Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Electronic Data Collection Using MedWatchPlus, 23721-23727 [E9-11687]
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Federal Register / Vol. 74, No. 96 / Wednesday, May 20, 2009 / Notices
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Dated: May 14, 2009.
Jerry A. Holmberg,
Executive Secretary, Advisory Committee on
Blood Safety and Availability.
[FR Doc. E9–11675 Filed 5–19–09; 8:45 am]
BILLING CODE 4150–41–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
OMB No.: 0970–0260.
Description: The Office of Head Start
is proposing to renew authority to
collect information regarding the Head
Start transportation requirement
without changes. The transportation
requirement provides the requirement
that each child be seated in a child
restraint system while the vehicle is in
motion, and the requirement that each
bus have at least one bus monitor on
board at all times. Waivers would be
granted when the Head Start or Early
Head Start grantee demonstrates that
compliance with the requirement(s) for
which the waiver is being sought will
result in a significant disruption to the
Head Start program or the Early Head
Start program and that waiving the
requirement(s) is in the best interest of
the children involved.
Respondents: Head Start and Early
Head Start program grants recipients.
Submission for OMB Review;
Comment Request
Title: Extension to HS Transportation
Requirement.
ANNUAL BURDEN ESTIMATES
Instrument
Number of
respondents
Number of
responses per
respondent
Average
burden hours
per response
Total burden
hours
Form .................................................................................................................
275
1
1
275
Estimated Total Annual Burden
Hours: 275.
Additional Information: Copies of the
proposed collection may be obtained by
writing to the Administration for
Children and Families, Office of
Administration, Office of Information
Services, 370 L’Enfant Promenade, SW.,
Washington, DC 20447, Attn: ACF
Reports Clearance Officer. All requests
should be identified by the title of the
information collection. E-mail address:
infocollection@acf.hhs.gov.
OMB Comment: OMB is required to
make a decision concerning the
collection of information between 30
and 60 days after publication of this
document in the Federal Register.
Therefore, a comment is best assured of
having its full effect if OMB receives it
within 30 days of publication. Written
comments and recommendations for the
proposed information collection should
be sent directly to the following: Office
of Management and Budget, Paperwork
Reduction Project, Fax: 202–395–7245,
Attn: Desk Officer for the
Administration for Children and
Families.
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15:27 May 19, 2009
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Dated: May 14, 2009.
Janean Chambers,
Reports Clearance Officer.
[FR Doc. E9–11652 Filed 5–19–09; 8:45 am]
BILLING CODE 4184–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2008–N–0546]
Agency Information Collection
Activities; Submission for Office of
Management and Budget Review;
Comment Request; Electronic Data
Collection Using MedWatchPlus Portal
and Rational Questionnaire
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
SUMMARY: The Food and Drug
Administration (FDA) is announcing
that a proposed collection of
information has been submitted to the
Office of Management and Budget
(OMB) for review and clearance under
PO 00000
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the Paperwork Reduction Act of 1995
(the PRA).
DATES: Fax written comments on the
collection of information by June 19,
2009.
ADDRESSES: To ensure that comments on
the information collection are received,
OMB recommends that written
comments be faxed to the Office of
Information and Regulatory Affairs,
OMB, Attn: FDA Desk Officer, FAX:
202–395–6974, or e-mailed to
oira_submission@omb.eop.gov. All
comments should be identified with the
OMB control number 0910–NEW and
title ‘‘Electronic Data Collection Using
MedWatchPlus Portal and Rational
Questionnaire.’’ Also include the FDA
docket number found in brackets in the
heading of this document.
FOR FURTHER INFORMATION CONTACT:
Jonna Capezzuto, Office of Information
Management (HFA–710), Food and Drug
Administration, 5600 Fishers Lane,
Rockville, MD 20857, 301–796–3794.
SUPPLEMENTARY INFORMATION: In
compliance with 44 U.S.C. 3507, FDA
has submitted the following proposed
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collection of information to OMB for
review and clearance.
Electronic Data Collection Using
MedWatchPlus Portal and Rational
Questionnaire
FDA is implementing electronic data
collection to improve adverse event
reporting across the agency. FDA’s
current processes and systems for
adverse event reporting vary across its
centers and are not optimal for the
efficient collection of voluntary and
mandatory adverse event reports,
product problems/consumer
complaints, or errors associated with the
use of FDA-regulated products. Current
FDA reporting forms (Forms FDA 3500,
3500A, 1932, and 1932a) are an
outgrowth of a paper process era and
frequently result in the submission of
inconsistent and poor quality
information. In addition, the agency is
limited in its ability to modify its paper
forms to keep pace with changes in the
types of regulated products and the
information necessary to meet evolving
standards to ensure post market safety.
Further, the existing supporting
business processes are not able to
efficiently manage the information being
provided on the paper forms. For
example, the upfront data integrity
constraints on required (vital) data limit
the extent of reviewable information on
items such as reporter identification of
one or more subject product types
(animal and human food/feed, drug—
animal or human, device, etc.), reporter
name, date of occurrence, related
details, and followup information. Data
collected on paper forms must be
manually transcribed into an electronic
format for usability and analysis.
Furthermore, these forms are not very
intuitive for a casual reporter (e.g.,
consumers of FDA-regulated products),
that is, the paper forms lack the features
available in an electronic system that
assist a new user in understanding what
information is being requested.
FDA has launched the development
and implementation of a new electronic
system for collecting, submitting and
processing adverse event reports and
other safety information for all FDAregulated products. This new system,
MedWatchPlus Portal, will enhance the
current MedWatch collection system
and integrate the agency’s existing
safety reporting systems into the various
FDA Adverse Event Report Systems
(FAERS). FAERS will enable FDA staff
to more efficiently analyze thousands of
safety reports and to identify potential
safety problems earlier than would be
possible using paper forms. The
MedWatchPlus Portal provides one
central point-of-entry for persons
submitting information to FDA. The
agency believes that one central pointof-entry will better enable persons to
submit their information. In addition,
mandatory reporters will be able to use
the Internet to access the MedWatchPlus
Portal to report safety concerns about
dietary supplements, nonprescription
drugs, and human and animal food, thus
fulfilling the mandatory reporting
requirements of the Dietary Supplement
and Nonprescription Drug Consumer
Protection Act (DSNDCPA) (Public Law
109–462) and the Food and Drug
Administration Amendments Act of
2007 (FDAAA) (Public Law 110–85).
The MedWatchPlus Portal involves the
development of a single Web-based
portal and a user-friendly data
collection tool, the ‘‘Rational
Questionnaire,’’ which will make it easy
for anyone to report a safety problem.
The Rational Questionnaire will ask
users simple questions to help guide
them to determine what information
they should provide. Anyone will be
able to use the questionnaire to submit
adverse event, product problem/
consumer complaint, and medication
use error reports to the FDA. For
example, a healthcare practitioner could
report an adverse event; a medical
device maker could report a safety
concern about a product; a pet owner
could report a problem that their pet
experienced associated with the use of
an animal drug or animal food; a parent
could report a reaction that their child
experienced associated with the use of
a cosmetic; and a consumer could report
a concern about a drug they are taking
at home, or about a food that may have
made them ill. The system will compile
the users’ responses into a standardized
report that would be routed to the
appropriate FDA organizational
component(s) for review and analysis.
There are several types of information
that will be submitted to FDA via the
MedWatchPlus Portal and Rational
Questionnaire. Some of the information
is required to be submitted to FDA
(mandatory reporting) and some of the
information is submitted voluntarily
(voluntary reporting). The majority of
the information to be collected using the
MedWatchPlus Rational Questionnaire
has been approved previously by OMB
under the PRA. Recently, additional
information collection has been
mandated by DSNDCPA and FDAAA. A
complete list of information collections,
their current OMB approval numbers, as
well as citations to the relevant statute,
regulation or guidance information for
each is depicted in table 1 of this
document.
TABLE 1— INFORMATION COLLECTIONS
Mandatory (M)
or
Voluntary (V)
FDA Form No.
Center for Biologics Evaluation and Research/Center
for Drug Evaluation and
Research (CBER/CDER)
3500
0910–0291
MedWatch Form FDA 3500, Voluntary Reporting Instructions
V
CBER/CDER
3500A
0910–0291
21 CFR 310.305, 314.80, 314.98,
600.80 and 1271.350
M
Center for Devices and Radiological Health (CDRH)
3500
0910–0291
MedWatch Form FDA 3500, Voluntary Reporting Instructions
V
CDRH
3500A
0910–0291
21 CFR Part 803
M
Center for Food Safety and
Applied Nutrition (CFSAN)
3500
0910–0291
None
V
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OMB No.
Relevant Statute, Regulation or
Guidance Information
FDA Center
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Federal Register / Vol. 74, No. 96 / Wednesday, May 20, 2009 / Notices
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TABLE 1— INFORMATION COLLECTIONS—Continued
FDA Center
FDA Form No.
