensures and declares that the products in Class IIa are manufactured in conformity with the
technical documentation referred to in Section 3 of Annex VII and meet the requirements of this Directive
which apply to them.

6.2. For devices in Class IIa the notified body shall assess, as part of the assessment in Section 3.3, the technical
documentation as described in Section 3 of Annex VII for at least one representative sample for each
device subcategory for compliance with the provisions of this Directive.

6.3.

In choosing representative sample(s) the notified body shall take into account the novelty of the
technology, similarities in design, technology, manufacturing and sterilisation methods, the intended use
and the results of any previous relevant assessments (e.g. with regard to physical, chemical or biological
properties) that have been carried out in accordance with this Directive. The notified body shall document
and keep available to the competent authority its rationale for the sample(s) taken.

6.4. Further samples shall be assessed by the notified body as part of the surveillance assessment referred to in

Section 4.3.’;

7.

Annex VII shall be amended as follows:

(a)

Sections 1 and 2 shall be replaced by the following:

‘1.

2.

The EC declaration of conformity is the procedure whereby the manufacturer or his authorised
representative who fulfils the obligations imposed by Section 2 and, in the case of products placed on the
market in a sterile condition and devices with a measuring function, the obligations imposed by Section 5
ensures and declares that the products concerned meet the provisions of this Directive which apply to
them.

The manufacturer must prepare the technical documentation described in Section 3. The manufacturer or
his authorised representative must make this documentation, including the declaration of conformity,
available to the national authorities for inspection purposes for a period ending at least five years after the
last product has been manufactured. In the case of implantable devices the period shall be at least 15 years
after the last product has been manufactured.’;

(b)

Section 3 shall be amended as follows:

(i)

the first indent shall be replaced by the following:

‘— a general description of the product, including any variants planned and its intended use(s),’;

(ii)

the fifth indent shall be replaced by the following:

‘— in the case of products placed on the market in a sterile condition, description of the methods used

and the validation report,’;

(iii)

the seventh indent shall be replaced by the following indents:

‘— the solutions adopted as referred to in Annex I, Chapter I, Section 2,

— the pre-clinical evaluation,’;

(iv)

the following indent shall be inserted after the seventh indent:

‘— the clinical evaluation in accordance with Annex X,’;

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(c)

in Section 4, the introductory part shall be replaced by the following:

‘4.

The manufacturer shall institute and keep up to date a systematic procedure to review experience gained
from devices in the post-production phase, including the provisions referred to in Annex X, and to
implement appropriate means to apply any necessary corrective actions, taking account of the nature and
risks in relation to the product. He shall notify the competent authorities of the following incidents
immediately on learning of them:’;

(d)

in Section 5, the words ‘Annex IV, V or VI’ shall be replaced by the words ‘Annex II, IV, V or VI’;

8.

Annex VIII shall be amended as follows:

(a)

in Section 1, the words ‘established in the Community’ shall be deleted;

(b)

Section 2.1 shall be amended as follows:

(i)

the following indent shall be inserted after the introductory phrase:

‘— the name and address of the manufacturer,’;

(ii)

the fourth indent shall be replaced by the following:

‘— the specific characteristics of the product as indicated by the prescription,’;

(c)

Section 2.2 shall be amended as follows:

(i)

the second indent shall be replaced by the following:

‘— the clinical investigation plan,’;

(ii)

the following indents shall be inserted after the second indent:

‘— the investigator's brochure,

— the confirmation of insurance of subjects,

— the documents used to obtain informed consent,

— a statement indicating whether or not the device incorporates, as an integral part, a substance or

human blood derivative referred to in Section 7.4 of Annex I,

— a statement indicating whether or not the device is manufactured utilising tissues of animal origin as

referred to in Directive 2003/32/EC,’;

(d)

in Section 3.1, the first paragraph shall be replaced by the following:

‘3.1. For custom-made devices, documentation, indicating manufacturing site(s) and allowing an understanding
of the design, manufacture and performances of the product, including the expected performances, so as
to allow assessment of conformity with the requirements of this Directive.’;

