Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; MedWatch: The Food and Drug Administration Medical Products Reporting Program, 76417-76422 [2011-31341]
Download as PDF
Federal Register / Vol. 76, No. 235 / Wednesday, December 7, 2011 / Notices
affiliation, mailing address, telephone
number, email address);
• A letter of recommendation stating
the qualifications of the candidate.
Nomination materials must be
postmarked by December 30, 2011, and
sent to: Kim Distel, Office of Infectious
Diseases, Centers for Disease Control
and Prevention, 1600 Clifton Road NE.,
Mailstop D10, Atlanta, Georgia 30333,
telephone (404) 639–2100.
Candidates invited to serve will be
asked to submit the ‘‘Confidential
Financial Disclosure Form for Special
Government Employees Serving on
Federal Advisory Committees at the
Centers for Disease Control and
Prevention.’’ This form allows CDC to
determine whether there is a statutory
conflict between that person’s public
responsibilities as a Special Government
Employee and private interests and
activities, or the appearance of a lack of
impartiality, as defined by Federal
regulation. The form may be viewed and
downloaded at https://www.usoge.gov/
forms/oge450_pdf/oge450_
accessible.pdf. This form should not be
submitted as part of a nomination.
The Director, Management Analysis
and Services Office, has been delegated
the authority to sign Federal Register
notices pertaining to announcements of
meetings and other committee
management activities for both the
Centers for Disease Control and
Prevention, and the Agency for Toxic
Substances and Disease Registry.
Dated: November 29, 2011.
Elaine L. Baker,
Director, Management Analysis and Services
Office, Centers for Disease Control and
Prevention.
[FR Doc. 2011–31429 Filed 12–6–11; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Office of Planning, Research and
Evaluation Advisory Committee on
Head Start Research and Evaluation
Administration for Children
and Families (ACF), Department of
Health and Human Services (HHS).
ACTION: Notice.
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AGENCY:
This notice announces a
forthcoming meeting of a public
advisory committee of ACF. The
meeting will be open to the public.
Name of Committee: Advisory
Committee for Head Start Research and
Evaluation.
SUMMARY:
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General Function of Committee: The
Advisory Committee for Head Start
Research and Evaluation will provide
feedback on the published final report
for the Head Start Impact Study, offering
interpretations of the findings,
discussing implications for practice and
policy, and providing recommendations
on follow-up research, including
additional analysis of the Head Start
Impact Study data. The Committee will
also be asked to provide
recommendations to the Secretary
regarding how to improve Head Start
and other early childhood programs by
enhancing the use of research-informed
practices in early childhood. Finally,
the Committee will be asked to provide
recommendations on the overall Head
Start research agenda, including—but
not limited to—how the Head Start
Impact Study fits within this agenda.
The Committee will provide advice
regarding future research efforts to
inform HHS about how to guide the
development and implementation of
best practices in Head Start and other
early childhood programs around the
country.
DATES: The meeting will be held from
8:30 a.m. to 5 p.m. on January 18–19,
2012.
ADDRESSES: Washington Plaza Hotel, 10
Thomas Circle NW., Washington, DC
20005, Phone: (202) 842–1300.
FOR FURTHER INFORMATION CONTACT:
Jennifer Brooks, Office of Planning,
Research, and Evaluation, email
jennifer.brooks@acfhhs.gov or call (202)
205–8212.
Agenda: The Committee will review
draft recommendations developed by
the subcommittees on the topics of
quality teaching and learning; parent,
family, and community engagement; the
impact of Head Start and Early Head
Start; health and mental health; and
cultural and linguistic responsiveness.
Procedure: Interested persons may
present data, information or views, in
writing, on issues pending before the
Committee. Written submissions may be
made to Jennifer Brooks at
jennifer.brooks@acf.hhs.gov on or before
January 2, 2012. All written materials
provided to the contact person will be
shared with the Committee members.
ACF welcomes the attendance of the
public at this advisory committee
meeting and will make every effort to
accommodate persons with physical
disabilities or special needs. If you
require special accommodations due to
a disability, please contact Jennifer
Brooks at least seven days in advance of
the meeting. Information about the
Committee and this meeting can be
found at the Committee Web site, http:
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//www.acfhhs.gov/programs/opre/hs/
advisory_com/.
Notice of this meeting is given under
the Federal Advisory Committee Act (5
U.S.C. app. 2).
Dated: November 22, 2011.
George H. Sheldon,
Acting Assistant Secretary for Children and
Families.
[FR Doc. 2011–31196 Filed 12–6–11; 8:45 am]
BILLING CODE M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2011–N–0608]
Agency Information Collection
Activities; Submission for Office of
Management and Budget Review;
Comment Request; MedWatch: The
Food and Drug Administration Medical
Products Reporting Program
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
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.
DATES: Fax written comments on the
collection of information by January 6,
2012.
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) 395–7285, or emailed to
oira_submission@omb.eop.gov. All
comments should be identified with the
OMB control number 0910–0291. Also
include the FDA docket number found
in brackets in the heading of this
document.
SUMMARY:
FOR FURTHER INFORMATION CONTACT:
Jonna Capezzuto, Office of
Information Management, Food and
Drug Administration, 1350 Piccard Dr.,
PI50–400B, Rockville, MD 20850, (301)
796–3794,
Jonnalynn.Capezzuto@fda.hhs.gov.
In
compliance with 44 U.S.C. 3507, FDA
has submitted the following proposed
collection of information to OMB for
review and clearance.
SUPPLEMENTARY INFORMATION:
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MedWatch: The FDA Medical Products
Reporting Program—(OMB Control
Number 0910–0291)—Extension
I. Background
To ensure the marketing of safe and
effective products, postmarketing
adverse outcomes and product problems
must be reported for all FDA-regulated
human health care products, including
drugs, both prescription and over-thecounter (OTC); biologics; medical
devices; dietary supplements and other
special nutritional products (e.g., infant
formula and medical foods); and
cosmetics. In addition, FDA has
regulatory responsibility for tobacco
products and an interest in receiving
reports about adverse outcomes and
product problems for these products.
