Source: https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/HowtoMarketYourDevice/PremarketSubmissions/PremarketApprovalPMA/ucm047991.htm
Timestamp: 2019-04-26 04:45:45+00:00

Document:
During the administrative and limited scientific review, FDA determines whether a PMA is suitable for filing by reviewing the PMA submission for information required by the FD&C Act, the PMA regulations (21 CFR 814), and the PMA Acceptance and Filing Review Policy.
The filing of an application means that FDA has made a threshold determination that the application is sufficiently complete to begin an in-depth review. Within 45 days after a PMA is received by FDA, the agency will notify the applicant whether the application has been filed. The letter will include the PMA reference number and the date FDA filed the PMA. Expedited review status, if appropriate, may be communicated at this time. The date of filing is the date that a PMA accepted for filing was received by the agency. The 180-day period for review of a PMA starts on the date of filing.
FDA will refuse to file the application for substantive review if a PMA application does not meet a minimum threshold of acceptability. If the information or data are presented unclearly or incompletely or are not capable of withstanding rigorous scientific review, FDA may consider the PMA incomplete and not file it. If FDA refuses to file a PMA, FDA will notify the applicant of the reasons for the refusal. This notice will identify the deficiencies in the application that prevent filing and will include the PMA reference number. FDA will advise the manufacturer of what information must be provided, or steps to be taken, to make the application fileable.
The applicant may request in writing within 10 working days of the date of receipt of the notice refusing to file the PMA, an informal conference with the Director of the Office of Device Evaluation to review FDA`s decision not to file the PMA. FDA will hold the informal conference within 10 working days after receiving the request and will make its decision on filing within 5 working days after the informal conference. If FDA then accepts the PMA for filing, the date of filing will be the date of the decision to accept the PMA for filing. If FDA does not reverse its decision, the applicant may request reconsideration of the decision from the Director of the Center for Devices and Radiological Health. The Director`s decision will constitute final administrative action for the purpose of judicial review.
Should the applicant decide to request a meeting concerning a refuse-to-file decision, the applicant must choose either: 1) an informal conference at which the decision not to file the application will be reviewed; or 2) a meeting with the ODE division to discuss the specific deficiencies and the measures necessary to correct these deficiencies. Please be advised that FDA will not typically grant requests for an informal conference and a meeting with the reviewing ODE division regarding this decision due to resource limitations. Applicants should either request an informal conference or schedule a meeting with the reviewing ODE division to discuss the preparation of an appropriate response.
The applicant has a pending Premarket Notification 510(k) with respect to the same device, and FDA has not determined whether the device falls within the scope of Sec. 814.1(c).
The PMA contains a false statement of material fact.
The PMA is not accompanied by a statement of either certification or disclosure as required by 21 CFR 54 Financial Disclosure by Clinical Investigators.
FDA will begin substantive review of the PMA after it is accepted for filing (§814.42). During the review process, FDA will notify the PMA applicant via major/minor deficiency letters of any information needed by FDA to complete the review of the application. The applicant may request to meet with FDA within 100 days of the filing of the PMA to discuss the review status of the application. The procedure for "Day-100 Meetings" can be found in the guidance document "Guidance on PMA Interactive Procedures for Day-100 Meetings and Subsequent Deficiencies - for Use by CDRH and Industry; Final"
If the applicant on their own initiative or at FDA`s request submits a PMA amendment (§814.37) which contains significant new data from a previously unreported study, significant updated data from a previously reported study, detailed new analyses of previously submitted data, or significant required information previously omitted, the review period may be extended up to 180 days.
FDA may refer the PMA to an outside panel of experts (advisory committee). In general, all PMAs for the first-of-a-kind device are taken before the appropriate advisory panel for review and recommendation. However, as soon as FDA believes that (1) the pertinent issues in determining the safety and effectiveness for the type of medical device are understood and (2) FDA has developed the ability to address those issues, future PMAs for devices of that type are not be taken before an advisory panel unless a particular application presents an issue that can best be addressed through panel review.
The PMA, or relevant portions, may be forwarded to each member of the appropriate FDA advisory committee for review. During the review process, FDA may communicate with the applicant [§814.37(b)] or with the advisory committee to respond to questions that may be raised by committee members or to provide additional information to the panel. FDA will maintain a record of all communications with the applicant and with the advisory committee.
If the PMA is referred to an advisory committee, the committee must hold a public meeting to review the PMA in accordance with 21 CFR 14. The advisory committee must submit a final report to FDA that includes the committee's recommendation and the basis for such recommendation on the PMA. The advisory committee report and recommendation may be in the form of a meeting transcript signed by the chairperson of the committee.
