[Title 21 CFR 804]
[Code of Federal Regulations (annual edition) - April 1, 1999 Edition]
[Title 21 - FOOD AND DRUGS]
[Chapter I - FOOD AND DRUG ADMINISTRATION,]
[Subchapter H - MEDICAL DEVICES]
[Part 804 - MEDICAL DEVICE DISTRIBUTOR REPORTING]
[From the U.S. Government Printing Office]


21FOOD AND DRUGS81999-04-011999-04-01falseMEDICAL DEVICE DISTRIBUTOR REPORTING804PART 804FOOD AND DRUGSFOOD AND DRUG ADMINISTRATION,MEDICAL DEVICES
PART 804--MEDICAL DEVICE DISTRIBUTOR REPORTING--Table of Contents




                      Subpart A--General Provisions

Sec.
804.1  Scope.
804.3  Definitions.
804.9  Public availability of reports.

                     Subpart B--Reports and Records

804.25  Reports by distributors.
804.27  Where to submit a report.
804.28  Reporting form.
804.30  Annual certification.
804.31  Additional requirements.
804.32  Supplemental information.
804.33  Alternative reporting requirements.
804.34  Written MDR procedures.
804.35  Files.

    Authority: 21 U.S.C. 352, 360, 360i, 360j, 371, 374.

    Source: 58 FR 46519, Sept. 1, 1993, unless otherwise noted.



                      Subpart A--General Provisions



Sec. 804.1  Scope.

    (a) FDA is requiring medical device distributors to report deaths, 
serious illnesses, and serious injuries that are attributed to medical 
devices. Distributors are also required to report certain device 
malfunctions and to submit a report to FDA annually certifying the 
number of medical device reports filed during the preceding year, or 
that no reports were filed. These reports enable FDA to protect the 
public health by helping to ensure that devices are not adulterated or 
misbranded and are otherwise safe and effective for their intended use. 
In addition, device distributors are required to establish and maintain 
complaint files or incident files as described in Sec. 804.35, and to 
permit any authorized FDA employee at all reasonable times to have

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access to, and to copy and verify, the records contained in this file. 
This part supplements, and does not supersede, other provisions of this 
subchapter, including the provisions of part 820 of this chapter.
    (b) References in this part to regulatory sections of the Code of 
Federal Regulations are to chapter I of title 21, unless otherwise 
noted.



Sec. 804.3  Definitions.

    (a) Act means the Federal Food, Drug, and Cosmetic Act.
    (b)-(c) [Reserved]
    (d) Distributor means any person, including any person who imports a 
device into the United States, who furthers the marketing of a device 
from the original place of manufacture to the person who makes final 
delivery or sale to the ultimate user but who does not repackage or 
otherwise change the container, wrapper, or labeling of the device or 
device package. One who repackages or otherwise changes the container, 
wrapper, or labeling, is a manufacturer under Sec. 804.3(k).
    (e) Distributor Report Number means the number that uniquely 
identifies each report submitted by a distributor. Distributors who 
receive or submit reports shall use their seven digit FDA registration 
number, calendar year that the report is received, and a sequence 
number. For example, the complete number will appear as follows: 
1234567-1991-0001. Distributor report numbers shall also be required on 
FDA form 3500A.
    (f) FDA means the Food and Drug Administration.
    (g) [Reserved]
    (h) Incident files are those files containing documents or other 
information, which are related to adverse events that may have been 
caused by a device.
    (i) Information that reasonably suggests that there is a probability 
that a device has caused or contributed to a death or serious injury or 
serious illness means information, including professional, scientific, 
or medical facts, observations, or opinions, which would cause a 
reasonable person to believe that a device caused or contributed to a 
death, serious injury, or serious illness.
    (j) Malfunction means the failure of a device to meet any of its 
performance specifications or otherwise to perform as intended. 
Performance specifications include all claims made in the labeling for 
the device. The intended performance of a device refers to the objective 
intent of the persons legally responsible for the labeling of the 
device. The intent is determined by such persons' expressions or may be 
shown by the circumstances surrounding the distribution of the device. 
This objective intent may, for example, be shown by labeling claims, 
advertising matter, or oral or written statements by such persons or 
their representatives. It also may be shown by the circumstances that 
the device is, with the knowledge of such persons or their 
representatives, offered and used to perform a function for which it is 
neither labeled nor advertised.
    (k) Manufacturer means any person who manufactures, prepares, 
propagates, compounds, assembles, or processes a device chemically, 
physically, biologically, or by other procedures. The term includes any 
person who:
    (1) Repackages or otherwise changes the container, wrapper, or 
labeling of a device in furtherance of the distribution of the device 
from the original place of manufacture, to the person who makes final 
delivery or sale to the ultimate user or consumer;
    (2) Initiates specifications for devices that are manufactured by a 
second party for subsequent distribution by the person initiating the 
specifications; or
    (3) Manufactures components or accessories which are devices that 
are ready to be used and are intended to be commercially distributed and 
are intended to be used as is, or are processed by a licensed 
practitioner or other qualified person to meet the needs of a particular 
patient.
    (l) MDR means medical device report.
    (m) MDR reportable event means:
    (1) The event for which a distributor, other than an importer, 
required to report under this part has received or become aware of 
information that reasonably suggests that there is a probability that a 
device has caused or contributed to a death, serious illness, or serious 
injury; or

