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Guidance on Medical Device Patient Labeling: Final Guidance for Industry and FDA Staff

FinalCenter for Devices and Radiological Health04/19/2001
safe and effective useHuman FactorsQuality Control Checks

Description

(2) to assist Center reviewers in their review and evaluation of medical device patient labeling to help make it understandable to and usable by patients (or family members or other lay persons caring for patients).

Key Topics

Terms and concepts identified from this document

Scope & Applicability

Product Classes

8
therapeutic devices

This labeling may pertain to therapeutic, restorative, diagnostic, or cosmetic devices.

non-prescription drugs

Referenced in studies regarding warning labels

home medical equipment

Example of an acronym (HME) that should be defined.

Prescription devices

bone plates, screws, and washers categorized as prescription devices

Home Infusion Pump

Example of a primary device used by patients.

diagnostic devices

The use of phantoms may also be appropriate for the assessment of certain diagnostic devices

implants

Devices that would have patient labeling consisting primarily of risk/benefit information.

Medical Device

FDA intends to assess device cybersecurity based on a number of factors; demonstrate or maintain its safety and effectiveness; ensuring cybersecurity has become essential to FDA’s ability to protect the public health; Cyber-resiliency capabilities for medical devices

Stakeholders

10
Lay User

Intended user population for emergency use auto-injectors

lay users

intended users in an over-the-counter use scenario

health care practitioners

target audience for prescribing information

visually impaired users

For elderly or visually impaired users, use at least 14 points.

elderly

For elderly or visually impaired users, use at least 14 points.

Health Care Professional

Intended users such as nurses in a nonemergency setting

Biomedical Engineer

A professional who may perform complex maintenance.

manufacturer

Entity required to conduct postmarket surveillance; entity responsible for submitting postmarket surveillance plans; Entity holding the approved PMA, HDE, or cleared 510(k); The entity responsible for conducting postmarket surveillance and submitting reports.; Entity that can use the checklist as a reference for submissions.

Center reviewers

to assist Center reviewers in their review and evaluation

patient

individual receiving expanded access treatment; The individual receiving the investigational treatment and providing consent.

Regulatory Context

Regulatory Activities

1
Premarket Notification

A medical device submission type (510(k)).

Document Types

10
medical device patient labeling

Medical device patient labeling is any information associated with a device targeted to the patient; Supplied in many formats, for example, as patient brochures, patient leaflets, user manuals, and videotapes.; The primary document being discussed for lay users.; The primary document being discussed for patient use.; The document provides principles for clear, concise writing in medical device patient labeling.; Don't promote the product in the medical device patient labeling.; The primary docum

owners manual

Document containing warnings and instructions

Device Labeling Guidance

CDRH General Program Memorandum #G91-1

A Plain English Handbook

SEC handbook for creating clear disclosure documents

Draft Report on Medical Device Labeling

A qualitative research report on labeling needs

Write It Right

HHS Publication FDA 93-4258; 1993; HHS Publication FDA 93-4258 regarding labeling

Warranty

Additional Information includes warranty

instruction manuals

Specific type of documentation where tables and graphs are normally not appropriate.

instruction manual

Read the instruction manual before using this device.

summary page

Include a summary page with critical information for lengthy labeling.

Attributes

10
indications for use

FDA believes that modifications included in a PCCP should also maintain the device within the device's indications for use.

hazard perception

User's understanding of risk based on labeling

font size

Characteristic affecting the likelihood of reading warnings

Readability

Content recommendation for patient labeling

clinical significance

Determines the order of topics in the counseling section.

signal word

Terms like WARNING or CAUTION used to alert the reader.

ragged right margins

Recommended formatting for ease of reading.

white space

Used to keep labeling from looking too cramped or spread out.

Arabic numbers

Number each step in Arabic numbers such as 1, 2, 3.

serif font

Use a serif font for the text.

Technical Details

Substances

1
mercury

Mercury is toxic.

Testing Methods

10
Pretesting

Appendix F Pretesting; Systematically gather target audience reactions through focus groups.; systematic gathering of target audience reactions before final issuance; The medical device patient labeling adheres to the guidance recommended for pretesting; Developing and testing materials before finalization

Cloze Procedure

Cloze Procedure: a new tool for measuring readability

SMOG grading

SMOG grading - a new readability formula

self-administered questionnaires

method of pretesting labeling

focus group interviews

method of pretesting labeling involving 8 to 10 people

individual in-depth interviews

method of pretesting labeling

readability indexes

tools that predict but do not measure actual comprehension

Qualitative analysis

Assessment of jargon, organization, and style to enhance comprehension.

Readability formulas

Quantitative tools used to predict the reading level of text.; The place of readability formulas in technical communication; Methods used to evaluate the complexity of printed materials

Calibration

Procedures specify the steps for establishing calibration intervals

Processes

4
Surgical Procedure

Labeling should describe steps for implantation

resterilization

Example of a process that might cause damage if not handled with precaution.

Disinfecting

Intended use of soft contact lens care products

Checkout Procedures

Procedures required for safety and effectiveness such as calibration.; Operating Information includes checkout procedures

Clinical Concepts

7
contraindications

Information required in labeling for medical products

allergic reaction

Example of a nature of hazard statement.

adverse reactions

The most common side effects which may occur with PROPRIETARY NAME include: <list adverse reactions here>.

Osteoporosis

result of inadequate consumption of calcium and vitamin D; Adverse health effect from inadequate nutrient intake.

adverse events

Safety events that must be tracked for different updates

Hypersensitivity

Included in the definition of immunotoxicity

Adverse Event

Reactions or events observed in patients; Information described in an ICSR; Information associated with the use of biopharmaceuticals; Clinical information corrected during an amendment; Section D describes the singular subject who experienced one or several adverse events/reactions.; Reactions or events observed in patients or foetuses; The onset of a reaction/event following drug administration.; Reporting of reactions to suspect drugs; Reaction or event reported by the primary source; Reactio

Identified Hazards

Hazards

10
risks

balanced presentation of adverse events and the risks and benefits of the device; Labeling informs patients about proper use, risks, and benefits.; Risks and benefits

Product Safety

General safety concerns addressed by ANSI standards

hazard identification

one of the four elements of an effective hazard alert

hazard avoidance

one of the four elements of an effective hazard alert

minor or moderate injury

The severity level associated with a precaution.

death or serious injury

The severity level associated with a warning.

mercury spill

call the local authorities for help with the mercury spill

rust

Dampness may affect the device and cause rust.

Device Failure

Technical reason for PRO non-completion.

Foreseeable Hazards

List known and reasonably foreseeable hazards in the labeling.

Standards & References

External Standards

1
ANSI Z535.4-1998

Standard cited for the definitions of warnings and precautions.; American National Standard for Product Safety Signs and Labels

Related CFR Sections (1)

  • 21CFR801.109§ 801.109 Prescription devices.

    A device which, because of any potentiality for harmful effect, or the method of its use, or the collateral measures necessary to its use is not safe except under the supervision of a practitioner licensed by law to direct the use of such device, and hence for which “adequate directions for use” canRead full regulation →

Related MFDS Guidelines

Korean regulatory guidelines covering similar topics

See Also (8)