Sunday, November 30, 2014

Training In The Organization

ISO 13485 emphasizes a lot on the training of all employees to be competent and skilled in their job functions. US FDA 21 CFR 820 also requires a lot of training as well.
Training is another important part of medical device’s quality system. Ideally all personnel must be trained well to perform their daily works. Therefore, a procedure to handle training is warranted.

The purpose of this training procedure is to provide a system, assign responsibilities, identify training needs, provide the required training and  maintain training record.
The objective of a robust training program is to ensure all employees acquire the knowledge and skills when performing their jobs. They should be conversant with the relevant requirements of the quality system pertaining to their job functions.
The training blog is subdivided into 1) Company-wide Training and Awareness Programs 2) Departmental Training and 3) Training Effectiveness and Evaluation and 4) Training Record and Documentation.

 1)    Company-wide Training and Awareness Programs
Company-wide training and awareness programs are discussed sub-categorically into the following sections. One of the great training tool is to have a training matrix for each individual employee. This training matrix shall include general orientation, quality system, safety training and department specific training. In that case, it is comprehensive.

1.1  General Orientation and Quality System Training
Normally, the human resource department provides for the general orientation while training department provides the quality system training. This training make the employees familiar with administrative rules, employee program and benefits, 401K plan, vacation policy, sexual harassment etc. The training also explains the medical device products, product requirements and the quality system. The product and quality system should comprises of the following:
 ·       Discussion of the Quality Policy. Normally, even the employee badge has the quality policy printed.
·       Overview of the company’s company system. For example, 21 CFR 820 quality system for medical device plus perhaps ISO 13485.
·       Training on each product the company make. Each employee shall be trained on each product on critical quality characteristics and ramification of a failure or malfunction of the device. How the product is made etc?
·       An explanation of how individual employee contributes to the well-being of the company quality system.

1.2  Safety Training
Safety training is also important in the organization. Many of the medical devices manufacturing processes and tool, for examples can cause serious harm to the employees during production. You do not want to start a fire to burn down the facility.
Therefore, all employees are trained in safe work practices, first aid, use of personal protective equipment, emergency procedures, fire extinguisher handling, as applicable. Safety training is provided by the individual responsible for Human Resources or directly by departments. Human Resources maintain these records.

1.3  Company-Wide System
Examples of company-wide system are Trackwise system. Trackwise system is used to record CAPA, Laboratory Investigation and Deviations. Other systems are Windchill, SAP, material-coding and bar-code system.

 1.4  External Training
Many medical device sponsors have educational reimbursement policy for employees to participate in seminars, conferences or even getting another advance degree or certification pertaining to the industry. For example, project manager might take the Professional Management Professional (PMP) certification to efficiently handle a project. Or an employee who is getting a M.Sc in Regulatory Affairs to know more of the regulatory affairs.

1.5  Quality and Regulatory Certification
Company encourages personnel to be certified as Regulatory Affairs Certification (RAC) especially if you are in or planning to move to the Regulatory Affairs department. Certified Quality Auditor (CQA) and Certified Quality Engineer (CQE) are also useful as a quality professional like in auditing. There are also other certification like Clinical Research Associate and the list go on and on.

 2)    Departmental Training
Each department is responsible to provide the necessary training to ensure employees are skilled, capable, and competent to perform their functions in the department in question. For example, if you are in the manufacturing, may be, more training on production process validation, process capability, out of specification training, verification and validation related activities training.
On-the-job training (OJT) is another important and efficient way to train less experienced employees. There are simply not easy to learn from a procedure and protocol. OJT must be used more often. Experience in the industry tells me that OJT is important, there may be things which are difficult to be captured in the procedure.

3)    Training Effectiveness and Evaluation
Training effectiveness is often not being paid more attention. After each employee is trained and it does not mean he or she is effectively trained. Often times, employees do not think it is important. They attend the training and sign the document and considered trained. Therefore, to gauge the effectiveness of the training regiment, the approaches are shown below.
This evaluation assesses whether a particular training has achieved its objectives and if the employee is competent and skilled to perform the new job function. The evaluation is taking test and performing several productions to gauge how many products have defects. Results of all the evaluation are recorded and is kept with the original training record.

 4)    Training Record and Documentation
All training records can be kept virtually and in a cabinet. In this day and age, there are many training software to be deployed so that to keep all training records like Master Control. This is particularly important for sponsor which employs thousands of employees.