Under sections 505, 512, 513, 515,
519 and 903 of the Federal Food, Drug,
and Cosmetic Act (the FD&C Act) (21
U.S.C. 355, 360b, 360c, 360e, 360i and
393) and section 351 of the Public
Health Service Act (42 U.S.C. 262), FDA
has the responsibility to ensure the
safety and effectiveness of drugs,
biologics, and devices. Under section
502(a) of the FD&C Act (21 U.S.C.
352(a)), a drug or device is misbranded
if its labeling is false or misleading.
Under section 502(f)(2) of the FD&C Act,
it is misbranded if it fails to bear
adequate warnings, and under section
502(j), it is misbranded if it is dangerous
to health when used as directed in its
labeling. Under section 502(t)(2) of the
FD&C Act, devices are considered to be
misbranded if there has been a failure or
refusal to give required notification or to
furnish required material or information
required under section 519.
Requirements regarding mandatory
reporting of adverse events or product
problems have been codified in parts
310, 314, 600, and 803 (21 CFR 310,
314, 600, and 803), specifically
§§ 310.305, 314.80, 314.98, 600.80,
803.30, 803.50, 803.53, 803.56, and
specified in sections 760 and 761 of the
FD&C Act (21 U.S.C. 379aa and 379aa–
1). Mandatory reporting of adverse
reactions for human cells, tissues, and
cellular and tissue-based products
(HCT/Ps) has been codified in 21 CFR
1271.350.
FDA regulates the safety (i.e.,
adulteration) of dietary supplements
under section 402 of the FD&C Act (21
U.S.C. 342). Dietary supplements do not
require premarket approval by FDA and
the Agency bears the burden to gather
and review evidence that a dietary
supplement may be adulterated under
section 402 of the FD&C Act after that
product is marketed. Under section
761(b)(1) of the FD&C Act, a dietary
supplement manufacturer, packer, or
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distributor whose name appears on the
label of a dietary supplement marketed
in the United States is required to
submit to FDA any serious adverse
event report it receives regarding use of
the dietary supplement in the United
States.
Mandatory reporting, since 1993, has
been supplemented by voluntary
reporting by health care professionals,
their patients, and consumers via the
MedWatch reporting process. To carry
out its responsibilities, the Agency
needs to be informed when an adverse
event, product problem, error with use
of a human medical product or evidence
of therapeutic failure (inequivalence) is
suspected or identified in clinical use.
When FDA receives this information
from either health care professionals or
patients, the report becomes data that
will be used to assess and evaluate the
risk associated with the product, and
then take whatever action is necessary
to reduce, mitigate, or eliminate the
public’s exposure to the risk through
regulatory and public health
interventions.
To implement these provisions for
reporting on human medical products
during their postapproval and marketed
lifetimes, two forms are available from
the Agency. FDA Form 3500 is used for
voluntary (i.e., not mandated by law or
regulation) reporting by health care
professionals and the public. FDA Form
3500A is used for mandatory reporting
(i.e., required by law or regulation).
Respondents to this collection of
information are health care
professionals; medical care
organizations and other user-facilities
(e.g., extended care facilities,
ambulatory surgical centers);
consumers; manufacturers of biological,
dietary supplement, and drug products
or medical devices; and importers.
II. Use of FDA Form 3500 (Voluntary
Version)
The voluntary version of the form is
used to submit all reports not mandated
by Federal law or regulation. Individual
health professionals are not required by
law or regulation to submit reports to
the Agency or the manufacturer, with
the exception of certain adverse
reactions following immunization with
vaccines as mandated by the National
Childhood Vaccine Injury Act of 1986.
Those mandatory reports are not
submitted to FDA on the 3500 or 3500A
form but are submitted to the joint FDA/
Centers for Disease Control and
Prevention Vaccines Adverse Event
Reporting System (VAERS) on the
VAERS–1 form (see https://
vaers.hhs.gov/resources/
vaers_form.pdf).
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Hospitals are not required by Federal
law or regulation to submit reports
associated with drug products,
biological products, or special
nutritional products. However, hospitals
and other user facilities are required by
Federal law to report medical devicerelated deaths and serious injuries.
Under Federal law and regulation
(section 761(b)(1) of the FD&C Act), a
dietary supplement manufacturer,
packer, or distributor whose name
appears on the label of a dietary
supplement marketed in the United
States is required to submit to FDA any
serious adverse event report it receives
regarding use of the dietary supplement
in the United States. However, FDA
bears the burden to gather and review
evidence that a dietary supplement may
be adulterated under section 402 of the
FD&C Act after that product is
marketed. Therefore, the Agency
depends on the voluntary reporting by
health professionals and especially by
consumers of suspected serious adverse
events and product quality problems
associated with the use of dietary
supplements.
III. Use of FDA Form 3500A
(Mandatory Version)
A. Drug and Biologic Products
In sections 505(j) and 704 (21 U.S.C.
374) of the FD&C Act, Congress has
required that important safety
information relating to all human
prescription drug products be made
available to the FDA so that it can take
appropriate action to protect the public
health when necessary. Section 702 of
the FD&C Act (21 U.S.C. 372) authorizes
investigational powers to FDA for
enforcement of the FD&C Act. These
statutory requirements regarding
mandatory reporting have been codified
by FDA under 21 parts 310 and 314
(drugs) and 600 (biologics) of the Code
of Federal Regulations. Parts 310, 314,
and 600 mandate the use of FDA Form
3500A for reporting to FDA on adverse
events that occur with drugs and
biologics. Mandatory reporting of
adverse reactions for HCT/Ps has been
codified in 21 CFR 1271.350.
