Home India Ministry of Health and Family Welfare Classification of Medical Device pertaining to Oncology unde...
Date: 2022-10-11 Category: Not Applicable State: Union Government Country: India

Classification of Medical Device pertaining to Oncology under the provisions 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 Central Drugs Standard Control Organization (CDSCO) provides a classification of various medical devices pertaining to oncology based on their risk level. The classification includes the device name, intended use, and risk class (A, B, C, or D).

Key Changes

  • The notification classifies 48 different medical devices used in oncology.
  • Devices are classified into four risk classes: A, B, C, and D, with A being the lowest risk and D being the highest.
  • Examples of Class A devices include Antimicrobial postsurgical brassiere, Antimicrobial postsurgical female underpants, Breast binder, Brachytherapy radionuclide phantom, test object and Cytotoxic waste receptacle.
  • Examples of Class B devices include Bladder instillation buffer solution, Colonic cytology sampling set, Electronic clinical breast examination system, Acupressure wristband, Cervical cytology scraper (single use), Externally-propelled flexible video colonoscope, Extravascular-circulation hyperthermia system, Facial prosthesis, Flexible fibre optic bronchoscope, Flexible ultrasound bronchoscope, Flexible video bronchoscope, and Robotic Guidance system for image Guided procedures.
  • Examples of Class C devices include FerriScan R2-MRI Analysis System, Alternating electric field antimitotic cancer treatment system generator, Alternating electric field antimitotic cancer treatment system transducer array, Breast 3-D infrared imaging/vascular analysis system, Cryosurgical set, Capsular tension ring, Electro cancer therapy system, Endocervical aspirator, Balloon kyphoplasty kit, Accelerator system chair, Accelerator system quality assurance device, Anorectal brachytherapy system applicator (manual and remote-afterloading), Blood photochemical treatment agent, Brachytherapy source spacer, Brachytherapy system remote-afterloading operator console, Breast brachytherapy system applicator (remote-afterloading), Breast ultrasound imaging system (intracorporeal), Cervical cone knife, Electroporation therapy system, Electroporation therapy system endoscopic applicator, Extravascular-circulation hyperthermia system applicator (intracorporeal), Fixed-aperture therapeutic x-ray system collimator, Flexible fibre optic mediastinoscope, General-purpose infusion pump (mechanical, single-use), General-purpose infusion pump (mechanical, reusable).
  • An example of Class D device is Alternating electric field antimitotic cancer treatment system.
  • The classification is based on the intended use and risk associated with each device.

Impact Analysis

Manufacturers

  • Action Item: Update regulatory filings and quality management systems to reflect the assigned risk classification.

Healthcare Providers

  • Action Item: Incorporate the risk classifications into device selection and utilization protocols.

Patients

  • Action Item: Healthcare providers should communicate the risk classification of devices to patients as part of the informed consent process.

Regulatory Bodies

  • Action Item: CDSCO should actively monitor the market for compliance with these classifications and take appropriate action against non-compliant manufacturers.