Reference
Criteria
ISO 13485 6.2.1
Are personnel performing work affecting product quality competent on the basis of appropriate education, training, skills, and experience?
ISO 13485
6.2.2 .a
Has the company determined the necessary competence for personnel performing work affecting product quality?
ISO 13485
6.2.2 .b
Does company provide training or take other actions to satisfy these competence needs?
ISO 13485
6.2.2 .c
Does the company evaluate the effectiveness of the training and other actions taken?
ISO 13485
6.2.2 .d
Does the company ensure that its personnel are aware of the relevance and importance of their activities and how they contribute to the achievement of the quality objectives?
ISO 13485
6.2.2 .e
Does the company maintain appropriate records of education, training, skills and experience?


Disclaimer: Although the author had exhaustively researched all sources to ensure the accuracy and completeness of the information contained in this blog, but no warranty and fitness is implied. I assumed no responsibility and implied warranty of any kind for errors, inaccuracies, omission, or any inconsistency herein. No liability is assumed for incidental or consequential damages in connection with the use of the information contained herein. Readers should always use their own judgment and review all related regulatory guidelines. Guidelines can change over time.

Management Review



ISO 13485 is probably one of the key quality system regulation for medical device sponsors to comply with. ISO 13485 shares many similarities with US FDA 21 CFR 820. Management review is the focus for this blog.

1.     Frequency and Scheduling
Executive management should review the quality performance and quality management of the whole organization at least once a year. Specific dates like June and December should be stated if the management review decided to review twice a year. Executive management when responding to changing and special conditions and events like consent decree and warning letter can call for any unscheduled and extraordinary reviews. Nothing is carved in stone.
 2.     Attendance
Management reviews should be chaired by top executive like CEO and attended by managers representing Quality Assurance, Marketing and Sales, Design Engineering, Regulatory Affairs, Manufacturing, Quality Control, Purchasing and Human Resources. Managers who cannot be present can send representative and he or she after receiving the meeting minutes, may submit their input and comments to the CEO and/or quality assurance.
 3.     Agenda
QA should setup the agenda for management review a week or more prior to the meeting and distributed to all participating managers. This will give respective managers some time to prepare for the meeting and raise some quality issue during the management review.
 4.     Management Review Input
The following are some of the quality issues which can be discussed in the quality review: action Items from last meeting, process performance and product conformity, internal quality audits, external quality audits, corrective and preventive action (CAPA), post-production feedback, customer complaints, product recall, customer recall, training, continual improvement, new or revised regulatory requirements and its ramification, medical device reporting (MDR), safety and effectiveness, application status and any changes that could affect the company’s quality system.
 5.     Quality Policy and Quality Objectives
Quality policy and quality objectives are two keys issues to be discussed during management review. During management review, the progress of quality policy and quality objectives must be discussed.  Quality objectives must be systematically evaluated to access the progress during management review. If the quality objective of certain issue is closed, the resource can be moved to deal with another quality objective.
 If any quality objective is not achieved on time, the review can investigate and determine the causes of the failure to achieve the deadline. Management can decide what to do with the failed quality objective. They can drop the objective, reduce the scope, reassign responsibility, allocate additional resources or extend the deadline.
 During the management review, new objectives are established when necessary to improve quality performance during the management review. These new objectives should be documented in the Quality Objective Record.
 The quality policy of the organization shall be discussed to access its suitability to the whole organization amidst of new regulatory, addition of new product, product changes and the like. For example, if a medical device company begins to manufacture Class III device, its quality policy and quality system may need to be updated.
 6.     Management Review Output
Resources needed for the implementations of the improvements are identified as review output. This includes the assignment of responsibility, timeframe, and allocation of human like more personnel and the employment of consultants, equipment and know-how. Management review output is documented in review meeting’s minutes. Action items are highlighted.

7.     Record
Management review output during the meeting should be prepared by Quality Assurance and distributed to the attending managers and absent managers as well. All the management review record shall be stored in a known location both virtually and hard-copy. These record can only be disposed according to the timeframe stated in control of record’s policy.

