Home India Ministry of Health and Family Welfare Classification of Medical Device Pertaining to Obstetrical a...
Date: 2022-06-03 Category: Not Applicable State: Union Government Country: India

Classification of Medical Device Pertaining to Obstetrical and Gynecological Under the provision of Medical Devices Rules 2017

Issued by Ministry of Health and Family Welfare · Central Drugs Standard Control Organization

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Executive Summary & Key Takeaways

What it means

  • This gazette notification from the Drugs Controller General (India), Central Drugs Standard Control Organisation, provides a classification of medical devices pertaining to obstetrical and gynecological use based on their intended use and risk class.
  • The notification lists 123 different medical devices, specifying their intended use and assigning a risk class (A, B, C, or D) to each.

Key Changes

  • The notification classifies 123 medical devices related to obstetrics and gynecology.
  • Risk classes assigned are: Class A (low risk), Class B (moderate risk), Class C (high risk), and Class D (highest risk).
  • Examples of Class A devices include powered birthing beds/tables, gynecological examination/treatment tables, and umbilical ligators.
  • Examples of Class B devices include abortion suction system manual aspirators, cervical anesthesia kits, colposcopes, endocervical aspirators, endometrial biopsy curettes, fallopian tube catheterization kits, flexible fiberoptic culdoscope, foetal blood sampler, foetal vacuum extraction cup, hysteroscopic insufflator, intrauterine cannula, and Papanicolaou smear kit.
  • Examples of Class C devices include abdominal decompression chamber, cardiotocograph, cardiotocograph transducer, cardiotocography telemetric monitoring system components, contraceptive cervical cap, contraceptive spermicide, contraceptive sponge, foetal bladder shunt, foetal cardiac monitor, foetal pleuro-amniotic catheter, foetal scalp electrode, Foetal Doppler system, Preservation medium for human semen, Vitrification freezing kit, Handling medium, Gamete and embryo retrieval, storage and transfer medium, Hyaluronidase solution, Polyvinylpyrrolidone (PVP) Solution, Sperm processing media, In Vitro embryo Culture medium, through day 5/6 of development, In Vitro embryo culture medium, through day 3 of development.
  • An example of a Class D device is the Fallopian tube occlusion insert.

Impact Analysis

Manufacturers

  • Action Item: Review the list of devices and their classifications to determine the impact on their product portfolio. Prepare for necessary regulatory submissions based on the assigned risk classes.

Healthcare Providers

  • Action Item: Familiarize themselves with the classification of devices used in their practice to ensure appropriate usage and safety protocols.

Regulatory Agencies

  • Action Item: Implement the classification system for regulatory activities, including inspections, market surveillance, and adverse event monitoring.

Patients

  • Action Item: No direct action is required from patients, but they can be informed about the regulatory framework for medical devices to increase awareness and confidence in the healthcare system.