Relevant Statute, Regulation or
Guidance Information
OMB No.
Mandatory (M)
or
Voluntary (V)
CFSAN1
3500A
OMB approval is in process
Pub. L. 109–462; Section 761(b)(1)
of the Federal Food, Drug, and Cosmetic Act (the act) (21 U.S.C.
379aa–1(b)(1))
M
CFSAN/Center for Veterinary
Medicine (CVM)1
None
This notice solicits comments
on this proposed new collection
Pub. L. 110–85; Section 417 of the
act (21 U.S.C. 350f)
M
CVM
1932a
0910–0284
Veterinary Adverse Drug Reaction,
Lack of Effectiveness, or Product Defect Report Form and Instructions
V
CVM
1932
0910–0284
21 CFR 514.80
M
CVM1
None
This notice solicits comments
on this proposed new collection
Pub. L. 110–85; Section 1002 of
FDAAA
V
Office of Regulatory Affairs
(ORA)
None
This notice solicits comments
on this proposed new collection
None
V
1 New
reporting requirements included in DSNDCPA and FDAAA.
The single portal and a harmonized,
Web-based format for submitting safety
information will greatly enhance the
ability of FDA to protect the public
health. FDA will analyze electronic
adverse event and safety reports for all
marketed products and track safety
signals throughout the life cycle of FDAregulated products. FDA intends to
review the information the agency
receives to ensure that the submitters
comply with the criteria established by
the Federal Food, Drug, and Cosmetic
Act (the act), where required.
Description of respondents: The
respondents to this collection of
information include all persons
submitting mandatory or voluntary
information electronically to FDA via
the MedWatchPlus Portal and Rational
Questionnaire.
FDA expects that all of its centers and
ORA will be utilizing the electronic
reporting capabilities of MedWatchPlus
Portal by Fiscal Year 2011. Thus, FDA
has prepared its estimate of the annual
reporting burden on the basis that the
majority of all submissions will be
submitted electronically.
In accordance with 5 CFR 1320.8(d),
in the Federal Register of October 23,
2008 (73 FR 63153), FDA published a
60-day notice requesting public
comment on the proposed information
collection. FDA received five letters in
response to the four specified aspects of
the collection of information, each
containing one or more comments.
(Comment 1) Several comments
commended FDA for implementing
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electronic data collection to improve
adverse event reporting and expected
the new format to greatly improve the
agency’s ability to utilize adverse event,
product problem/consumer complaints,
and medication use error reports
submitted to FDA.
(Response) FDA agrees. As discussed
previously in this document, the new
system will enhance the current
MedWatch collection system and
integrate the Agency’s existing adverse
event reporting systems. This will
enable FDA staff to more efficiently
analyze thousands of safety reports and
to identify potential safety problems
earlier than would be possible using
paper forms.
(Comment 2) One comment
recommended that FDA continue to
allow the submission of adverse event
reports via paper. Another comment
requested that FDA allow for a paper
based contingency in the event that the
MedWatchPlus system becomes
unavailable.
(Response) FDA agrees. The agency is
not eliminating paper, or telephone
reporting. We will continue to support
and accept reports submitted to us by
mail, fax or telephone including when
the system is unavailable.
(Comment 3) One comment stated
that FDA should recognize that the
major component of the reporting
burden is in the assembly of data, not
in the transmission of data. The
comment suggested that the submission
of mandatory data to the MedWatch
system will take 1 hour per initial report
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and from one-half hour to 3 hours for
supplemental reports.
(Response) FDA agrees that the
assembly of data is a major component
of the reporting burden. However, the
agency notes that the comment did not
provide any data to support the burden
hour figures set forth. Thus, FDA has
not changed the burden hour estimates
in tables 1 and 2 of this document.
(Comment 4) Several comments
suggested that FDA consider using pilot
programs in the different stages of
developing the system. One comment
suggested using a pilot with the
proposed questionnaire. Another
comment asked FDA to consider
developing a pilot project with
electronic medical record software
vendors to assess the functionality and
determine the impact on the
practitioner’s time to complete the
submission. A third comment offered to
provide the assistance of its professional
association members to assess the
functionality of the MedWatchPlus portal
and rational questionnaire.
(Response) FDA agrees. The agency
intends to utilize internal and external
early adopters for user acceptance
testing that will include a test site
environment for beta testing prior to
implementation of the portal. However,
the integration of electronic medical
record software is not in scope for the
planned releases of MedWatchPlus portal
and rational questionnaire.
(Comment 5) One comment expressed
concern that those wanting to use the
Web portal would not be able to find it.
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Another comment suggested that FDA
initiate a public education campaign to
ensure potential users are aware of the
new system and use the new system
correctly.
(Response) FDA agrees and is working
with National Institutes of Health and
the FDA Internet teams to follow the
HHS Internet guidelines for Web design.
We expect that the link to the
MedWatchPlus portal and rational
questionnaire will be prominently
displayed on the FDA home page. FDA
also intends to reach out to our industry
stakeholders, as well as professional
organizations and community interest
groups. The rational questionnaire will
provide the user with detailed
navigation instructions to include dropdown menus, lists of values and
controlled vocabularies where possible.
In addition, FDA will issue guidance
and technical documents for the
iterative releases of the rational
questionnaire. The FDA intends to
provide a phased approach. The first
release will include Reportable Food
Reports. Early Warning Pet Food Recall
and adverse event reports for veterinary
drug products will follow. Other
product reports (CFSAN, CVM, CDER,
CBER and CDRH) will be rolled out in
later releases.
(Comment 6) One comment suggested
that FDA include a means by which
adverse events associated with other
products could be reported using the
MedWatchPlus portal and rational
questionnaire, including: devices used
in animals, compounded drugs for
animals, and biologics used in animals.
(Response) FDA agrees that
individuals should be able to report
adverse events associated with devices
used in animals and adverse reactions
associated with compounded drugs for
animals. For example, when the
MedWatchPlus portal is operational,
reporters will be able to use the animal
adverse event view of the rational
questionnaire to submit these reports.
Furthermore, adverse event reports
submitted through the portal for
biologic products used for animals will
be forwarded to the U.S. Department of
Agriculture.
(Comment 7) One comment suggested
that the Naranjo scale be incorporated
into the rational questionnaire.
(Response) FDA disagrees. The
Naranjo scale is a causality assessment
tool. FDA does not plan to require
assessment of causality by reporters
who already suspect a product-event
association and have made the decision
to report by accessing the MedWatchPlus
portal.
(Comment 8) One comment suggested
that FDA should adjust its business
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processes to effectively leverage and
appropriately respond to rapidly
changing data in terms of number of
reports, varying quality, and potential
impact to signal detection.
(Response) FDA agrees. The rational
questionnaire will facilitate the
collection of consistent, complete,
accurate information and produce a
structured report utilizing the HL7–
ICSR data exchange message. The
agency will continue to support the
submission of ‘‘batched’’ adverse event
reports through the FDA electronic
submission gateway. FDA is moving
toward the use of the HL7–ICSR
message exchange; however, acceptable,
alternative data exchange message
formats (e.g., E2BM, E2BR) will be
supported for a period of time that has
not been yet been determined.
(Comment 9) One comment suggested
that the MedWatchPlus portal and
rational questionnaire should document
who submits the information and stated
that the type of submitter (e.g.,
pharmacist, physician, patient) provides
a good indication of the accuracy of and
the reasons behind the information
provided.
(Response) FDA agrees that
information describing the type of
submitter is useful. The rational
questionnaire reporting views will be
created to include questions describing
who the reporter is, the type of report
(adverse event, product problem/
consumer complaint or product use
error), whether the reporting is
mandatory, and identify the suspect
product. From that information, the
agency can infer the type of submitter as
follows: General citizen, health care
professional, and whether or not the
reporter is a mandatory or voluntary
reporter.
(Comment 10) One comment
recommended that FDA obtain contact
information from all individuals who
submit adverse event reports, arguing
that false reports could be submitted
more readily if individual contact
submission is not required for report
submission. The comment also noted
that such information would allow FDA
to follow up with individuals and verify
reported information in the event that
FDA had questions or concerns
regarding an individual report.
(Response) FDA is encouraging all
users to provide contact information in
all reports which both verifies the
source of the report and allows FDA to
conduct any needed followup. However,
FDA will accept voluntary reports
submitted by anonymous sources. Only
mandatory reporters will be required to
include their contact information.
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(Comment 11) One comment urged
FDA to consider how duplicate
reporting through different mechanisms
will be reduced or eliminated.
(Response) FDA agrees. We have a
system requirement that addresses our
abilities to assess and link duplicate
reports to minimize the problem of
duplicate reporting. In addition, the
Web portal will allow followup
information as well as attachments to be
entered and linked to a previously
submitted report.
