Sunday, November 29, 2020

MDSAP Device Marketing Authorization and Facility Registration - Part 5

Hi friends!!!


In our previous blog we had a introduction about Medical Device Single Audit Program, MDSAP Audit Cycle, Management process Audi. Please check out for the link below.


Medical Device Single Audit Program - Part 1


MDSAP Audit Cycle - Part 2


MDSAP Management Process Audit - Part 3


MDSAP Management Process Audit - Part 4


In today's blog we will discuss in detail about Medical Device Single Audit Program (MDSAP) CHAPTER 2 -  Device Marketing Authorization and Facility Registration.


MDSAP is a common Medical Device auditing program followed by countries like Australia, USA, Brazil, Canada and Japan. Therefore it is important for every healthcare professionals who wish to market their product in the above mentioned countries to know in detail about MDSAP.


Let's get into the topic.


CHAPTER 2 – DEVICE MARKETING 

AUTHORIZATION AND FACILITY

REGISTRATION


The following are the tasks to be performed during device marketing authorization and facility registration audit.

TASK 1 – Submission of Device Marketing Authorization and Facility Registration.

TASK 2 – Evidence of Marketing Clearance or Approval.

TASK 3 – Notification of Changes to Marketed Devices or to the QMS.


Let's discuss about each task in detail.

TASK 1 – Submission of

Device Marketing

Authorization and Facility

Registration


Ensure that medical device organization has complied with requirements to register and or license the device facilities. Verify whether medical device organization has submitted device listing information to regulatory authorities where it markets and distributes their products.


Ensure that the importers/MAHs/Sponsors have provided appropriate information to applicable regulatory authorities indicating that the medical device organization is the legal manufacturer even though the medical device organization inappropriately considers themselves to be an original equipment manufacturer.


The compliance of appropriate market authorization processes can be checked by reviewing the labelling of the product being supplied to a particular jurisdiction.


APPLICABLE REGULATORY STANDARDS AND CLAUSE


ISO 13485:2016: 4.1.1, 4.2.1, 5.2, 7.2.1, 7.2.3.

FDA: 21 CFR 807.

TGA: TG(MD)R Sch3 P1 CI1.8

ANVISA: RDC ANVISA 16/2013: 1.2.9.

To be considered as a registered manufacturing site, the medical device organization has to submit an application to PMDA for registration by itself according to PMD act 23-2-3.1, 23-2-4.


TASK 2 – Evidence of

Marketing Clearance or

Approval


Confirm that the medical device organization has received appropriate marketing clearance or approval from applicable regulatory jurisdictions where the medical device organization markets its devices.


APPLICABLE REGULATORY STANDARDS AND CLAUSE


ISO 13485:2016: 4.1.1, 4.2.1, 5.2, 7.2.1, 7.2.3.

AUSTRALIA: TG Act s41FJ, TG Act Part 4-7.

BRAZIL: ANVISA RDC nº 36/2015, RDC nº 40/2015.

JAPAN: PMD Act 23-2-5.1, 23-2-23.1, 23-2-12.

US FDA: 21 CFR 807.81- Premarket Notification, 21 CFR 814 – Premarket Approval.


A medical device manufacturer should ensure that the product is not released for supply to the Australian market until the sponsor has been issued with a “Certificate of Inclusion in the Australian Register of Therapeutic Goods”. It states that each kind of medical device that has been approved for supply to the Australian market according to [TG Act s41FJ] or the sponsor holds a relevant exemption as per (TG Act Part 4-7).


TASK 3 – Notification of

Changes to Marketed

Devices or to the QMS


Ensure that the medical device organization has arranged for assessment of changes whenever applicable and obtained marketing authorization for changes to devices or the quality management system which require amendment to existing marketing authorization.


The audit team should pay attention to design changes that may require notification to the applicable regulatory bodies to which the changed devices are marketed.