(e)

Section 3.2 shall be replaced by the following:

‘3.2. For devices intended for clinical investigations, the documentation must contain:

— a general description of the product and its intended use,

— design drawings, methods of manufacture envisaged,
diagrams of components, sub-assemblies, circuits, etc.,

in particular as regards sterilisation, and

— the descriptions and explanations necessary to understand the abovementioned drawings and

diagrams and the operation of the product,

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— the results of the risk analysis and a list of the standards referred to in Article 5, applied in full or in
part, and descriptions of the solutions adopted to meet the essential requirements of this Directive if
the standards referred to in Article 5 have not been applied,

— if the device incorporates, as an integral part, a substance or human blood derivative referred to in
Section 7.4 of Annex I, the data on the tests conducted in this connection which are required to
assess the safety, quality and usefulness of that substance or human blood derivative, taking account
of the intended purpose of the device,

— if the device is manufactured utilising tissues of animal origin as referred to in Directive 2003/32/
EC, the risk management measures in this connection which have been applied to reduce the risk of
infection,

— the results of the design calculations, and of the inspections and technical tests carried out, etc.

The manufacturer must take all the measures necessary to ensure that the manufacturing process produces
products which are manufactured in accordance with the documentation referred to in the first paragraph of
this Section.

The manufacturer must authorise the assessment, or audit where necessary, of the effectiveness of these
measures.’;

(f)

Section 4 shall be replaced by the following:

‘4.

The information contained in the declarations concerned by this Annex shall be kept for a period of time
of at least five years. In the case of implantable devices the period shall be at least 15 years.’;

(g)

the following section shall be added:

‘5.

For custom-made devices, the manufacturer must undertake to review and document experience gained in
the post-production phase, including the provisions referred to in Annex X, and to implement appropriate
means to apply any necessary corrective action. This undertaking must include an obligation for the
manufacturer to notify the competent authorities of the following incidents immediately on learning of
them and the relevant corrective actions:

(i)

(ii)

any malfunction or deterioration in the characteristics and/or performance of a device, as well as
any inadequacy in the labelling or the instructions for use which might lead to or might have led to
the death of a patient or user or to a serious deterioration in his state of health;

any technical or medical reason connected with the characteristics or performance of a device for
the reasons referred to in subparagraph (i) leading to systematic recall of devices of the same type by
the manufacturer.’;

9.

Annex IX shall be amended as follows:

(a)

Chapter I shall be amended as follows:

(i)

in Section 1.4, the following sentence shall be added:

‘Stand alone software is considered to be an active medical device.’;

(ii)

Section 1.7 shall be replaced by the following:

‘1.7. Central circulatory system

For the purposes of this Directive, “central circulatory system” means the following vessels:

arteriae pulmonales, aorta ascendens, arcus aorta, aorta descendens to the bifurcatio aortae, arteriae
coronariae, arteria carotis communis, arteria carotis externa, arteria carotis interna, arteriae
cerebrales, truncus brachiocephalicus, venae cordis, venae pulmonales, vena cava superior, vena
cava inferior.’;

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21.9.2007

(b)

in Chapter II, Section 2, the following section shall be added:

‘2.6.

In calculating the duration referred to in Section 1.1 of Chapter I, continuous use means “an uninterrupted
actual use of the device for the intended purpose”. However where usage of a device is discontinued in
order for the device to be replaced immediately by the same or an identical device this shall be considered
an extension of the continuous use of the device.’;

(c)

Chapter III shall be amended as follows:

(i)

the introductory phrase of the first paragraph of Section 2.1 shall be replaced by the following:

‘All invasive devices with respect to body orifices, other than surgically invasive devices and which are not
intended for connection to an active medical device or which are intended for connection to an active
medical device in Class I:’;

(ii)

Section 2.2 shall be replaced by the following:

‘2.2. Rule 6

All surgically invasive devices intended for transient use are in Class IIa unless they are:

