Medical Devices; Hematology and Pathology Devices; Reclassification from Class III to Class II of Automated Blood Cell Separator Device Operating by Centrifugal Separation Principle, 11887-11893 [05-4758]
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Federal Register / Vol. 70, No. 46 / Thursday, March 10, 2005 / Proposed Rules
SUPPLEMENTARY INFORMATION:
Comments Invited
Interested parties are invited to
participate in this proposed rulemaking
by submitting such written data, views,
or arguments as they may desire.
Comments that provide the factual basis
supporting the views and suggestions
presented are particularly helpful in
developing reasoned regulatory
decisions on the proposal. Comments
are specifically invited on the overall
regulatory, aeronautical, economic,
environmental, and energy-related
aspects of the proposal.
Communications should identify both
docket numbers and be submitted in
triplicate to the address listed above.
Commenters wishing the FAA to
acknowledge receipt of their comments
on this document must submit with
those comments a self-addressed,
stamped postcard on which the
following statement is made:
‘‘Comments to Docket No. FAA–2005–
20055/Airspace Docket No. 05–AGL–
01.’’ The postcard will be date/time
stamped and returned to the
commenter. All communications
received on or before the specified
closing date for comments will be
considered before taking action on the
proposed rule. The proposal contained
in this action may be changed in light
of comments received. All comments
submitted will be available for
examination in the Rules Docket, FAA,
Great Lakes Region, Office of the
Regional Counsel, 2300 East Devon
Avenue, Des Plaines, Illinois, both
before and after the closing date for
comments. A report summarizing each
substantive public contact with FAA
personnel concerned with this
rulemaking will be filed in the docket.
Availability of NPRM’s
An electronic copy of this document
may be downloaded through the
Internet at https://dms.dot.gov. Recently
published rulemaking documents can
also be accessed through the FAA’s Web
page at https://www.faa.gov or the
Superintendent of Document’s Web
page at https://www.access.gpo.gov/nara.
Additionally, any person may obtain
a copy of this notice by submitting a
request to the Federal Aviation
Administration, Office of Air Traffic
Airspace Management, ATA–400, 800
Independence Avenue, SW.,
Washington, DC 20591, or by calling
(202) 267–8783. Communications must
identify both docket numbers for this
notice. Persons interested in being
placed on a mailing list for future
NPRM’s should contact the FAA’s
Office of Rulemaking, (202) 267–9677,
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to request a copy of Advisory Circular
No. 11–2A, Notice of Proposed
Rulemaking Distribution System, which
describes the application procedure.
The Proposal
The FAA is considering an
amendment to 14 CFR part 71 to modify
Class E airspace at Muskegon, MI, for
Grand Haven Memorial Airpark.
Controlled airspace extending upward
from 700 feet or more above the surface
of the earth is needed to contain aircraft
executing instrument approach
procedures. The area would be depicted
on appropriate aeronautical charts.
Class E airspace areas extending upward
from 700 feet or more above the surface
of the earth are published in paragraph
6005 of FAA Order 7400.9M dated
August 30, 2004, and effective
September 16, 2004, which is
incorporated by reference in 14 CFR
71.1. The Class E designations listed in
this document would be published
subsequently in the Order.
The FAA has determined that this
proposed regulation only involves an
establishment body of technical
regulations for which frequent and
routine amendments are necessary to
keep them operationally current.
Therefore this, proposed regulation—(1)
Is not a ‘‘significant regulatory action’’
under Executive Order 12866; (2) is not
a ‘‘significant rule’’ under DOT
Regulatory Policies and Procedures (44
FR 11034; February 26, 1979); and (3)
does not warrant preparation of a
Regulatory Evaluation as the anticipated
impact is so minimal. Since this is a
routine matter that will only affect air
traffic procedures and air navigation, it
is certified that this proposed rule will
not have a significant economic impact
on a substantial number of small entities
under the criteria of the Regulatory
Flexibility Act.
List of Subjects in 14 CFR Part 71
Airspace, Incorporation by reference,
Navigation (air).
The Proposed Amendment
Accordingly, pursuant to the
authority delegated to me, the Federal
Aviation Administration proposes to
amend 14 CFR part 71 as follows:
PART 71—DESIGNATION OF CLASS A,
CLASS B, CLASS C, CLASS D, AND
CLASS E AIRSPACE AREAS;
AIRWAYS; ROUTES; AND REPORTING
POINTS
1. The authority citation for part 71
continues to read as follows:
Authority: 49 U.S.C. 106(g), 40103, 40113,
40120; E.O. 10854, 24 FR 9565, 3 CFR, 1959–
1963 Comp., p. 389.
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§ 71.1
[Amended]
2. The incorporation by reference in
14 CFR 71.1 of the Federal Aviation
Administration Order 7400.9M,
Airspace Designations and Reporting
Points, dated August 30, 2004, and
effective September 16, 2004, is
amended as follows:
*
*
*
*
*
Paragraph 6005 Class E airspace areas
extending upward from 700 feet or more
above the surface of the earth.
*
*
*
*
*
AGL MI E5 Muskegon, MI [Revised]
Muskegon County Airport, MI
(Lat. 43°10′10″ N., long., 86°14′18″ W.)
Grand Haven Memorial Airpark, MI
(Lat. 43°02′03″ N., long., 86°11′53″ W.)
Muskegon VORTAC
(Lat. 43°10′09″ N., long., 86°02′22″ W.)
That airspace extending upward from 700
feet above the surface within a 6.8-mile
radius of the Muskegon County Airport, and
within 2.6 miles each side of the ILS localizer
southeast course extending from the 6.8-mile
radius to 10.8 miles southeast of the airport,
and within 2.4 miles each side of the
localizer northwest course extending from
the 6.8-mile radius to 12.1 miles northwest
of the airport, and within 2.8 miles each side
of the Muskegon VORTAC 266° radial
extending from the 6.8-mile radius to 12.7
miles west of the airport, and within 1.3
miles each side of the Muskegon VORTAC
271° radial extending from the VORTAC to
the 6.8-mile radius of the airport and within
a 6.4-mile radius of the Grand Haven
Memorial Airpark.
*
*
*
*
*
Issued in Des Plaines, Illinois, on February
18, 2005.
Nancy B. Kort,
Area Director, Central Terminal Operations.
[FR Doc. 05–4655 Filed 3–9–05; 8:45 am]
BILLING CODE 4910–13–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
21 CFR Part 864
[Docket No. 2005N–0017]
Medical Devices; Hematology and
Pathology Devices; Reclassification
from Class III to Class II of Automated
Blood Cell Separator Device Operating
by Centrifugal Separation Principle
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Proposed rule.
SUMMARY: The Food and Drug
Administration (FDA) is proposing to
reclassify from class III to class II
(special controls) the automated blood
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cell separator device operating on a
centrifugal separation principle and
intended for the routine collection of
blood and blood components. This
proposed rule would also modify the
special control for the device with the
same intended use but operating on a
filtration separation principle. The
reclassification is being proposed on
FDA’s own initiative under procedures
set forth in FDA regulations and based
on information provided to FDA. This
action is being taken under the Federal
Food, Drug, and Cosmetic Act (the act),
as amended by the Medical Device
Amendments of 1976 (the 1976
amendments), the Safe Medical Devices
Act of 1990 (the SMDA), and the Food
and Drug Administration Modernization
Act of 1997 (FDAMA). The agency
proposes this reclassification because
special controls, in addition to general
controls, are capable of providing
reasonable assurance of the safety and
effectiveness of the device. Elsewhere in
this issue of the Federal Register, FDA
is publishing a notice of availability of
a draft guidance document entitled
‘‘Class II Special Controls Guidance
Document: Automated Blood Cell
Separator Device Operating by
Centrifugal or Filtration Separation
Principle,’’ which will serve as the
special control if this proposal becomes
final.
DATES: Submit written or electronic
comments by June 8, 2005. See section
XVI of this document for the proposed
effective date of a final rule based on
this document.
ADDRESSES: You may submit comments,
identified by Docket No. 2005N–0017,
by any of the following methods:
• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
• Agency Web site: https://
www.fda.gov/dockets/ecomments.
Follow the instructions for submitting
comments on the agency Web site.
• E-mail: fdadockets@oc.fda.gov.
Include Docket No. 2005N–0017 in the
subject line of your e-mail message.
• FAX: 301–827–6870.
• Mail/Hand delivery/Courier [For
paper, disk, or CD–ROM submissions]:
Division of Dockets Management, 5630
Fishers Lane, rm. 1061, Rockville, MD
20852.
Instructions: All submissions received
must include the agency name and
Docket No. or Regulatory Information
Number (RIN) for this rulemaking. All
comments received will be posted
without change to https://www.fda.gov/
ohrms/dockets/default.htm, including
any personal information provided. For
detailed instructions on submitting
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comments and additional information
on the rulemaking process, see the
Comments heading of the
SUPPLEMENTARY INFORMATION section of
this document.
Docket: For access to the docket to
read background documents or
comments received, go to https://
www.fda.gov/ohrms/dockets/
default.htm and insert the docket
number, found in brackets in the
heading of this document, into the
‘‘Search’’ box and follow the prompts
and/or go to the Division of Dockets
Management, 5630 Fishers Lane, rm.
1061, Rockville, MD 20852.
FOR FURTHER INFORMATION CONTACT:
Kathleen E. Swisher, Center for
Biologics Evaluation and Research
(HFM–17), Food and Drug
Administration, suite 200N, 1401
Rockville Pike, Rockville, MD 20852–
1448, 301–827–6210.