The following document provides guidance for panel review.
FDA takes into consideration the transcript of the meeting, the panel`s recommendation(s), and other information in reaching a final decision on the PMA. FDA informs the applicant whether FDA agrees with the panel`s recommendation or disagrees and what additional information is needed from the applicant (approvable/not approvable decision). If the application is approvable, the applicant must agree to the "Conditions of Approval."
The "Conditions of Approval" are the standard postapproval conditions imposed by FDA. These are applicable to all original PMAs and PMA supplements. As a condition of approval the sponsor agrees to abide by advertising and final printed labeling requirements and to submit adverse event reports, annual reports, and PMA supplements for certain changes. Additional specific conditions may be required for implanted devices. Applicants should carefully read the conditions of approval attached to the FDA approval letter. The "Conditions of Approval" is available on the Internet.
OC review of manufacturing information for compliance with the Quality System regulation (21 CFR 820).
Applicants are encouraged to contact FDA to obtain further guidance prior to the submission of a PMA application. This will be especially beneficial to new applicants who have not previously had contact with FDA and for applicants proposing to study new technologies or new uses for existing technologies. Early interaction with FDA should help to increase the applicant's understanding of FDA requirements, regulations, and guidance documents, and will allow FDA personnel to familiarize themselves with the new technologies. Increased interaction between FDA and applicants should help to speed the regulatory process and minimize delays in the development of useful devices intended for human use.
The applicant may request a "Pre-Submission" meeting with FDA. The pre-submission program provides the applicant with the opportunity to obtain FDA feedback prior to the submission of a marketing application. Through the pre-submission program the applicant will interact directly with the appropriate review branch. The applicant may request a formal written response, a face-to-face meeting, or a teleconference to address their concerns, questions, etc. Details regarding how to submit a pre-submission request to the FDA for feedback are provided in the “Requests for Feedback on Medical Device Submissions: The Pre-Submission Program and Meetings with Food and Drug Administration Staff” guidance document.
In addition, the applicant may request a "determination" meeting with FDA. This meeting held early in device development will provide the applicant with the agency`s determination of the type of valid scientific evidence that will be necessary to determine if the device is effective for its intended use. FDA’s determination is to be written, shared with the applicant within 30 days following the meeting, and is binding upon the Agency, unless it would be contrary to public health. Additional information on determination meetings can be found in "Early Collaboration Meetings under the FDA Modernization Act (FDAMA)".
For certain medical devices that demonstrate the potential to address unmet medical needs for life threatening or irreversibly debilitating diseases or conditions, the Expedited Access for Premarket Approval and De Novo Medical Devices Intended for Unmet Medical Need for Life Threatening or Irreversibly Debilitating Diseases or Conditions guidance document introduces a new, voluntary program: the Expedited Access Pathway. The Expedited Access Pathway program intends to proactively work with sponsors to try to reduce the time and cost from development to marketing decision. Additional information about this and other aspects of the EAP program can be found at the Expedited Access Pathway Program webpage.
The applicant may request a meeting (100-Day Meeting) to discuss the review status of the application. The meeting request should be submitted with the PMA or as an amendment to the PMA no later than 70 days from FDA receipt of the PMA accepted for filing or 70 days from submission of the amendment making the PMA filable ("filing date"). This 30 day lead time is needed to allow FDA sufficient time to schedule the meeting. In the written request, the applicant should specify the type of meeting desired, e.g., face-to-face, teleconference, or videoconference, provide a list of the persons who will attend for the company, and identify several possible dates for the meeting. After a letter filing the application has been issued, the reviewing division will contact the applicant to set up the meeting if requested. For further information, please refer to the Guidance on PMA Interactive Procedures for Day-100 Meetings and Subsequent Deficiencies - for Use by CDRH and Industry.
For general questions relating to the PMA laws, regulations, policies, and administrative issues, please contact the Division of Industry and Consumer Education (DICE) at 1-800-638-2041 or 301-796-7100, or via email at DICE@fda.hhs.gov. Or, you may contact the PMA Staff at (301) 796-5640.
an order denying approval under §814.45.
After FDA reviews the committee`s final report, the FDA will issue an order to the applicant that the PMA is approved if none of the reasons in §814.45 (Denial of approval for a PMA) for denying approval of the application applies. FDA will approve an application on the basis of draft final labeling. Approval will be based on the condition that the applicant submits to FDA a copy of the final printed labeling before marketing.