Key Entities Referenced

Drugs Controller General (India) (DCGI): The regulatory authority responsible for the approval and regulation of pharmaceuticals and medical devices in India. Central Drugs Standard Control Organisation (CDSCO): The national regulatory body for Indian pharmaceuticals and medical devices under the Ministry of Health and Family Welfare. Medical Devices Rules, 2017: The rules governing the regulation of medical devices in India, including classification, registration, manufacturing, import, and sale.
Official Source Record View Original Source →
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Appendix-A File No. 29/Misc./03/2020-DC (181) Drugs Controller General (India) Directorate General of Health Services Central Drugs Standard Control Organisation FDA Bhawan, Kotla Road, New Delhi Notice Classification of Medical Devices Pertaining to Obstetrical and Gynecological Sr. DEVICE NAME INTENDED USE Risk No. Class Abdominal Non- invasive medical device placed at abdomen to alleviate 1 decompression C abdominal pain during pregnancy or delivery. chamber Abdominal A dedicated pump used with hood-like device to control and 2 decompression C reduce abdominal pressure of a pregnant women. chamber pump A non-sterile, manual, syringe-like device to aspirate fluid from Abortion suction the uterus for treatment of incomplete abortion, first 3 system manual B trimester abortion, and/or for menstrual regulation. Also used aspirator for endometrial biopsy. Birthing bed/table, 4 Bed used during labor and delivery. A powered A device that records fetal heart rate and uterine 5 Cardiotocograph C contraction simultaneously. A device that converts birthing contractions to electrical signals Cardiotocograph 6 and is used together with cardiotocograph (CTG) which C transducer displays the signals. An assembly of devices intended to be used to continuously Cardiotocography measure and wirelessly transmit foetal heart rate and uterine 7 telemetric C contraction signals from a patient to a monitoring system monitor. Cardiotocography A part of wireless telemeter system. It receives signals from 8 telemetric transmitter that senses fetal heart rate and uterine C monitoring system contraction during labor. receiver Cardiotocography It transmits signals related to fetal heart rate and uterine 9 telemetric C contractions to the receiver. monitoring system transmitter For providing intercervical nerve block during gynaecological diagnostic tests such as dilation and Cervical 10 curettage, small excisional procedures such as B anaesthesia kit endometrial biopsy, or for pain management during labour and/or delivery. This is a single-use device. Cervical A sharp bevel-edged, hollow tubular metal instrument 11 anaesthesia needle, intended to be used to administer anaesthetic agent to B reusable or single function as an intracervical nerve-block. use Special microscope for examination of female genital 12 Colposcope B organs (e.g., vagina, cervix). Page 1 of 9Contraceptive cervical Device inserted into the cervix to prevent semen from 13 cap, reusable or C entering the uterus. single use A chemical substance (e.g., nonoxynol-9) intended to be Contraceptive introduced with an applicator or the finger into the vagina 14 C spermicide before sexual intercourse, to destroy sperm (spermatozoa) to prevent pregnancy. Bubble like device works as a physical barrier to prevent 15 Contraceptive sponge C spermatic invasion into uterus. A circular device placed in the vagina prior to intercourse 16 Diaphragm pessary C to mechanically prevent conception. A collection of devices designed to remove superficial tissue 17 Endocervical aspirator from the mucous membrane lining the cervical canal B (endometrium) through manually-powered suction. Sterile devices intended to be used for the collection, Endocervical specimen preservation, and transport of cellular and/or other material 18 collection kit, no B collected from the endocervix for culture, analysis, and/or additive other investigation (a) Endometrial biopsy curette, reusable Surgical instrument used for the removal of small amounts of B (b) Endometrial biopsy endometrial secretions and/or tissue from the uterus for biopsy 19 curette, single purposes. B use/disposable For the collection of a tissue sample taken from the lining of the 20 Endometrial biopsy kit B uterus (endometrium). Endometrial cytology A brush used to collect mucosal cell for pathological 21 B brush diagnosis during endoscopic examination. Fallopian tube biopsy A sterile device intended to be inserted through a 22 everting-balloon hysteroscope to obtain biopsy samples from a fallopian tube B catheter for cytological examination. A