SUPPLEMENTARY INFORMATION:
I. Background (Regulatory Authorities)
The act (21 U.S.C. 301 et seq.), as
amended by the 1976 amendments
(Public Law 94–295), the SMDA (Public
Law 101–629), and FDAMA (Public Law
105–115), established a comprehensive
system for the regulation of medical
devices intended for human use.
Section 513 of the act (21 U.S.C. 360c)
established three categories (classes) of
devices, depending on the regulatory
controls needed to provide reasonable
assurance of their safety and
effectiveness. The three categories of
devices are class I (general controls),
class II (special controls), and class III
(premarket approval).
Under the 1976 amendments, class II
devices were defined as those devices
for which there is insufficient
information to show that general
controls themselves will assure safety
and effectiveness, but for which there is
sufficient information to establish
‘‘performance standards’’ to provide
such assurance. The SMDA revised the
definition of class II devices to include
those devices for which there is
insufficient information to show that
general controls themselves will assure
safety and effectiveness, but for which
there is sufficient information to
establish special controls to provide
such assurance. Special controls may
include performance standards,
postmarket surveillance, patient
registries, development and
dissemination of guidelines,
recommendations, and any other
appropriate actions the agency deems
necessary (section 513(a)(1)(B) of the
act). The SMDA also directs FDA to
revise the classification of such
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preamendments class III devices into
class I or class II or require the device
to remain in class III; and directs FDA
to issue a schedule for section 515(b) of
the act (21 U.S.C. 360e(b)) rulemaking
within 12 months of publication of a
regulation retaining a device in class III.
However, the SMDA does not prevent
FDA from proceeding immediately to
section 515(b) rulemaking on specific
devices, in the interest of public health,
independent of the 515(i) process.
Under section 513 of the act, devices
that were in commercial distribution
before May 28, 1976 (the date of
enactment of the 1976 amendments),
generally referred to as preamendments
devices, are classified after FDA has: (1)
Received a recommendation from a
device classification panel (an FDA
advisory committee); (2) published the
panel’s recommendation for comment,
along with a proposed regulation
classifying the device; and (3) published
a final regulation classifying the device.
FDA has classified most
preamendments devices under these
procedures.
Devices that were not in commercial
distribution before May 28, 1976,
generally referred to as postamendments
devices, are classified automatically by
statute (section 513(f) of the act) into
class III without any FDA rulemaking
process. Those devices remain in class
III and require premarket approval,
unless and until: (1) The device is
reclassified into class I or II; (2) FDA
issues an order classifying the device
into class I or II in accordance with
section 513(f)(2) of the act, as amended
by FDAMA; or (3) FDA issues an order
finding the device to be substantially
equivalent, under section 513(i) of the
act, to a predicate device that does not
require premarket approval. The agency
determines whether new devices are
substantially equivalent to previously
offered devices by means of premarket
notification procedures in section 510(k)
of the act and 21 CFR part 807 of the
regulations.
A preamendments device that has
been classified into class III may be
marketed, by means of premarket
notification procedures, without
submission of a premarket approval
application (PMA) until FDA issues a
final regulation under section 515(b) of
the act requiring premarket approval.
Reclassification of classified
preamendments devices is governed by
section 513(e) of the act. Section 513(e)
of the act provides that FDA may, by
rulemaking, reclassify a device (in a
proceeding that parallels the initial
classification proceeding) based upon
‘‘new information.’’ The reclassification
can be initiated by FDA or by the
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petition of an interested person. The
term ‘‘new information,’’ as used in
section 513(e) of the act, includes
information developed as a result of a
reevaluation of the data before the
agency when the device was originally
classified, as well as information not
presented, not available, or not
developed at that time. (See, e.g.,
Holland Rantos v. United States
Department of Health, Education, and
Welfare, 587 F.2d 1173, 1174 n.1 (D.C.
Cir. 1978); Upjohn v. Finch, 422 F.2d
944 (6th Cir. 1970); Bell v. Goddard, 366
F.2d 177 (7th Cir. 1966).)
Reevaluation of the data previously
before the agency is an appropriate basis
for subsequent regulatory action where
the reevaluation is made in light of
newly available regulatory authority
(see Bell v. Goddard, supra, 366 F.2d at
181; Ethicon, Inc. v. FDA, 762 F.Supp.
382, 389–91 (D.D.C. 1991)), or in light
of changes in ‘‘medical science.’’ (See
Upjohn v. Finch, supra, 422 F.2d at
951.) Regardless of whether data before
the agency are past or new data, the
‘‘new information’’ upon which
reclassification under section 513(e) of
the act is based must consist of ‘‘valid
scientific evidence,’’ as defined in
section 513(a)(3) of the act and 21 CFR
860.7(c)(2). (See, e.g., General Medical
Co. v. FDA, 770 F.2d 214 (D.C. Cir.
1985); Contact Lens Assoc. v. FDA, 766
F.2d 592 (D.C. Cir.), cert. denied, 474
U.S. 1062 (1985)). FDA relies upon
‘‘valid scientific evidence’’ in the
classification process to determine the
level of regulation for devices. For the
purpose of reclassification, the valid
scientific evidence upon which the
agency relies must be publicly available.
Publicly available information excludes
trade secret and/or confidential
commercial information, e.g., the
contents of a pending PMA. (See section
520(c) of the act (21 U.S.C. 360j(c).)
II. Regulatory History of the Device
The automated blood cell separator
device operating by centrifugal
separation principle intended for the
routine collection of blood and blood
components is a preamendments device
classified into class III. The 1976
amendments did not immediately
subject preamendments devices
classified in class III to the premarket
approval process. The act requires FDA
to publish 515(b) regulations directing
the submission of premarket approval
applications for preamendments class III
devices. The 515(b) process involves the
publication of two Federal Register
notices, the proposed rule and the final
rule. The 515(b) proposed rule
announces FDA’s intention to call for
PMAs, lists the issues to be addressed
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in PMA submissions, states a deadline
for the receipt of comments, and affords
an opportunity to request
reclassification. The final rule addresses
any comments received, repeats the
issues to be addressed in PMA
submissions, and sets a deadline for the
submission of premarket approval
applications or investigational device
exemptions of not more than 90 days
after the date of publication.
In the Federal Register of September
11, 1979 (44 FR 53050), FDA issued a
proposed rule to classify into class III
the automated blood cell separator
device intended for routine collection of
blood and blood components. The
preamble to the proposed rule to
classify the device included the
recommendation of an FDA advisory
committee, The Hematology Device
Classification Panel, regarding the
classification of the device.
In the Federal Register of September
12, 1980 (45 FR 60643), FDA issued a
final rule (§ 864.9245 (21 CFR
864.9245)) classifying into class III the
automated blood cell separator
operating either on a centrifugal or
filtration separation principle intended
for routine collection of blood and blood
components.
A. Centrifugal Separation Principle
In the Federal Register of February
19, 1988 (53 FR 5108),1 FDA published
a proposed rule to require the filing of
a PMA or a notice of completion of a
product development protocol (PDP) for
the automated blood cell separator
device based on a centrifugal separation
principle and intended for the routine
collection of blood and blood
components. The February 1988
proposed rule summarized the risks and
benefits associated with the use of the
automated blood cell separator. FDA
also announced an opportunity for
interested persons to request a change in
the classification of the device based on
new information.
In the Federal Register of May 16,
1988 (53 FR 17227), FDA extended the
comment period of the proposed rule
from 60 days to 90 days in response to
a letter from a medical trade association
requesting additional time to submit
comments. In response to the February
1988 proposed rule, the agency received
17 letters of comment. New information
in the form of scientific evidence was
submitted with several of the comments
1 In the Federal Register of April 22, 2003 (68 FR
19766), FDA issued a withdrawal of certain
proposed rules and other proposed actions; notice
of intent to withdraw Hematology and Pathology
Devices; Premarket Approval of the Automated
Blood Cell Separator Intended for Routine
Collection of Blood and Blood Components.
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to FDA on the automated blood cell
separator operating on the centrifugal
separation principle. The majority of the
letters of comment indicated there is
sufficient evidence to provide
reasonable assurance of the safety and
effectiveness of the automated blood
cell separator operating on the
centrifugal separation principle, and
supported reclassifying the device into
class II when intended only for routine
collection of blood and blood
components. Many of the comment
letters provided scientific information
and references in support of the
reclassification. FDA has evaluated the
information submitted and decided that
there is valid scientific evidence
supporting a change in classification of
the centrifugal-based automated blood
cell separator with the intended use of
routine collection of blood and blood
components from class III, requiring
premarket approval, to class II, requiring
special controls.
Consistent with the act and
regulation, FDA referred the proposed
reclassification to a panel for its
recommendation on the requested
change in classification. FDA
announced in the Federal Register of
April 18, 1989 (54 FR 15558), that the
agency would consult with the Blood
Products Advisory Committee (BPAC)
in an open meeting on May 11, 1989
(Ref. 1), regarding the reclassification of
the automated blood cell separator
operating on a centrifugal separation
principle. BPAC acts in the capacity of
a device classification panel for such
matters as new information regarding a
device and its classification. FDA
requested that BPAC consider the new
information and provide its
recommendation as to whether BPAC
agreed that the new information was
substantial and supported
reclassification. The recommendation of
BPAC is further discussed in section IV
of this document.