The majority of the mandatory reports
for drug products, which at inception of
FDA Form 3500A’s use were received
by the Agency on the paper version of
FDA Form 3500A (by mail or FAX), are
now submitted and received by the
Agency via an electronic submission
route. In that case, the FDA Form 3500A
is not used.
B. Medical Device Products
Section 519 of the FD&C Act requires
manufacturers and importers of devices
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intended for human use to establish and
maintain records, make reports, and
provide information as the Secretary of
Health and Human Services may by
regulation reasonably require to assure
that such devices are not adulterated or
misbranded and to otherwise assure its
safety and effectiveness. The Safe
Medical Device Act of 1990, signed into
law on November 28, 1990, amends
section 519 of the FD&C Act. The
amendment requires that user facilities
such as hospitals, nursing homes,
ambulatory surgical facilities, and
outpatient treatment facilities report
deaths related to medical devices to
FDA and to the manufacturer, if known.
Serious illnesses and injuries are to be
reported to the manufacturer or to FDA
if the manufacturer is not known. These
statutory requirements regarding
mandatory reporting have been codified
by FDA under 21 CFR part 803, which
mandates the use of FDA Form 3500A
for reporting to FDA on medical
devices. The Medical Device User Fee
and Modernization Act of 2002, Public
Law 107–250, signed into law October
26, 2002, amended section 519 of the
FD&C Act. The amendment (section
303) required FDA to revise the
MedWatch forms ‘‘to facilitate the
reporting of information * * * relating
to reprocessed single-use devices,
including the name of the reprocessor
and whether the device has been
reused.’’
C. Nonprescription Drug Products and
Dietary Supplements
Section 502(x) in the FD&C Act
implements the requirements of the
Dietary Supplement and
Nonprescription Drug Consumer
Protection Act, which became law (Pub.
L. 109–462) on December 22, 2006.
These requirements apply to
manufacturers, packers, and distributors
of nonprescription (OTC) human drug
products marketed without an approved
application. The law requires reports of
serious adverse events to be submitted
to FDA by manufacturers of dietary
supplements and nonprescription drugs.
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IV. Proposed Modifications to Existing
Forms 3500 and 3500A
A. General Changes
The proposed modifications to FDA
Form 3500 and FDA Form 3500A reflect
changes that will bring the form into
conformation, since the previous
authorization in 2008, with current
regulations, rules, and guidances.
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B. Changes Proposed for FDA Form
3500
No additional fields will be added
and no fields deleted. There are no
proposed formatting changes to the
location or distribution of the fields.
Modifications are proposed to several
field labels and descriptions to better
clarify for reporters the range of
reportable products, including tobacco
products and food (e.g., food allergens
causing allergic or anaphylaxis
reactions). Descriptive text in the field
labels and instructions were modified to
permit a better understanding of data
requested. For section E, field E4, the
label ‘‘Other’’ will be renamed ‘‘Unique
Identifier #’’ in anticipation of the use
of this product information by the
Agency for specific characterization and
identification of the medical device. The
form remains a one-sided, one-page
form with instructions for use on the
reverse side and a self-addressed,
postage-paid return mailer.
C. Changes Proposed for FDA Form
3500A
Certain formatting changes are
proposed to allow mandatory reporters
to better utilize available space for data
entry and facilitate specification of the
device product’s coding. In section D,
field D2, it is proposed that the same
field be used to request the procode
(D2b) to correspond to the existing
common device name (D2a). The D4
field currently named ‘‘Other’’ will be
renamed ‘‘Unique Identifier #.’’ Section
H, currently named ‘‘Device
Manufacturers Only’’ will be renamed
‘‘Manufacturers Only.’’ Field H1 will
have the ‘‘Other’’ checkbox removed
and field H6, renamed ‘‘Event Problem
and Evaluation Codes,’’ will have
patient code and device code boxes
added, as in the existing form’s field
F10. In section G, field G5, STN # will
be relabeled BLA #. Given the need to
contact mandatory reporters in a timely
manner, the Agency proposes that a
field be added to FDA Form 3500A to
request an email address for the
mandatory reporter, to supplement the
phone number and mailing address
currently included on the form. This
change is proposed for fields E1 and G1.
V. Proposed Addition of Consumer
Version of FDA Form 3500
FDA supports and encourages direct
reporting to the Agency by consumers
(patients and their caregivers) of
suspected serious adverse outcomes and
other product problems associated with
human medical products (https://
www.fda.gov/Safety/ReportaProblem/
default.htm.) Since the inception of the
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MedWatch program, launched in July
1993 by then FDA Commissioner David
Kessler, the program has been
promoting and facilitating voluntary
reporting by both the general public and
health care professionals (Ref. 1). FDA
has further encouraged voluntary
reporting by requiring inclusion of the
MedWatch toll-free telephone number
or the MedWatch Internet address on all
outpatient drug prescriptions dispensed,
as mandated by section 17 of the Best
Pharmaceuticals for Children Act (Pub.
L. 107–109).
On March 25, 2008, section 906 of the
FDA Amendments Act amended section
502(n) of the FD&C Act and mandated
that published direct-to-consumer
advertisements for prescription drugs
include the following statement printed
in conspicuous text (this includes
vaccine products): ‘‘You are encouraged
to report negative side effects of
prescription drugs to the FDA. Visit
https://www.fda.gov/medwatch, or call
1–(800) FDA–1088.’’ Most private
vendors of consumer medication
information, the drug product-specific
instructions dispensed to consumers at
outpatient pharmacies, remind patients
to report ‘‘side effects’’ to FDA and
provide contact information to permit
reporting via the MedWatch process and
FDA Form 3500.