APPLICABLE REGULATORY STANDARDS AND CLAUSE


ISO 13485:2016: 4.1.1, 4.2.1, 5.2, 7.2.1, 7.2.3, 7.3.9

AUSTRALIA: Therapeutic Goods (Medical Devices) Regulations 2002: Regulation 3.5 – Medical devices manufactured outside Australia, Schedule 3 - The relevant conformity assessment procedure chosen by the Manufacturer.

JAPAN: PMD Act 23-2-5.1, 23-2-5.11, 23-2-5.12, 23-2-23.1, 23-2-23.6, 23-2-23.7.

CANADA: section 32 CMDR 34, section 34 or 43.1 CMDR 43, CMDR 43(3), section 34 CMDR 43.1.

US FDA: 21 CFR 807 - Establishment Registration and Device Listing for Manufacturers and Initial Importers of Devices, 21 CFR 814.39 – PMA Supplements, 21 CFR 807.81- Premarket Notification.


Auditing Organization should evaluate the changes made by the medical device organization to determine whether there is a requirement for special audit to verify the continuing integrity of the quality management system. Adequacy of technical documentation as a result of the change should also be verified by the auditing organization.


Examples of changes that may require an notification for applicable regulatory bodies: Design, Composition, Raw material, Sterilization method, Manufacturing method Manufacturing site Patient or user safety features, Operating Parameters or conditions for use, Indication for use, Shelf life, Performance Specification.


Now I hope you have acquired some knowledge about MDSAP Device Marketing Authorization and Facility Registration.  We will discuss in detail about Medical Device Single Audit Program in our future blogs.


NOTE: Dear friends!!!... Please do comment a topic related to Biomedical, so that we can discuss it in future blogs.


Check out for this blog about Computed Tomography,  X ray, MRI scan, ECG.


Generations of CT Scanners


COMPUTED TOMOGRAPHY|TECHNOLOGY|ARTIFACTS


x ray machine working principle


components of x ray tube


MRI scan 


MRI With Contrast


Brain MRI


Types of MRI scanners


ELECTROCARDIOGRAM


12 Lead ECG Placement


HOW TO READ AN ECG


Holter Monitor


DON’T FORGET TO FOLLOW THIS BLOG PAGE


DROP YOUR MAIL ID TO GET IMMEDIATE UPDATES


If you find this blog post knowledgeable, 

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Saturday, November 21, 2020

Functions of Liver

Hi Friends!!!


In our previous anatomy and physiology session we have discussed about Lung Anatomy, Function and Disease, Anatomy of Kidney, Functions of Kidney, Anatomy of Liver.  Please check out for the link below.


Functions of Kidney

Lung Anatomy, Function and Disease

Anatomy of  Kidney

Anatomy of Liver


Being a healthcare professional, it is very important to have knowledge about human body.


Today we are going to discuss about Functions of Liver.


Liver is one of the important organs in our human body. It is the second largest organ in our body. Therefore it is important for every healthcare professionals to know in detail about liver.


Let's get into the topic.


FUNCTIONS OF LIVER


Liver performs majority of functions in human body. Liver helps in regulating blood sugar levels and also contributes to production, excretion, metabolism, activation, storage and synthesis of many factors.


Here are some of the most important functions of liver.


1. Enzyme activation.


2. Production of immune factors for resisting

infections.


3. Metabolism of fats, proteins and

carbohydrates.


4. Makes certain proteins for blood plasma,

such as albumin.


5. Regulating blood clotting.


6. Storage of glycogen, vitamins, and

minerals.


7. Bile production and excretion.


8. Excretion of bilirubin from red blood cells.

The bilirubin secretion in blood may lead to

yellowish skin and eyes.


9. Excretion of cholesterol, hormones and

drugs.


Let’s discuss in detail about the above-mentioned functions in detail.



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IMMUNOLOGICAL FUNCTION

Liver is a part of mononuclear phagocyte system. It contains high numbers of Kupffer cells that are involved in immune activity. Kupffer cells are cells which destroy any disease-causing agents which might enter the liver through the gut. As a part of filtering process, liver also removes bacteria from the bloodstream.