In accordance with section 513(e) of
the act and § 860.130(b)(1) (21 CFR
860.130(b)(1)), based on new
information with respect to the device,
FDA, on its own initiative, is proposing
to reclassify the centrifugal-based
automated blood cell separator device
from class III to class II (special
controls) when the intended use of the
device is for the routine collection of
blood and blood components. For all
other uses, including therapeutic
apheresis, the device remains in its
current classification as class III. All
therapeutic apheresis (blood cell
separator) devices are regulated by
FDA’s Center for Devices and
Radiological Health and are not part of
§ 864.9245.
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B. Filtration Separation Principle
The automated blood cell separator
device operating on a filtration
separation principle and intended for
the routine collection of blood and
blood components is a postamendments
device originally classified into class III
under section 513(f)(1) of the act. On
June 17, 1996, the Baxter Healthcare
Corp. submitted to FDA a petition
requesting reclassification from class III
to class II of its AUTOPHERESIS–C
SYSTEM device. The petition contained
information in the form of scientific
evidence to provide reasonable
assurance of the safety and effectiveness
of the filtration-based AUTOPHERESIS–
C SYSTEM device. Consistent with
section 513(f)(3) of the act and 21 CFR
860.134, FDA referred the petition to the
BPAC medical devices panel for its
recommendation on the requested
change in classification. At a public
meeting held on September 27, 1996,
BPAC unanimously recommended that
the AUTOPHERESIS–C SYSTEM and
subsequent membrane-based blood cell
separators substantially equivalent to
this device, intended for routine
collection of blood and blood
components, be reclassified from class
III to class II. The panel believed that
class II with the special controls of a
periodic report filed annually for a
minimum of 3 years with emphasis on
adverse reactions would provide
reasonable assurance of the safety and
effectiveness of the device.
FDA published a notice of BPAC’s
recommendation in the Federal Register
of May 29, 2001 (66 FR 29149). In this
notice, FDA issued its tentative findings
on BPAC’s recommendation and
requested from the public comments on
BPAC’s recommendation. The comment
period closed August 13, 2001. After
receiving no comments on BPAC’s
recommendation for reclassification or
our tentative findings on BPAC’s
recommendation, FDA approved the
reclassification petition by order in the
form of a letter to the petitioner.
In the Federal Register of February
28, 2003 (68 FR 9530), FDA published
a final rule announcing the decision to
reclassify from class III to class II the
filtration-based automated blood cell
separator device intended for routine
collection of blood and blood
components (the February 2003 final
rule). In addition to general controls of
the act, the February 2003 final rule also
provided for special controls applicable
to the filtration-based devices in order
to provide reasonable assurance of the
safety and effectiveness of the device.
In this rule, we are proposing to
change the special control listed in the
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February 2003 final rule for the
filtration-based device. We propose the
special control to be a draft guidance
entitled ‘‘Class II Special Controls
Guidance Document: Automated Blood
Cell Separator Device Operating by
Centrifugal or Filtration Separation
Principle.’’ This draft guidance, if
finalized, will provide the special
controls for both filtration- and
centrifugal-based automated blood cell
separator devices intended for the
routine collection of blood and blood
components.
III. Device Description
Current § 864.9245 provides a brief
description of the automated blood cell
separator device operating on either a
centrifugal separation principle or a
filtration separation principle. The
current section describes the automated
blood cell separator as a device that
automatically withdraws whole blood
from a donor, separates the blood into
components (red blood cells, white
blood cells, plasma, and platelets),
retains one or more of the components,
and returns the remainder of the blood
to the donor. The components obtained
are transfused or used for further
manufacturing to prepare blood
products for administration. The
separation bowls of centrifugal blood
cell separators may be reusable or
disposable.
The current section classifies the
centrifugal-based automated blood cell
separator into class III (premarket
approval). This proposed rule
reclassification from class III to class II
(special controls) applies to the
automated blood cell separator device
that operates by centrifugal separation
principle and is intended for the routine
collection of blood and blood
components for transfusion or further
manufacturing use. The proposed rule
removes in the identification of the
automated blood cell separator the
words that were in parentheses—red
blood cells, white blood cells, plasma,
and platelets.
IV. Recommendation of the Panel
At a public meeting held on May 11,
1989, the BPAC panel considered the
new information presented in the letters
of comment and unanimously
recommended that the centrifugal-based
automated blood cell separator be
reclassified from class III (premarket
approval) to class II (performance
standards; now included in special
controls). The panel believed that class
II with performance standards (now
included in special controls) would
provide reasonable assurance of the
safety and effectiveness of the
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automated blood cell separator and that
there is sufficient information publicly
available to establish a performance
standard (special control) to assure
safety and effectiveness of the device.
We believe another device
classification panel recommendation is
not necessary since, prior to the SMDA,
a panel recommended classification into
class II. If a panel recommended that a
device be reclassified from class III into
class II under the 1976 definition of
class II, which included only
performance standards as a class II
control, then the panel’s
recommendation for class II status
would not change if special controls are
required that would include
performance standards, among other
controls. Under the SMDA, FDA may
establish special controls, including
performance standards, postmarket
surveillance, patient registries,
guidelines, and other appropriate
actions it believes necessary to provide
reasonable assurance of the safety and
effectiveness of the device.
V. Summary of Reasons for
Recommendation (Reclassification)
The panel believes that the
centrifugal-based automated blood cell
separator device should be reclassified
into class II because performance
standards (special controls), in addition
to general controls, provide reasonable
assurance of the safety and effectiveness
of the device, and there is sufficient
information to establish special controls
to provide such assurance.
VI. Risks to Health
In the February 1988 proposed rule,
FDA outlined its proposed findings
regarding potential risks associated with
the automated blood cell separator
intended for routine collection of blood
and blood components. FDA’s proposed
findings showed the following: A major
risk to health of donors is that the
process of removing blood, handling the
blood outside the body, and returning
the blood to the donor’s circulatory
system could injure the cellular
components of the blood and activate
the body’s complement system (a series
of enzymatic proteins capable, when
activated, of destroying intact cells).
Another potential donor reaction is
fever, due to a breakdown of
granulocytes (leukocytes containing
granules) during the pump cycle of the
automated blood cell separator.
Also, if the automated blood cell
separator fails to perform satisfactorily,
the donor may have one or more of the
following adverse reactions: (1) Shock
resulting from blood loss; (2) toxic
reaction to high levels of anticoagulants,
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such as citrate, that the automated blood
cell separator adds to the blood as it is
collected and before the blood is
returned to the donor; (3) stress reaction
due to the removal or loss of blood; (4)
thrombosis due to activation of clotting
factors in the blood by surfaces within
the automated blood cell separator; or
(5) sepsis and fever due to bacterial
contamination of the blood returned to
the donor.
Lastly, an unexpected or an
undetected leak in the blood handling
system of the device presents risks of
infections to donors, patients, and
operators of the device. The device
presents a risk of electrical shock or
injury to operators and donors if the
device has an electrical malfunction. If
the automated blood cell separator fails
to perform satisfactorily, the blood or
blood components collected from a
donor may not be suitable for use
because of cellular damage to blood or
blood components during the collection
process. One form of cellular damage is
red blood cell hemolysis (destruction of
the cell membrane accompanied by the
release of hemoglobin).
Public comments received in response
to the proposed rule indicated that the
occurrence of these risks was very low,
referred to ample evidence showing the
safety and effectiveness of the
automated blood cell separator, and
supported reclassification of the device
into class II.
Presently, FDA has identified the
following risks associated with
apheresis blood donation and
processing: (1) The potential loss of
blood due to leaks; (2) thrombosis due
to activation of factors by foreign
surfaces; (3) toxic reaction to citrate
anticoagulant; (4) damage to red blood
cells, activation of complement, and
denaturation of proteins; (5) potential
for sepsis and fever due to bacterial
contamination of the donor’s blood
returned to the donor; (6) infectious
disease risk to the donor or to the
operator due to leaks; (7) electrical
shock hazard; (8) donor stress reaction
due to removal or loss of blood; (9) air
embolism; (10) hemolysis; and (11)
reservoir rupture.
In addition to the potential risks of
the centrifugal-based automated blood
cell separator, there is sufficient
information about the benefits of the
device. Extensive experience with the
device indicates that the centrifugalbased automated blood cell separator is
safe and effective for the intended use
of routine collection of blood and blood
components.
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VII. Summary of Data Upon Which the
Recommendation (Reclassification) is
Based
In response to the February 1988 rule
proposing to place the device in class
III, we received 17 letters of comment
from manufacturers and the blood
banking community (Ref. 1 at 103).
These commenters included such
organizations as the Health Industry
Manufacturers Association and the
American Association of Blood Banks
(Ref. 1 at 104). The comments received
indicated the risk to benefit ratio is low.
In proposing this reclassification, we
considered these industry comments
and the history for over 30 years of safe
use of the centrifugal-based automated
blood cell separator device.
VIII. FDA’s Tentative Findings
FDA believes that the special controls
discussed in section IX of this document
are capable of providing reasonable
assurance of the safety and effectiveness
of the automated blood cell separator
device operating on a centrifugal
separation principle with regard to the
identified risks to health of this device.