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    (2) The event for which an importer required to report under this 
part has received or become aware of information that reasonably 
suggests that a device may have caused or contributed to a death or 
serious injury; or
    (3) A malfunction, for which a distributor, other than an importer, 
required to report under this part has received or become aware of 
information that reasonably suggests that there is a probability that 
the device, if the malfunction were to recur, would be likely to cause 
or contribute to a death, serious illness, or serious injury; or
    (4) A malfunction, for which an importer required to report under 
this part has received or become aware of information that reasonably 
suggests that a device has malfunctioned and that such device or a 
similar device would be likely to cause or contribute to a death or 
serious injury if the malfunction were to recur.
    (n)-(p) [Reserved]
    (q) Permanent means nonreversible impairment or damage.
    (r) Probability, probable, or probably means, for purposes of this 
section, that a person would have reason to believe, based upon an 
analysis of the event and device, that the device has caused or 
contributed to an adverse event. This term does not signify statistical 
probability.
    (s) A remedial action is any recall, repair, modification, 
adjustment, relabeling, destruction, inspection, patient monitoring, 
notification, or any other action relating to a device that is initiated 
by a distributor, in response to information that it receives or 
otherwise becomes aware of, that reasonably suggests that one of its 
marketed devices has caused or contributed to an MDR reportable event.
    (t) Serious illness means an event that:
    (1) Is life threatening;
    (2) Results in permanent impairment of a body function or permanent 
damage to the body structure; or
    (3) Necessitates immediate medical or surgical intervention to 
preclude permanent impairment of a body function or permanent damage to 
a body structure.
    (u) Serious injury means an event that:
    (1) Is life threatening;
    (2) Results in permanent impairment of a body function or permanent 
damage to a body structure, or
    (3) Necessitates medical or surgical intervention to preclude 
permanent impairment of a body function or permanent damage to a body 
structure.
    (v) [Reserved]
    (w) Work day means Monday through Friday excluding Federal holidays. 
Federal holidays include New Year's Day, Martin Luther King Jr.'s 
Birthday, Presidents' Day, Memorial Day, Independence Day, Labor Day, 
Columbus Day, Veterans Day, Thanksgiving Day, and Christmas Day.
    (x) Any term defined in section 201 of the act shall have the same 
definition unless otherwise defined in this part.



Sec. 804.9  Public availability of reports.

    (a) Any report, including any FDA record of a telephone report, 
submitted under this part is available for public disclosure in 
accordance with part 20 of this chapter.
    (b) Before public disclosure of a report, FDA will delete from the 
report:
    (1) Any information that constitutes trade secret or confidential 
commercial or financial information under Sec. 20.61 of this chapter; 
and
    (2) Any personnel, medical, and similar information, including the 
serial numbers of implanted devices, which would constitute a clearly 
unwarranted invasion of personal privacy under Sec. 20.63 of this 
chapter; provided, that, except for the information under Sec. 20.61 of 
this chapter, FDA will disclose to a patient who requests a report all 
the information in the report concerning that patient.