SYNTHESIS OF ALBUMIN

Albumin is most common protein in blood serum. It transports fatty acids and steroid hormones to help maintain the correct pressure and prevent the leaking of blood vessels.


SYNTHESIS OF ANGIOTENSINOGEN

During the production of an enzyme called renin in the kidneys, the angiotensinogen raises the blood pressure by narrowing the blood vessels.


BILE PRODUCTION

Bile is a fluid which is very critical for the process of digestion. Bile also helps small intestine break down and absorb fat, cholesterol and some vitamins. Bile consists of bile salts, cholesterol, bilirubin, electrolytes, and water.


CARBOHYDRATE METABOLIZATION

Carbohydrates are stored in the liver, where they are broken into glucose and siphoned into bloodstream to maintain control glucose levels.


VITAMINS AND MINERAL STORAGE

Liver stores significant amount of vitamins A, D, E, K, and B12 as well as iron and copper. Liver stores iron from hemoglobin in the form of ferritin, which are ready to make new red blood cells.


FILTERING OF BLOOD

All blood leaving the stomach and intestine pass through liver, which filters and removes waste substances like toxins, byproducts and other harmful substances.


SUPPORTING BLOOD CLOTS

Vitamin K is necessary for the creation of certain coagulants that helps in clotting of the blood. Bile is essential for vitamin K absorption and is created in the liver. If the liver does not produce enough bile, there will be a lack clotting factors.


GLUCOSE PROCESSING

Liver converts excess glucose into glycogen for storage and makes glucose available when needed.


AMMONIA EXCRETION

The liver converts ammonia to urea, which is then excreted via urine.


REGENERATION

As long as 25 percentage of the liver remains healthy it can regenerate completely without any lost in its function and ability. Liver is the only organ that can regenerate completely and it regrows to its previous size. The new liver tissue is indistinguishable from the original tissue.


Factors that helps in regrowth of liver as follows.


1. Hepatocyte growth factor.

2. Interleukin-6.

3. Insulin.

4. Norepinephrine.

5. Transforming growth factor-alpha.

6. Epidermal growth factor.


Now I hope you have acquired some knowledge about Functions of Liver.  We will discuss in detail about a topic related to biomedical engineering in our future blogs.


NOTE: Dear friends!!!... Please do comment a topic related to Biomedical, so that we can discuss it in future blogs.


Check out for this blog about Computed Tomography,  X ray, MRI scan, ECG.


Generations of CT Scanners


COMPUTED TOMOGRAPHY|TECHNOLOGY|ARTIFACTS


x ray machine working principle


components of x ray tube


MRI scan 


MRI With Contrast


Brain MRI


Types of MRI scanners


ELECTROCARDIOGRAM


12 Lead ECG Placement


HOW TO READ AN ECG


Holter Monitor


DON’T FORGET TO FOLLOW THIS BLOG PAGE


DROP YOUR MAIL ID TO GET IMMEDIATE UPDATES


If you find this blog post knowledgeable, 

comment & share it with a friend!  

Monday, November 9, 2020

Anatomy of Liver

 Hi Friends!!!


In our previous anatomy and physiology session we have discussed about Lung Anatomy, Function and Disease, Anatomy of Kidney, Functions of Kidney.  Please check out for the link below.


Functions of Kidney

Lung Anatomy, Function and Disease

Anatomy of  Kidney


Being a healthcare professional, it is very important to have knowledge about human body.


Today we are going to discuss about Anatomy of Liver.


Liver is one of the important organs in our human body. It is the second largest organ in our body. Therefore it is important for every healthcare professionals to know in detail about liver.


Let's get into the topic.


ANATOMY OF LIVER

 

Liver is the second largest organ in human body after the skin and it is located on the right side of the abdomen below the lungs and inferior to the diaphragm and deep between 7th to 11th ribs.