collection of sterile devices for the trans uterine Fallopian tube 23 catheterization of the fallopian tubes to inject dye or B catheterization kit contrast medium for the evaluation of tubal patency. Active invasive device designed to insufflate the Fallopian tube 24 Fallopian tubes with a gas [typically carbon dioxide B insufflator (CO2)] to maintain tubal patency for a procedure. Contraceptive implantable device implanted into the uterine Fallopian tube end of the fallopian tubes to function as a contraceptive by 25 occlusion insert D obstructing the natural fallopian tube passage. (a) Fixed-diameter cervical dilator, B reusable To dilate the cervical canal with balloon when uterine does 26 (b) Fixed-diameter not dilate enough due to inertia uteri. cervical dilator, B single use/disposable Page 2 of 9Flexible fibreoptic Flexible endoscope for visual examination, diagnosis, and 27 B culdoscope treatment of urinary bladder and urethra. Flexible fibreoptic For the visual examination and treatment of the canal of the 28 B hysteroscope cervix and the uterine cavity (uterus). Flexible fibreoptic For the visual examination and treatment of the 29 B laparoscope abdominal/retroperitoneal cavity and its organs Flexible fibreoptic For the visual examination and treatment of the 30 B mammary ductoscope mammary duct. Flexible fibreoptic For the visual examination and treatment of the fallopian tubes 31 B salpingoscope (oviducts). For the visual examination, treatment, and ultrasonic Flexible ultrasound 32 imaging of the abdominal/retroperitoneal cavity and its B laparoscope organs. Flexible video For the visual examination and treatment of the female 33 B culdoscope peritoneal cavity and organs. Flexible video For the visual examination and treatment of the canal of the 34 B hysteroscope cervix and the uterine cavity (uterus). Flexible video For the visual examination and treatment of the 35 B laparoscope abdominal/retroperitoneal cavity and its organs. Flexible video For the visual examination and treatment of the 36 B mammary ductoscope mammary duct. Flexible video For the visual examination and treatment of the fallopian tubes 37 B salpingoscope (oviducts). Uses sound stimuli to assess foetal well-being. This device is used to evaluate the status of the foetus as expressed Foetal acoustic 38 by, e.g., foetal heart rate changes or foetal acid-base B stimulator status, in antepartum tests and/or during intrapartum monitoring. A sterile non-bioabsorbable tubular device implanted in the bladder of a foetus with post-vesicular obstructive uropathy, 39 Foetal bladder shunt to decompress the urinary tract for urine to pass from bladder C into the amniotic sac, until the defect can be surgically repaired after birth Invasive device to collect fetal blood through uterine 40 Foetal blood sampler B cervix. Active device designed to detect, measure, and display foetal 41 Foetal cardiac monitor C heart activity during the perinatal period Foetal pleuro-amniotic Sterile implantable device used to continuously drain 42 C catheter fetal pleural effusion to maternal amniotic cavity. Foetal scalp Placed directly on the scalp of the fetus in the uterus to 43 C electrode, clip monitor fetal vital signs. Mechanical hearing device used to listen to fetal 44 Foetal stethoscope A heartbeat. Foetal vacuum A device used to extract the head of the fetus with a 45 extraction cup, B vacuum cup. reusable or single use Page 3 of 9A battery-powered vacuum measuring device that is connected via tubing to the suction line of a foetal vacuum Foetal vacuum extracting cup, to measure and record data related to a 46 extraction system B vacuum-assisted delivery such as level of vacuum applied, monitor the number and duration of pulls, and number of pop-offs. Foetal vacuum extraction system, To facilitate the delivery of a foetus during vaginal childbirth 47 B manual, reusable or or Caesarean. single use Foetal vacuum To facilitate the delivery of a foetus during vaginal childbirth 48 extraction system, B or Caesarean. pneumatic To imitate a variety of physiological parameters and conditions Foetal/maternal (both foetal and maternal) expressed during pregnancy in order multiple physiological 49 to test and calibrate foetal and patient monitoring and recording B parameter simulation equipment, check patient cable kit continuity, or train healthcare providers. To imitate a variety of physiological parameters and conditions Foetal/maternal (both foetal and maternal) expressed during pregnancy in order 50 multiple physiological to test and calibrate foetal and patient monitoring and recording B parameter simulator equipment, check patient cable continuity, or train healthcare providers. 