                     Subpart B--Reports and Records



Sec. 804.25  Reports by distributors.

    (a)(1) A distributor, other than an importer, shall submit to FDA a 
report, and a copy of such report to the manufacturer, containing the 
information required by Sec. 804.28 on FDA form 3500A as soon as 
practicable, but not later than 10 working days after the distributor 
receives or otherwise becomes aware of information from any

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source, including user facilities, individuals, or medical or scientific 
literature, whether published or unpublished, that reasonably suggests 
that there is a probability that a device marketed by the distributor 
has caused or contributed to a death, serious illness, or serious 
injury.
    (2) An importer shall submit to FDA a report, and a copy of such 
report to the manufacturer, containing the information required by 
Sec. 804.28 on FDA form 3500A as soon as practicable, but not later than 
10 working days after the importer receives or otherwise becomes aware 
of information from any source, including user facilities, individuals, 
or medical or scientific literature, whether published or unpublished, 
that reasonably suggests that one of its marketed devices may have 
caused or contributed to a death or serious injury.
    (b)(1) A distributor, other than an importer, shall submit to the 
manufacturer a report containing information required by Sec. 804.28 on 
FDA form 3500A, as soon as practicable, but not later than 10 working 
days after the distributor receives or otherwise becomes aware of 
information from any source, including user facilities, individuals, or 
through the distributor's own research, testing, evaluation, servicing, 
or maintenance of one of its devices, that one of the devices marketed 
by the distributor has malfunctioned and such information reasonably 
suggests that there is a probability that the device or any other device 
marketed by the distributor would cause a death, serious illness, or 
serious injury, if the malfunction were to recur.
    (2) An importer shall submit to the manufacturer a report containing 
information required by Sec. 804.28 on FDA form 3500A, as soon as 
practicable, but not later than 10 working days after the importer 
receives or otherwise becomes aware of information from any source, 
including user facilities, individuals, or through the distributor's own 
research, testing, evaluation, servicing, or maintenance of one of its 
devices, that one of the devices marketed by the importer has 
malfunctioned and that such device or a similar device marketed by the 
importer would be likely to cause or contribute to a death or serious 
injury if the malfunction were to recur.
    (c) Distributors as defined in part 897 of this chapter shall submit 
medical device reports concerning cigarettes and smokeless tobacco under 
this part only for adverse events related to contamination.

[58 FR 46519, Sept. 1, 1993, as amended at 61 FR 44615, Aug. 28, 1996]



Sec. 804.27  Where to submit a report.

    (a) Any telephone report required under this part shall be provided 
to 301-427-7500.
    (b) Any facsimile report required under this part shall be provided 
to 301-881-6670.
    (c) Any written report or additional information required under this 
part shall be submitted to:

Food and Drug Administration,
Center for Devices and Radiological   Health,
Distributor Report,
P.O. Box 3002,
Rockville, MD 20847-3002.



Sec. 804.28  Reporting form.

    (a) Each distributor that submits a report on an MDR reportable 
event shall complete and submit the applicable portions of FDA form 
3500A in so far as the information is known or should be known to the 
distributor, and submit it to FDA, and to the manufacturer as required 
by Sec. 804.25.
    (b) Each distributor shall submit the information requested on FDA 
form 3500A, including:
    (1) Identification of the source of the report.
    (i) Type of source that reported the event to thedistributor (e.g., 
lay user owner; lay user lessee, hospital, nursing home, outpatient 
diagnostic facility, outpatient treatment facility, ambulatory surgical 
facility);
    (ii) Distributor report number;
    (iii) Name, address, and telephone number of the reporting 
distributor and the source that reported the event to the distributor; 
and
    (iv) Name of the manufacturer of the device.
    (2) Date information.
    (i) The date of the occurrence of the event;