 

Liver occupies three abdominal regions: Right hypochondriac, Epigastric, and left hypochondriac. Major part of the liver is protected by rib cage. And there is impression of ribcage on top of the liver. Liver is wedge in shape and weighs about 1.2 to 1.5 kg.

 


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BLOOD SUPPLY TO LIVER

 

Major blood supply to liver is by hepatic portal vein which contributes 75% of blood supply to liver. It supplies partially deoxygenated blood by carrying the nutrients absorbed from the small intestines and it is dominant in blood supply to liver parenchyma.

 

The hepatic artery which is derived from celiac trunk supplies non-parenchymal structures of liver with arterial blood. Venous drainage of the liver is done by hepatic veins, which drains the deoxygenated blood into inferior vena cava.

 

HEPATIC LIGAMENTS

 

Position of the liver is supported by several peritoneal ligaments. These ligaments are as follows:

 

Falciform ligament

 

The falciform ligament is a sickle shaped ligament which attaches the anterior surface of the liver to the anterior abdominal wall. It forms a natural anatomical division between right and left lobes of the liver. The free edge of falciform ligament contains Remnant of umbilical vein.

 

Triangular ligament

 

Right triangular ligament is formed adjacent to the bare area and attaches the diaphragm with the right lobe of the liver.

 

Left triangular ligament is formed by the union of anterior and posterior layers of coronary ligament at the apex of the liver and attaches left lobe of the liver with the diaphragm.

 

Coronary ligament

 

Coronary ligament attaches superior surface of the liver to the inferior surface of the diaphragm. Coronary ligament also demarcates the bare area of the liver. The anterior and posterior folds unite to form triangular ligaments on the left and right lobes of the liver.

 

Lesser omentum

 

 It attaches liver to the lesser curvature of the stomach and 1st part of duodenum. It consists of hepatoduodenal ligament and hepatogastric ligament.

 


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HEPATIC RECESSES

 

The hepatic recesses are anatomical spaces between liver and its surrounding structures. Recesses are area subjected to infections, which leads to formation of abscess.

 

Subphrenic space

 

The subphrenic space is located between diaphragm and the anterior and superior aspects of the liver. The subphrenic space separates diaphragmatic surface of the liver from the diaphragm. The subphrenic space is divided into right and left by falciform ligament.

 

Subhepatic space

 

The subhepatic space is a subdivision of supra colic compartment. It is located between the transverse colon and the inferior surface of the liver.

 

Morison’s pouch

 

The Morison pouch is a potential space between visceral surface and the right kidney. It is the deepest part of the peritoneal cavity when lying flat or supine. So, pathological abdominal fluid like blood or ascites is most likely to be collected in this region in bedridden patients.

 

LOBES OF LIVER

 

The liver has four lobes. The right and left lobe, separated by the falciform ligament. The Caudate and quadrate lobe delimited by the fissures of the visceral surface.

 

Each lobe is made of thousands of hexagonally-shaped lobules. These lobules are very small. Each lobule is made up of numerous liver cells, called hepatocytes. Between each row are sinusoids. These small blood vessels diffuse oxygen and nutrients through their capillary walls into the liver cells.

 

SEGMENTS OF LIVER

 

The Liver has 8 segments

 

The Middle hepatic vein divides liver into right and left halves. The Right hepatic vein divides right lobe into anterior and posterior lobes. The Left hepatic vein divides left lobe into medial and lateral halves. The Portal vein runs transversely dividing liver into 8 segments.

 

NERVE SUPPLY OF LIVER

 

The nerve innervation of the liver is by hepatic nervous plexus which runs along the hepatic artery and portal vein. It receives sympathetic fibres from the celiac plexus and parasympathetic fibres from the anterior and posterior vagal trunks.

 
LYMPHATIC DRAINAGE OF LIVER

 

The lymph that is produced by the liver is collected mainly by the hepatic nodes which are situated around the porta hepatis. From there the fluid is carried to the celiac nodes which are part of intestinal lymphatic trunks and merge directly into thoracic duct.