(Comment 12) One comment
suggested that FDA should incorporate
the Alternative Summary Report (ASR)
methodology in MedWatchPlus.
(Response) FDA is considering
including summary reporting (ASRs) in
future releases of the rational
questionnaire, but the exact mechanism
has not been determined.
(Comment 13) The rational
questionnaire should not have
supplemental questions, which are not
required by the agency’s regulations at
21 CFR Part 803.
(Response) The rational questionnaire
will include the information mandated
by regulation, legislation or otherwise
deemed necessary by the agency for a
complete report. Reporters will not be
required to submit information in
response to optional questions.
(Comment 14) One comment
recommended that a single
acknowledgement bearing the MDR
report number and the official time
receipt stamp be transmitted to the
sender within one hour of the MDR
submission. Another comment noted
that the FDA 3500A form is the
evidentiary record of the MDR. The
comment went on to express concern
about how the MedWatchPlus system
would acknowledge the submission of
the adverse event report in the required
timeframe.
(Response) FDA agrees. The reporter
will receive an electronic response with
an acknowledgement containing a
unique FDA identification number,
which the reporter can save and print.
The acknowledgement receipt will be
generated immediately by the
MedWatchPlus system. The reporter may
also print and save an electronic copy
of their report. If the reporter creates an
account, the reporter will have access,
for an undetermined finite period of
time, to both their in-process and
previously submitted reports using the
MedWatchPlus system. However, FDA
notes that voluntary reporters who
report anonymously will not receive
such a response because we will not
have their email address, but they will
be able to print and save an electronic
copy of their report.
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(Comment 15) One comment asked
that FDA engage stakeholders in a
public consultation process and asked
FDA to subject a draft of the rational
questionnaire to a public consultation
period to permit manufacturers,
patients, and other stakeholders to
comment prior to finalizing a
questionnaire for production use.
(Response) FDA agrees. We plan to
use internal and external stakeholders
in user acceptance testing. Additionally,
the agency intends to hold two public
meetings for Reportable Foods and give
presentations on the Web-based portal
and the rational questionnaire at
professional organization and industry
meetings.
(Comment 16) One comment
suggested that FDA make the electronic
collection tool user friendly and asked
that the questionnaire be made
accessible and intuitive for a broad
population to use, with easy to
understand data entry instructions and
a user-friendly interface that requires
limited computer or technical expertise
to complete. Another comment stated
that the effectiveness of the rational
questionnaire would depend on the
length of time required for the user to
complete the adverse event report.
(Response) FDA agrees that the
rational questionnaire should be user
friendly. We are taking every available
step in developing this tool to ensure
that it is user-friendly and accessible for
public use while minimizing user time.
Such steps include utilizing both
internal and external expertise with
Web-techniques and leveraging current
technology. The agency is following
HHS Web standards in developing the
portal and rational questionnaire and
plans to collect feedback during the user
acceptance testing.
(Comment 17) Another comment
suggested that questions on the rational
questionnaire should be prioritized to
capture the most important questions
and information first in a shorter period
of time. Another comment suggested
that FDA should use an electronic
approach that will ensure that reporters
only see and fill out those fields
relevant to the event that they are
reporting.
(Response) FDA agrees that the
questions should be prioritized. The
rational questionnaire is designed to
request the mandatory information first,
then present the optional questions. In
addition, the specific reporting
situations will use a tree-branching logic
approach. The reporter will be provided
only those fields necessary to providing
a full report and they will not see
questions that are not needed, which
helps in prioritizing the information.
(Comment 18) One comment
suggested that FDA create an intelligent
questionnaire that aligns with the
reporter’s knowledge base and
experience. Another comment requested
that FDA provide an advanced method
of submitting information using the
rational questionnaire that would allow
individuals familiar with the system to
more quickly and efficiently input the
information.
(Response) FDA agrees. FDA is aware
that persons familiar with the reporting
process do not want to be led through
the questionnaire because they know
what information they want to report.
The agency is planning future releases
of the rational questionnaire with an
‘‘Expert Reporter’’ mode for those who
are familiar with the information and
frequent reporters. FDA notes that if a
user chooses to establish an account
with FDA, the system will be designed
so that when the user properly signs in,
the system will pre-populate the pointof-contact information. In addition,
when a report is submitted, a user will
be able to retain and save unique
identifying information which can be
used to access a previously filed report
for additional followup reporting.
(Comment 19) One comment
suggested that FDA ensure that the
MedWatchPlus portal is interoperable
with software that institutions currently
use to document suspected adverse drug
events internally.
(Response) The MedWatchPlus portal
is available to all users through the
Internet, without requiring the use of
special software. The portal will also
allow submission of attachments to
reports in commonly-used file formats,
such as Microsoft Word, Excel and
Adobe. The agency intends to publish
guidance that will provide a list of
acceptable file types. In the event that
a user would like to submit an
attachment that is in an unacceptable
file type, the agency intends to
communicate with the user via a
message providing instructions for file
types we will accept and contact
information for a help desk providing IT
support and additional assistance to the
public. The current MedWatchPlus
portal and rational questionnaire project
scope does not include the integration
with electronic medical record software,
but may be considered in the future as
medical software systems mature and
are increasingly utilized.
(Comment 20) One comment asked
FDA to ensure interoperability utilizing
HL7 or other appropriate standards.
Another comment asked FDA to utilize
international consensus standards in
electronic case reporting.
(Response) FDA agrees. The
MedWatchPlus rational questionnaire
will produce an HL7–ICSR data
exchange message and the portal will
accept HL7–ICSR compliant exchange
messages that are formatted outside the
rational questionnaire. As noted
previously in this document, the agency
will continue to support the submission
of ‘batched’ adverse event reports
through the FDA electronic submission
gateway. FDA is moving toward the use
of the HL7–ICSR message exchange;
however, acceptable, alternative data
exchange message formats (e.g., E2BM,
E2BR) will be supported for a period of
time that has not been yet been
determined. We intend to use structured
and controlled vocabularies and
terminologies where they exist.
FDA estimates the burden of this
collection of information as follows:
TABLE 2—ESTIMATED ANNUAL REPORTING BURDEN1
Number of
Respondents
FDA Activity
Voluntary View
Total Annual
Responses
Hours per
Response
Total Hours
37,565
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37,565
0.6
22,539
199
128,403
1.0
128,403
2,578
Mandatory View using direct Gatewayto-Gateway transmission2
1
645
Mandatory View using MedWatchPlus
Rational Questionnaire2
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Annual Frequency
per
Response
199.2
513,613
0.6
308,168
Frm 00046
Fmt 4703
Sfmt 4703
E:\FR\FM\20MYN1.SGM
20MYN1
23726
Federal Register / Vol. 74, No. 96 / Wednesday, May 20, 2009 / Notices
TABLE 2—ESTIMATED ANNUAL REPORTING BURDEN1—Continued
Number of
Respondents
FDA Activity
Annual Frequency
per
Response
Total Annual
Responses
Hours per
Response
Total Hours
Reportable Food (human and animal)
Mandatory View
1,200
1
1,200
0.6
720
Reportable Food (human and animal)
Voluntary View
1,200
1
1,200
0.6
720
Early Warning Recall Voluntary View
540
1
540
0.6
324
Total
460,874
1 There
are no capital costs or operating and maintenance costs associated with this collection of information.
reporter may choose to use the MedWatchPlus Rational Questionnaire or a direct Gateway-to-Gateway transmission to submit a Mandatory report. FDA believes that these are different reporting burdens for these two types of transmission of information. The reporting burden for
use of the MedWatchPlus Rational Questionnaire Mandatory View is estimated to be 1 hour. The reporting burden for a direct Gateway-to-Gateway transmission is estimated to be 0.6 hours. Current reporting estimates indicate that approximately 80 percent of the Mandatory Reports
would be submitted via a Gateway-to-Gateway transmission and 20 percent of reports would be received via the MedWatchPlus Rational Questionnaire in the future. The Mandatory View reporting burden estimates reflect this calculation.