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    (ii) The date the source that reported the event to the distributor 
became aware of the event;
    (iii) The date the event was reported to the manufacturer and/or 
FDA; and
    (iv) The date of this report.
    (3) The type of MDR reportable event, e.g., death, serious illness, 
serious injury, or malfunction, and whether an imminent hazard was 
involved;
    (4) Patient information including age, sex, diagnosis, and medical 
status immediately prior to the event and after the event;
    (5) Device information including brand and labeled name, generic 
name, model number or catalog number or other identifying numbers, 
serial number or lot number, purchase date, expected shelf life/
expiration date (if applicable), whether the device was labeled for 
single use, and date of implant (if applicable);
    (6) Maintenance/service information data including the last date of 
service performed on the device, where service was performed, whether 
service documentation is available, and whether service was in 
accordance with the service schedule;
    (7) Whether the device is available for evaluation and, if not, the 
disposition of the device;
    (8) Description of the event.
    (i) Who was operating or using the device when the eventoccurred;
    (ii) Whether the device was being used as labeled or as otherwise 
intended;
    (iii) The location of the event;
    (iv) Whether there was multi-patient involvement, and if so, how 
many patients were involved;
    (v) A list of any other devices whose performance may have 
contributed to the event and their manufacturers, and the results of any 
analysis or evaluation with respect to such device (or a statement of 
why no analysis or evaluation was performed); and
    (vi) A complete description of the event including, but not limited 
to, what happened, how the device was involved, the nature of the 
problem, patient followup/treatment required, and any environmental 
conditions that may have influenced the event.
    (9) The results of any analysis of the device and the event, 
including:
    (i) The method of evaluation or an explanation of why no evaluation 
was necessary or possible;
    (ii) The results and conclusions of the evaluation;
    (iii) The corrective actions taken; and
    (iv) The degree of certainty concerning whether the device caused or 
contributed to the reported event;
    (10) The name, title, address, telephone number, and signature of 
the person who prepared the report.



Sec. 804.30  Annual certification.

    (a) All distributors required to report under this section shall 
submit an annual certification report to FDA, on FDA Form 3381, or 
electronic equivalent as approved under Sec. 803.14 of this chapter. The 
date for submission of certification coincides with the date for the 
firm's annual registration, as designated in Sec. 807.21 of this 
chapter. The certification period will be the 12-month period ending 1 
month before the certification date, except that the first certification 
period shall cover at least a 6-month period from the effective date of 
this section, ending 1 month before the certification date.
    (b) The distributor shall designate, as the certifying official, an 
individual with oversight responsibilities for, and knowledge of, the 
firm's MDR reporting system. A distributor may determine, based upon its 
organizational structure, that one individual cannot oversee or have 
complete knowledge of the operation of the reporting system at all 
organizational components or distribution sites owned by the firm. In 
this circumstance, the firm may designate more than one certifying 
official (one for each component or site), each of whom will sign a 
certification statement pertaining to their respective identified 
organizational component(s) or site(s), provided that all organizational 
components and sites are covered under a certification statement.
    (c) The report shall contain the following information:
    (1) Name, address, and FDA registration number or FDA assigned 
identification number of the firm;

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    (2) Name, title, address, telephone number, signature, and date of 
signature of the person making the certification;
    (3) Name, address, and FDA registration number or FDA assigned 
identification number for the distributor covered by the certification, 
and the number of reports submitted for devices distributed by the 
distributor;
    (4) A statement certifying that:
    (i) The individual certifying for the firm has read the MDR 
requirements under part 804;
    (ii) The firm has established a system to implement MDR reporting;
    (iii) Following the procedures of its MDR reporting system, the firm 
submitted the specified number of reports, or no reports, during the 
certification period; and
    (iv) The certification is made to the best of the certifying 
official's knowledge and belief.

[62 FR 13306, Mar. 20, 1997]



Sec. 804.31  Additional requirements.

    Requests for additional information. If FDA determines that the 
protection of the public health requires information in addition to that 
included in the medical device reports submitted to FDA under this part, 
the distributor shall, upon FDA's request, submit such additional 
information. Any request by FDA under this section shall state the 
reason or purpose for which the information is being requested, and 
specify a due date for the submission of such information.