Based on FDA’s evaluation of the
additional information received in the
letters of comment, as well as the 1989
BPAC panel recommendation and the
safety record of the device in actual use,
the agency has reconsidered the
February 1988 proposed rule, and
believes that the centrifugal-based
automated blood cell separator device
should be classified into class II (special
controls). FDA, through an agency-wide
action of proposed rule withdrawals
(April 22, 2003, 68 FR 19766),
announced its intention to withdraw the
February 1988 proposed rule. Now, FDA
is proposing to amend the device
regulations by reclassifying from class
III to class II (special controls guidance)
the centrifugal-based automated blood
cell separator device intended for the
routine collection of blood and blood
components. FDA is also changing the
special control for the automated blood
cell separator device using the filtration
separation principle for the routine
collection of blood and blood
components. The same special control
guidance will apply to the filtration and
centrifugal-based devices when these
devices are used for the routine
collection of blood and blood
components.
IX. Special Controls
Based on available information and in
addition to general controls, FDA
believes that the FDA guidance for
industry and FDA staff entitled ‘‘Class II
Special Controls Guidance Document:
PO 00000
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Fmt 4702
Sfmt 4702
11891
Automated Blood Cell Separator Device
Operating by Centrifugal or Filtration
Separation Principle,’’ can provide
reasonable assurance of the safety and
effectiveness of the device. Elsewhere in
this issue of the Federal Register, FDA
is announcing the availability of this
draft guidance document.
For currently marketed products not
approved under the PMA process, the
draft guidance document recommends
that the manufacturer file with FDA for
three consecutive years an annual report
on the anniversary date of the final rule
for reclassification or on the anniversary
date of 510(k) clearance. Any
subsequent change to the device
requiring the submission of a premarket
notification in accordance with section
510(k) of the act should be included in
the annual report. A manufacturer of a
device that is determined to be
substantially equivalent to the
automated blood cell separator device
operating by centrifugal or filtration
separation principles intended for
routine collection of blood and blood
components, also would be required to
comply with the same general and
special controls. The firm would need to
show that its device meets the
recommendations of the guidance or in
some other way provides equivalent
assurances of safety and effectiveness.
The draft guidance document (special
control) recommends that each annual
report include, at a minimum, the
following information:
• A summary of anticipated and
unanticipated donor adverse device
events that have occurred and that are
not required to be reported by
manufacturers under Medical Device
Reporting (MDR).2 We recommend
summarizing and reporting donor
adverse device events such as those
required under § 606.160(b)(1)(iii) (21
CFR 606.160(b)(1)(iii))3,4 to be recorded
and maintained by the facility5 using
2 21 CFR 803.1(a) — ‘‘* * * device user facilities,
importers, and manufacturers, as defined in § 803.3,
must report deaths and serious injuries to which a
device has or may have caused or contributed * *
* .’’
3 Section 606.160(b) — ‘‘Records shall be
maintained that include, but are not limited to, the
following when applicable: * * * (1)(iii) Donor
adverse reaction complaints and reports, including
results of all investigations and followup.’’
4 In a separate proposed rulemaking (Safety
Reporting Requirements for Human Drug and
Biological Products; Proposed Rule (68 FR 12405,
March 14, 2003)), FDA has proposed amending 21
CFR 606.170 to require the investigation and
recording by blood establishments of any complaint
of a serious adverse reaction related to the
collection or transfusion of blood or blood
components.
5 ‘‘Facility’’ means any area used for the
collection, processing, compatibility testing, storage
or distribution of blood and blood components (21
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the device for the routine collection of
blood and blood components. Under 21
CFR 803.50(b)(2), manufacturers are
responsible for conducting an
investigation of each event and
evaluating the cause of the event.
Therefore, this information should be
available to the manufacturer to
summarize and provide to FDA in the
annual report. We emphasize that safety
information submitted to FDA is not to
be considered an admission of causation
or liability (October 27, 1994, 59 FR
54046 at 54051).
• Any subsequent change to the
device requiring the submission of a
premarket notification in accordance
with section 510(k) of the act.6
• Any subsequent change to the
preamendments class III device
requiring a 30-day notice in accordance
with 21 CFR 814.39(f).
The reporting of adverse device
events summarized in an annual report
will alert FDA to trends or clusters of
events that might be a safety issue
otherwise unreported under the MDR
regulation. Adverse reactions
contributed to or caused by an apheresis
blood donation device, such as operator
infection or injury; equipment failures,
including software, hardware, and
disposable item failures; thrombosis;
sepsis; and shock resulting from blood
loss, may be reportable under MDR. The
annual report need not include MDR
reports.
X. References
The following reference has been
placed on display in the Division of
Dockets Management (see ADDRESSES)
and may be seen by interested persons
between 9 a.m. and 4 p.m., Monday
through Friday.
1. Blood Products Advisory
Committee Meeting Transcript, May 11,
1989.
XI. Environmental Impact
The agency has determined under 21
CFR 25.34(b) that this proposed
reclassification action is of a type that
does not individually or cumulatively
have a significant effect on the human
environment. Therefore, neither an
environmental assessment nor an
CFR 606.3(h)). Also, applicable is ‘‘device user
facility’’ under § 803.3(f), meaning ‘‘a hospital,
ambulatory surgical facility, nursing home,
outpatient diagnostic facility, or outpatient
treatment facility * * *.’’ (Note: The donor becomes
a patient when he or she experiences and is treated
for an adverse event contributed to or caused by the
medical device.)
6 For assistance see the guidance document
entitled ‘‘Deciding When to Submit a 510(k) for a
Change to an Existing Device,’’ January 1997, at
https://www.fda.gov/cdrh.
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18:23 Mar 09, 2005
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environmental impact statement is
required.
XII. Federalism
FDA has analyzed this proposed rule
in accordance with the principles set
forth in Executive Order 13132. FDA
has determined that the proposed rule
does not contain policies that have
substantial direct effects on the States,
on the relationship between the
National Government and the States, or
on the distribution of power and
responsibilities among the various
levels of government. Accordingly, the
agency tentatively concludes that the
proposed rule does not contain policies
that have federalism implications as
defined in the Executive order and,
consequently, a federalism summary
impact statement has not been prepared.
XIII. Analysis of Impacts
FDA has examined the impacts of this
proposed rule under Executive Order
12866 and the Regulatory Flexibility Act
(5 U.S.C. 601–612), and the Unfunded
Mandates Reform Act of 1995 (Public
Law 104–4). Executive Order 12866
directs agencies to assess all costs and
benefits of available regulatory
alternatives and, when regulation is
necessary, to select regulatory
approaches that maximize net benefits
(including potential economic,
environmental, public health and safety,
and other advantages; distributive
impacts; and equity). The agency
believes that this proposed rule is
consistent with the regulatory
philosophy and principles identified in
the Executive order. In addition, the
proposed rule is not a significant
regulatory action as defined by the
Executive order and so is not subject to
review under the Executive order.
Under the Regulatory Flexibility Act,
if a rule has a significant economic
impact on a substantial number of small
entities, an agency must consider
alternatives that would minimize the
economic impact of the rule on small
entities. Reclassification of this device
from class III to class II will relieve
manufacturers of the cost of complying
with the premarket approval
requirements of section 515 of the act,
and may permit small potential
competitors to enter the marketplace by
lowering their costs. Although the
proposed rule special control guidance
document recommends that
manufacturers of these devices file with
FDA an annual report for three
consecutive years, this is less
burdensome than the current premarket
approval requirements including the
submission of periodic reports (21 CFR
814.84).
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Fmt 4702
Sfmt 4702
The agency, therefore, certifies that
this proposed rule, if finalized, will not
have a significant economic impact on
a substantial number of small entities,
and no further analysis is required
under the Regulatory Flexibility Act. In
addition, the Unfunded Mandates
Reform Act does not require FDA to
prepare a statement of costs and benefits
for this proposed rule because the
proposed rule will not impose costs of
$100 million or more on State, local,
and tribal governments in the aggregate,
or the private sector, in any one year
(adjusted annually for inflation).
XIV. Paperwork Reduction Act of 1995
FDA tentatively concludes that this
proposed rule contains no collections of
information. Therefore, clearance by the
Office of Management and Budget under
the Paperwork Reduction Act of 1995
(44 U.S.C. 3501–3520) is not required.
XV. Comments
Interested persons may submit to the
Division of Dockets Management (see
ADDRESSES) written or electronic
comments regarding this document.
Submit a single copy of electronic
comments or two paper copies of any
mailed comments, except that
individuals may submit one paper copy.
Comments are to be identified with the
docket number found in brackets in the
heading of this document. Received
comments may be seen in the Division
of Dockets Management between 9 a.m.
and 4 p.m., Monday through Friday.
XVI. Proposed Effective Date
The agency is proposing that any final
rule that may issue based upon this
proposed fule become effective 30 days
after its date of publication in the
Federal Register.
List of Subjects in 21 CFR Part 864
Blood, Medical devices, Packaging
and containers.
Therefore, under the Federal Food,
Drug, and Cosmetic Act and under
authority delegated to the Commissioner
of Food and Drugs, it is proposed that 21
CFR part 864 be amended as follows:
I
PART 864—HEMATOLOGY AND
PATHOLOGY DEVICES
1. The authority citation for 21 CFR
part 864 continues to read as follows:
I
Authority: 21 U.S.C. 351, 360, 360c, 360e,
360j, 371.
2. Section 864.9245 is revised to read
as follows:
I
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§ 864.9245
separator.
Automated blood cell
(a) Identification. An automated blood
cell separator is a device that uses a
centrifugal or filtration separation
principle to automatically withdraw
whole blood from a donor, separate the
whole blood into blood components,
collect one or more of the blood
components, and return to the donor the
remainder of the whole blood and blood
components. The automated blood cell
separator device is intended for routine
collection of blood and blood
components for transfusion or further
manufacturing use.
