Post-market evaluation of medical electrical equipment

Jorge Luiz Guerra do Nascimento1,2, Rodrigo P. B. Costa-Felix2
1JMed Material Hospitalar EIRELI-ME, São João de Meriti, Brazil
2Laboratory of Ultrasound, National Institute of Metrology, Quality, and Technology (Inmetro), Duque de Caxias, Brazil

Tóm tắt

The present paper discusses the technical assistance for electrical equipment under sanitary surveillance by analyzing Brazilian regulations and legislation and proposes an improved post-market approach based on international standards. Brazilian legal and regulatory documentation was the basis of this research. The time span from 2000 to 2020 was used to review the legislation. The actual post-market practice in Brazil was examined in detail, and it was pointed out that there is a clear dichotomy between the legal foundation and the patient protective practice. The Brazilian National Health Surveillance Agency regulates and the Brazilian National Institute of Metrology, Quality, and Technology owns the conformity assessment scheme of medical electrical equipment under a sanitary surveillance system. The conformity assessment is based on a certification process using technical standard series IEC 60601. The certification in its present form does not consider any active post-market surveillance, which is a potential risk for the final users because of the varied medical electrical equipment. From the consumer protection perspective, the objective responsibility of service providers includes accountability to the eventual harm caused by the equipment in normal operation. Therefore, a clear regulation or legislation on post-market technical assistance is of interest to the medical industry and technicians. The prospective assurance of the safety and performance of the well-being of citizens would be much more probable to be assured with the renewing of legislation on the post-market evaluation of medical electrical equipment, mainly if international technical standards are used. The dissemination of available medical electrical equipment technology would consequently help public health. Revising the post-market surveillance approach could lead to a better response to deal with medical electrical equipment maintenance issues.

Từ khóa


Tài liệu tham khảo

ANVISA. Board of directors’ resolution RDC n° 25/2001. Deals with the importation, sale, and donation of used and refurbished health products. February 15th, 2001 (in Portuguese). ANVISA. Board of directors’ resolution RDC n° 02/2010. Provides the management of health technologies at health facilities. January 25th, 2010 (in Portuguese). ANVISA. Board of directors’ resolution RDC n° 16/2013. Approves the technical regulation of good manufacturing practices of medical products and products for diagnostic use in vitro and provides other measures. March 28th, 2013 (in Portuguese). ANVISA. Board of directors’ resolution RDC n° 16/2014. Deals with the criteria for requesting operating authorization (AFE) and special authorization (AE) of companies. April 01st, 2014 (in Portuguese). ANVISA. Board of directors’ resolution RDC n° 349/2020. Defines the extraordinary and temporary criteria and procedures for dealing with requests for regularization of personal protective equipment, medical equipment such as a pulmonary ventilator, and other medical devices identified as strategic by Anvisa, owing to the public health emergency of international concern resulting from the new Coronavirus and other measures. March 19th, 2020a (in Portuguese). ANVISA. Brazilian technical surveillance system. URL http://portal.anvisa.gov.br/tecnovigilancia. Accessed on August 03rd, 2020b. BIPM JCGM. JCGM 106:2012. Evaluation of measurement data: the role of measurement uncertainty in conformity assessment. BIPM: Geneve. 48pp. 2012. Chan M. Medical devices: an area of great promise. In: Global forum on medical devices. Thailand, September 2010. URL http://www.who.int/dg/speeches/2010/med_device_20100909/en/. Accessed on April 08th, 2019. CONFEA. Resolution n° 1.073 (April 19th, 2016) of the Federal Council of Engineering and Agronomy (CONFEA). URL http://normativos.confea.org.br/ementas/visualiza.asp?idEmenta=59111. Accessed on August 03rd, 2020a. CONFEA. Resolution n° 1.103 (July 26th, 2018) of the Federal Council of Engineering and Agronomy (CONFEA). URL http://normativos.confea.org.br/ementas/visualiza.asp?idEmenta=66643. Accessed on August 03rd, 2020b. Costa-Felix RPB. Medical electromedical equipment: requirements of the series of technical standards ABNT NBR IEC 60601. Rio de Janeiro: Brasport. ISBN 978–85–7452-896-0. 106pp, 2018 (in Portuguese). Guerra-Bretaña RM, Flórez-Rendón AL. Impact of regulations on innovation in the field of medical devices. Res Biomed Eng. 2018;34(4):356–67. https://doi.org/10.1590/2446-4740.180054. IEC (International Electrotechnical Commission). IEC 62353:2014. Medical electrical equipment–recurrent test and test after repair of medical electrical equipment. URL: https://webstore.iec.ch/publication/6913. Accessed on April 11th, 2020b. IEC (International Electrotechnical Commission). IEC 62462:2017. Ultrasonics–output test–guidance for the maintenance of ultrasound physiotherapy systems. URL: https://webstore.iec.ch/publication/29821. Accessed on April 11th, 2020c. IEC (International Electrotechnical Commission). IEC 60601–1:2020 SER. Series. Medical electrical equipment–all parts. URL: https://webstore.iec.ch/publication/2603. Accessed on April 11th, 2020a. INMETRO. Requirements for conformity assessment for medical electrical equipment under the sanitary surveillance regime. Ordinance Inmetro n° 54/2016 (in Portuguese). INMETRO. Terms of reference for the Brazilian Conformity Assessment System (SBAC). 2012. URL: http://www.inmetro.gov.br/qualidade/comites/sbac_termo.asp. Accessed 30 Sept 2020 (in Portuguese). INMETRO. The compulsory certification of medical-hospital supplies for coping with the coronavirus epidemic (COVID-19) is suspended. Ordinance Inmetro n° 102/2020. Published on March 20th, 2020a (in Portuguese). INMETRO. Approves extraordinary conditions for conducting conformity assessment activities during the coronavirus pandemic (COVID-19). Ordinance Inmetro n° 111/2020. Published on March 27th, 2020b (in Portuguese). ISO (International Organization for Standardization). ISO 80601-2-12:2020. Medical electrical equipment–parts 2–12: particular requirements for the basic safety and essential performance of critical care ventilators. URL: https://webstore.iec.ch/publication/27356. Accessed on April 11th, 2020. Pane J, RDC F, KMC V, Orozco M, Viroux H, Rebollo I, et al. EU post-market surveillance plans for medical devices. Pharmacoepidemiol Drug Saf. 2019;V28:1155–65. https://doi.org/10.1002/pds.4859. Zippel C, Bohnet-Joschko S. Post-market surveillance in the German medical device sector–current state and future perspectives. Health Policy. 2017;121(8):880–6. https://doi.org/10.1016/j.healthpol.2017.06.005.