2 The
The term ‘‘Voluntary View’’ refers to
the MedWatchPlus Rational
Questionnaire as it appears to a
respondent submitting a voluntary
report. The term ‘‘Mandatory View’’
refers to the Gateway-to-Gateway and
the MedWatchPlus Rational
Questionnaire as it appears to a
respondent submitting a mandatory
report. The estimated number of
responses and hours per response for
the voluntary view and the mandatory
view are based on FDA’s experience and
the average number of voluntary reports
and mandatory reports submitted to
FDA in 2007 (and in the case of
mandatory dietary supplement reports,
those submitted to FDA from January 1,
2008, to April 15, 2008) via the existing
methods of submission, including paper
submission. The term, ‘‘Reportable Food
(human and animal) Mandatory View’’
refers to the MedWatchPlus Rational
Questionnaire as it appears to a
respondent submitting a mandatory
report under section 417 of the act (21
U.S.C. 350f). The term, ‘‘Reportable
Food (human and animal) Voluntary
View’’ refers to the MedWatchPlus
Rational Questionnaire as it appears to
the respondent submitting a voluntary
report under section 417 of the act. The
estimated number of responses and
hours per response for the reportable
food (human and animal) mandatory
and voluntary views are based on FDA’s
experience with reports recently
submitted to FDA that would be
considered ‘‘Reportable Food’’ reports
in the future. The term, ‘‘Early Warning
Recall Voluntary View,’’ refers to the
MedWatchPlus Rational Questionnaire as
it appears to a respondent submitting a
mandatory report under FDAAA Section
1002 of the act (Public Law 110–85).
The estimated number of responses and
hours per response for the early warning
VerDate Nov<24>2008
15:27 May 19, 2009
Jkt 217001
recall voluntary view are based on
FDA’s experience with reports recently
submitted to FDA that would be
considered ‘‘Early Warning Recall’’
reports in the future.
In an effort to meet the needs of all
reporters, the Rational Questionnaire
will allow for the submission of a report
by completing certain minimum data
elements. Both mandatory and
voluntary reporters will see and be
provided the opportunity to submit
additional optional information. A
reporter can answer one, a few, or all of
the optional questions. Reporters are
strongly encouraged to submit as much
optional information as possible. This
will help to ensure FDA has sufficient
information to identify products and
problems, and enhance their ability to
address these problems.
The optional questions serve a
purpose for both the reporter and FDA.
The reporter may believe that additional
information is needed for FDA to fully
understand the event/problem and the
optional questions provide an
opportunity to provide such
information. For FDA, the optional
questions may aid in fully
understanding the problem and may
eliminate the need for extensive
followup with the reporter. Because
reporters can choose to answer none,
one, a few, or all of the optional
questions, we estimated the maximum
time needed to submit a safety report
online for both voluntary and
mandatory reporters in the hours per
response column in table 2 of this
document.
The agency’s estimate of the number
of respondents and the total annual
responses in table 2 of this document is
based on the mandatory and voluntary
reports submitted to the centers and
ORA. The estimated total annual
PO 00000
Frm 00047
Fmt 4703
Sfmt 4703
responses in table 2 are based on initial
reports. Followup reports, if any, are not
counted as new reports. FDA estimates
that it will receive 37,565 voluntary
reports [23,033 (CBER/CDER) + 4,369
(CDRH) + 5,000 (CFSAN) + 163 (CVM)
+ 5,000 (ORA) = 37,565]. FDA estimates
that it will receive 642,016 mandatory
reports [459,121 (CBER/CDER) +
146,274 (CDRH) + 856 (CFSAN) +
35,765 (CVM) + 0 (ORA) = 642,016].
FDA received 23,033 voluntary
reports to CBER/CDER during 2007.
Based on this experience, FDA estimates
that CBER and CDER, collectively, will
receive 23,033 voluntary reports
annually from 23,033 users of the
electronic reporting system. FDA
estimates the reporting burden for a
voluntary report to be 0.6 hours, for a
total burden of 13,820 hours (23,033
reports x 0.6 hours = 13,819.8 hours).
FDA received 459,121 mandatory
reports to CBER/CDER during 2007.
Based on this experience, FDA estimates
that CBER and CDER, collectively, will
receive 459,121 mandatory reports
annually from 600 users of the
electronic reporting system. FDA
estimates the maximum reporting
burden for a mandatory report to be 1
hour, for a total burden of 459,121 hours
(459,121 reports x 1 hour) or a
minimum burden of 312,202 hours with
((459,121 reports x 80% x 0.60 hour) +
(459,121 reports x 20% x 1 hour) =
312,202.28 hours).
FDA received 4,369 voluntary reports
to CDRH during 2007. Based on this
experience, FDA estimates that CDRH
will receive 4,369 voluntary reports
annually from 4,369 users of the
electronic reporting system. FDA
estimates the reporting burden for a
voluntary report to be 0.6 hours, for a
total burden of 2,621 hours (4,369
reports x 0.6 hours = 2,621.4 hours).
E:\FR\FM\20MYN1.SGM
20MYN1
Federal Register / Vol. 74, No. 96 / Wednesday, May 20, 2009 / Notices
FDA received 146,274 mandatory
reports to CDRH during 2007. Based on
this experience, FDA estimates that
CDRH will receive 146,274 mandatory
reports annually from 1,665 users of the
electronic reporting system (a group
comprised of facilities, importers, and
manufacturers). FDA estimates the
maximum reporting burden for a
mandatory report to be 1 hour, for a
total burden of 146,274 hours (146,274
reports x 1 hour = 146,274 hours) or a
minimum burden of 99,466 hours with
((146,274 reports x 80% x 0.60 hour) +
(146,274 reports x 20% x 1 hour) =
99,466.32 hours). FDA received 5,000
voluntary reports to CFSAN during
2007. Based on this experience, FDA
estimates that CFSAN will receive 5,000
voluntary reports annually from 5,000
users of the electronic reporting system.
FDA estimates the reporting burden for
a voluntary report to be 0.6 hours, for
a total burden of 3,000 hours (5,000
reports x 0.6 hours = 3,000 hours).
FDA received 214 mandatory dietary
supplement reports to CFSAN from
January 1, 2008, to April 15, 2008.
Based on this experience, FDA estimates
that CFSAN will receive 856 mandatory
reports annually from 150 users of the
electronic reporting system. FDA
estimates the maximum reporting
burden for a mandatory report to be 1
hour, for a total burden of 856 hours
(856 reports x 1 hour = 856 hours) or a
minimum burden of 582 hours with
((856 reports x 80% x 0.60 hour) + (856
reports x 20% x 1 hour) = 582.08 hours).
FDA received 163 voluntary reports to
CVM during 2007. Based on this
experience, FDA estimates that CVM
will receive 163 voluntary reports
annually from 163 users of the
electronic reporting system. FDA
estimates the reporting burden for a
voluntary report to be 0.6 hours for a
total burden of 98 hours (163 reports x
0.6 hours = 97.8 hours).
FDA received 35,765 mandatory
reports to CVM during 2007. Based on
this experience, FDA estimates that
CVM will receive 35,765 mandatory
reports annually from 808 users of the
electronic reporting system. FDA
estimates the maximum reporting
burden for a mandatory report to be 1
hour, for a total burden of 35,765 hours
(35,765 reports x 1 hour = 35,765 hours)
or a minimum burden of 24,320 hours
with ((35,765 reports x 80% x 0.6 hour)
+ (35,765 reports x 20% x 1 hour) =
24,320.20 hours).
FDA received 5,000 voluntary reports
to ORA during 2007. Based on this
experience, FDA estimates that ORA
will receive 5,000 voluntary reports
annually from 5,000 users of the
electronic reporting system. FDA
VerDate Nov<24>2008
15:27 May 19, 2009
Jkt 217001
estimates the reporting burden for a
voluntary report to be 0.6 hours, for a
total burden of 3,000 hours (5,000
reports x 0.6 hours = 3,000 hours). ORA
does not receive mandatory reports.
FDAAA, Section 1005, the Reportable
Food Registry, established new
electronic mandatory and voluntary
reporting requirements for instances of
‘‘reportable’’ food, meaning an article of
food (other than infant formula) for
which there is a reasonable probability
that the use of, or exposure to, such
article of food will cause serious adverse
health consequences or death to humans
or animals. FDA received 625 voluntary
food complaints leading to adverse
events from January 1, 2008, to June 30,
2008, and there were 206 and 182 Class
1 Recalls for human food in Fiscal Years
2006 and 2007, respectively. Based on
these experiences, FDA estimates that
FDA could receive 200 to 1,200
‘‘reportable’’ food reports annually from
200 to 1,200 mandatory and voluntary
users of the electronic reporting system.
FDA will utilize the upper-bound
estimate of 1,200 for these calculations.
FDA estimates the reporting burden for
a mandatory ‘‘reportable’’ food report to
be 0.6 hours, for a total burden of 720
hours (1,200 reports x 0.6 hours = 720
hours). FDA estimates the reporting
burden for a voluntary ‘‘reportable’’
food report to be 0.6 hours, for a total
burden of 720 hours (1,200 reports x 0.6
hours = 720 hours).
FDAAA, Section 1002, Early Warning
Recall, mandated FDA establish a
system to receive voluntary pet food
complaint reports and provide an Early
Warning Recall system for the public.