Key Entities Referenced

Central Drugs Standard Control Organization (CDSCO): The national regulatory body for pharmaceuticals and medical devices in India. Medical Devices: Instruments, apparatus, appliances, implants, reagents for in vitro use, etc., intended for diagnosis, prevention, monitoring, treatment, or alleviation of disease. Risk Classes (A, B, C, D): Categories of medical devices based on the level of risk associated with their use, with Class A being the lowest risk and Class D being the highest.
Official Source Record View Original Source →
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Appendix A File No. 29/Misc/03/2020-DC (153) – Part 1 Government of India Directorate General of Health Services Central Drugs Standard Control Organization FDA, Bhawan, New Delhi-110002 Notice Classification of Medical Devices Pertaining to Oncology S. Risk Medical Device Name Intended Use No. class The FerriScan R2-MRI Analysis System is intended to measure liver FerriScan R2-MRI iron concentration to aid in the identification and monitoring of non- 1 C Analysis System transfusion dependent thalassemia patients receiving therapy with deferasirox. Alternating electric field antimitotic cancer Alternating electric fields therapy is a novel anticancer treatment that 2 C treatment system disrupts tumor cell mitosis. generator Alternating electric field antimitotic cancer Alternating electric fields therapy is a novel anticancer treatment that 3 C treatment system disrupts tumor cell mitosis. transducer array A sterile buffer solution intended to be used exclusively for bladder Bladder instillation instillation to help create an optimal environment necessary for the 4 B buffer solution effective treatment of superficial bladder cancer with a chemotherapy agent. An assembly of mains electricity (AC-powered) devices intended for Breast 3-D infrared three-dimensional (3-D) breast imaging and breast vascular analysis, 5 imaging/vascular C typically used with mammography screening to perform a breast analysis system cancer risk examination. A collection of non-sterile devices intended to collect exfoliated Colonic cytology 6 colonic cells (colonocytes) from the surface of human rectal mucosa B sampling set for colorectal cancer investigation and/or patient screening. A sterile collection of disposable devices used in conjunction with a cryosurgical unit as well as monitoring and other devices to perform a 7 Cryosurgical set C surgical technique that involves freezing a targeted area of tissue to damage and destroy cancer cells in the unwanted portions. A circular band intended to be used to enhance the mechanical 8 Capsular tension ring stability of a subluxated crystalline lens capsule in the presence of C weak or absent supporting zonules. An assembly of devices designed for the treatment of tumours and the Electro cancer therapy destruction of their cancerous cells using low-voltage direct current of 9 C system small intensity delivered via electrodes placed across the affected body area. Page 1 of 6A portable assembly of devices designed to electronically measure, Electronic clinical breast map, document and store information about breast lesions/masses 10 B examination system with regard to shape, size, location, consistency/relative hardness during a clinical breast examination (CBE) A collection of devices designed to remove superficial tissue from the 11 Endocervical aspirator mucous membrane lining the cervical canal (endometrium) through C manually-powered suction. An assembly of portable devices designed to apply low-intensity, Alternating electric field intermediate-frequency (100-300 kHz) alternating electric fields to 12 antimitotic cancer D treat certain forms of recurrent or newly-diagnosed cancer; typically treatment system glioblastoma multiforme (GBM) [malignant brain tumour]. A collection of sterile surgical instruments and devices used for the reduction of a vertebral compression fractures (VCFs) caused by 13 Balloon kyphoplasty kit C trauma, cancer, or osteoporosis during a minimally invasive procedure commonly known as balloon kyphoplasty. A seat, typically with legs, that is a component of a therapeutic accelerator system, and used to support and position a seated patient 14 Accelerator system chair C during radiation therapy treatments involving the use of either a medical linear accelerator or non-linear accelerator. An instrument specifically designed to be used to check the Accelerator system calibration and performance of linear and non-linear medical 15 C quality assurance device accelerator systems used for radiation therapy applications, for quality assurance (QA) purposes A device designed to be worn on the wrist(s) for the application of 16 Acupressure wristband pressure to the Nei-kuan (P6) acupressure point, the area identified to B help relieve the sensation of nausea. Anorectal brachytherapy A manual brachytherapy applicator specifically designed to be used 17 system applicator, C in radiation therapy treatments of the rectum and/or anus. manual Anorectal brachytherapy A remote afterloading brachytherapy applicator specifically designed 18 system applicator, C for use in radiation therapy treatments of the rectum and/or anus. remote-afterloading A woman's undergarment which includes antimicrobial properties Antimicrobial designed to support and/or contour the breast(s) or hold a dressing in 19 A postsurgical brassiere place after surgical intervention (e.g. thoracic surgery, mastectomy, lumpectomy) It is intended for use during medical treatment (e.g., chemotherapy) Antimicrobial or be used to protect the skin following treatment with a medication 20 postsurgical female (e.g. ointment, cream). It is specifically designed for patient A underpants support/comfort in the home or healthcare facility. This is a reusable device. A sterile photochemical agent (psoralen) intended to be used in Blood photochemical conjunction with ultraviolet A (UVA) irradiation to eliminate 21 C treatment agent nucleated cells from blood or blood components (e.g. plasma, leukocyte-enriched blood fraction). Brachytherapy A non-tissue configured model designed to mimic the 22 radionuclide phantom, functional/physical characteristics of normal