Reference
Criteria
ISO 13485 5.5.2.a
Has top management appointed a member of the management who, irrespective of other responsibilities, has responsibility and authority that includes ensuring that processes needed for the quality management system are established, implemented and maintained?
ISO 13485 5.5.2.b
Has top management appointed a member of the management who, irrespective of other responsibilities, has responsibility and authority that includes reporting to top management on the performance of the quality management system and any need for improvement?
ISO 13485 5.5.2.c
Has top management appointed a member of the management who, irrespective of other responsibilities, has responsibility and authority that includes ensuring the promotion of awareness of regulatory and customer requirements throughout the organization?
ISO 13485 5.5.3
Has top management ensured that appropriate communication processes are established within the organization and that communication takes place regarding the effectiveness of the quality management system?
ISO 13485
5.6.1
Has top management reviewed the company's quality management system, at planned intervals, to ensure its continuing suitability, adequacy, and effectiveness? Does the review include assessing opportunities for improvement and the need for changes to the quality management system, including the quality policy and quality objectives?  Does the company maintain records from these management reviews?
ISO 13485
5.6.2 a
Does the input to management review include information on the results of audits?
ISO 13485 
5.6.2 b
Does the input to management review include information on customer feedback?
ISO 13485 
5.6.2 c
Does the input to management review include information on process performance and product conformity?
ISO 13485 5.6.2 d
Does the input to management review include information on status of preventive and corrective actions?
ISO 13485 5.6.2 e
Does the input to management review include information on follow-up actions from previous management reviews?
ISO 13485 
5.6.2 f
Does the input to management review shall include information on changes that could affect the quality management system?
ISO 13485 
5.6.2 g
Does the input to management review shall include information on recommendations for improvement?
ISO 13485
5.6.2 h
Does the input to management review include information on new or revised regulatory requirements?
ISO 13485 
5.6.3 a
Does the output from the management review include any decisions and actions related to improvements needed to maintain the effectiveness of the quality management system and its processes? Does the output from the management review include any decisions and actions related to improvement of the effectiveness of the quality management system and its processes.
ISO 13485 
5.6.3 b
Does the output from the management review include any decisions and actions related to improvement of the product related to customer requirements?
ISO 13485 
5.6.3 c
Does the output from the management review include any decisions and actions related to resource needs?


Disclaimer: Although the author had exhaustively researched all sources to ensure the accuracy and completeness of the information contained in this blog, but no warranty and fitness is implied. I assumed no responsibility and implied warranty of any kind for errors, inaccuracies, omission, or any inconsistency herein. No liability is assumed for incidental or consequential damages in connection with the use of the information contained herein. Readers should always use their own judgment and review all related regulatory guidelines. Guidelines can change over time.




Friday, November 28, 2014

Quality Objectives

This blog and the subsequent few dozen blogs will discuss the key quality requirements of EU medical device regulation, the ISO 13485. This blog is about quality objectives.
A procedure for ‘quality objectives’ is to provide a system and instructions, and to assign responsibility for the initiation, implementation and monitoring to achieve quality objectives in the organization. The objective of this procedure is to improve the quality of the products, manufacturing and support processes and the entire quality management system.
1)    Establishment of Quality Objectives in the Organization:
The quality objectives are established to improve the performance and quality system in order to achieve the quality policy, organizational goals and objectives.
New quality objectives can be established and recorded at the management review.  Management review and the process is discussed in another blog.
For each quality objective, the QA Manager shall establish a quality objective record. The following information should be in the quality objective.
·       Quality objective to be achieved by the project.
·       The present level of the objective and the performance level to be achieved. (For example, at present, there are 30 CAPAs generated each month and in 12 months, the goal of the quality objective is to reduce by 50%, therefore only 15 CAPAs or less can be generated.
·       A target date or time-frame must be in the quality objective. Try as hard as possible to achieve within the target date. Should an extension be made, ensure to record the justification as to why the extension is warranted.
·       The assignment of personnel like project manager and human and financial resources must also be clearly stated in the quality objective. How many personnel required to complete the quality objective on time like the hiring of consultants, additions of full time employees and how much money be allocated in the project must be clearly stated and justified.

2)    Implementation of Project to achieve the Quality Objective
 The next phase is the implementation which is the hardest portion. Project
       manager must garner support from all related departments to ensure the
       seamless execution and implementation of the quality objective.  After the
       quality objective is bought in by all related departments, QA manager will
       have to initiate the following:
·       The identification of the major elements and phases of the project; areas where the project to be implemented; other departments’ involvement, managers; requirement for personnel, facilities, equipment and other resources must be clearly identified and stated in the quality objective.
·       Monitoring and measurement methods and means to be used to measure the progress toward the underlying objective. Interim progress, problems, issue and state of the project must be periodically assimilated to all involved with the project.
·       QA manager should prepare intermediate reviews and distributed to all related personnel. Should there be any adjustment like additional resources, more personnel required; these shall be discussed in the meeting and reported in the interim report.
·       The establishment of a special project file to organize associated documents and records like interim reports, data sheets and meeting minutes. A special folder in the computer should be established and collect all documents and organized them well in the folder. For hardcopy, a special cabinet shall be provided to collect them in a logical and chronological manner.