51 Gynaecological bib A piece of cloth worn by the patient. A Gynaecological To support a woman's body in the appropriate positions during 52 examination/treatment A gynaecological examinations. table A component of a modular operating table designed as a Gynaecological 53 detachable table top constructed for gynaecological A operating table top surgical procedures. Gynaecological operating table, Active device designed to support a patient during 54 electrohydraulic or A gynaecological surgical procedures electromechanical or hydraulic (a) Gynaecological B scissors, reusable To cut tissues during a gynaecological surgical 55 (b) Gynaecological procedure; it is not intended for obstetric use. scissors, single B use/disposable To improve visualization of anatomical structures via Gynaecological 56 transmitted light during gynaecological surgery (e.g., on the A surgical microscope fallopian tubes). A device used during a medical/surgical procedure to steadily 57 Heel stirrup hold a patient's foot (feet) by cradling the heel or A the whole foot. Hysteroscopic A device that sends the gas into the fallopian tube to 58 B insufflator maintain the patency of the tubes. Used during endoscopic procedures of the uterus to distend (expand by pressure) the uterus by filling the uterine cavity Hysteroscopic with a liquid to improve visualization and enlarge the surgical 59 irrigation/insufflation B field. It also circulates the fluid to provide irrigation that will system remove tissue/debris from the site. Page 4 of 9(a) Intrauterine To aspirate fluid/material from the uterus for treatment of B cannula, reusable incomplete abortion, first trimester abortion, and/or for 60 (b) Intrauterine menstrual regulation; it may also be intended for endometrial cannula, single B biopsy. use/disposable A sterile, flexible tube with an inflatable balloon inserted into Intrauterine the uterus and distended with a medium (e.g., sterile 61 haemostatic balloon B water, medical air or other appropriate gas) to reduce catheter postpartum bleeding with pressure. Intrauterine Inserted into the uterus to reduce postpartum bleeding 62 haemostatic suction through aspiration of blood/debris and induction of uterine B catheter contractions. Intrauterine imaging Intrauterine injection of an opaque tracer medium, to 63 B medium catheter facilitate radiography of the fallopian tubes/uterus. Intrauterine imaging Sterile devices intended for the intrauterine injection of an 64 medium opaque tracer medium, to facilitate radiography of the B catheterization kit fallopian tubes/uterus. (a) Laparoscope laser B coupler To connect the laparoscope to the laser or the laser arm for 65 laparoscopic laser treatment. (b) Laparoscope laser A adaptor For the visual examination and treatment of the 66 Laparoscope system abdominal/retroperitoneal cavity and its organs B (laparoscopy). For the visual examination and treatment of the Laparoscope system, 67 abdominal/retroperitoneal cavity and its organs B reusable or single use (laparoscopy). Manual expandable To dilate the cervical canal with balloon when uterine 68 B cervical dilator does not dilate enough due to inertia uteri. To imitate a foetal heart (e.g., foetal heart ultrasound signals) when used in combination with a foetal/maternal multiple 69 Mechanical foetal physiological parameter simulator in order to test foetal B heart simulator monitoring and recording equipment [e.g., cardiotocograph (CTG)], check patient cable continuity, or to train healthcare providers. Active surgical instrument designed for grasping, mobilizing, Motorized 70 and suturing tissues/vessels under direct or B laparoscopic forceps endoscopic visualization during a surgical procedure. Papanicolaou smear Used to collect and prepare pap smears samples in a 71 kit or Endometrial B medical institute. sampling kit 72 Pelvic examination kit For performing pelvic examination B A measuring device used to determine the pelvic 73 Pelvimeter B dimensions. An endoscope used for visual examination and diagnosis of 74 Pelviscope B pelvis. 