Now I hope you have acquired some knowledge about Anatomy of Liver.  We will discuss in detail about a topic related to biomedical engineering in our future blogs.


NOTE: Dear friends!!!... Please do comment a topic related to Biomedical, so that we can discuss it in future blogs.


Check out for this blog about Computed Tomography,  X ray, MRI scan, ECG.


Generations of CT Scanners


COMPUTED TOMOGRAPHY|TECHNOLOGY|ARTIFACTS


x ray machine working principle


components of x ray tube


MRI scan 


MRI With Contrast


Brain MRI


Types of MRI scanners


ELECTROCARDIOGRAM


12 Lead ECG Placement


HOW TO READ AN ECG


Holter Monitor


DON’T FORGET TO FOLLOW THIS BLOG PAGE


DROP YOUR MAIL ID TO GET IMMEDIATE UPDATES


If you find this blog post knowledgeable, 

comment & share it with a friend!   

Monday, November 2, 2020

MDSAP Management Process Audit - Part 4

 Hi friends!!!


In our previous blog we had a introduction about Medical Device Single Audit Program, MDSAP Audit Cycle and Management process Audit Task 1 -5 Please check out for the link below.


Medical Device Single Audit Program - Part 1


MDSAP Audit Cycle - Part 2


MDSAP Management Process Audit - Part 3


In today's blog we will discuss in detail about Medical Device Single Audit Program (MDSAP) Management Process Audit Tasks 6 - 11


MDSAP is a common Medical Device auditing program followed by countries like Australia, USA, Brazil, Canada and Japan. Therefore it is important for every healthcare professionals who wish to market their product in the above mentioned countries to know in detail about MDSAP.


Let's get into the topic.


MANAGEMENT PROCESS AUDIT


The purpose of auditing the management process is to ensure whether the top management demonstrated a necessary commitment to establish a effective quality management system. There are totally 11 tasks to be performed during management process audit. The tasks are as follows.

 

Task 1: QMS Planning, Implementation, Changes and Quality Manual.

Task 2: Management Representative.

Task 3: Quality Policy and Quality Objectives.

Task 4: Organizational Structure, Responsibility, Authority and Resources.

Task 5: Extent of Outsourcing.

Task 6: Personnel Competency and Training.

Task 7: Risk Management Planning and Review.

Task 8: Document and Record Controls.

Task 9: Management Reviews.

Task 10: Distribution of Devices with Appropriate Marketing Authorization.

Task 11: Top Management Commitment to Quality.


In our previous blog, we have discussed about Tasks 1 - 5. Now we will discuss about Task 6 - 11


Let’s discuss in detail about each task.



TASK 6: Personnel Competency

and Training


Ensure that the medical device organization has defined necessary competencies for personnel’s performing activities affecting product quality. Ensure that medical device organization is providing appropriate training for personnel’s influencing the quality of the product. Make sure that medical device organization has created awareness on importance and relevance of employee’s activities with respect to product quality and achievement of quality objectives.


APPLICABLE REGULATORY

STANDARDS AND CLAUSE


ISO 13485:2016: 4.2.1, 6.2.

FDA: 21 CFR 820.20(b) (2), 820.25

ANVISA: RDC ANVISA 16/2013: 2.2.3, 2.2.4, 2.3

MHLW/PMDA: MO169: 6, 22, 23, 25.4


As per ANVISA Brazilian regulation, Any consultancy which is giving advice to the manufacturing firm regarding design, purchase, manufacturing, packaging, labelling, storage, installation and service should have appropriate qualification to do so. This consultancy should be contracted as a service supplier by the manufacturing firm as per RDC ANVISA 16/2013: 2.2.3.


TASK 7: Risk Management

Planning and Review


Ensure that medical device organizations management has commitment for overall risk management planning. Check the management’s ongoing review for effectiveness of risk management activities including policies, practices and procedures which are documented and executed for analyzing, evaluating and controlling product risk throughout product realization. The top management should be responsible for forming the risk acceptability criteria.