(b) Classification. Class II (special
controls). The special control for this
device is a guidance for industry and
FDA staff entitled ‘‘Class II Special
Controls Guidance Document:
Automated Blood Cell Separator Device
Operating by Centrifugal or Filtration
Separation Principle.’’
Dated: March 1, 2005.
Jeffrey Shuren,
Assistant Commissioner for Policy.
[FR Doc. 05–4758 Filed 3–9–05; 8:45 am]
BILLING CODE 4160–01–S
NATIONAL INDIAN GAMING
COMMISSION
25 CFR Part 542
RIN 3141–AA27
Minimum Internal Control Standards
National Indian Gaming
Commission.
ACTION: Proposed rule.
AGENCY:
SUMMARY: In response to the inherent
risks of gaming enterprises and the
resulting need for effective internal
controls in Tribal gaming operations,
the National Indian Gaming
Commission (Commission or NIGC) first
developed Minimum Internal Control
Standards (MICS) for Indian gaming in
1999, and then later revised them in
2002. The Commission recognized from
the outset that periodic technical
adjustments and revisions would be
necessary in order to keep the MICS
effective in protecting Tribal gaming
assets and the interests of Tribal
stakeholders and the gaming public. To
that end, the following proposed rule
revisions contain certain proposed
corrections and revisions to the
Commission’s existing MICS, which are
necessary to clarify, improve, and
update other existing MICS provisions.
The purpose of these proposed MICS
revisions is to address apparent
shortcomings in the MICS and various
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18:23 Mar 09, 2005
Jkt 205001
changes in Tribal gaming technology
and methods.
DATES: Submit comments on or before
April 25, 2005. After consideration of all
received comments, the Commission
will make whatever changes to the
proposed revisions that it deems
appropriate and then promulgate and
publish the final revisions to the
Commission’s MICS Rule, 25 CFR part
542.
ADDRESSES: Mail comments to
‘‘Comments to Second Set of Proposed
MICS Rule Revisions, National Indian
Gaming Commission, 1441 L Street,
NW., Washington, DC 20005, Attn:
Acting General Counsel, Penny J.
Coleman.’’ Comments may be
transmitted by facsimile to (202) 632–
7066.
FOR FURTHER INFORMATION CONTACT:
Vice-Chairman Nelson Westrin, (202)
632–7003 (not a toll-free number).
SUPPLEMENTARY INFORMATION:
Background
On January 5, 1999, the Commission
first published its Minimum Internal
Control Standards (MICS) as a Final
Rule. As gaming Tribes and the
Commission gained practical experience
applying the MICS, it became apparent
that some of the standards required
clarification or modification to operate
as the Commission had intended and to
accommodate changes and advances
that had occurred over the years in
Tribal gaming technology and methods.
Consequently, the Commission,
working with an Advisory Committee
composed of Commission and Tribal
representatives published the new final
revised MICS rule on June 27, 2002. As
the result of the practical experience of
the Commission and Tribes working
with the newly revised MICS, it has
once again become apparent that
additional corrections, clarifications,
and modifications are needed to ensure
that the MICS continue to operate as the
Commission intended. To identify
which of the current MICS need
correction, clarification or modification,
the Commission initially solicited input
and guidance from NIGC employees,
who have extensive gaming regulatory
expertise and experience and work
closely with Tribal gaming regulators in
monitoring the implementation,
operation, and effect of the MICS in
Tribal gaming operations. The resulting
input from NIGC staff convinced the
Commission that the MICS require
continuing review and prompt revision
on an ongoing basis to keep them
effective and up-to-date. To address this
need, the Commission decided to
establish a Standing MICS Advisory
PO 00000
Frm 00008
Fmt 4702
Sfmt 4702
11893
Committee to assist it in both
identifying and developing necessary
MICS revisions on an ongoing basis.
In recognition of its government-togovernment relationship with Tribes
and related commitment to meaningful
Tribal consultation, the Commission
requested gaming Tribes, in January
2004, for nominations of Tribal
representatives to serve on its Standing
MICS Advisory Committee. From the
twenty-seven (27) Tribal nominations
that it received, the Commission
selected nine (9) Tribal representatives
in March 2004 to serve on the
Committee. The Commission’s Tribal
Committee member selections were
based on several factors, including the
regulatory experience and background
of the individuals nominated, the size(s)
of their affiliated Tribal gaming
operation(s), the types of games played
at their affiliated Tribal gaming
operation(s), and the areas of the
country in which their affiliated Tribal
gaming operation(s) are located. The
selection process was very difficult,
because numerous highly qualified
Tribal representatives were nominated
to serve on this important Committee.
As expected, the benefit of including
Tribal representatives on the
Committee, who work daily with the
MICS, has proved to be invaluable.
Tribal representatives selected to
serve on the Commission’s Standing
MICS Advisory Committee are: Tracy
Burris, Gaming Commissioner,
Chickasaw Nation Gaming Commission,
Chickasaw Nation of Oklahoma; Jack
Crawford, Chairman, Umatilla Gaming
Commission, Confederated Tribes of the
Umatilla Indian Reservation; Patrick
Darden, Executive Director, Chitimacha
Gaming Commission, Chitimacha Indian
Tribe of Louisiana; Mark N. Fox,
Compliance Director, Four Bears Casino,
Three Affiliated Tribes of the Fort
Berthold Reservation; Sherrilyn Kie,
Senior Internal Auditor, Pueblo of
Laguna Gaming Authority, Pueblo of
Laguna; Patrick Lambert, Executive
Director, Eastern Band of Cherokee
Gaming Commission, Eastern Band of
Cherokee Indians; John Meskill,
Director, Mohegan Tribal Gaming
Commission, Mohegan Indian Tribe;
Jerome Schultze, Executive Director,
Morongo Gaming Agency, Morongo
Band of Mission Indians; and Lorna
Skenandore, Assistant Gaming Manager,
Support Services, Oneida Bingo and
Casino, formerly Gaming Compliance
Manager, Oneida Gaming Commission,
Oneida Tribe of Indians of Wisconsin.
The Advisory Committee also includes
the following Commission
representatives: Philip N. Hogen,
Chairman; Nelson Westrin, Vice-
E:\FR\FM\10MRP1.SGM
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Agencies
[Federal Register Volume 70, Number 46 (Thursday, March 10, 2005)]
[Proposed Rules]
[Pages 11887-11893]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-4758]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
21 CFR Part 864
[Docket No. 2005N-0017]
Medical Devices; Hematology and Pathology Devices;
Reclassification from Class III to Class II of Automated Blood Cell
Separator Device Operating by Centrifugal Separation Principle
AGENCY: Food and Drug Administration, HHS.
ACTION: Proposed rule.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA) is proposing to
reclassify from class III to class II (special controls) the automated
blood
[[Page 11888]]
cell separator device operating on a centrifugal separation principle
and intended for the routine collection of blood and blood components.
This proposed rule would also modify the special control for the device
with the same intended use but operating on a filtration separation
principle. The reclassification is being proposed on FDA's own
initiative under procedures set forth in FDA regulations and based on
information provided to FDA. This action is being taken under the
Federal Food, Drug, and Cosmetic Act (the act), as amended by the
Medical Device Amendments of 1976 (the 1976 amendments), the Safe
Medical Devices Act of 1990 (the SMDA), and the Food and Drug
Administration Modernization Act of 1997 (FDAMA). The agency proposes
this reclassification because special controls, in addition to general
controls, are capable of providing reasonable assurance of the safety
and effectiveness of the device. Elsewhere in this issue of the Federal
Register, FDA is publishing a notice of availability of a draft
guidance document entitled ``Class II Special Controls Guidance
Document: Automated Blood Cell Separator Device Operating by
Centrifugal or Filtration Separation Principle,'' which will serve as
the special control if this proposal becomes final.
DATES: Submit written or electronic comments by June 8, 2005. See
section XVI of this document for the proposed effective date of a final
rule based on this document.
ADDRESSES: You may submit comments, identified by Docket No. 2005N-
0017, by any of the following methods:
Federal eRulemaking Portal: https://www.regulations.gov.
Follow the instructions for submitting comments.
Agency Web site: https://www.fda.gov/dockets/ecomments.
Follow the instructions for submitting comments on the agency Web site.
E-mail: fdadockets@oc.fda.gov. Include Docket No. 2005N-
0017 in the subject line of your e-mail message.
FAX: 301-827-6870.
Mail/Hand delivery/Courier [For paper, disk, or CD-ROM
submissions]: Division of Dockets Management, 5630 Fishers Lane, rm.
1061, Rockville, MD 20852.
Instructions: All submissions received must include the agency name
and Docket No. or Regulatory Information Number (RIN) for this
rulemaking. All comments received will be posted without change to
https://www.fda.gov/ohrms/dockets/default.htm, including any personal
information provided. For detailed instructions on submitting comments
and additional information on the rulemaking process, see the Comments
heading of the SUPPLEMENTARY INFORMATION section of this document.
Docket: For access to the docket to read background documents or
comments received, go to https://www.fda.gov/ohrms/dockets/default.htm
and insert the docket number, found in brackets in the heading of this
document, into the ``Search'' box and follow the prompts and/or go to
the Division of Dockets Management, 5630 Fishers Lane, rm. 1061,
Rockville, MD 20852.