FDA will notify the public of the approval. The announcement of the decision and the availability of a summary of the safety and effectiveness data (SSED) on which the decision is based will be published on the Internet. The summary will include information about any adverse effects of the device on health. The announcement also provides the applicant and other interested persons an opportunity for administrative review of the FDA approval under section 515(d)(3) of the FD&C Act. On a quarterly basis, FDA will publish a list of approvals announced during that quarter in the Federal Register. When a notice of approval is published, data and information in the PMA file will be available for public disclosure in accordance with §814.9.
The applicant may have to agree to a postapproval study, restrictions on prescription use, or restrictions on the training of individuals who may use the device before approval. The applicant may also be notified of required postmarket surveillance and/or tracking requirements.
the applicant submits a written notice to FDA that the PMA has been withdrawn.
Any FDA orders, such as approval or denial, will be emailed to the PMA applicant or its designated agent. A PMA applicant or its designated agent may arrange to pick up the FDA order at 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002 by contacting the PMA Staff at 301-796-5640.
The device`s proposed labeling does not comply with the requirements in Part 801, Labeling, or Part 809, In Vitro Diagnostic Products for Human Use.
An essential nonclinical laboratory study described in the PMA was not conducted in compliance with the good laboratory practice (GLP) regulations in 21 CFR 58 and no reason for the noncompliance is provided, or, if it is, the differences between the practices used in conducting the study and the good laboratory practice regulations do not support the validity of the study.
Any clinical investigation involving human subjects described in the PMA that is subject to the Institutional Review Board regulations in 21 CFR 56 or to the Informed Consent regulations in 21 CFR 50 and was not conducted in compliance with these regulations such that the rights or safety of human subjects were not adequately protected.
FDA will issue any order denying approval of a PMA in accordance with §814.17. The order will inform the applicant of the deficiencies in the PMA, including each applicable ground for denial under section 515(d)(2) of the FD&C Act and the regulations under Part 814, and, where practical, will identify measures required to place the PMA in approvable form. The order will include a notice of an opportunity to request review under section 515(d)(3) of the FD&C Act.
FDA will use the criteria specified in §860.7 (Determination of Safety and Effectiveness) in deciding whether to approve or deny approval of a PMA. FDA may use information other than that submitted by the applicant in making such determination.
FDA will publish a Federal Register notice of an order denying approval of the PMA. The notice will be placed on the Internet and will state that a detailed summary of information concerning the safety and effectiveness of the device, including information about any adverse effects on health, is available on the Internet and has been placed on public display. FDA will publish in the Federal Register after each quarter a list of the denials announced in that quarter. When a notice of denial of approval is made publicly available, data and information in the PMA file will be available for public disclosure in accordance with §814.9.
petitioned for review under section 515(d)(3) of the FD&C Act by filing a petition in the form of a petition for reconsideration (21 CFR10.33).
any clinical investigation involving human subjects described in the PMA that is subject to the IRB regulations in 21 CFR 56 or to informed consent regulations in 21 CFR 50, was not conducted in compliance with these regulations, such that the rights or safety of human subjects were not adequately protected.
FDA may seek advice on scientific matters from any appropriate FDA advisory committee in deciding whether to withdraw approval of a PMA. FDA may also use information other than that submitted by the applicant in deciding whether to withdraw approval of a PMA.
Before issuing an order to withdraw approval of a PMA, FDA will issue the holder of the approved application a notice of opportunity for an informal hearing under 21 CFR 16. If the applicant does not request a hearing or, if after the 21 CFR 16 hearing is held, FDA decides to proceed with the withdrawal, FDA will issue an order withdrawing approval of the application. The order (§814.17) will state each ground for withdrawing approval and will include a notice of an opportunity for administrative review under section 515(e)(2) of the FD&C Act.
FDA will publish a Federal Register notice of an order withdrawing approval of a PMA. The notice will state that a detailed summary of information concerning the safety and effectiveness of the device, including information about any adverse effects on health, has been placed on public display and that copies are available upon request. When a notice of withdrawal of approval is published, data and information in the PMA file will be available for public disclosure under §814.9.
If, after providing the sponsor with an opportunity for a regulatory informal hearing regarding the proposed withdrawal of PMA approval, and FDA determines there is a reasonable probability that continued distribution of a PMA-approved device would cause serious adverse health consequences or death, FDA shall by order temporarily suspend the PMA. In cases where there are sufficient grounds, FDA will proceed expeditiously to withdraw the PMA approval.

References: §814
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 §860
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