75 Perineal warmer it is useful for pain relief in the vulva after episiotomy. B To determine perineal muscle strength through resistance to spontaneous contraction of perineal 76 Perineometer B muscle. Also used to diagnose and treat urinary incontinence and sexual dysfunction through movement. Page 5 of 9Pudendal A collection of sterile devices designed to deliver 77 B anaesthesia kit anaesthetic agent to the external genitalia of humans. An endoscope used for visual examination, diagnosis 78 Resectoscope B and treatment, especially for resection of tissues. An endoscope with a rigid inserted portion intended for the 79 Rigid culdoscope visual examination and treatment of the female peritoneal B cavity and organs. An endoscope with a rigid inserted portion intended for the Rigid fibreoptic 80 visual examination and treatment of the canal of the cervix B hysteroscope and the uterine cavity (uterus). An endoscope with a rigid inserted portion intended for the Rigid mammary 81 visual examination and treatment of the mammary duct B ductoscope An endoscope with a rigid inserted portion intended for the Rigid optical 82 visual examination and treatment of the B laparoscope abdominal/retroperitoneal cavity and its organs. An endoscope with a rigid inserted portion intended for the 83 Rigid salpingoscope visual examination and treatment of the fallopian tubes B (oviducts) An endoscope with a rigid inserted portion, combined with Rigid ultrasound an ultrasound probe, intended for the visual examination, 84 B laparoscope treatment, and ultrasonic imaging of the abdominal/retroperitoneal cavity and its organs Active device intended to allow visual examination and Rigid video 85 treatment of the canal of the cervix and the uterine cavity B hysteroscope (uterus). An endoscope with a rigid inserted portion intended for the Rigid video 86 visual examination and treatment of the B laparoscope abdominal/retroperitoneal cavity and its organs (a) Suprapubic needle, surgical, B reusable Percutaneously puncture the lower abdominal wall to 87 (b) Suprapubic provide suprapubic access for surgical repair. needle, surgical, B single use/ disposable 88 Umbilical ligator Surgical device used for umbilical cord ligation. A Used to inject liquid, drug, or other substance into uterus. It is a 89 Uterine injector B reusable device. Uterine manipulator Allow manipulation of the uterus under suction whilst 90 cervical preventing laparoscopic insufflation gas from escaping from B cup/transilluminator the cervix (during hysterectomy). (a) Uterine manipulator, B Surgical instrument designed to mechanically manipulate the reusable 91 position of the uterus during a gynaecological intervention (b) Uterine manipulator, single B use/disposable Page 6 of 9A hand-held, surgical instrument used to introduce 92 Uterine packer dressings into the uterus or vagina. This is a reusable A device. (a) Uterine probe, B reusable For exploring the uterus during a surgical procedure. Used 93 (b) Uterine probe, as a component of a uterine manipulator single B use/disposable Uterus-supporting 94 Inserted into the vagina to hold the uterus in place. B pessary Vaginal applicator, 95 A device designed to apply medication to the vagina. A reusable or single use (a) Vaginal dilator, B reusable Inserted into the vagina to dilate a narrow vaginal opening 96 (b) Vaginal dilator, due to congenital defect. Can be used during examination, single use/ treatment or surgical procedure. B disposable Vaginal douche, To deliver a liquid (usually solution) directly into the 97 B reusable or single use vaginal cavity for hygienic purpose as a douche. A device that measures the length and diameter of 98 Vaginometer A vagina. For paediatric vaginal examination. To search foreign 99 Vaginoscope B matter or bleeding site. Used to hold an organ at proper position (i.e., viscera) while Viscera retention the surgeon performs a suturing procedure 100 paddle or Visceral B (typically internal wound closure). It is also implanted into a retainer surgical site temporarily. Active device transmitted through the female breast to visualize Breast 101 translucent tissue for the diagnosis of cancer, or C transilluminator other conditions, diseases or abnormalities. A surgical instrument used to rupture the amniotic Amniotic membrane 102 membrane to assist in childbirth, without causing injury to the A perforator, reusable mother or foetus A surgical instrument used to rupture the amniotic 103 Amniotome, reusable membrane to assist in childbirth, without causing injury to the B mother or foetus inserted into the vagina to facilitate management of female Bladder-supporting 104 urinary incontinence and/or to reduce bladder B pessary prolapse. Catheter-tip A device intended to be incorporated into the distal end 105 B transducer, pressure of a catheter (not included) to measure pressure. Foetal Doppler Active non-invasive device to detect foetal heart beats 106 C system using ultrasound/Doppler technology. Placed on the surface of a pregnant woman's abdomen Foetal Doppler 107 to detect foetal heart beats using ultrasonic/Doppler C system probe technology. It is intended for cryopreservation of human semen for later use Preservation 108 in Assisted Reproductive procedure. It may include medicinal medium for and biological components like glycerol, gentamicin, Test