Currently, the non-health care
professional public may submit
voluntary reports using FDA Form 3500
(https://www.fda.gov/Safety/MedWatch/
HowToReport/ucm053074.htm). This
reporting form was created 20 years ago
and modeled after an earlier version of
the Agency’s reporting form for health
care professionals. FDA Form 3500 is
provided in paper and electronic
formats (HTML version at https://
www.fda.gov/medwatch/report.htm and
fillable pdf version at https://
www.fda.gov/downloads/Safety/
MedWatch/HowToReport/
DownloadForms/ucm082725.pdf), and
is used to report to the Agency about
serious adverse events, product
problems, product use errors, and
therapeutic failure (therapeutic
inequivalence). Reporting is supported
for all FDA-regulated human medical
care products, including drugs,
biologicals, medical devices, special
nutritional products, dietary
supplements, cosmetics, and
nonprescription (OTC) human drug
products marketed without an approved
application.
Qualitative assessment by social
scientists, and comments and feedback
from the public, have recognized that
FDA Form 3500 is written and
formatted at a literacy/
comprehensibility level that far exceeds
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the level recommended for the general
public by health literacy experts and
does not conform to recommendations
in the Plain Writing Act of 2010
(https://www.gpo.gov/fdsys/pkg/PLAW–
111publ274/pdf/PLAW–
111publ274.pdf).
The proposed consumer version of the
voluntary FDA Form 3500 will request
no new data from the voluntary reporter
not already included in the existing
FDA Form 3500 that is currently used
for reporting from both health care
professionals and consumers (patients).
Certain existing fields not considered
essential data for the consumer report
but present on the standard (i.e., health
care professional) version of FDA Form
3500 have been eliminated to facilitate
and expedite consumer submissions and
reduce reporting burden. The formatting
and plain language used are compatible
with the intent of the Plain Writing Act
and is expected to provide non-health
care professionals with a second option
to the existing FDA Form 3500 that will
reduce the burden of reporting by
facilitating their understanding of the
requested data and further clarify the
voluntary reporting process.
The proposed consumer version of
FDA Form 3500 evolved from several
iterations of draft versions, with input
from human factors experts, from other
regulatory agencies and with extensive
input from consumer advocacy groups
and the general public. The Agency
recognizes that many consumer
reporters have a preference for accessing
a copy of the voluntary reporting form
on the Internet or submitting to FDA
using an electronic version of the form.
The Agency currently supports
voluntary reporting with the forms
submitted by mail, by FAX, by
telephone via the toll free 800 number
and online at https://www.fda.gov/
medwatch/report.htm. It is the Agency’s
expectation that an approved consumer
version of the voluntary form will be
provided for consumer use by these
same channels.
In the Federal Register of September
9, 2011 (76 FR 55919), FDA published
a 60-day notice requesting public
comment on the proposed collection of
information. Comments were received
from seven individuals and
organizations.
VI. Response to Comments
1. 3500 Form
(Comment 1) One comment observed
that it may be difficult for FDA to
identify the pregnancy status of the
person experiencing the reported
adverse event and suggested that the
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Agency add a separate field for
documenting pregnancy status.
(Response) FDA agrees that
documenting pregnancy status is
important; however, FDA does not plan
to add an additional checkbox for
pregnancy to the forms at this time. In
2005, FDA proposed adding checkboxes
for both ‘‘Product Used During
Pregnancy’’ and ‘‘Product Used During
Breast Feeding’’ to section B.5 of both
forms. FDA received comments
expressing concern that these new data
fields introduced divergence from
International Council on Harmonisation
standards and appeared to duplicate
information that is usually provided in
the narrative section and in coded
adverse event terms. The pregnancy
status data can also be captured in field
B7 as ‘‘Other Relevant History’’. FDA
agreed with the comments and did not
include these checkboxes with the 2005
revisions; FDA believes these reasons
are still valid.
(Comment 2) One comment
encouraged the FDA to use the
voluntary consumer version of the form
to allow for electronic filing of reports
and to continue to promote the
reporting process to the public, whether
by the traditional paper-based route or
electronically.
(Response) FDA agrees with the
comment and expects to support both
the promotion of the use of the new
consumer version of the voluntary form
and to explore methods of facilitating
reporting and reducing reporter burden
by using online and other electronic
means of report submission.
(Comment 3) One comment supported
the plan to deploy a consumer version
of the voluntary form and suggested that
its use also be promoted to health care
providers for their use. The comment
also encouraged the Agency to expedite
a process for converting the paper-based
reporting process to allow for electronic
submission of voluntary reports using
the consumer version of the form.
(Response) FDA agrees that support of
electronic submissions of voluntary
reports should be supported and
facilitated. The new form was designed
as a consumer friendly option for use by
non-health care professionals. The
standard FDA Form 3500 will continue
to be the primary form offered to health
care professionals. FDA encourages the
continued use of FDA Form 3500 by
health care professionals; however, if a
health care professional chooses to
submit a report using the consumer
form, it will be accepted by FDA.
(Comment 4) One comment stated
that implementing a consumer friendly
version of FDA Form 3500 would not
‘‘serve any value’’ and suggested that
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instead a more comprehensible form be
created that would be used by health
care professionals and consumers.
(Response) The Agency disagrees. The
current FDA Form 3500 is widely
known, well accepted, and used by the
range of health care professionals.
Assessment of, and feedback from,
consumers has demonstrated the
demand and need for a modified form
that would serve those non-health care
professional reporters, using both
literacy-appropriate language and
formatting that will serve consumers but
not be optimal for health care
professional reporting.
(Comment 5) A comment suggested
that for the proposed change to field E4
from ‘‘Other’’ to ‘‘Unique Identifier’’
that the term used be ‘‘UDI#’’.
(Response) FDA agrees with this
comment.
(Comment 6) One comment supported
the development of a consumer friendly
version of the voluntary form but
observed that with the anticipated
increase in the number of consumerinitiated reports that the Agency
consider a process for ‘‘broader sharing
with industry sponsors of adverse event
reports made directly to FDA.’’