3)    Review and Close-out of Quality Objectives

After the quality objective is achieved, the result should be reported to the management review. The closing out of the project is recorded in the closeout of the management review and shall be documented in the Quality Objective Record. All documents either virtual or hardcopies shall be updated in the folder and specific cabinet.

Reference
Criteria
ISO 13485
5.4.1
Has top management ensured that quality objectives, including those that are needed to meet requirements for product, are established at relevant functions and levels within the company?
ISO 13485
5.4.1
Are the quality objectives measurable and consistent with the quality policy?
ISO 13485
5.4.2.a
Has top management ensured that the planning of the quality management system is carried out in order to meet the requirements given in 4.1, as well as the quality objectives?
ISO 13485
5.4.2.b
Has top management ensured that the integrity of the quality management system is maintained when changes to the quality management system are planned and implemented?


Disclaimer: Although the author had exhaustively researched all sources to ensure the accuracy and completeness of the information contained in this blog, but no warranty and fitness is implied. I assumed no responsibility and implied warranty of any kind for errors, inaccuracies, omission, or any inconsistency herein. No liability is assumed for incidental or consequential damages in connection with the use of the information contained herein. Readers should always use their own judgment and review all related regulatory guidelines. Guidelines can change over time.


Thursday, November 27, 2014

EU Medical Device Classification

This first blog is about European Union (EU) medical device classification. EU medical device classification is mainly classified into three main categories and governed by the following three directives.
1.     Medical Devices Directive (MDD): 93/42/EEC
2.     In Vitro Diagnostic Directive (IVDD): 98/79/EC
3.     Active Implantable Medical Device (AIMDD): 90/385/EEC
In order to market medical device into the EU, medical device company has to obtain a CE marking, generally. A CE certification is basically to verify that the device in question meets one of the above directives: MDD: 93/42/EEC, IVDD): 98/79/EC and AIMDD): 90/385/EEC.
Assuming you are a regulatory affair and marketing department director of medical device sponsor, the following steps should be followed to market your product into EU market.
1.     Determine which of the above three directives apply to your device.
2.     Perform a detail device classification according to the above three directives. For example, using Annex IX of the Medical Devices. Please be aware that each directive has their own sub-classes. For example, in MDD 93/42/EEC, there are Class I non-sterile and non-measuring, Class I Sterile and Measuring, Class IIa, Class IIb and Class III.
3.     Implement a Quality Management System (QMS) in according to Annex II or V of MDD. Most device companies apply the ISO 13485 standard to achieve the QMS compliance. Device also has to be in compliance with risk management of ISO 14971. Generally speaking, many companies implement other quality system like US FDA 21 CFR 820 or perhaps also comply with Korean Food and Drug Administration (kFDA) as well.
In this day and age of globalized economy, it is best that you should think of other markets as well, not only US and EU, but the rest of the world.
4.     Depending on the classification, prepare a technical file or technical dossier (Class III). In preparation of a technical file and dossier is very involved and must be planned ahead of them. It requires a lot of testing and planning.
5.     The next step is to appoint an Authorized Representative (EC Rep) located in Europe. This is the group who can handle regulatory issues or perhaps guide and coach you in the EU market. Then, you can place the EC REP name and address on the Instruction for Use (IFU).
6.     Except for the Class I (non-sterile and non-measuring), your QMS, Technical File and Design Dossier must be audited by a Notified Body. A Notified Body is a third party accredited by the EU to audit medical device companies and product. This is a little different from US which the FDA will audit the quality system. Examples of Notified Bodies are TUV SUD, BSI, TUV Rheinland and National Standards Authority of Ireland (NSAI).
7.     Except for Class I (non-sterile and non-measuring), EU CE marking certificate for your device will be issued (CE certificates are typically valid for 3 years from the date of issuance). ISO 13485 certification can also be issued and it has to be renewed every year.
8.     Prepare a Declaration of Conformity. Declaration of Conformity is basically a legally binding document prepared by the device manufacturing to state that the device is in compliance with the applicable Directive. Then you may affix the CE Marking on your product or packaging insert.

                         Courtesy of www.ec.europa.eu

98/79/EC
In Vitro Diagnostic Directive
93/42/EEC
Medical Devices Directive
90/385/EEC
Active Implantable Medical Device

Disclaimer: Although the author had exhaustively researched all sources to ensure the accuracy and completeness of the information contained in this blog, but no warranty and fitness is implied. I assumed no responsibility and implied warranty of any kind for errors, inaccuracies, omission, or any inconsistency herein. No liability is assumed for incidental or consequential damages in connection with the use of the information contained herein. Readers should always use their own judgment and review all related regulatory guidelines. Guidelines can change over time.