# FDA Submission Guide

## FDA Medical Device Classification and Pathways

### Class I Devices
- **510(k) Exempt** - Most Class I devices
- **General Controls** apply (21 CFR 820)
- **FDA registration** required
- **Device listing** mandatory

### Class II Devices
- **510(k) Clearance** - Premarket notification
- **General + Special Controls** apply
- **Predicate device** identification required
- **Substantial equivalence** demonstration

### Class III Devices
- **PMA (Premarket Approval)** - Full safety and effectiveness review
- **IDE (Investigational Device Exemption)** for clinical studies
- **Clinical data** typically required
- **Post-market surveillance** obligations

### De Novo Classification
- **Novel devices** without predicate
- **Low to moderate risk** profile
- **Creates new device classification**
- **Special controls** development

## Submission Pathways and Requirements

### 1. 510(k) Premarket Notification
**Traditional 510(k)**
- Predicate device comparison
- Performance testing documentation
- Software documentation (if applicable)
- Labeling and indications for use

**Special 510(k)**
- Modifications to cleared devices
- Design controls documentation
- Risk analysis of changes
- Performance validation

**Abbreviated 510(k)**
- Guidance document compliance
- Recognized standards conformance
- Special controls adherence
- Reduced documentation requirements

### 2. PMA (Premarket Approval)
**Clinical Investigation Requirements**
- IDE study protocol approval
- GCP compliance documentation
- Clinical study reports
- Statistical analysis plans

**Manufacturing Information**
- ISO 13485 QMS compliance
- Manufacturing process validation
- Facility inspection readiness
- Supply chain documentation

### 3. De Novo Classification Request
**Risk-based Classification**
- Benefit-risk profile analysis
- Predicate device absence justification
- Special controls recommendations
- Clinical evidence strategy

## FDA Submission Process

### Pre-Submission Activities
1. **Q-Sub Meeting** - Pre-submission consultation
2. **Classification determination** confirmation
3. **Predicate device** identification and analysis
4. **Testing strategy** development and validation
5. **FDA guidance** review and compliance assessment

### Submission Preparation
1. **Technical documentation** compilation per FDA format
2. **Quality system** documentation and readiness
3. **Clinical evidence** compilation (if required)
4. **Labeling** and indications for use finalization
5. **eCopy submission** preparation

### FDA Review Process
1. **Administrative review** (15 days for completeness)
2. **Substantive review** (90 days for 510(k), 180 days for PMA)
3. **Additional information** requests and responses
4. **FDA questions** and clarifications
5. **Clearance/approval** or denial decision

## Special Considerations

### Software as Medical Device (SaMD)
- **Software documentation** per FDA guidance
- **Cybersecurity** considerations and risk management
- **Software lifecycle** process documentation
- **Change control** procedures

### Combination Products
- **OPDP assignment** determination
- **Lead center** coordination
- **Intercenter agreement** requirements
- **Combination product** specific guidance

### HIPAA Compliance
- **Protected Health Information** safeguards
- **Business associate** agreements
- **Risk assessment** and management
- **Breach notification** procedures

## Quality System Requirements

### 21 CFR Part 820 (QMSR — ISO 13485:2016 incorporated by reference)

> **⚠️ STATUS — QMSR transition (effective 2026-02-02):** FDA's QMSR final rule (89 FR 7496) amended 21 CFR Part 820 to incorporate ISO 13485:2016 by reference and removed the legacy QSR subsection structure. Cite the ISO 13485 clauses — the legacy 820.x numbers below are historical index only.

- **Design and development** — ISO 13485 §7.3 (legacy QSR 820.30, historical)
- **Document control** — ISO 13485 §4.2.4 (legacy QSR 820.40, historical)
- **Management responsibility** — ISO 13485 §5 (legacy QSR 820.20, historical)
- **Corrective and preventive action** — ISO 13485 §8.5.2/§8.5.3 (legacy QSR 820.100, historical)

## Key Performance Metrics

- **Review timeline** adherence and predictability
- **First-time clearance** rates and success factors
- **Additional information** request frequency
- **Post-market compliance** effectiveness
- **FDA inspection** readiness and outcomes