(Response) FDA agrees that adverse
event report data should be more readily
available to the public (which includes
industry). The current mechanisms that
FDA has to share reports with industry
are the MedWatch to Manufacturer
Program and through requests to
Freedom of Information. In addition, as
part of Phase II of the FDA
Transparency Initiative, FDA is
planning to provide the public with
online access (in a searchable format) to
public information from adverse event
reports submitted to FDA.
2. 3500A Form
(Comment 7) One comment asked that
no changes be made to the FDA Form
3500A at the present time due to
consideration of the costs and
expenditure of resources incurred by
mandatory reporters who are often using
electronic systems to do their required
reporting to FDA. In addition, the
comment noted that there are several
proposed or not yet finalized rules that
might further impact the content of the
mandatory FDA Form 3500. A comment
stated that they would ask for a 12month implementation time to allow for
design, testing, and validation of any
software changes necessary.
(Response) The Agency has
considered the impact of implementing
changes to FDA Form 3500A and the
need for mandatory reporters to change
their electronic systems to comply with
the proposed changes. FDA will allow
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for sufficient time for design, testing,
and validation of any software changes
as a result of any new data requirements
that may follow from new requirements
based on final rules and regulations.
(Comment 8) One comment stated
that for mandatory reporters the
estimate of burden has been
underestimated and fails to take into
consideration the effort by firms to
collect facts, prepare investigations, and
evaluate the data.
(Response) The Agency disagrees that
the estimate for the average time to
complete a given report is low. This
estimate is intended not to represent the
totality of the effort for completing the
postmarket drug and device safety
surveillance process mandated by law,
rule, and regulation for application
holders but a fair estimate of data
collection, organization, entry, and
submission time for a given ‘‘average’’
report.
(Comment 9) A comment suggested
that for the proposed change to field D4
from ‘‘Other’’ to ‘‘Unique Identifier’’
that the term used be ‘‘UDI#’’.
(Response) FDA agrees with this
comment. We recommend changing this
to UDI#.
(Comment 10) A comment disagreed
with requesting an email address from
the reporter in field E1, and a second
comment expressed similar reservations
but suggested that, if used, the initial
reporter understand that this
information is optional.
(Response) FDA recognizes that an
email address is one of several elements
in the contact information that may
assist FDA and others in effective
postmarket safety surveillance and
followup inquiries. The reporter is not
compelled to complete the information
in this field in order for the report to be
considered complete and registered in
the appropriate database. A statement
that this information is optional will be
made clear in the instructions for
completing the form.
(Comment 11) A comment disagreed
with the proposed change in the Section
H heading from ‘‘Device Manufacturers
Only’’ to ‘‘Manufacturers Only’’.
(Response) FDA agrees that this title
should not be changed. Section H
should be titled ‘‘Device Manufacturers
Only’’ as it currently appears.
(Comment 12) Two comments
recommended the addition of a new
checkbox field in Section/field H2
named ‘‘Final report’’ that would be
used to ‘‘reflect the best efforts of the
manufacturer to retrieve and analyze
information pertaining to the reported
event’’.
(Response) FDA disagrees that ‘‘Final
report’’ should be added to Section H2.
This information can be added as part
of the text narrative in Section H10.
(Comment 13) Two comments
disagreed with the removal of field H1’s
‘‘Other’’ checkbox and stated that there
are rare examples of events that do not
meet the regulatory definition of death,
serious injury, or malfunction but are
considered by the mandatory reporting
entity to be necessary and required
reports. One comment suggested that if
76421
the checkbox is removed, that specific
instruction be provided for handling
reports that would have been
compatible with an ‘‘Other’’
designation.
(Response) FDA disagrees. FDA
recommends removal of the ‘‘Other’’
checkbox. In lieu of the checkbox, FDA
proposes that rare events that fit the
definition of ‘‘Other significant adverse
device experiences’’ as specified in
FD&C Act section 519(a)(3) can be
submitted to the FDA using the mailing
address identified in 21 CFR 803.12(a).
(Comment 14) One comment
suggested changing the title of field B4
from ‘‘Date of This Report’’ to ‘‘Date of
First Contact With Initial Reporter’’.
(Response) FDA disagrees. On August
21, 2009, FDA published a proposed
rule (74 FR 42203) to amend part 803 to
require manufacturers, importers, and
user facilities to submit medical device
reports to the Agency in an electronic
format (i.e., the 2009 proposed rule).
Section II(4)(D)(2) of the 2009 proposed
rule specified that in the final rule, FDA
specifically proposed to change
§§ 803.32(b)(4), 803.42(b)(4), and
803.52(b)(4) from ‘‘date of report by the
initial reporter’’ to ‘‘date of this report’’.
Further it states, ‘‘This change would
make part 803 consistent with the way
that other FDA Centers interpret FDA
Form 3500A, Block B4 and how Block
B4 appears on FDA Form 3500A.’’
FDA estimates the burden of this
collection of information as follows:
TABLE 1—ESTIMATED ANNUAL REPORTING BURDEN 1
FDA Center
FDA Form
(21 CFR Section)
Number of responses per respondent
Number of
respondents
Center for Biologics Evaluation and Research/Center for Drug Evaluation
and Research:
Form 3500 ......................................
Total annual
responses
28,952
1
28,952
599
96
57,504
4,585
1
4,585
Form 3500A (§ 803) .......................
1,485
225
334,125
Center for Food Safety and Applied Nutrition:
Form 3500 ......................................
srobinson on DSK4SPTVN1PROD with NOTICES
Form 3500A (§§ 310.305, 314.80,
314.98, and 600.80).
Center for Devices and Radiological
Health:
Form 3500 ......................................
297
1
297
Form 3500A ....................................