FDA received 270 voluntary pet food
reports from January 1, 2008, to June 30,
2008. FDA received 10,740 and 99 pet
food complaints in FY 2007 and 2006,
respectively. Based on these
experiences, FDA estimates that FDA
could receive 540 voluntary pet food
reports annually from 540 users of the
electronic reporting system. FDA
estimates the reporting burden for a
voluntary ‘‘Early Warning Recall’’ report
to be 0.6 hours, for a total burden of 324
hours (540 reports x 0.6 hours = 324
hours).
Dated: May 13, 2009.
Jeffrey Shuren,
Associate Commissioner for Policy and
Planning.
[FR Doc. E9–11687 Filed 5–19–09; 8:45 am]
BILLING CODE 4160–01–S
PO 00000
Frm 00048
Fmt 4703
Sfmt 4703
23727
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Government-Owned Inventions;
Availability for Licensing
AGENCY: National Institutes of Health,
Public Health Service, HHS.
ACTION: Notice.
SUMMARY: The inventions listed below
are owned by an agency of the U.S.
Government and are available for
licensing in the U.S. in accordance with
35 U.S.C. 207 to achieve expeditious
commercialization of results of
federally-funded research and
development. Foreign patent
applications are filed on selected
inventions to extend market coverage
for companies and may also be available
for licensing.
ADDRESSES: Licensing information and
copies of the U.S. patent applications
listed below may be obtained by writing
to the indicated licensing contact at the
Office of Technology Transfer, National
Institutes of Health, 6011 Executive
Boulevard, Suite 325, Rockville,
Maryland 20852–3804; telephone: 301/
496–7057; fax: 301/402–0220. A signed
Confidential Disclosure Agreement will
be required to receive copies of the
patent applications.
A549 Cells: A Well-Characterized Lung
Carcinoma Cell Line Utilized for a
Variety of Scientific Studies, Including
Adenovirus Production and Testing
Description of Technology: Scientists
at the National Institutes of Health have
developed a cell line designated A549
that was derived from explanted
cultures of human lung cancer tissue.
The A549 cell line has been tested
under the guidance of the United States
Food and Drug Administration (FDA)
so, under current Good Manufacturing
Practices (GMP), these cells may be
suitable for use in manufacturing
constructs for use in clinical trials. The
A549 cell line has also been found to be
suitable for adenovirus production,
most notably replicating adenovirus
constructs that do not require
complementation by the viral oncogene,
early region 1A (E1A), which is
responsible for viral gene transcription.
This cell line is further utilized as a
negative control in assays to measure
the replication of adenoviruses that lack
E1A and as a target cell line to detect
replication competent adenoviruses
(RCA). A549 cells have been well
characterized through their use in a
wide variety of molecular studies, such
as anti-tumor drug permeability and
E:\FR\FM\20MYN1.SGM
20MYN1
Agencies
[Federal Register Volume 74, Number 96 (Wednesday, May 20, 2009)]
[Notices]
[Pages 23721-23727]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-11687]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA-2008-N-0546]
Agency Information Collection Activities; Submission for Office
of Management and Budget Review; Comment Request; Electronic Data
Collection Using MedWatch\Plus\ Portal and Rational Questionnaire
AGENCY: Food and Drug Administration, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA) is announcing that a
proposed collection of information has been submitted to the Office of
Management and Budget (OMB) for review and clearance under the
Paperwork Reduction Act of 1995 (the PRA).
DATES: Fax written comments on the collection of information by June
19, 2009.
ADDRESSES: To ensure that comments on the information collection are
received, OMB recommends that written comments be faxed to the Office
of Information and Regulatory Affairs, OMB, Attn: FDA Desk Officer,
FAX: 202-395-6974, or e-mailed to oira_submission@omb.eop.gov. All
comments should be identified with the OMB control number 0910-NEW and
title ``Electronic Data Collection Using MedWatch\Plus\ Portal and
Rational Questionnaire.'' Also include the FDA docket number found in
brackets in the heading of this document.
FOR FURTHER INFORMATION CONTACT: Jonna Capezzuto, Office of Information
Management (HFA-710), Food and Drug Administration, 5600 Fishers Lane,
Rockville, MD 20857, 301-796-3794.
SUPPLEMENTARY INFORMATION: In compliance with 44 U.S.C. 3507, FDA has
submitted the following proposed
[[Page 23722]]
collection of information to OMB for review and clearance.
Electronic Data Collection Using MedWatch\Plus\ Portal and Rational
Questionnaire
FDA is implementing electronic data collection to improve adverse
event reporting across the agency. FDA's current processes and systems
for adverse event reporting vary across its centers and are not optimal
for the efficient collection of voluntary and mandatory adverse event
reports, product problems/consumer complaints, or errors associated
with the use of FDA-regulated products. Current FDA reporting forms
(Forms FDA 3500, 3500A, 1932, and 1932a) are an outgrowth of a paper
process era and frequently result in the submission of inconsistent and
poor quality information. In addition, the agency is limited in its
ability to modify its paper forms to keep pace with changes in the
types of regulated products and the information necessary to meet
evolving standards to ensure post market safety. Further, the existing
supporting business processes are not able to efficiently manage the
information being provided on the paper forms. For example, the upfront
data integrity constraints on required (vital) data limit the extent of
reviewable information on items such as reporter identification of one
or more subject product types (animal and human food/feed, drug--animal
or human, device, etc.), reporter name, date of occurrence, related
details, and followup information. Data collected on paper forms must
be manually transcribed into an electronic format for usability and
analysis. Furthermore, these forms are not very intuitive for a casual
reporter (e.g., consumers of FDA-regulated products), that is, the
paper forms lack the features available in an electronic system that
assist a new user in understanding what information is being requested.
FDA has launched the development and implementation of a new
electronic system for collecting, submitting and processing adverse
event reports and other safety information for all FDA-regulated
products. This new system, MedWatch\Plus\ Portal, will enhance the
current MedWatch collection system and integrate the agency's existing
safety reporting systems into the various FDA Adverse Event Report
Systems (FAERS). FAERS will enable FDA staff to more efficiently
analyze thousands of safety reports and to identify potential safety
problems earlier than would be possible using paper forms. The
MedWatch\Plus\ Portal provides one central point-of-entry for persons
submitting information to FDA. The agency believes that one central
point-of-entry will better enable persons to submit their information.
In addition, mandatory reporters will be able to use the Internet to
access the MedWatch\Plus\ Portal to report safety concerns about
dietary supplements, nonprescription drugs, and human and animal food,
thus fulfilling the mandatory reporting requirements of the Dietary
Supplement and Nonprescription Drug Consumer Protection Act (DSNDCPA)
(Public Law 109-462) and the Food and Drug Administration Amendments
Act of 2007 (FDAAA) (Public Law 110-85).
The MedWatch\Plus\ Portal involves the development of a single Web-
based portal and a user-friendly data collection tool, the ``Rational
Questionnaire,'' which will make it easy for anyone to report a safety
problem. The Rational Questionnaire will ask users simple questions to
help guide them to determine what information they should provide.
Anyone will be able to use the questionnaire to submit adverse event,
product problem/consumer complaint, and medication use error reports to
the FDA. For example, a healthcare practitioner could report an adverse
event; a medical device maker could report a safety concern about a
product; a pet owner could report a problem that their pet experienced
associated with the use of an animal drug or animal food; a parent
could report a reaction that their child experienced associated with
the use of a cosmetic; and a consumer could report a concern about a
drug they are taking at home, or about a food that may have made them
ill. The system will compile the users' responses into a standardized
report that would be routed to the appropriate FDA organizational
component(s) for review and analysis.
There are several types of information that will be submitted to
FDA via the MedWatch\Plus\ Portal and Rational Questionnaire. Some of
the information is required to be submitted to FDA (mandatory
reporting) and some of the information is submitted voluntarily
(voluntary reporting). The majority of the information to be collected
using the MedWatch\Plus\ Rational Questionnaire has been approved
previously by OMB under the PRA. Recently, additional information
collection has been mandated by DSNDCPA and FDAAA. A complete list of
information collections, their current OMB approval numbers, as well as
citations to the relevant statute, regulation or guidance information
for each is depicted in table 1 of this document.