or diseased human A test object organs during performance evaluations of brachytherapy system Page 2 of 6components or radiation therapy treatment planning devices. A sterile, bioabsorbable device designed to separate radioactive Brachytherapy source sources of the seed type that are permanently implanted in close 23 C spacer proximity to a selected localized tumour, to increase the distribution of radioactivity to the tumour. A mains electricity (AC-powered) component of a remote- afterloading brachytherapy system intended to function as the primary control panel for the remote afterloader. It typically includes Brachytherapy system hardware and software that allows for information display and/or 24 remote-afterloading C transfer, data processing, analysis, and information archiving operator console functions; it may also be intended to interface with other devices (e.g., radiation therapy treatment planning computer) as part of a picture archiving and communication system (PACS). A strip or roll of fabric or plastic material applied to the breast or 25 Breast binder A breasts for soft tissue support. This is a single-use device. A sterile, remote-afterloading brachytherapy applicator specifically designed for use in radiation therapy treatments of the breast. It is typically Breast brachytherapy designed for temporary implantation within the breast and serves as a guide 26 system applicator, for computer-controlled placement and removal of single or multiple C remote-afterloading radioactive sources. Included are various types of applicators such as hollow needles, tubes, or catheters, and their associated components. This is a single-use device. A mains electricity (AC-powered) transilluminating device with a built-in light source using low intensity emissions of visible light and near-infrared radiation (700 to 1050 nm) that is transmitted through 27 Breast transilluminator A the female breast to visualize translucent tissue for the diagnosis of cancer, or other conditions, diseases or abnormalities. This device may also be known as a diaphanoscope. An assembly of mains electricity (AC-powered) devices designed for intracorporeal (endosonography or endoscopic) ultrasound imaging 28- Breast ultrasound procedures involving the breast. It typically includes special imaging C a imaging system tables used to optimize the ability to give reproducible images of the breast. An assembly of mains electricity (AC-powered) devices designed for 28- Breast ultrasound extracorporeal ultrasound imaging procedures involving the breast. It B b imaging system typically includes special imaging tables used to optimize the ability to give reproducible images of the breast A surgical, manually-operated, instrument that is inserted into the 29 Cervical cone knife vagina and designed for excising a sample of abnormal tissue, e.g., C indicated by the presence of precancerous changes, from the cervix. blunt surgical instrument used to scrape and retrieve cytological Cervical cytology material from the surface of the cervix (neck of the uterus) or vaginal 30 A scraper, reusable area for pathological examination and diagnosis, often for the detection of cervical cancer. This is a reusable device. A hand-held, manual, blunt surgical instrument designed to scrape and retrieve cytological material from the surface of the cervix (neck Cervical cytology 31 of the uterus) or vaginal area for pathological examination and B scraper, single-use diagnosis, often for the detection of cervical cancer. This is a single- use device. Page 3 of 6A sterile flexible tube intended to deliver/remove radiation therapy sources into a coronary artery, typically into the lumen of an Coronary artery implanted stent, as part of a manual-afterloading brachytherapy brachytherapy system system. It is introduced into the patient and subsequently connected to 32 D applicator, manual- the brachytherapy system source transfer device; it includes afterloading radiopaque markers to monitor the position of the radiation source. Disposable devices associated with the procedure may be included (e.g., syringe, connectors). This is a single-use device. A device designed as a container to allow the safe deposit, collection Cytotoxic waste 33 and storage of cytotoxic materials (e.g., chemotherapy/antineoplastic A receptacle drugs). A mobile assembly of devices designed to apply electrical impulses to the tissue to enable electroporation, a phenomenon that induces Electroporation therapy alteration in the structure of cell membranes to increase their 34 C system permeability and allow molecules that usually cannot enter the cell membrane, such as drugs [electrochemotherapy (ECT)] and genetic materials [electrogenetherapy (EGT)], to reach the cytoplasm. A sterile, patient-contact component of an electroporation therapy system intended to fit onto the distal tip of an endoscope and connect to an electroporation therapy system generator to deliver electrical Electroporation therapy impulses to tissues during endoscopy as part of electroporation, a 35 system endoscopic C phenomenon that induces alteration in the structure of cell applicator membranes to increase their permeability and allow molecules that usually cannot enter the cell membrane, such as drugs [electrochemotherapy (ECT)], to reach the cytoplasm. A non-sterile endoscope with a highly flexible sleeve and distal tip intended Externally-propelled for the visual examination of the entire adult colon [lower gastrointestinal 36 B flexible video colonoscope (GI) tract].It is used for the screening of colorectal cancer and the detection of other diseases of the lower GI tract. This is a single-use device. An assembly of devices designed to produce and control heated fluids circulated within a vessel applied to the body (e.g., vest, mattress, Extravascular-circulation 37 jacket, band, pad, body wrap, catheter, probe) for systemic or B hyperthermia system localized heating to treat malignant tumours, benign growths, or other disease-related conditions. A vessel applied to the outside of the body (e.g., in the form of a jacket, vest, body wrap, cushion, blanket, or mattress) that incorporates tubing through which heated fluids are circulated for Extravascular-circulation