FOR FURTHER INFORMATION CONTACT: Kathleen E. Swisher, Center for
Biologics Evaluation and Research (HFM-17), Food and Drug
Administration, suite 200N, 1401 Rockville Pike, Rockville, MD 20852-
1448, 301-827-6210.
SUPPLEMENTARY INFORMATION:
I. Background (Regulatory Authorities)
The act (21 U.S.C. 301 et seq.), as amended by the 1976 amendments
(Public Law 94-295), the SMDA (Public Law 101-629), and FDAMA (Public
Law 105-115), established a comprehensive system for the regulation of
medical devices intended for human use. Section 513 of the act (21
U.S.C. 360c) established three categories (classes) of devices,
depending on the regulatory controls needed to provide reasonable
assurance of their safety and effectiveness. The three categories of
devices are class I (general controls), class II (special controls),
and class III (premarket approval).
Under the 1976 amendments, class II devices were defined as those
devices for which there is insufficient information to show that
general controls themselves will assure safety and effectiveness, but
for which there is sufficient information to establish ``performance
standards'' to provide such assurance. The SMDA revised the definition
of class II devices to include those devices for which there is
insufficient information to show that general controls themselves will
assure safety and effectiveness, but for which there is sufficient
information to establish special controls to provide such assurance.
Special controls may include performance standards, postmarket
surveillance, patient registries, development and dissemination of
guidelines, recommendations, and any other appropriate actions the
agency deems necessary (section 513(a)(1)(B) of the act). The SMDA also
directs FDA to revise the classification of such preamendments class
III devices into class I or class II or require the device to remain in
class III; and directs FDA to issue a schedule for section 515(b) of
the act (21 U.S.C. 360e(b)) rulemaking within 12 months of publication
of a regulation retaining a device in class III. However, the SMDA does
not prevent FDA from proceeding immediately to section 515(b)
rulemaking on specific devices, in the interest of public health,
independent of the 515(i) process.
Under section 513 of the act, devices that were in commercial
distribution before May 28, 1976 (the date of enactment of the 1976
amendments), generally referred to as preamendments devices, are
classified after FDA has: (1) Received a recommendation from a device
classification panel (an FDA advisory committee); (2) published the
panel's recommendation for comment, along with a proposed regulation
classifying the device; and (3) published a final regulation
classifying the device. FDA has classified most preamendments devices
under these procedures.
Devices that were not in commercial distribution before May 28,
1976, generally referred to as postamendments devices, are classified
automatically by statute (section 513(f) of the act) into class III
without any FDA rulemaking process. Those devices remain in class III
and require premarket approval, unless and until: (1) The device is
reclassified into class I or II; (2) FDA issues an order classifying
the device into class I or II in accordance with section 513(f)(2) of
the act, as amended by FDAMA; or (3) FDA issues an order finding the
device to be substantially equivalent, under section 513(i) of the act,
to a predicate device that does not require premarket approval. The
agency determines whether new devices are substantially equivalent to
previously offered devices by means of premarket notification
procedures in section 510(k) of the act and 21 CFR part 807 of the
regulations.
A preamendments device that has been classified into class III may
be marketed, by means of premarket notification procedures, without
submission of a premarket approval application (PMA) until FDA issues a
final regulation under section 515(b) of the act requiring premarket
approval.
Reclassification of classified preamendments devices is governed by
section 513(e) of the act. Section 513(e) of the act provides that FDA
may, by rulemaking, reclassify a device (in a proceeding that parallels
the initial classification proceeding) based upon ``new information.''
The reclassification can be initiated by FDA or by the
[[Page 11889]]
petition of an interested person. The term ``new information,'' as used
in section 513(e) of the act, includes information developed as a
result of a reevaluation of the data before the agency when the device
was originally classified, as well as information not presented, not
available, or not developed at that time. (See, e.g., Holland Rantos v.
United States Department of Health, Education, and Welfare, 587 F.2d
1173, 1174 n.1 (D.C. Cir. 1978); Upjohn v. Finch, 422 F.2d 944 (6th
Cir. 1970); Bell v. Goddard, 366 F.2d 177 (7th Cir. 1966).)
Reevaluation of the data previously before the agency is an
appropriate basis for subsequent regulatory action where the
reevaluation is made in light of newly available regulatory authority
(see Bell v. Goddard, supra, 366 F.2d at 181; Ethicon, Inc. v. FDA, 762
F.Supp. 382, 389-91 (D.D.C. 1991)), or in light of changes in ``medical
science.'' (See Upjohn v. Finch, supra, 422 F.2d at 951.) Regardless of
whether data before the agency are past or new data, the ``new
information'' upon which reclassification under section 513(e) of the
act is based must consist of ``valid scientific evidence,'' as defined
in section 513(a)(3) of the act and 21 CFR 860.7(c)(2). (See, e.g.,
General Medical Co. v. FDA, 770 F.2d 214 (D.C. Cir. 1985); Contact Lens
Assoc. v. FDA, 766 F.2d 592 (D.C. Cir.), cert. denied, 474 U.S. 1062
(1985)). FDA relies upon ``valid scientific evidence'' in the
classification process to determine the level of regulation for
devices. For the purpose of reclassification, the valid scientific
evidence upon which the agency relies must be publicly available.
Publicly available information excludes trade secret and/or
confidential commercial information, e.g., the contents of a pending
PMA. (See section 520(c) of the act (21 U.S.C. 360j(c).)
II. Regulatory History of the Device
The automated blood cell separator device operating by centrifugal
separation principle intended for the routine collection of blood and
blood components is a preamendments device classified into class III.
The 1976 amendments did not immediately subject preamendments devices
classified in class III to the premarket approval process. The act
requires FDA to publish 515(b) regulations directing the submission of
premarket approval applications for preamendments class III devices.
The 515(b) process involves the publication of two Federal Register
notices, the proposed rule and the final rule. The 515(b) proposed rule
announces FDA's intention to call for PMAs, lists the issues to be
addressed in PMA submissions, states a deadline for the receipt of
comments, and affords an opportunity to request reclassification. The
final rule addresses any comments received, repeats the issues to be
addressed in PMA submissions, and sets a deadline for the submission of
premarket approval applications or investigational device exemptions of
not more than 90 days after the date of publication.
In the Federal Register of September 11, 1979 (44 FR 53050), FDA
issued a proposed rule to classify into class III the automated blood
cell separator device intended for routine collection of blood and
blood components. The preamble to the proposed rule to classify the
device included the recommendation of an FDA advisory committee, The
Hematology Device Classification Panel, regarding the classification of
the device.
In the Federal Register of September 12, 1980 (45 FR 60643), FDA
issued a final rule (Sec. 864.9245 (21 CFR 864.9245)) classifying into
class III the automated blood cell separator operating either on a
centrifugal or filtration separation principle intended for routine
collection of blood and blood components.
A. Centrifugal Separation Principle
In the Federal Register of February 19, 1988 (53 FR 5108),\1\ FDA
published a proposed rule to require the filing of a PMA or a notice of
completion of a product development protocol (PDP) for the automated
blood cell separator device based on a centrifugal separation principle
and intended for the routine collection of blood and blood components.
The February 1988 proposed rule summarized the risks and benefits
associated with the use of the automated blood cell separator. FDA also
announced an opportunity for interested persons to request a change in
the classification of the device based on new information.
---------------------------------------------------------------------------
\1\ In the Federal Register of April 22, 2003 (68 FR 19766), FDA
issued a withdrawal of certain proposed rules and other proposed
actions; notice of intent to withdraw Hematology and Pathology
Devices; Premarket Approval of the Automated Blood Cell Separator
Intended for Routine Collection of Blood and Blood Components.
---------------------------------------------------------------------------
In the Federal Register of May 16, 1988 (53 FR 17227), FDA extended
the comment period of the proposed rule from 60 days to 90 days in
response to a letter from a medical trade association requesting
additional time to submit comments. In response to the February 1988
proposed rule, the agency received 17 letters of comment. New
information in the form of scientific evidence was submitted with
several of the comments to FDA on the automated blood cell separator
operating on the centrifugal separation principle. The majority of the
letters of comment indicated there is sufficient evidence to provide
reasonable assurance of the safety and effectiveness of the automated
blood cell separator operating on the centrifugal separation principle,
and supported reclassifying the device into class II when intended only
for routine collection of blood and blood components. Many of the
comment letters provided scientific information and references in
support of the reclassification. FDA has evaluated the information
submitted and decided that there is valid scientific evidence
supporting a change in classification of the centrifugal-based
automated blood cell separator with the intended use of routine
collection of blood and blood components from class III, requiring
premarket approval, to class II, requiring special controls.
Consistent with the act and regulation, FDA referred the proposed
reclassification to a panel for its recommendation on the requested
change in classification. FDA announced in the Federal Register of
April 18, 1989 (54 FR 15558), that the agency would consult with the
Blood Products Advisory Committee (BPAC) in an open meeting on May 11,
1989 (Ref. 1), regarding the reclassification of the automated blood
cell separator operating on a centrifugal separation principle. BPAC
acts in the capacity of a device classification panel for such matters
as new information regarding a device and its classification. FDA
requested that BPAC consider the new information and provide its
recommendation as to whether BPAC agreed that the new information was
substantial and supported reclassification. The recommendation of BPAC
is further discussed in section IV of this document.
In accordance with section 513(e) of the act and Sec.