— intended specifically to control, diagnose, monitor or correct a defect of the heart or of the
central circulatory system through direct contact with these parts of the body, in which case
they are in Class III,

— reusable surgical instruments, in which case they are in Class I,

— intended specifically for use in direct contact with the central nervous system, in which case

they are in Class III,

— intended to supply energy in the form of ionising radiation in which case they are in Class IIb,

— intended to have a biological effect or to be wholly or mainly absorbed in which case they are

in Class IIb,

— intended to administer medicines by means of a delivery system, if this is done in a manner
that is potentially hazardous taking account of the mode of application, in which case they are
in Class IIb.’;

(iii)

in Section 2.3, the first indent shall be replaced by the following:

‘— either specifically to control, diagnose, monitor or correct a defect of the heart or of the central
circulatory system through direct contact with these parts of the body, in which case they are in
Class III,’;

(iv)

in Section 4.1, first paragraph, the reference ‘65/65/EEC’ shall be replaced by the reference ‘2001/83/EC’;

(v)

in Section 4.1, the second paragraph shall be replaced by the following:

‘All devices incorporating, as an integral part, a human blood derivative are in Class III.’;

(vi)

in Section 4.3, second paragraph, the following phrase shall be added:

‘unless they are specifically to be used for disinfecting invasive devices in which case they are in Class IIb.’;

(vii)

in Section 4.4, the words ‘Non-active devices’ shall be replaced by the word ‘Devices’;

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10. Annex X shall be amended as follows:

(a)

Section 1.1 shall be replaced by the following:

‘1.1.

As a general rule, confirmation of conformity with the requirements concerning the characteristics and
performances referred to in Sections 1 and 3 of Annex I, under the normal conditions of use of the
device, and the evaluation of the side-effects and of the acceptability of the benefit/risk ratio referred to
in Section 6 of Annex I, must be based on clinical data. The evaluation of this data, hereinafter referred
to as “clinical evaluation”, where appropriate taking account of any relevant harmonised standards, must
follow a defined and methodologically sound procedure based on:

1.1.1. Either a critical evaluation of the relevant scientific literature currently available relating to the safety,

performance, design characteristics and intended purpose of the device, where:

— there is demonstration of equivalence of the device to the device to which the data relates, and

— the data adequately demonstrate compliance with the relevant essential requirements.

1.1.2. Or a critical evaluation of the results of all clinical investigations made.

1.1.3. Or a critical evaluation of the combined clinical data provided in 1.1.1 and 1.1.2.’

(b)

The following Sections shall be inserted:

‘1.1a

In the case of implantable devices and devices in Class III clinical investigations shall be performed
unless it is duly justified to rely on existing clinical data.

1.1b

1.1c

The clinical evaluation and its outcome shall be documented. This documentation shall be included
and/or fully referenced in the technical documentation of the device.

The clinical evaluation and its documentation must be actively updated with data obtained from the
post-market surveillance. Where post-market clinical follow-up as part of the post-market surveillance
plan for the device is not deemed necessary, this must be duly justified and documented.

1.1d Where demonstration of conformity with essential requirements based on clinical data is not deemed
appropriate, adequate justification for any such exclusion has to be given based on risk management
output and under consideration of
the clinical
performances intended and the claims of the manufacturer. Adequacy of demonstration of conformity
with the essential requirements by performance evaluation, bench testing and pre-clinical evaluation
alone has to be duly substantiated.’;

the device/body interaction,

the specifics of

(c)

in Section 2.2, the first sentence shall be replaced by the following:

‘Clinical investigations must be carried out in accordance with the Helsinki Declaration adopted by the 18th
World Medical Assembly in Helsinki, Finland, in 1964, as last amended by the World Medical Assembly.’;

(d)

Section 2.3.5 shall be replaced by the following:

‘2.3.5. All serious adverse events must be fully recorded and immediately notified to all competent authorities

of the Member States in which the clinical investigation is being performed.’.