ER Guidance
ER Guidance
ER Guidance
1 Choice of materials
A manufacturer must be able to demonstrate that the materials used in the medical device are
appropriate, given the intended purpose of the device. For example, a well-reasoned risk analysis
should consider toxicity, flammability and biocompatibility risks, and examine if particular labelling or
instructions could mitigate any residual risks.
Historical data on materials used in similar devices should be reviewed and included in the
documented analysis.
A biological evaluation, based on relevant standards, should be made. It may be possible to limit any
testing by considering the results of previous and relevant tests on the same or similar materials used
in the same or similar applications.
The work undertaken by the manufacturer could involve, but is not restricted to:
– documented analysis and review of historical data on materials used in similar devices
– conducting a biological evaluation based on relevant standards. ISO 10993[1] can provide further
guidance on this, but is not a mandatory standard that must be used.
– In minimizing risks, particular consideration must be given to the likely duration and frequency of
any tissue exposure associated with the transportation, storage or use of the device.
The work undertaken by the manufacturer could involve, but is not restricted to:
– if necessary, demonstrating that the labelling and Instructions for Use supplied with the device
inform users of how to reduce or mitigate risks associated with contaminants and residues that
cannot be eliminated.
– If the device is intended to be used to administer medicine, it must be designed and produced in a
way that ensures that the device:
– is compatible with the provisions and restrictions applying to the medicine to be administered; and
allows the medicine to perform as intended.
The analysis should also consider any specified materials that may be required to clean, disinfect or
sterilize the medical device, as well as the effects of these materials during these procedures.
It may be necessary to use particular labelling or Instructions for Use supplied with the device to
reduce or mitigate some risks associated with the interactions of these materials, substances or gases
with the device.
Warnings are required if it is foreseeable that an interaction between the device and incompatible
materials could occur. These warnings should be included in the labelling or Instructions for
Use included with the device.
If the device is intended to administer medicine, the design, production and packaging processes
should take into account any provisions or restrictions for the medicine as well as ensuring that the
medicine can perform as intended.
The work undertaken by the manufacturer could involve, but is not restricted to:
– if necessary, demonstrating that the labelling and Instructions For Use supplied with the device
informs users of how to reduce or mitigate risks associated with the use of the device with materials
that cannot be eliminated
– labelling and Instructions For Use to include warnings relating to a foreseeable interaction between
a device and an incompatible material
– if the device is to administer a medicine, demonstrating that the design, production and packaging
of the device take into account any provisions or restrictions for the medicine.
– the safety and quality of the substance must be verified in accordance with the requirements for
medicines; and
– the ancillary action of the substance must be verified having regard to the intended purpose of the
device.
For the purposes of this clause, any stable derivative of human blood or human plasma is considered
to be a medicine.
A manufacturer of a medical device that contains a medicine as an integral part must show that the
device component and the medicinal substance function together to achieve the intended purpose.
In addition, the manufacturer will need to provide evidence that the medicine meets all the necessary
Australian regulatory requirements to be supplied as a medicine.
The work undertaken by the manufacturer could involve, but is not restricted to:
– evidence to demonstrate that the ‘substance-device combination’ works together as intended (for
example, device specific tests to establish drug elution profile, coating integrity, device performance,
degradation, particulate release)
– evidence of stability of the medicinal substance establishing that ‘substance’ incorporated in the
device remains stable during manufacturing, transportation and storage (for example, sustained
activity of regulated substance, evidence of tracking relevant characteristics during storage)
– evidence that the medicinal substance to be incorporated meets current relevant Australian
regulatory requirements. The device manufacturer should include evidence of quality of manufacture
and safety of the medicinal substance.
This Essential Principle deals specifically with leaching, which in this context means the removal of
the soluble contents of a medical device by running water, another liquid or body fluids, leaving the
insoluble portion behind and related to the use of the device. Examples of leachables are:
– additives
– sterilant residues
– process residues
– degradation products
– solvents
– plasticisers
– lubricants
– coloring agents
– fillers
– monomers
The design and production processes should take into account the outcomes or conclusions from a
well-reasoned and documented risk analysis that has identified and analysed the significance of any
foreseeable effects of a substance that could leach from a medical device and the effects it could
have on users of the device and other people who may come into contact with the device, during the
intended use of the device as specified in the Instructions for Use.
Please note: This is different from Essential Requirement 7.5 in the European Essential Requirements,
which deals specifically with leaking—the escape, entry, or passage of something through a breach or
flaw.
The work undertaken by the manufacturer could involve, but is not restricted to a well-reasoned and
documented risk analysis addressing issues such as:
– Does the medical device come into contact with water or another liquid?
– Does the medical device contain any substances capable of leaching?
– Are any of the substances that are capable of leaching from the device hazardous to humans?
– Is the concentration of the leached hazardous substances like to approach the limit for toxic
effects?
– biological evaluation including testing. ISO 10993[2] can provide further guidance on this, but is not
a mandatory standard that must be used
– in vivo toxicokinetic studies where relevant. ISO 109933 Part 16 and 17 can provide further
guidance on this, but is not a mandatory standard that must be used
– in vitro testing of the medical device (for example, assessing the kinds and levels of compounds
leached from the medical device by physiologic media that contacts the device during normal use,
such as blood).
For the purposes of this Essential Principle, unintentional ingress means substances that are not
intended to enter the device and unintentional egress means substances that are not intended to
leave the device.
The work undertaken by the manufacturer could involve, but is not restricted to:
– biological evaluation including testing. ISO 10993 can provide further guidance on this, but is not a
mandatory standard that must be used
– in vitro testing of the medical device (for example, assessing the kinds and levels of compounds
leached from the medical device by physiologic media that contacts the device during normal use,
such as blood).
[1]ISO 10993 is a multi-part standard for the biological evaluation of medical devices. Each part
covers a different aspect of the evaluation.
[2] ISO 10993 is a multi-part standard for the biological evaluation of medical devices. Each part
covers a different aspect of the evaluation.