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嘉峪檢測(cè)網(wǎng) 2021-11-03 12:48
2021年10月份, FDA發(fā)布了一個(gè)和吻合器/吻合釘相關(guān)的指南文件。該指南文件的主要內(nèi)容是吻合器/吻合釘產(chǎn)品的標(biāo)識(shí)上(標(biāo)簽和說(shuō)明書(shū)上)推薦應(yīng)出現(xiàn)的內(nèi)容。文件分成了正文和附件,正文由四大部分內(nèi)容組成。今天筆者來(lái)幫大家解讀一下這個(gè)文件。

我們先來(lái)看正文的第一部分,也就是簡(jiǎn)介。簡(jiǎn)介的部門(mén)非常精練地把這個(gè)文件的主要內(nèi)容做了介紹,就是吻合器/吻合釘產(chǎn)品的標(biāo)識(shí)上推薦應(yīng)出現(xiàn)的內(nèi)容。在簡(jiǎn)介部分同時(shí)提到這個(gè)指南文件中提到的要求并不是強(qiáng)制的。這里筆者插一句,雖然不是強(qiáng)制,其實(shí)FDA的審核員在審核時(shí)都會(huì)考慮這些要求。
正文的第二部分是背景信息。就是為什么要發(fā)布這個(gè)文件。這里直接給大家呈現(xiàn)一些極具沖擊力的數(shù)據(jù)。FDA發(fā)現(xiàn)很多不良事件是和吻合器/吻合釘相關(guān)的,從2011年1月到2018年3月, FDA收到了41,000多件和吻合器/吻合釘相關(guān)的不良事件,每年將近7,000多件。在這41,000多件不良事件當(dāng)中有超過(guò)360件涉及到死亡的不良事件。主要的根本原因是器械誤用和功能失效。如果提供給終端用戶(hù)的說(shuō)明書(shū)內(nèi)容不充分,沒(méi)有提供充分的警示信息和使用注意事項(xiàng)信息都會(huì)讓器械誤用的情況發(fā)生得更加頻繁,不良事件很可能會(huì)增加。反過(guò)來(lái)想,F(xiàn)DA相信如果在標(biāo)識(shí)上有針對(duì)性地放上一些內(nèi)容,會(huì)讓器械誤用的情況有所減少。
正文的第三部分提及了該文件適用的產(chǎn)品。具體請(qǐng)見(jiàn)下表。
|
Product code |
Regulation number |
Name |
|
GAG |
21 CFR 878.4740 |
Stapler, Surgical |
|
GDW |
21 CFR 878.4750 |
Staple, Implantable |
|
NLL |
21 CFR 878.4750 |
Staple, Implantable, Reprocessed |
|
NAY |
21 CFR 876.1500 |
System, Surgical, Computer Controlled Instrument |
最重要的內(nèi)容出現(xiàn)在正文的第四部分。FDA對(duì)禁忌癥信息(Contraindications),警示信息(Warnings),使用說(shuō)明(Directions for use)和技術(shù)特征和性能參數(shù)(Technical characteristics and performance parameters)四個(gè)方面的內(nèi)容給出了建議。方便大家瀏覽,筆者用表格的方式幫大家做了整理。
|
Item |
Section |
Points should be added per FDA,s Recommendation |
|
1 |
Contraindications |
A statement noting that the device should not be used to staple tissues that are necrotic, friable, or have altered integrity, e.g., ischemic or edematous tissues |
|
2 |
Warnings |
A statement noting that the device should not be used to staple tissue outside of the labeled limits for maximum and minimum tissue thickness A statement to visually inspect prior to firing for inclusion of unintended anatomic structures within the staple line A statement to ensure that no obstructions, such as clips, are incorporated into the instrument jaws when positioning the stapler on the application site, and that firing over an obstruction may result in incomplete cuttingaction and/or improperly formed staples A statement that clamping and unclamping of delicate structures, such as venous structures and bile ducts, may result in damage totissue irrespective of stapler firing A statement to avoid use of the stapler on the aorta A statement that, where practical, proximal control of blood vessels is recommended prior to stapling, and that surgeons should havemethods of blood vessel control in place in the event of stapler failure A statement to ensure that the staples are compatible with the stapler A statement that there is a risk of increased leak rates when staple lines are crossed, even if there may be clinical circumstances when a surgeon may deem it necessary or appropriate to do so |
|
3 |
Directions for use |
Specific user instructions for proper device use including measures associated with the prevention of device malfunction, and evaluation of the appropriate-ness of the target tissue for stapling
Validated methods and instructions for reprocessing of any reusable device components An expiration date/shelf life |
|
4 |
Technical characteristics and performance parameters |
List of staples with which the stapler has been demonstrated to be compatible Identification of key performance parameters and technical characteristics of the stapler and the compatible staples needed for safe use of the device Information regarding tissues on which the stapler is intended to be used Identification of safety mechanisms of the stapler Package labels must include critical information and technical characteristics necessary for proper device selection |
最后的附件給出了一些具體的例子供供應(yīng)商參考。
以上就是該指南文件的主要內(nèi)容,吻合器/吻合釘?shù)膹S商在提交510(k)應(yīng)充分考慮這些要求。

來(lái)源:?jiǎn)⑸Y訊