Table 1-- Information Collections
------------------------------------------------------------------------
Relevant
Statute, Mandatory
FDA FDA Form No. OMB No. Regulation or (M) or
Center Guidance Voluntary
Information (V)
------------------------------------------------------------------------
Center 3500 0910-0291 MedWatch Form V
for FDA 3500,
Biologic Voluntary
s Reporting
Evaluati Instructions
on and
Research/
Center
for Drug
Evaluati
on and
Research
(CBER/
CDER)
------------------------------------------------------------------------
CBER/CDER 3500A 0910-0291 21 CFR M
310.305,
314.80,
314.98,
600.80 and
1271.350
------------------------------------------------------------------------
Center 3500 0910-0291 MedWatch Form V
for FDA 3500,
Devices Voluntary
and Reporting
Radiolog Instructions
ical
Health
(CDRH)
------------------------------------------------------------------------
CDRH 3500A 0910-0291 21 CFR Part M
803
------------------------------------------------------------------------
Center 3500 0910-0291 None V
for Food
Safety
and
Applied
Nutritio
n
(CFSAN)
------------------------------------------------------------------------
[[Page 23723]]
CFSAN\1\ 3500A OMB Pub. L. 109- M
approval 462; Section
is in 761(b)(1) of
process the Federal
Food, Drug,
and Cosmetic
Act (the
act) (21
U.S.C. 379aa-
1(b)(1))
------------------------------------------------------------------------
CFSAN/ None This Pub. L. 110- M
Center notice 85; Section
for solicits 417 of the
Veterina comments act (21
ry on this U.S.C. 350f)
Medicine proposed
(CVM)\1\ new
collectio
n
------------------------------------------------------------------------
CVM 1932a 0910-0284 Veterinary V
Adverse Drug
Reaction,
Lack of
Effectivenes
s, or
Product
Defect
Report Form
and
Instructions
------------------------------------------------------------------------
CVM 1932 0910-0284 21 CFR 514.80 M
------------------------------------------------------------------------
CVM\1\ None This Pub. L. 110- V
notice 85; Section
solicits 1002 of
comments FDAAA
on this
proposed
new
collectio
n
------------------------------------------------------------------------
Office of None This None V
Regulato notice
ry solicits
Affairs comments
(ORA) on this
proposed
new
collectio
n
------------------------------------------------------------------------
\1\ New reporting requirements included in DSNDCPA and FDAAA.
The single portal and a harmonized, Web-based format for submitting
safety information will greatly enhance the ability of FDA to protect
the public health. FDA will analyze electronic adverse event and safety
reports for all marketed products and track safety signals throughout
the life cycle of FDA-regulated products. FDA intends to review the
information the agency receives to ensure that the submitters comply
with the criteria established by the Federal Food, Drug, and Cosmetic
Act (the act), where required.
Description of respondents: The respondents to this collection of
information include all persons submitting mandatory or voluntary
information electronically to FDA via the MedWatch\Plus\ Portal and
Rational Questionnaire.
FDA expects that all of its centers and ORA will be utilizing the
electronic reporting capabilities of MedWatch\Plus\ Portal by Fiscal
Year 2011. Thus, FDA has prepared its estimate of the annual reporting
burden on the basis that the majority of all submissions will be
submitted electronically.
In accordance with 5 CFR 1320.8(d), in the Federal Register of
October 23, 2008 (73 FR 63153), FDA published a 60-day notice
requesting public comment on the proposed information collection. FDA
received five letters in response to the four specified aspects of the
collection of information, each containing one or more comments.
(Comment 1) Several comments commended FDA for implementing
electronic data collection to improve adverse event reporting and
expected the new format to greatly improve the agency's ability to
utilize adverse event, product problem/consumer complaints, and
medication use error reports submitted to FDA.
(Response) FDA agrees. As discussed previously in this document,
the new system will enhance the current MedWatch collection system and
integrate the Agency's existing adverse event reporting systems. This
will enable FDA staff to more efficiently analyze thousands of safety
reports and to identify potential safety problems earlier than would be
possible using paper forms.
(Comment 2) One comment recommended that FDA continue to allow the
submission of adverse event reports via paper. Another comment
requested that FDA allow for a paper based contingency in the event
that the MedWatch\Plus\ system becomes unavailable.
(Response) FDA agrees. The agency is not eliminating paper, or
telephone reporting. We will continue to support and accept reports
submitted to us by mail, fax or telephone including when the system is
unavailable.
(Comment 3) One comment stated that FDA should recognize that the
major component of the reporting burden is in the assembly of data, not
in the transmission of data. The comment suggested that the submission
of mandatory data to the MedWatch system will take 1 hour per initial
report and from one-half hour to 3 hours for supplemental reports.
(Response) FDA agrees that the assembly of data is a major
component of the reporting burden. However, the agency notes that the
comment did not provide any data to support the burden hour figures set
forth. Thus, FDA has not changed the burden hour estimates in tables 1
and 2 of this document.
(Comment 4) Several comments suggested that FDA consider using
pilot programs in the different stages of developing the system. One
comment suggested using a pilot with the proposed questionnaire.
Another comment asked FDA to consider developing a pilot project with
electronic medical record software vendors to assess the functionality
and determine the impact on the practitioner's time to complete the
submission. A third comment offered to provide the assistance of its
professional association members to assess the functionality of the
MedWatch\Plus\ portal and rational questionnaire.
(Response) FDA agrees. The agency intends to utilize internal and
external early adopters for user acceptance testing that will include a
test site environment for beta testing prior to implementation of the
portal. However, the integration of electronic medical record software
is not in scope for the planned releases of MedWatch\Plus\ portal and
rational questionnaire.
(Comment 5) One comment expressed concern that those wanting to use
the Web portal would not be able to find it.
[[Page 23724]]
Another comment suggested that FDA initiate a public education campaign
to ensure potential users are aware of the new system and use the new
system correctly.
(Response) FDA agrees and is working with National Institutes of
Health and the FDA Internet teams to follow the HHS Internet guidelines
for Web design. We expect that the link to the MedWatch\Plus\ portal
and rational questionnaire will be prominently displayed on the FDA
home page. FDA also intends to reach out to our industry stakeholders,
as well as professional organizations and community interest groups.
The rational questionnaire will provide the user with detailed
navigation instructions to include drop-down menus, lists of values and
controlled vocabularies where possible. In addition, FDA will issue
guidance and technical documents for the iterative releases of the
rational questionnaire. The FDA intends to provide a phased approach.
The first release will include Reportable Food Reports. Early Warning
Pet Food Recall and adverse event reports for veterinary drug products
will follow. Other product reports (CFSAN, CVM, CDER, CBER and CDRH)
will be rolled out in later releases.
(Comment 6) One comment suggested that FDA include a means by which
adverse events associated with other products could be reported using
the MedWatch\Plus\ portal and rational questionnaire, including:
devices used in animals, compounded drugs for animals, and biologics
used in animals.
(Response) FDA agrees that individuals should be able to report
adverse events associated with devices used in animals and adverse
reactions associated with compounded drugs for animals. For example,
when the MedWatch\Plus\ portal is operational, reporters will be able
to use the animal adverse event view of the rational questionnaire to
submit these reports. Furthermore, adverse event reports submitted
through the portal for biologic products used for animals will be
forwarded to the U.S. Department of Agriculture.
(Comment 7) One comment suggested that the Naranjo scale be
incorporated into the rational questionnaire.
(Response) FDA disagrees. The Naranjo scale is a causality
assessment tool. FDA does not plan to require assessment of causality
by reporters who already suspect a product-event association and have
made the decision to report by accessing the MedWatch\Plus\ portal.
(Comment 8) One comment suggested that FDA should adjust its
business processes to effectively leverage and appropriately respond to
rapidly changing data in terms of number of reports, varying quality,
and potential impact to signal detection.
(Response) FDA agrees. The rational questionnaire will facilitate
the collection of consistent, complete, accurate information and
produce a structured report utilizing the HL7-ICSR data exchange
message. The agency will continue to support the submission of
``batched'' adverse event reports through the FDA electronic submission
gateway. FDA is moving toward the use of the HL7-ICSR message exchange;
however, acceptable, alternative data exchange message formats (e.g.,
E2BM, E2BR) will be supported for a period of time that has not been
yet been determined.
(Comment 9) One comment suggested that the MedWatch\Plus\ portal
and rational questionnaire should document who submits the information
and stated that the type of submitter (e.g., pharmacist, physician,
patient) provides a good indication of the accuracy of and the reasons
behind the information provided.
(Response) FDA agrees that information describing the type of
submitter is useful. The rational questionnaire reporting views will be
created to include questions describing who the reporter is, the type
of report (adverse event, product problem/consumer complaint or product
use error), whether the reporting is mandatory, and identify the
suspect product. From that information, the agency can infer the type
of submitter as follows: General citizen, health care professional, and
whether or not the reporter is a mandatory or voluntary reporter.
(Comment 10) One comment recommended that FDA obtain contact
information from all individuals who submit adverse event reports,
arguing that false reports could be submitted more readily if
individual contact submission is not required for report submission.
The comment also noted that such information would allow FDA to follow
up with individuals and verify reported information in the event that
FDA had questions or concerns regarding an individual report.
(Response) FDA is encouraging all users to provide contact
information in all reports which both verifies the source of the report
and allows FDA to conduct any needed followup. However, FDA will accept
voluntary reports submitted by anonymous sources. Only mandatory
reporters will be required to include their contact information.