APPLICABLE REGULATORY

STANDARDS AND CLAUSE


ISO 13485:2016: 4.1.2 (b), 7.1.

FDA: 21 CFR 820.30(g).

TGA: TG(MD)R Sch1 P1 2

ANVISA: RDC ANVISA 16/2013: 2.4

MHLW/PMDA: MO169: 26.


TASK 8: Document and Record

Control


Ensure that procedures for document and record control have been defined, documented and implemented for both internal and external origin documents required by QMS. Ensure that medical device organization retains atleast one obsolete copy of controlled documents for a period atleast equivalent to lifetime of the medical device which should not be less than 2 years from the date of product release.


APPLICABLE REGULATORY

STANDARDS AND CLAUSE


ISO 13485:2016: 4.1.4, 4.2.1, 4.2.4, 4.2.5.

FDA: 21 CFR 820.40, 820.180.

TGA: TG(MD)R Sch3 P1 1.4(4).

ANVISA: RDC ANVISA 16/2013: 3.1.

MHLW/PMDA: MO169: 5, 6, 8, 9.


TASK 9: Management Reviews


Ensure that management review procedure has been documented. Ensure that management reviews are conducted at planned intervals. Ensure that management review includes the review of quality policy, quality objectives, quality management systems suitability and effectiveness to ensure that medical device organizations quality management system meets all applicable regulatory requirements.


APPLICABLE REGULATORY

STANDARDS AND CLAUSE


ISO 13485:2016: 5.6.

FDA: 21 CFR820.20(c).

TGA: TG(MD)R Sch3 P1 1.4(5)(b)(iii)(f)

ANVISA: RDC ANVISA 16/2013: 2.2.6.

MHLW/PMDA: MO169: 18, 19, 20.


TASK 10 – Distribution of Devices

with appropriate Marketing

Authorization


Verify that only devices having appropriate marketing authorization are distribution or offered for commercial distribution in only applicable markets. Ensure that medical device organization has identified and documented the responsibilities of employees for ensuring proper registration, licensing, notification, approval information and listing. The same should be submitted to regulatory authorities.

 

APPLICABLE REGULATORY

STANDARDS AND CLAUSE


ISO 13485:2016: 4.1.1, 4.2.1, 5.2, 7.2.1, 7.2.3.


TASK 11 – Top Management 

Commitment to Quality


Verify that top management has demonstrated necessary commitment to ensure the suitability and effectiveness of quality management system. Verify that the effectiveness of quality management system has been communicated to personnel.


APPLICABLE REGULATORY

STANDARDS AND CLAUSE


ISO 13485:2016: 4.1.1, 4.1.4, 5.1, 5.5.3

FDA: 21 CFR 820.20(a), 820.5.

ANVISA: RDC ANVISA 16/2013: 2.1, 2.2.1.

MHLW/PMDA: MO169: 5, 10, 17.


Now I hope you have acquired some knowledge about MDSAP Management Process Audit.  We will discuss in detail about remaining tasks of management process audit in our future blogs.


NOTE: Dear friends!!!... Please do comment a topic related to Biomedical, so that we can discuss it in future blogs.


Check out for this blog about Computed Tomography,  X ray, MRI scan, ECG.


Generations of CT Scanners


COMPUTED TOMOGRAPHY|TECHNOLOGY|ARTIFACTS


x ray machine working principle


components of x ray tube


MRI scan 


MRI With Contrast


Brain MRI


Types of MRI scanners


ELECTROCARDIOGRAM


12 Lead ECG Placement


HOW TO READ AN ECG


Holter Monitor


DON’T FORGET TO FOLLOW THIS BLOG PAGE


DROP YOUR MAIL ID TO GET IMMEDIATE UPDATES


If you find this blog post knowledgeable, 

comment & share it with a friend!