Sec. 804.32  Supplemental information.

    (a) Only one MDR is required under this part if the distributor 
becomes aware, from more than one source, of information concerning the 
same patient and the same event.
    (b) An MDR that would otherwise be required under this section is 
not required by the distributor if:
    (1) The distributor determines that the information received is 
erroneous in that a death, serious injury, serious illness, or the 
malfunction did not occur; or
    (2) The distributor determines that the information received is 
erroneous in that the device that is the subject of the information was 
distributed by another distributor. A distributor shall forward to FDA 
any report that is erroneously sent to the distributor, with a cover 
letter explaining that the product in question is not distributed by 
that firm.
    (c) A report or information submitted by a distributor under this 
part (and any release by FDA of that report or information) does not 
necessarily reflect a conclusion by the party submitting the report or 
by FDA that the report or information constitutes an admission that the 
device, the establishment submitting the report, or employees thereof, 
caused or contributed to a death, serious injury, serious illness, or 
malfunction. A distributor need not admit, and may deny, that the report 
or information submitted under this part constitutes an admission that 
the device, the party submitting the report, or employees thereof, 
caused or contributed to a death or serious injury, serious illness, or 
malfunction.



Sec. 804.33  Alternative reporting requirements.

    (a) Distributors may request exemptions from any or all of the 
reporting requirements in this part. These requests are required to be 
in writing and to include both the information necessary to identify the 
firm and device and an explanation why the request is justified.
    (b) FDA may grant a distributor, in writing, an exemption from any 
or all of the reporting requirements in this part and may change the 
frequency of reporting to quarterly, semiannually, annually, or other 
appropriate time periods. In granting such exemptions, FDA may impose 
other reporting requirements to ensure the protection of public health 
and safety. FDA may also authorize the use of alternative reporting 
media such as magnetic tape or disk, in lieu of FDA forms.
    (c) FDA may revoke alternative reporting options, in writing, if FDA 
determines that protection of the public health justifies a return to 
the requirements as stated in this part.



Sec. 804.34  Written MDR procedures.

    Device distributors shall maintain and implement written MDR 
procedures in the following areas:

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    (a) Training and education programs informing employees about 
obligations under this section, including how to identify and report MDR 
reportable events;
    (b) Internal systems that provide for timely and effective 
identification, communication, and evaluation of events that may be 
subject to MDR requirements, a standardized review process/procedure for 
determining when an event meets the criteria for reporting under this 
part, and timely transmission of complete MDR's to FDA and/or 
manufacturers; and
    (c) Documentation and recordkeeping requirements for:
    (1) Information that may be the subject of an MDR;
    (2) All MDR's and information submitted to FDA and manufacturers;
    (3) Information that facilitates the submission of certification 
reports; and
    (4) Systems that ensure access to information that facilitates 
timely followup and inspection by FDA.



Sec. 804.35  Files.

    (a) A device distributor shall establish a device complaint file in 
accordance with Sec. 820.198 of this chapter and maintain a record of 
any information, including any written or oral communication, received 
by the distributor concerning all events that were considered for 
possible reporting under this part. Device incident records shall be 
prominently identified as such and shall be filed by device. The file 
shall also contain a copy of any MDR along with any additional 
information submitted to FDA under this part. A distributor shall 
maintain records that document the submission of copies of MDR's to 
manufacturers.
    (b) A device distributor shall retain copies of the records required 
to be maintained under this section for a period of 2 years from the 
date that the report or additional information is submitted to FDA under 
Sec. 804.25, or for a period of time equivalent to the design and 
expected life of the device, whichever is greater, even if the 
distributor has ceased to distribute the device that is the subject of 
the report or the additional information.
    (c) A device distributor shall maintain the device complaint files 
established under this section at the distributor's principal business 
establishment. A distributor that is also a manufacturer may maintain 
the file at the same location as the manufacturer maintains its 
complaint file under Secs. 820.180 and 820.198 of this chapter. A device 
distributor shall permit any authorized FDA employee, during all 
reasonable times, to have access to, and to copy and verify, the records 
required by this part.