1,039
1
1,039
Total ........................................
............................
............................
............................
1 There
Average burden per
response
Total hours
0.60 ..............................
(36 minutes) .................
1.10.
17,371
............................
0.60 ..............................
(36 minutes) .................
1.10 ..............................
(66 minutes).
2,751
............................
367,538
0.6 ................................
(36 minutes).
1.10 ..............................
(66 minutes).
......................................
178
are no capital costs or operating and maintenance costs associated with this collection of information.
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Federal Register / Vol. 76, No. 235 / Wednesday, December 7, 2011 / Notices
VII. Reference
The following reference has been
placed on display in the Division of
Dockets Management (HFA–305), Food
and Drug Administration, 5630 Fishers
Lane, rm. 1061, Rockville, MD 20852,
and may be seen by interested persons
between 9 a.m. and 4 p.m., Monday
through Friday.
1. Kessler, D.A., ‘‘Introducing MEDWatch:
A New Approach to Reporting Medication
and Device Adverse Effects and Product
Problems,’’ Journal of the American Medical
Association, 269: 2765–2768, 1993.
Dated: December 1, 2011.
Leslie Kux,
Acting Assistant Commissioner for Policy.
[FR Doc. 2011–31341 Filed 12–6–11; 8:45 am]
BILLING CODE 4160–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2011–N–0858]
Agency Information Collection
Activities; Proposed Collection;
Comment Request; Experimental
Study on Comparing Data Obtained
From Landline Telephone and Cell
Phone Surveys
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
The Food and Drug
Administration (FDA) is announcing an
opportunity for public comment on the
proposed collection of certain
information by the Agency. Under the
Paperwork Reduction Act of 1995 (the
PRA), Federal Agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information and to allow 60 days for
public comment in response to the
notice. This notice solicits comments on
a study entitled ‘‘Experimental Study on
Comparing Data Obtained From
Landline Telephone and Cell Phone
Surveys.’’
SUMMARY:
Submit either electronic or
written comments on the collection of
information by February 6, 2012.
ADDRESSES: Submit electronic
comments on the collection of
information to https://
www.regulations.gov. Submit written
comments on the collection of
information to the Division of Dockets
Management (HFA–305), Food and Drug
Administration, 5630 Fishers Lane, Rm.
1061, Rockville, MD 20852. All
comments should be identified with the
srobinson on DSK4SPTVN1PROD with NOTICES
DATES:
VerDate Mar<15>2010
17:00 Dec 06, 2011
Jkt 226001
docket number found in brackets in the
heading of this document.
FOR FURTHER INFORMATION CONTACT:
Denver Presley, II, Office of Information
Management, Food and Drug
Administration, 1350 Piccard Dr., PI50–
400B, Rockville, MD 20850, (301) 796–
3793.
SUPPLEMENTARY INFORMATION: Under the
PRA (44 U.S.C. 3501–3520), Federal
Agencies must obtain approval from the
Office of Management and Budget
(OMB) for each collection of
information they conduct or sponsor.
‘‘Collection of information’’ is defined
in 44 U.S.C. 3502(3) and 5 CFR
1320.3(c) and includes Agency requests
or requirements that members of the
public submit reports, keep records, or
provide information to a third party.
Section 3506(c)(2)(A) of the PRA (44
U.S.C. 3506(c)(2)(A)) requires Federal
Agencies to provide a 60-day notice in
the Federal Register concerning each
proposed collection of information
before submitting the collection to OMB
for approval. To comply with this
requirement, FDA is publishing notice
of the proposed collection of
information set forth in this document.
With respect to the following
collection of information, FDA invites
comments on these topics: (1) Whether
the proposed collection of information
is necessary for the proper performance
of FDA’s functions, including whether
the information will have practical
utility; (2) the accuracy of FDA’s
estimate of the burden of the proposed
collection of information, including the
validity of the methodology and
assumptions used; (3) ways to enhance
the quality, utility, and clarity of the
information to be collected; and (4)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques,
when appropriate, and other forms of
information technology.
Experimental Study on Comparing Data
Obtained From Landline Telephone
and Cell Phone Surveys—(OMB Control
Number 0910–NEW)
I. Background
Since the early 1980s, the Center for
Food Safety and Applied Nutrition at
FDA has been commissioning several
waves of two national consumer
surveys, the Food Safety Survey (FSS)
and the Health and Diet Survey (HDS),
to gather data on consumer knowledge,
perceptions, and behaviors regarding
food safety and nutrition. The purposes
of the surveys are three-fold: (1) To
generate nationally representative
estimates of knowledge, perception, and
PO 00000
Frm 00064
Fmt 4703
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practice of interest at a given point in
time; (2) to track trends of the estimates
over time; and (3) to understand the
relationships among knowledge,
perceptions, and practices regarding
food safety and nutrition and how these
relate to demographic characteristics.
Traditionally, all waves of the surveys
have been administered via landline
telephones and have used the random
digit dialing (RDD) technique to recruit
national samples of adults (18 years old
or above) from households with
landline telephone numbers. A
noticeable phenomenon that has
appeared in our recent surveys is a
precipitous decline of younger
respondents in completed interviews.
For example, the proportion of
respondents in the 18 to 29 age group
for the FSS has dropped from 17 percent
in 2001 to 11 percent in 2006 to only 4
percent in 2010; the corresponding
proportion for the HDS has gone from
14 percent in 2002, to 15 percent in
2004, to only 6 percent in 2008.
