Often, the first thing we hear from a consultant or a medical device company regarding an FDA 510(k) premarket notification is that it was delayed because the FDA reviewer did not understand something simple within the application, or completely missed it.

What is wrong with the reviewer? How could they have missed something so simple?  I couldn’t have been any clearer!

Sound familiar?

FDA is overworked, under-resourced, and will most likely miss something simple in your file upon reviewing.

As the specification developer, you know the design and history of the product better than anyone. You are providing that entire history in a formal application for review, and hopefully, clearance. A basic understanding of the technology is a must; however, think about the situation from the FDA reviewers’ point of view. 510(k) applications are inherently technical and sometimes need a brief discussion with the FDA reviewer for clarification or a general overview of your device.

Starting this dialog earlier is important for a smooth path to clearance. Part of this process involves requesting a Pre-Submission (“Pre-Sub”).  Pre-Subs are a type of feedback that is part of FDA’s Q-Submission program.

Pre-Subs

Pre-Subs are a formal written request from an applicant for feedback from FDA to be provided in the form of a formal written response or a meeting (in-person or teleconference) in which the feedback is documented in meeting minutes.  A Pre-Sub provides the opportunity for a submitter to obtain FDA feedback prior to intended submission of a premarket submission (i.e., IDE, PMA, HDE, De Novo request, 510(k), Dual, BLA, IND) or Accessory Classification Request, among others.

Pre-Subs are entirely voluntary on the part of the applicant. However, early interaction with FDA and careful consideration of FDA’s feedback may improve the quality of subsequent submissions, shorten total review times, and facilitate the development process for new devices.

Pre-Subs provide FDA reviewers with an introduction to you and your device rather than just having a 510(k) application dumped on their desk.  FDA reviewers appreciate Pre-subs because they can get a sense of when they should anticipate filings and can plan their workloads accordingly.

FDA reviewers, like all of us, only have a certain amount of time during the day.  If they are unable to find information easily or do not properly understand something, then they may state that the relevant information is missing from the application or needs further clarification.  This kicks the 510(k) application back to you and stops the review clock. That is directly on the industry submitter, not the FDA reviewer.

The bottom line

FDA reviewers are people too.  This is an obvious but often overlooked point to make.  Sometimes they miss simple (and sometimes seemingly apparent) information.  They make mistakes.  The last thing you want to do is start yelling or pointing fingers.  After all, you don’t want to burn any bridges as you will most likely deal with the same FDA reviewer upon subsequent submissions for similar products.  Always be timely, concise, straightforward and respectful.

At the end of the day, keep in mind that your FDA reviewer isn’t as familiar with your medical device as you are.  You need to help them understand items that are unclear, and the only way to do that is through building the communication channel early and having constructive conversations.

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