860.130(b)(1) (21 CFR 860.130(b)(1)), based on new information with
respect to the device, FDA, on its own initiative, is proposing to
reclassify the centrifugal-based automated blood cell separator device
from class III to class II (special controls) when the intended use of
the device is for the routine collection of blood and blood components.
For all other uses, including therapeutic apheresis, the device remains
in its current classification as class III. All therapeutic apheresis
(blood cell separator) devices are regulated by FDA's Center for
Devices and Radiological Health and are not part of Sec. 864.9245.
[[Page 11890]]
B. Filtration Separation Principle
The automated blood cell separator device operating on a filtration
separation principle and intended for the routine collection of blood
and blood components is a postamendments device originally classified
into class III under section 513(f)(1) of the act. On June 17, 1996,
the Baxter Healthcare Corp. submitted to FDA a petition requesting
reclassification from class III to class II of its AUTOPHERESIS-C
SYSTEM device. The petition contained information in the form of
scientific evidence to provide reasonable assurance of the safety and
effectiveness of the filtration-based AUTOPHERESIS-C SYSTEM device.
Consistent with section 513(f)(3) of the act and 21 CFR 860.134, FDA
referred the petition to the BPAC medical devices panel for its
recommendation on the requested change in classification. At a public
meeting held on September 27, 1996, BPAC unanimously recommended that
the AUTOPHERESIS-C SYSTEM and subsequent membrane-based blood cell
separators substantially equivalent to this device, intended for
routine collection of blood and blood components, be reclassified from
class III to class II. The panel believed that class II with the
special controls of a periodic report filed annually for a minimum of 3
years with emphasis on adverse reactions would provide reasonable
assurance of the safety and effectiveness of the device.
FDA published a notice of BPAC's recommendation in the Federal
Register of May 29, 2001 (66 FR 29149). In this notice, FDA issued its
tentative findings on BPAC's recommendation and requested from the
public comments on BPAC's recommendation. The comment period closed
August 13, 2001. After receiving no comments on BPAC's recommendation
for reclassification or our tentative findings on BPAC's
recommendation, FDA approved the reclassification petition by order in
the form of a letter to the petitioner.
In the Federal Register of February 28, 2003 (68 FR 9530), FDA
published a final rule announcing the decision to reclassify from class
III to class II the filtration-based automated blood cell separator
device intended for routine collection of blood and blood components
(the February 2003 final rule). In addition to general controls of the
act, the February 2003 final rule also provided for special controls
applicable to the filtration-based devices in order to provide
reasonable assurance of the safety and effectiveness of the device.
In this rule, we are proposing to change the special control listed
in the February 2003 final rule for the filtration-based device. We
propose the special control to be a draft guidance entitled ``Class II
Special Controls Guidance Document: Automated Blood Cell Separator
Device Operating by Centrifugal or Filtration Separation Principle.''
This draft guidance, if finalized, will provide the special controls
for both filtration- and centrifugal-based automated blood cell
separator devices intended for the routine collection of blood and
blood components.
III. Device Description
Current Sec. 864.9245 provides a brief description of the
automated blood cell separator device operating on either a centrifugal
separation principle or a filtration separation principle. The current
section describes the automated blood cell separator as a device that
automatically withdraws whole blood from a donor, separates the blood
into components (red blood cells, white blood cells, plasma, and
platelets), retains one or more of the components, and returns the
remainder of the blood to the donor. The components obtained are
transfused or used for further manufacturing to prepare blood products
for administration. The separation bowls of centrifugal blood cell
separators may be reusable or disposable.
The current section classifies the centrifugal-based automated
blood cell separator into class III (premarket approval). This proposed
rule reclassification from class III to class II (special controls)
applies to the automated blood cell separator device that operates by
centrifugal separation principle and is intended for the routine
collection of blood and blood components for transfusion or further
manufacturing use. The proposed rule removes in the identification of
the automated blood cell separator the words that were in parentheses--
red blood cells, white blood cells, plasma, and platelets.
IV. Recommendation of the Panel
At a public meeting held on May 11, 1989, the BPAC panel considered
the new information presented in the letters of comment and unanimously
recommended that the centrifugal-based automated blood cell separator
be reclassified from class III (premarket approval) to class II
(performance standards; now included in special controls). The panel
believed that class II with performance standards (now included in
special controls) would provide reasonable assurance of the safety and
effectiveness of the automated blood cell separator and that there is
sufficient information publicly available to establish a performance
standard (special control) to assure safety and effectiveness of the
device.
We believe another device classification panel recommendation is
not necessary since, prior to the SMDA, a panel recommended
classification into class II. If a panel recommended that a device be
reclassified from class III into class II under the 1976 definition of
class II, which included only performance standards as a class II
control, then the panel's recommendation for class II status would not
change if special controls are required that would include performance
standards, among other controls. Under the SMDA, FDA may establish
special controls, including performance standards, postmarket
surveillance, patient registries, guidelines, and other appropriate
actions it believes necessary to provide reasonable assurance of the
safety and effectiveness of the device.
V. Summary of Reasons for Recommendation (Reclassification)
The panel believes that the centrifugal-based automated blood cell
separator device should be reclassified into class II because
performance standards (special controls), in addition to general
controls, provide reasonable assurance of the safety and effectiveness
of the device, and there is sufficient information to establish special
controls to provide such assurance.
VI. Risks to Health
In the February 1988 proposed rule, FDA outlined its proposed
findings regarding potential risks associated with the automated blood
cell separator intended for routine collection of blood and blood
components. FDA's proposed findings showed the following: A major risk
to health of donors is that the process of removing blood, handling the
blood outside the body, and returning the blood to the donor's
circulatory system could injure the cellular components of the blood
and activate the body's complement system (a series of enzymatic
proteins capable, when activated, of destroying intact cells). Another
potential donor reaction is fever, due to a breakdown of granulocytes
(leukocytes containing granules) during the pump cycle of the automated
blood cell separator.
Also, if the automated blood cell separator fails to perform
satisfactorily, the donor may have one or more of the following adverse
reactions: (1) Shock resulting from blood loss; (2) toxic reaction to
high levels of anticoagulants,
[[Page 11891]]
such as citrate, that the automated blood cell separator adds to the
blood as it is collected and before the blood is returned to the donor;
(3) stress reaction due to the removal or loss of blood; (4) thrombosis
due to activation of clotting factors in the blood by surfaces within
the automated blood cell separator; or (5) sepsis and fever due to
bacterial contamination of the blood returned to the donor.
Lastly, an unexpected or an undetected leak in the blood handling
system of the device presents risks of infections to donors, patients,
and operators of the device. The device presents a risk of electrical
shock or injury to operators and donors if the device has an electrical
malfunction. If the automated blood cell separator fails to perform
satisfactorily, the blood or blood components collected from a donor
may not be suitable for use because of cellular damage to blood or
blood components during the collection process. One form of cellular
damage is red blood cell hemolysis (destruction of the cell membrane
accompanied by the release of hemoglobin).
Public comments received in response to the proposed rule indicated
that the occurrence of these risks was very low, referred to ample
evidence showing the safety and effectiveness of the automated blood
cell separator, and supported reclassification of the device into class
II.
Presently, FDA has identified the following risks associated with
apheresis blood donation and processing: (1) The potential loss of
blood due to leaks; (2) thrombosis due to activation of factors by
foreign surfaces; (3) toxic reaction to citrate anticoagulant; (4)
damage to red blood cells, activation of complement, and denaturation
of proteins; (5) potential for sepsis and fever due to bacterial
contamination of the donor's blood returned to the donor; (6)
infectious disease risk to the donor or to the operator due to leaks;
(7) electrical shock hazard; (8) donor stress reaction due to removal
or loss of blood; (9) air embolism; (10) hemolysis; and (11) reservoir
rupture.
In addition to the potential risks of the centrifugal-based
automated blood cell separator, there is sufficient information about
the benefits of the device. Extensive experience with the device
indicates that the centrifugal-based automated blood cell separator is
safe and effective for the intended use of routine collection of blood
and blood components.
VII. Summary of Data Upon Which the Recommendation (Reclassification)
is Based
In response to the February 1988 rule proposing to place the device
in class III, we received 17 letters of comment from manufacturers and
the blood banking community (Ref. 1 at 103). These commenters included
such organizations as the Health Industry Manufacturers Association and
the American Association of Blood Banks (Ref. 1 at 104). The comments
received indicated the risk to benefit ratio is low. In proposing this
reclassification, we considered these industry comments and the history
for over 30 years of safe use of the centrifugal-based automated blood
cell separator device.
VIII. FDA's Tentative Findings
FDA believes that the special controls discussed in section IX of
this document are capable of providing reasonable assurance of the
safety and effectiveness of the automated blood cell separator device
operating on a centrifugal separation principle with regard to the
identified risks to health of this device. Based on FDA's evaluation of
the additional information received in the letters of comment, as well
as the 1989 BPAC panel recommendation and the safety record of the
device in actual use, the agency has reconsidered the February 1988
proposed rule, and believes that the centrifugal-based automated blood
cell separator device should be classified into class II (special
controls). FDA, through an agency-wide action of proposed rule
withdrawals (April 22, 2003, 68 FR 19766), announced its intention to
withdraw the February 1988 proposed rule. Now, FDA is proposing to
amend the device regulations by reclassifying from class III to class
II (special controls guidance) the centrifugal-based automated blood
cell separator device intended for the routine collection of blood and
blood components. FDA is also changing the special control for the
automated blood cell separator device using the filtration separation
principle for the routine collection of blood and blood components. The
same special control guidance will apply to the filtration and
centrifugal-based devices when these devices are used for the routine
collection of blood and blood components.