One possible reason for the decline is
the rapid adoption of cell phones in
recent years. During the second half of
2010, 28 percent of American adults
lived in households with only wireless
service (‘‘wireless-only households’’ or
‘‘cell-phone only households’’),
compared to 15 percent in the second
half of 2007 and 5 percent in the second
half of 2004 (Ref. 1). During the second
half of 2010, 17 percent of adults lived
in households that received all or
almost all calls on cell phones despite
having a landline phone (‘‘wirelessmostly households’’ or ‘‘cell-phone
mostly households’’), an increase of 3
percentage points from the first half of
2008 (Ref. 1). Thus, the number of
adults reachable by landline phone calls
has decreased in recent years. The rate
of cell phone adoption, however, has
been uneven among adults with
different demographic characteristics. In
2010, adults living in wireless-only
households were more likely to be 18 to
34 year olds, living in poorer
households, without a college or higher
educational degree, or Hispanics or
Latinos (Ref. 1). Meanwhile, adults who
live in landline households differ from
those who live in wireless-only
households as well those in wirelessmostly households (Ref. 2), and the
demographic characteristics of adults
living in wireless-mostly households are
much less diverse than that of adults
living in wireless-only households (Ref.
1).
The under-representation of wirelessonly or wireless-mostly adults,
especially those in younger age groups,
in landline surveys can affect national
estimates of the prevalence of certain
E:\FR\FM\07DEN1.SGM
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Agencies
[Federal Register Volume 76, Number 235 (Wednesday, December 7, 2011)]
[Notices]
[Pages 76417-76422]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-31341]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA-2011-N-0608]
Agency Information Collection Activities; Submission for Office
of Management and Budget Review; Comment Request; MedWatch: The Food
and Drug Administration Medical Products Reporting Program
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.
DATES: Fax written comments on the collection of information by January
6, 2012.
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) 395-7285, or emailed to oira_submission@omb.eop.gov. All
comments should be identified with the OMB control number 0910-0291.
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, Food and Drug
Administration, 1350 Piccard Dr., PI50-400B, Rockville, MD 20850, (301)
796-3794, Jonnalynn.Capezzuto@fda.hhs.gov.
SUPPLEMENTARY INFORMATION: In compliance with 44 U.S.C. 3507, FDA has
submitted the following proposed collection of information to OMB for
review and clearance.
[[Page 76418]]
MedWatch: The FDA Medical Products Reporting Program--(OMB Control
Number 0910-0291)--Extension
I. Background
To ensure the marketing of safe and effective products,
postmarketing adverse outcomes and product problems must be reported
for all FDA-regulated human health care products, including drugs, both
prescription and over-the-counter (OTC); biologics; medical devices;
dietary supplements and other special nutritional products (e.g.,
infant formula and medical foods); and cosmetics. In addition, FDA has
regulatory responsibility for tobacco products and an interest in
receiving reports about adverse outcomes and product problems for these
products.
Under sections 505, 512, 513, 515, 519 and 903 of the Federal Food,
Drug, and Cosmetic Act (the FD&C Act) (21 U.S.C. 355, 360b, 360c, 360e,
360i and 393) and section 351 of the Public Health Service Act (42
U.S.C. 262), FDA has the responsibility to ensure the safety and
effectiveness of drugs, biologics, and devices. Under section 502(a) of
the FD&C Act (21 U.S.C. 352(a)), a drug or device is misbranded if its
labeling is false or misleading. Under section 502(f)(2) of the FD&C
Act, it is misbranded if it fails to bear adequate warnings, and under
section 502(j), it is misbranded if it is dangerous to health when used
as directed in its labeling. Under section 502(t)(2) of the FD&C Act,
devices are considered to be misbranded if there has been a failure or
refusal to give required notification or to furnish required material
or information required under section 519. Requirements regarding
mandatory reporting of adverse events or product problems have been
codified in parts 310, 314, 600, and 803 (21 CFR 310, 314, 600, and
803), specifically Sec. Sec. 310.305, 314.80, 314.98, 600.80, 803.30,
803.50, 803.53, 803.56, and specified in sections 760 and 761 of the
FD&C Act (21 U.S.C. 379aa and 379aa-1). Mandatory reporting of adverse
reactions for human cells, tissues, and cellular and tissue-based
products (HCT/Ps) has been codified in 21 CFR 1271.350.
FDA regulates the safety (i.e., adulteration) of dietary
supplements under section 402 of the FD&C Act (21 U.S.C. 342). Dietary
supplements do not require premarket approval by FDA and the Agency
bears the burden to gather and review evidence that a dietary
supplement may be adulterated under section 402 of the FD&C Act after
that product is marketed. Under section 761(b)(1) of the FD&C Act, a
dietary supplement manufacturer, packer, or distributor whose name
appears on the label of a dietary supplement marketed in the United
States is required to submit to FDA any serious adverse event report it
receives regarding use of the dietary supplement in the United States.
Mandatory reporting, since 1993, has been supplemented by voluntary
reporting by health care professionals, their patients, and consumers
via the MedWatch reporting process. To carry out its responsibilities,
the Agency needs to be informed when an adverse event, product problem,
error with use of a human medical product or evidence of therapeutic
failure (inequivalence) is suspected or identified in clinical use.
When FDA receives this information from either health care
professionals or patients, the report becomes data that will be used to
assess and evaluate the risk associated with the product, and then take
whatever action is necessary to reduce, mitigate, or eliminate the
public's exposure to the risk through regulatory and public health
interventions.
To implement these provisions for reporting on human medical
products during their postapproval and marketed lifetimes, two forms
are available from the Agency. FDA Form 3500 is used for voluntary
(i.e., not mandated by law or regulation) reporting by health care
professionals and the public. FDA Form 3500A is used for mandatory
reporting (i.e., required by law or regulation).
Respondents to this collection of information are health care
professionals; medical care organizations and other user-facilities
(e.g., extended care facilities, ambulatory surgical centers);
consumers; manufacturers of biological, dietary supplement, and drug
products or medical devices; and importers.