(Comment 11) One comment urged FDA to consider how duplicate
reporting through different mechanisms will be reduced or eliminated.
(Response) FDA agrees. We have a system requirement that addresses
our abilities to assess and link duplicate reports to minimize the
problem of duplicate reporting. In addition, the Web portal will allow
followup information as well as attachments to be entered and linked to
a previously submitted report.
(Comment 12) One comment suggested that FDA should incorporate the
Alternative Summary Report (ASR) methodology in MedWatch\Plus\.
(Response) FDA is considering including summary reporting (ASRs) in
future releases of the rational questionnaire, but the exact mechanism
has not been determined.
(Comment 13) The rational questionnaire should not have
supplemental questions, which are not required by the agency's
regulations at 21 CFR Part 803.
(Response) The rational questionnaire will include the information
mandated by regulation, legislation or otherwise deemed necessary by
the agency for a complete report. Reporters will not be required to
submit information in response to optional questions.
(Comment 14) One comment recommended that a single acknowledgement
bearing the MDR report number and the official time receipt stamp be
transmitted to the sender within one hour of the MDR submission.
Another comment noted that the FDA 3500A form is the evidentiary record
of the MDR. The comment went on to express concern about how the
MedWatch\Plus\ system would acknowledge the submission of the adverse
event report in the required timeframe.
(Response) FDA agrees. The reporter will receive an electronic
response with an acknowledgement containing a unique FDA identification
number, which the reporter can save and print. The acknowledgement
receipt will be generated immediately by the MedWatch\Plus\ system. The
reporter may also print and save an electronic copy of their report. If
the reporter creates an account, the reporter will have access, for an
undetermined finite period of time, to both their in-process and
previously submitted reports using the MedWatch\Plus\ system. However,
FDA notes that voluntary reporters who report anonymously will not
receive such a response because we will not have their email address,
but they will be able to print and save an electronic copy of their
report.
[[Page 23725]]
(Comment 15) One comment asked that FDA engage stakeholders in a
public consultation process and asked FDA to subject a draft of the
rational questionnaire to a public consultation period to permit
manufacturers, patients, and other stakeholders to comment prior to
finalizing a questionnaire for production use.
(Response) FDA agrees. We plan to use internal and external
stakeholders in user acceptance testing. Additionally, the agency
intends to hold two public meetings for Reportable Foods and give
presentations on the Web-based portal and the rational questionnaire at
professional organization and industry meetings.
(Comment 16) One comment suggested that FDA make the electronic
collection tool user friendly and asked that the questionnaire be made
accessible and intuitive for a broad population to use, with easy to
understand data entry instructions and a user-friendly interface that
requires limited computer or technical expertise to complete. Another
comment stated that the effectiveness of the rational questionnaire
would depend on the length of time required for the user to complete
the adverse event report.
(Response) FDA agrees that the rational questionnaire should be
user friendly. We are taking every available step in developing this
tool to ensure that it is user-friendly and accessible for public use
while minimizing user time. Such steps include utilizing both internal
and external expertise with Web-techniques and leveraging current
technology. The agency is following HHS Web standards in developing the
portal and rational questionnaire and plans to collect feedback during
the user acceptance testing.
(Comment 17) Another comment suggested that questions on the
rational questionnaire should be prioritized to capture the most
important questions and information first in a shorter period of time.
Another comment suggested that FDA should use an electronic approach
that will ensure that reporters only see and fill out those fields
relevant to the event that they are reporting.
(Response) FDA agrees that the questions should be prioritized. The
rational questionnaire is designed to request the mandatory information
first, then present the optional questions. In addition, the specific
reporting situations will use a tree-branching logic approach. The
reporter will be provided only those fields necessary to providing a
full report and they will not see questions that are not needed, which
helps in prioritizing the information.
(Comment 18) One comment suggested that FDA create an intelligent
questionnaire that aligns with the reporter's knowledge base and
experience. Another comment requested that FDA provide an advanced
method of submitting information using the rational questionnaire that
would allow individuals familiar with the system to more quickly and
efficiently input the information.
(Response) FDA agrees. FDA is aware that persons familiar with the
reporting process do not want to be led through the questionnaire
because they know what information they want to report. The agency is
planning future releases of the rational questionnaire with an ``Expert
Reporter'' mode for those who are familiar with the information and
frequent reporters. FDA notes that if a user chooses to establish an
account with FDA, the system will be designed so that when the user
properly signs in, the system will pre-populate the point-of-contact
information. In addition, when a report is submitted, a user will be
able to retain and save unique identifying information which can be
used to access a previously filed report for additional followup
reporting.
(Comment 19) One comment suggested that FDA ensure that the
MedWatch\Plus\ portal is interoperable with software that institutions
currently use to document suspected adverse drug events internally.
(Response) The MedWatch\Plus\ portal is available to all users
through the Internet, without requiring the use of special software.
The portal will also allow submission of attachments to reports in
commonly-used file formats, such as Microsoft Word, Excel and Adobe.
The agency intends to publish guidance that will provide a list of
acceptable file types. In the event that a user would like to submit an
attachment that is in an unacceptable file type, the agency intends to
communicate with the user via a message providing instructions for file
types we will accept and contact information for a help desk providing
IT support and additional assistance to the public. The current
MedWatch\Plus\ portal and rational questionnaire project scope does not
include the integration with electronic medical record software, but
may be considered in the future as medical software systems mature and
are increasingly utilized.
(Comment 20) One comment asked FDA to ensure interoperability
utilizing HL7 or other appropriate standards. Another comment asked FDA
to utilize international consensus standards in electronic case
reporting.
(Response) FDA agrees. The MedWatch\Plus\ rational questionnaire
will produce an HL7-ICSR data exchange message and the portal will
accept HL7-ICSR compliant exchange messages that are formatted outside
the rational questionnaire. As noted previously in this document, the
agency will continue to support the submission of `batched' adverse
event reports through the FDA electronic submission gateway. FDA is
moving toward the use of the HL7-ICSR message exchange; however,
acceptable, alternative data exchange message formats (e.g., E2BM,
E2BR) will be supported for a period of time that has not been yet been
determined. We intend to use structured and controlled vocabularies and
terminologies where they exist.
FDA estimates the burden of this collection of information as
follows:
Table 2--Estimated Annual Reporting Burden\1\
----------------------------------------------------------------------------------------------------------------
Number of Annual Frequency Total Annual Hours per
FDA Activity Respondents per Response Responses Response Total Hours
----------------------------------------------------------------------------------------------------------------
Voluntary View 37,565 1 37,565 0.6 22,539
----------------------------------------------------------------------------------------------------------------
Mandatory View 645 199 128,403 1.0 128,403
using
MedWatch\Plus\
Rational
Questionnaire\2\
----------------------------------------------------------------------------------------------------------------
Mandatory View 2,578 199.2 513,613 0.6 308,168
using direct
Gateway-to-
Gateway
transmission\2\
----------------------------------------------------------------------------------------------------------------
[[Page 23726]]
Reportable Food 1,200 1 1,200 0.6 720
(human and
animal)
Mandatory View
----------------------------------------------------------------------------------------------------------------
Reportable Food 1,200 1 1,200 0.6 720
(human and
animal)
Voluntary View
----------------------------------------------------------------------------------------------------------------
Early Warning 540 1 540 0.6 324
Recall Voluntary
View
----------------------------------------------------------------------------------------------------------------
Total 460,874
----------------------------------------------------------------------------------------------------------------
\1\ There are no capital costs or operating and maintenance costs associated with this collection of
information.
\2\ The reporter may choose to use the MedWatch\Plus\ Rational Questionnaire or a direct Gateway-to-Gateway
transmission to submit a Mandatory report. FDA believes that these are different reporting burdens for these
two types of transmission of information. The reporting burden for use of the MedWatch\Plus\ Rational
Questionnaire Mandatory View is estimated to be 1 hour. The reporting burden for a direct Gateway-to-Gateway
transmission is estimated to be 0.6 hours. Current reporting estimates indicate that approximately 80 percent
of the Mandatory Reports would be submitted via a Gateway-to-Gateway transmission and 20 percent of reports
would be received via the MedWatch\Plus\ Rational Questionnaire in the future. The Mandatory View reporting
burden estimates reflect this calculation.
The term ``Voluntary View'' refers to the MedWatch\Plus\ Rational
Questionnaire as it appears to a respondent submitting a voluntary
report. The term ``Mandatory View'' refers to the Gateway-to-Gateway
and the MedWatch\Plus\ Rational Questionnaire as it appears to a
respondent submitting a mandatory report. The estimated number of
responses and hours per response for the voluntary view and the
mandatory view are based on FDA's experience and the average number of
voluntary reports and mandatory reports submitted to FDA in 2007 (and
in the case of mandatory dietary supplement reports, those submitted to
FDA from January 1, 2008, to April 15, 2008) via the existing methods
of submission, including paper submission. The term, ``Reportable Food
(human and animal) Mandatory View'' refers to the MedWatch\Plus\
Rational Questionnaire as it appears to a respondent submitting a
mandatory report under section 417 of the act (21 U.S.C. 350f). The
term, ``Reportable Food (human and animal) Voluntary View'' refers to
the MedWatch\Plus\ Rational Questionnaire as it appears to the
respondent submitting a voluntary report under section 417 of the act.