IX. Special Controls
Based on available information and in addition to general controls,
FDA believes that the FDA guidance for industry and FDA staff entitled
``Class II Special Controls Guidance Document: Automated Blood Cell
Separator Device Operating by Centrifugal or Filtration Separation
Principle,'' can provide reasonable assurance of the safety and
effectiveness of the device. Elsewhere in this issue of the Federal
Register, FDA is announcing the availability of this draft guidance
document.
For currently marketed products not approved under the PMA process,
the draft guidance document recommends that the manufacturer file with
FDA for three consecutive years an annual report on the anniversary
date of the final rule for reclassification or on the anniversary date
of 510(k) clearance. Any subsequent change to the device requiring the
submission of a premarket notification in accordance with section
510(k) of the act should be included in the annual report. A
manufacturer of a device that is determined to be substantially
equivalent to the automated blood cell separator device operating by
centrifugal or filtration separation principles intended for routine
collection of blood and blood components, also would be required to
comply with the same general and special controls. The firm would need
to show that its device meets the recommendations of the guidance or in
some other way provides equivalent assurances of safety and
effectiveness.
The draft guidance document (special control) recommends that each
annual report include, at a minimum, the following information:
A summary of anticipated and unanticipated donor adverse
device events that have occurred and that are not required to be
reported by manufacturers under Medical Device Reporting (MDR).\2\ We
recommend summarizing and reporting donor adverse device events such as
those required under Sec. 606.160(b)(1)(iii) (21 CFR
606.160(b)(1)(iii))\3\\,\\4\ to be recorded and maintained by the
facility\5\ using
[[Page 11892]]
the device for the routine collection of blood and blood components.
Under 21 CFR 803.50(b)(2), manufacturers are responsible for conducting
an investigation of each event and evaluating the cause of the event.
Therefore, this information should be available to the manufacturer to
summarize and provide to FDA in the annual report. We emphasize that
safety information submitted to FDA is not to be considered an
admission of causation or liability (October 27, 1994, 59 FR 54046 at
54051).
---------------------------------------------------------------------------
\2\ 21 CFR 803.1(a) -- ``* * * device user facilities,
importers, and manufacturers, as defined in Sec. 803.3, must report
deaths and serious injuries to which a device has or may have caused
or contributed * * * .''
\3\ Section 606.160(b) -- ``Records shall be maintained that
include, but are not limited to, the following when applicable: * *
* (1)(iii) Donor adverse reaction complaints and reports, including
results of all investigations and followup.''
\4\ In a separate proposed rulemaking (Safety Reporting
Requirements for Human Drug and Biological Products; Proposed Rule
(68 FR 12405, March 14, 2003)), FDA has proposed amending 21 CFR
606.170 to require the investigation and recording by blood
establishments of any complaint of a serious adverse reaction
related to the collection or transfusion of blood or blood
components.
\5\ ``Facility'' means any area used for the collection,
processing, compatibility testing, storage or distribution of blood
and blood components (21 CFR 606.3(h)). Also, applicable is ``device
user facility'' under Sec. 803.3(f), meaning ``a hospital,
ambulatory surgical facility, nursing home, outpatient diagnostic
facility, or outpatient treatment facility * * *.'' (Note: The donor
becomes a patient when he or she experiences and is treated for an
adverse event contributed to or caused by the medical device.)
---------------------------------------------------------------------------
Any subsequent change to the device requiring the
submission of a premarket notification in accordance with section
510(k) of the act.\6\
---------------------------------------------------------------------------
\6\ For assistance see the guidance document entitled ``Deciding
When to Submit a 510(k) for a Change to an Existing Device,''
January 1997, at https://www.fda.gov/cdrh.
---------------------------------------------------------------------------
Any subsequent change to the preamendments class III
device requiring a 30-day notice in accordance with 21 CFR 814.39(f).
The reporting of adverse device events summarized in an annual
report will alert FDA to trends or clusters of events that might be a
safety issue otherwise unreported under the MDR regulation. Adverse
reactions contributed to or caused by an apheresis blood donation
device, such as operator infection or injury; equipment failures,
including software, hardware, and disposable item failures; thrombosis;
sepsis; and shock resulting from blood loss, may be reportable under
MDR. The annual report need not include MDR reports.
X. References
The following reference has been placed on display in the Division
of Dockets Management (see ADDRESSES) and may be seen by interested
persons between 9 a.m. and 4 p.m., Monday through Friday.
1. Blood Products Advisory Committee Meeting Transcript, May 11,
1989.
XI. Environmental Impact
The agency has determined under 21 CFR 25.34(b) that this proposed
reclassification action is of a type that does not individually or
cumulatively have a significant effect on the human environment.
Therefore, neither an environmental assessment nor an environmental
impact statement is required.
XII. Federalism
FDA has analyzed this proposed rule in accordance with the
principles set forth in Executive Order 13132. FDA has determined that
the proposed rule does not contain policies that have substantial
direct effects on the States, on the relationship between the National
Government and the States, or on the distribution of power and
responsibilities among the various levels of government. Accordingly,
the agency tentatively concludes that the proposed rule does not
contain policies that have federalism implications as defined in the
Executive order and, consequently, a federalism summary impact
statement has not been prepared.
XIII. Analysis of Impacts
FDA has examined the impacts of this proposed rule under Executive
Order 12866 and the Regulatory Flexibility Act (5 U.S.C. 601-612), and
the Unfunded Mandates Reform Act of 1995 (Public Law 104-4). Executive
Order 12866 directs agencies to assess all costs and benefits of
available regulatory alternatives and, when regulation is necessary, to
select regulatory approaches that maximize net benefits (including
potential economic, environmental, public health and safety, and other
advantages; distributive impacts; and equity). The agency believes that
this proposed rule is consistent with the regulatory philosophy and
principles identified in the Executive order. In addition, the proposed
rule is not a significant regulatory action as defined by the Executive
order and so is not subject to review under the Executive order.
Under the Regulatory Flexibility Act, if a rule has a significant
economic impact on a substantial number of small entities, an agency
must consider alternatives that would minimize the economic impact of
the rule on small entities. Reclassification of this device from class
III to class II will relieve manufacturers of the cost of complying
with the premarket approval requirements of section 515 of the act, and
may permit small potential competitors to enter the marketplace by
lowering their costs. Although the proposed rule special control
guidance document recommends that manufacturers of these devices file
with FDA an annual report for three consecutive years, this is less
burdensome than the current premarket approval requirements including
the submission of periodic reports (21 CFR 814.84).
The agency, therefore, certifies that this proposed rule, if
finalized, will not have a significant economic impact on a substantial
number of small entities, and no further analysis is required under the
Regulatory Flexibility Act. In addition, the Unfunded Mandates Reform
Act does not require FDA to prepare a statement of costs and benefits
for this proposed rule because the proposed rule will not impose costs
of $100 million or more on State, local, and tribal governments in the
aggregate, or the private sector, in any one year (adjusted annually
for inflation).
XIV. Paperwork Reduction Act of 1995
FDA tentatively concludes that this proposed rule contains no
collections of information. Therefore, clearance by the Office of
Management and Budget under the Paperwork Reduction Act of 1995 (44
U.S.C. 3501-3520) is not required.
XV. Comments
Interested persons may submit to the Division of Dockets Management
(see ADDRESSES) written or electronic comments regarding this document.
Submit a single copy of electronic comments or two paper copies of any
mailed comments, except that individuals may submit one paper copy.
Comments are to be identified with the docket number found in brackets
in the heading of this document. Received comments may be seen in the
Division of Dockets Management between 9 a.m. and 4 p.m., Monday
through Friday.
XVI. Proposed Effective Date
The agency is proposing that any final rule that may issue based
upon this proposed fule become effective 30 days after its date of
publication in the Federal Register.
List of Subjects in 21 CFR Part 864
Blood, Medical devices, Packaging and containers.
0
Therefore, under the Federal Food, Drug, and Cosmetic Act and under
authority delegated to the Commissioner of Food and Drugs, it is
proposed that 21 CFR part 864 be amended as follows:
PART 864--HEMATOLOGY AND PATHOLOGY DEVICES
0
1. The authority citation for 21 CFR part 864 continues to read as
follows:
Authority: 21 U.S.C. 351, 360, 360c, 360e, 360j, 371.
0
2. Section 864.9245 is revised to read as follows:
[[Page 11893]]
Sec. 864.9245 Automated blood cell separator.
(a) Identification. An automated blood cell separator is a device
that uses a centrifugal or filtration separation principle to
automatically withdraw whole blood from a donor, separate the whole
blood into blood components, collect one or more of the blood
components, and return to the donor the remainder of the whole blood
and blood components. The automated blood cell separator device is
intended for routine collection of blood and blood components for
transfusion or further manufacturing use.
(b) Classification. Class II (special controls). The special
control for this device is a guidance for industry and FDA staff
entitled ``Class II Special Controls Guidance Document: Automated Blood
Cell Separator Device Operating by Centrifugal or Filtration Separation
Principle.''
Dated: March 1, 2005.
Jeffrey Shuren,
Assistant Commissioner for Policy.
[FR Doc. 05-4758 Filed 3-9-05; 8:45 am]
BILLING CODE 4160-01-S