In the European system, manufacturers of devices of classes II and III, as well as
devices of class I with either measuring function or sterile requirements, must submit to
the regulator (i.e., the competent authority): (1) a Declaration of Conformity to the appropriate
EC Directives; and (2) the conformity-assessment procedure followed. In addition,
for higher-risk class devices that require design examination or type examination, the corresponding EC-certificates issued by a Notified Body must be submitted to the competent
authority. Other medical devices of class I are exempted from pre-market submissions,
although they must follow labelling requirements and the essential principles of
safety and performance in their design and construction.
In the United States, most Class III and new devices that cannot be found to be substantially
equivalent to a legally marketed product that does not require an approved premarket
approval (PMA) application require clearance through the PMA or Product
Development Protocol (PDP) process. Most class II, and some class I, devices require
pre-market entry notification under paragraph 510(k) of the Medical Devices Act of 1976.
A 510(k) submission to the FDA comprises an information package that is subject to lessstringent
review than the PMA process. Most class I, and some class II, (low-risk) devices
are exempted from 510(k) submissions before sale but are still subject to general control
requirements. The 510(k) submission is a presentation of the proposed medical device
that is intended to show how it is substantially equivalent to a medical device that is
already on the U.S. market (Winston, 2003).
Different authorities acknowledge product clearance for the market in different ways.
In Canada, it is the Device License given by the Therapeutic Products Directorate (TPD).
In the EU, after receiving the EC certificate for a notified body, the CE mark is placed by
the manufacturer on or with the device. In the United States, the manufacturer of the
device receives a 510(k) Marketing Clearance or Approval Letter (PMA) from the FDA.