The first harmonized European Union Directive on Active Implantable Medical
Devices came into force in 1993. One can see that this field is evolving, particularly to
keep pace with the rapid technological innovations. Because of the explosive growth in
medical devices, estimated by the U.S. Food and Drug Administration Center for Devices
and Radiological Health (USA FDA CDRH) in June of 2001 to be 10,000 new devices
per year, and the concerns for safety, effectiveness, quality, and the impact on health care
costs, many other countries are only beginning to set up the regulatory or monitoring programs
for medical devices.
Different countries have been following different standards and regulatory systems.
This chapter describes the general concepts and approach used in the U.S., the
European Union, and Canada. Detailed descriptions of the U.S. system and the
European Union system are found elsewhere in this handbook (see Chapters 125 and
126).