systemic or localized heating to treat malignant tumours, benign hyperthermia system growths, or other disease-related conditions. he applicator typically 38 A applicator, includes a thermometry component that monitors the temperature of extracorporeal the applicator during operation. The applicator includes tubing, cables, and connectors that interface with the hyperthermia system's control unit during treatments. It is typically used in an oncology department. This is a reusable device. A component of a hyperthermia system that typically consists of Extravascular-circulation catheter-enclosed tubing which is introduced into the body either 39 hyperthermia system manually or endoscopically. Heated fluid is circulated through the C applicator, intracorporeal applicator's tubing for localized heating to treat malignant tumours, benign growths, or other disease-related conditions. The applicator Page 4 of 6(also called an interstitial applicator or probe) typically includes a thermometry component that monitors the temperature of the applicator during operation; it also includes tubing, cables, and connectors that interface with the hyperthermia system's control unit during treatments. It is typically used in an oncology department. This is a single-use device. An externally-applied device intended to be used as an artificial 40 Facial prosthesis substitute for parts or sections of the face [e.g., nose, eye(s), eye B brows, upper lip] to help restore facial appearance. A non-automated, x-ray beam-limiting device that is a component of a therapeutic x-ray system and whose opening size/length/shutter Fixed-aperture assembly is fixed. It is used in radiation therapy applications to limit 41 therapeutic x-ray system the effects of scattered radiation and to protect the patient by limiting C collimator or eliminating exposure to non-target body areas during treatment. This device is specifically designed for use with an x-ray simulation or therapeutic x-ray system. An endoscope with a flexible inserted portion intended for the visual examination and treatment of the trachea, bronchi, and lungs. It is inserted through the mouth or nose during bronchoscopy. Anatomical Flexible fibre optic images are transmitted to the user by the device through a fibre optic 42 B bronchoscope bundle. This device is commonly used to diagnose lung infections, pneumonia, or lung cancer, and allows physicians to view the insides of the lungs and take biopsies and samples of secretions. This is a reusable device. An endoscope with a flexible inserted portion intended for the visual examination and treatment of the mediastinum (the intrapleural space located behind the sternum). It is inserted into the body through an artificial orifice created by an incision made during mediastinoscopy. Flexible fibre optic 43 Anatomical images are transmitted to the user by the device through a C mediastinoscope fibre optic bundle. This device is commonly used to examine structures such as lymph nodes during a staging evaluation of lung cancer, or to establish the diagnosis of a tumour that is localized to the mediastinum. This is a reusable device. A portable, non-electric, mechanically-powered device designed to be operated by healthcare professionals for dispensing a single dose of fluid medication (e.g., for antibiotic therapy, chemotherapy, analgesia). It consists of an empty reservoir intended to be filled with General-purpose infusion medication, a flow-rate regulator and a non-sterile (sterilizable) 44 pump, mechanical, C administration line intended to be connected to an infusion catheter single-use (not included) for intravenous (IV), subcutaneous, intramuscular, or epidural administration. It may include flow and fluid level mechanical indicators and may be worn by the patient in and outside of healthcare settings. This is a single-use device. An endoscope with a flexible inserted portion intended for the visual examination and treatment of the trachea, bronchi, and lungs. It is Flexible ultrasound inserted through the mouth or nose during bronchoscopy. Anatomical 45 B bronchoscope images are transmitted to the user by the device typically through a fibre optic bundle or a video system, and an ultrasound probe. The probe may be built-in or inserted through a dedicated lumen so that its Page 5 of 6distal tip is positioned adjacent to that of the endoscope. It is commonly used to diagnose lung infections, pneumonia, or lung cancer, and allows physicians to view the insides of the lungs and take biopsies and samples of secretions. This is a reusable device. A non-electric, mechanically-powered (e.g., a spring mechanism) device designed for the continuous or intermittent infusion of medication, typically for antibiotic therapy, chemotherapy, or pain General-purpose infusion management by intravenous (IV), subcutaneous, intramuscular, or 46 pump, mechanical, C epidural routes. It is primarily designed to be worn by the patient reusable during ambulation in the home. It may be used for patient-controlled analgesia (PCA), and may include mechanical indicators for flow and fluid level status. This is a reusable device. An endoscope with a flexible inserted portion for endoscopic procedures of the airways and tracheobronchial tree (i.e., bronchoscopy). It is inserted through the mouth or nose during bronchoscopy. Anatomical images are transmitted to the user by a Flexible video 47 video system with a charge-coupled device (CCD) chip at the distal B bronchoscope, reusable end and the images showing on a monitor. It is commonly used to diagnose lung infections, pneumonia, or lung cancer, and allows physicians to view the insides of the lungs and take biopsies and samples of secretions. This is a reusable device. The Medical Device is an accessory to an imaging system (CT, CT- PET) intended for the spatial positioning and orientation of an Robotic Guidance instrument guide. A surgeon then manually advances one or more 48 system for image Guided instruments for percutaneous image guided interventional procedures B procedures through the instrument guide. The device is not intended to make any contact with the patient. Page 6 of 6

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