The estimated number of responses and hours per response for the
reportable food (human and animal) mandatory and voluntary views are
based on FDA's experience with reports recently submitted to FDA that
would be considered ``Reportable Food'' reports in the future. The
term, ``Early Warning Recall Voluntary View,'' refers to the
MedWatch\Plus\ Rational Questionnaire as it appears to a respondent
submitting a mandatory report under FDAAA Section 1002 of the act
(Public Law 110-85). The estimated number of responses and hours per
response for the early warning recall voluntary view are based on FDA's
experience with reports recently submitted to FDA that would be
considered ``Early Warning Recall'' reports in the future.
In an effort to meet the needs of all reporters, the Rational
Questionnaire will allow for the submission of a report by completing
certain minimum data elements. Both mandatory and voluntary reporters
will see and be provided the opportunity to submit additional optional
information. A reporter can answer one, a few, or all of the optional
questions. Reporters are strongly encouraged to submit as much optional
information as possible. This will help to ensure FDA has sufficient
information to identify products and problems, and enhance their
ability to address these problems.
The optional questions serve a purpose for both the reporter and
FDA. The reporter may believe that additional information is needed for
FDA to fully understand the event/problem and the optional questions
provide an opportunity to provide such information. For FDA, the
optional questions may aid in fully understanding the problem and may
eliminate the need for extensive followup with the reporter. Because
reporters can choose to answer none, one, a few, or all of the optional
questions, we estimated the maximum time needed to submit a safety
report online for both voluntary and mandatory reporters in the hours
per response column in table 2 of this document.
The agency's estimate of the number of respondents and the total
annual responses in table 2 of this document is based on the mandatory
and voluntary reports submitted to the centers and ORA. The estimated
total annual responses in table 2 are based on initial reports.
Followup reports, if any, are not counted as new reports. FDA estimates
that it will receive 37,565 voluntary reports [23,033 (CBER/CDER) +
4,369 (CDRH) + 5,000 (CFSAN) + 163 (CVM) + 5,000 (ORA) = 37,565]. FDA
estimates that it will receive 642,016 mandatory reports [459,121
(CBER/CDER) + 146,274 (CDRH) + 856 (CFSAN) + 35,765 (CVM) + 0 (ORA) =
642,016].
FDA received 23,033 voluntary reports to CBER/CDER during 2007.
Based on this experience, FDA estimates that CBER and CDER,
collectively, will receive 23,033 voluntary reports annually from
23,033 users of the electronic reporting system. FDA estimates the
reporting burden for a voluntary report to be 0.6 hours, for a total
burden of 13,820 hours (23,033 reports x 0.6 hours = 13,819.8 hours).
FDA received 459,121 mandatory reports to CBER/CDER during 2007.
Based on this experience, FDA estimates that CBER and CDER,
collectively, will receive 459,121 mandatory reports annually from 600
users of the electronic reporting system. FDA estimates the maximum
reporting burden for a mandatory report to be 1 hour, for a total
burden of 459,121 hours (459,121 reports x 1 hour) or a minimum burden
of 312,202 hours with ((459,121 reports x 80% x 0.60 hour) + (459,121
reports x 20% x 1 hour) = 312,202.28 hours).
FDA received 4,369 voluntary reports to CDRH during 2007. Based on
this experience, FDA estimates that CDRH will receive 4,369 voluntary
reports annually from 4,369 users of the electronic reporting system.
FDA estimates the reporting burden for a voluntary report to be 0.6
hours, for a total burden of 2,621 hours (4,369 reports x 0.6 hours =
2,621.4 hours).
[[Page 23727]]
FDA received 146,274 mandatory reports to CDRH during 2007. Based
on this experience, FDA estimates that CDRH will receive 146,274
mandatory reports annually from 1,665 users of the electronic reporting
system (a group comprised of facilities, importers, and manufacturers).
FDA estimates the maximum reporting burden for a mandatory report to be
1 hour, for a total burden of 146,274 hours (146,274 reports x 1 hour =
146,274 hours) or a minimum burden of 99,466 hours with ((146,274
reports x 80% x 0.60 hour) + (146,274 reports x 20% x 1 hour) =
99,466.32 hours). FDA received 5,000 voluntary reports to CFSAN during
2007. Based on this experience, FDA estimates that CFSAN will receive
5,000 voluntary reports annually from 5,000 users of the electronic
reporting system. FDA estimates the reporting burden for a voluntary
report to be 0.6 hours, for a total burden of 3,000 hours (5,000
reports x 0.6 hours = 3,000 hours).
FDA received 214 mandatory dietary supplement reports to CFSAN from
January 1, 2008, to April 15, 2008. Based on this experience, FDA
estimates that CFSAN will receive 856 mandatory reports annually from
150 users of the electronic reporting system. FDA estimates the maximum
reporting burden for a mandatory report to be 1 hour, for a total
burden of 856 hours (856 reports x 1 hour = 856 hours) or a minimum
burden of 582 hours with ((856 reports x 80% x 0.60 hour) + (856
reports x 20% x 1 hour) = 582.08 hours).
FDA received 163 voluntary reports to CVM during 2007. Based on
this experience, FDA estimates that CVM will receive 163 voluntary
reports annually from 163 users of the electronic reporting system. FDA
estimates the reporting burden for a voluntary report to be 0.6 hours
for a total burden of 98 hours (163 reports x 0.6 hours = 97.8 hours).
FDA received 35,765 mandatory reports to CVM during 2007. Based on
this experience, FDA estimates that CVM will receive 35,765 mandatory
reports annually from 808 users of the electronic reporting system. FDA
estimates the maximum reporting burden for a mandatory report to be 1
hour, for a total burden of 35,765 hours (35,765 reports x 1 hour =
35,765 hours) or a minimum burden of 24,320 hours with ((35,765 reports
x 80% x 0.6 hour) + (35,765 reports x 20% x 1 hour) = 24,320.20 hours).
FDA received 5,000 voluntary reports to ORA during 2007. Based on
this experience, FDA estimates that ORA will receive 5,000 voluntary
reports annually from 5,000 users of the electronic reporting system.
FDA estimates the reporting burden for a voluntary report to be 0.6
hours, for a total burden of 3,000 hours (5,000 reports x 0.6 hours =
3,000 hours). ORA does not receive mandatory reports.
FDAAA, Section 1005, the Reportable Food Registry, established new
electronic mandatory and voluntary reporting requirements for instances
of ``reportable'' food, meaning an article of food (other than infant
formula) for which there is a reasonable probability that the use of,
or exposure to, such article of food will cause serious adverse health
consequences or death to humans or animals. FDA received 625 voluntary
food complaints leading to adverse events from January 1, 2008, to June
30, 2008, and there were 206 and 182 Class 1 Recalls for human food in
Fiscal Years 2006 and 2007, respectively. Based on these experiences,
FDA estimates that FDA could receive 200 to 1,200 ``reportable'' food
reports annually from 200 to 1,200 mandatory and voluntary users of the
electronic reporting system. FDA will utilize the upper-bound estimate
of 1,200 for these calculations. FDA estimates the reporting burden for
a mandatory ``reportable'' food report to be 0.6 hours, for a total
burden of 720 hours (1,200 reports x 0.6 hours = 720 hours). FDA
estimates the reporting burden for a voluntary ``reportable'' food
report to be 0.6 hours, for a total burden of 720 hours (1,200 reports
x 0.6 hours = 720 hours).
FDAAA, Section 1002, Early Warning Recall, mandated FDA establish a
system to receive voluntary pet food complaint reports and provide an
Early Warning Recall system for the public. FDA received 270 voluntary
pet food reports from January 1, 2008, to June 30, 2008. FDA received
10,740 and 99 pet food complaints in FY 2007 and 2006, respectively.
Based on these experiences, FDA estimates that FDA could receive 540
voluntary pet food reports annually from 540 users of the electronic
reporting system. FDA estimates the reporting burden for a voluntary
``Early Warning Recall'' report to be 0.6 hours, for a total burden of
324 hours (540 reports x 0.6 hours = 324 hours).
Dated: May 13, 2009.
Jeffrey Shuren,
Associate Commissioner for Policy and Planning.
[FR Doc. E9-11687 Filed 5-19-09; 8:45 am]
BILLING CODE 4160-01-S