Yolk C human semen Buffer (TYB),etc. It is intended for use in Assisted Reproductive procedure Sperm 109 involving the cryopreservation and storage of semen. C cryopreservation medium Page 7 of 9It is intended for use in Assisted Reproductive procedure for Vitrification freezing kit 110 vitrification and storage of human oocytes (MII), Pronuclear (PN) zygotes through day 3 cleavage stage embryos and blastocyst C stage embryos. It may include medicinal and protein supplements like Gentamicin, Dextran Serum Supplement (DSS), etc. Intended for use in the thawing of vitrified oocytes (MII), Vitrification 111 pronuclear (PN) zygotes through day 3 cleavage stage embryos Thawing/Warming kit and blastocyst stage embryos that have been vitrified using C vitrification freeze kit.It may include medicinal and protein supplements like Gentamicin, Dextran Serum Supplement (DSS), etc. Intended for use in Assited reproductive procedure which Handling medium involves manipulation of gametes or embryos. Specially, it is 112 indicated for use as an oocyte retrival medium during ovarian follicle aspiration procedure, washing sperm prior to IVF and C ICSI (Intra Cytoplasmic sperm injection) fertilization procedures, and for transport of the embryo to the utreus during embryo transfer procedure. It may include medicinal and protein supplements like Gentamicin, Human Serum Albumin (HSA), etc. Used in Assisted reproductive procedure which includes Gamete and embryo 113 retrieval, culture, transport,storage, handling, and transfer of C retrieval, storage and human gametes and embryos by creating a physiological transfer medium environment. It may include buffer solution and medicinal substance like Gentamicin, etc. Intended for use in removing cumulus cells surrounding oocytes Hyaluronidase solution (denudation) in preparation for ICSI (Intra cytoplasmic sperm 114 injection) or other Assisted reproductive procedures. It is a C enzymatic solution containing of bovine derived hyaluronidase in a HEPES (4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid) buffered HTF (Human Tubal Fluid) medium supplemented with therapeutic grade human serum albumin and gentamicin sulfate. Used in Assisted reproductive procedure which include human Polyvinylpyrrolidone gamete and embryo manipulation. It uses PVP solution for C (PVP) Solution 115 immobilizing sperm for ICSI (Intra cytoplasmic sperm injection) procedures.This solution may include protein supplement like Human Serum Albumin (HSA), etc. It is intended for separation of the motile fraction of sperm from Sperm Separation 116 seminal fluid. It works on the principle of isopycnic separation. B Medium Designed to maintain sperm quality on the table top without CO2 Sperm processing 117 incubation. This procedure includes use of this medium for C media sperm washing by supporting all steps of sperm preparation prior to fertilization. It may contains protien supplements like human serum albumin (HSA), bovine serum albumin, etc. Intended for use in ART Laboratories procedure requiring a non- Water for Assisted 118 pyrogenic high quality pure grade of water. B Reproductive Technologies It is intended for use in assisted reproductive procedures which In Vitro embryo Culture 119 include gamete and embryo manipulation. It is used as a culture C medium, through day medium for human gametes and embryos from fertilization 5/6 of development through day 5/6 of development. It may include medicinal substance like Gentamicin and protein supplement like Human serum Albumin (HSA), etc. Page 8 of 9This medium is intended for use in assisted reproductive In Vitro embryo culture procedures which include human gamete and embryo C medium, through day 3 120 manipulation. It is used as a culture medium through day 3 of of development development. It may be used as a stand-alone medium, or as the first stage of a sequential medium protocol. It may include medicinal substance like Gentamicin, etc. For use in assisted reproductive procedures which include Protein supplement for 121 gamete and embryo manipulation, as a supplement for culture B in vitro embryo culture media. It may include protein supplement like Human Serum Albumin (HSA), Synthetic Serum Substitute (SSS), Dextran Serum Supplement (DSS), etc. Not for use as an injectable product. It is used as an overlay to cover small volumes of culture media Oil for embryo culture 122 during human embryo and gamete manipulation to prevent B evaporation of culture media. Placed in the vagina to collect blood and cellular debris Menstrual Cup 123 discharges during menstruation and discharges outside of the B monthly menses. Page 9 of 9

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