II. Use of FDA Form 3500 (Voluntary Version)
The voluntary version of the form is used to submit all reports not
mandated by Federal law or regulation. Individual health professionals
are not required by law or regulation to submit reports to the Agency
or the manufacturer, with the exception of certain adverse reactions
following immunization with vaccines as mandated by the National
Childhood Vaccine Injury Act of 1986. Those mandatory reports are not
submitted to FDA on the 3500 or 3500A form but are submitted to the
joint FDA/Centers for Disease Control and Prevention Vaccines Adverse
Event Reporting System (VAERS) on the VAERS-1 form (see https://vaers.hhs.gov/resources/vaers_form.pdf).
Hospitals are not required by Federal law or regulation to submit
reports associated with drug products, biological products, or special
nutritional products. However, hospitals and other user facilities are
required by Federal law to report medical device-related deaths and
serious injuries.
Under Federal law and regulation (section 761(b)(1) of the FD&C
Act), a dietary supplement manufacturer, packer, or distributor whose
name appears on the label of a dietary supplement marketed in the
United States is required to submit to FDA any serious adverse event
report it receives regarding use of the dietary supplement in the
United States. However, FDA bears the burden to gather and review
evidence that a dietary supplement may be adulterated under section 402
of the FD&C Act after that product is marketed. Therefore, the Agency
depends on the voluntary reporting by health professionals and
especially by consumers of suspected serious adverse events and product
quality problems associated with the use of dietary supplements.
III. Use of FDA Form 3500A (Mandatory Version)
A. Drug and Biologic Products
In sections 505(j) and 704 (21 U.S.C. 374) of the FD&C Act,
Congress has required that important safety information relating to all
human prescription drug products be made available to the FDA so that
it can take appropriate action to protect the public health when
necessary. Section 702 of the FD&C Act (21 U.S.C. 372) authorizes
investigational powers to FDA for enforcement of the FD&C Act. These
statutory requirements regarding mandatory reporting have been codified
by FDA under 21 parts 310 and 314 (drugs) and 600 (biologics) of the
Code of Federal Regulations. Parts 310, 314, and 600 mandate the use of
FDA Form 3500A for reporting to FDA on adverse events that occur with
drugs and biologics. Mandatory reporting of adverse reactions for HCT/
Ps has been codified in 21 CFR 1271.350.
The majority of the mandatory reports for drug products, which at
inception of FDA Form 3500A's use were received by the Agency on the
paper version of FDA Form 3500A (by mail or FAX), are now submitted and
received by the Agency via an electronic submission route. In that
case, the FDA Form 3500A is not used.
B. Medical Device Products
Section 519 of the FD&C Act requires manufacturers and importers of
devices
[[Page 76419]]
intended for human use to establish and maintain records, make reports,
and provide information as the Secretary of Health and Human Services
may by regulation reasonably require to assure that such devices are
not adulterated or misbranded and to otherwise assure its safety and
effectiveness. The Safe Medical Device Act of 1990, signed into law on
November 28, 1990, amends section 519 of the FD&C Act. The amendment
requires that user facilities such as hospitals, nursing homes,
ambulatory surgical facilities, and outpatient treatment facilities
report deaths related to medical devices to FDA and to the
manufacturer, if known. Serious illnesses and injuries are to be
reported to the manufacturer or to FDA if the manufacturer is not
known. These statutory requirements regarding mandatory reporting have
been codified by FDA under 21 CFR part 803, which mandates the use of
FDA Form 3500A for reporting to FDA on medical devices. The Medical
Device User Fee and Modernization Act of 2002, Public Law 107-250,
signed into law October 26, 2002, amended section 519 of the FD&C Act.
The amendment (section 303) required FDA to revise the MedWatch forms
``to facilitate the reporting of information * * * relating to
reprocessed single-use devices, including the name of the reprocessor
and whether the device has been reused.''
C. Nonprescription Drug Products and Dietary Supplements
Section 502(x) in the FD&C Act implements the requirements of the
Dietary Supplement and Nonprescription Drug Consumer Protection Act,
which became law (Pub. L. 109-462) on December 22, 2006. These
requirements apply to manufacturers, packers, and distributors of
nonprescription (OTC) human drug products marketed without an approved
application. The law requires reports of serious adverse events to be
submitted to FDA by manufacturers of dietary supplements and
nonprescription drugs.
IV. Proposed Modifications to Existing Forms 3500 and 3500A
A. General Changes
The proposed modifications to FDA Form 3500 and FDA Form 3500A
reflect changes that will bring the form into conformation, since the
previous authorization in 2008, with current regulations, rules, and
guidances.
B. Changes Proposed for FDA Form 3500
No additional fields will be added and no fields deleted. There are
no proposed formatting changes to the location or distribution of the
fields. Modifications are proposed to several field labels and
descriptions to better clarify for reporters the range of reportable
products, including tobacco products and food (e.g., food allergens
causing allergic or anaphylaxis reactions). Descriptive text in the
field labels and instructions were modified to permit a better
understanding of data requested. For section E, field E4, the label
``Other'' will be renamed ``Unique Identifier '' in
anticipation of the use of this product information by the Agency for
specific characterization and identification of the medical device. The
form remains a one-sided, one-page form with instructions for use on
the reverse side and a self-addressed, postage-paid return mailer.
C. Changes Proposed for FDA Form 3500A
Certain formatting changes are proposed to allow mandatory
reporters to better utilize available space for data entry and
facilitate specification of the device product's coding. In section D,
field D2, it is proposed that the same field be used to request the
procode (D2b) to correspond to the existing common device name (D2a).
The D4 field currently named ``Other'' will be renamed ``Unique
Identifier .'' Section H, currently named ``Device
Manufacturers Only'' will be renamed ``Manufacturers Only.'' Field H1
will have the ``Other'' checkbox removed and field H6, renamed ``Event
Problem and Evaluation Codes,'' will have patient code and device code
boxes added, as in the existing form's field F10. In section G, field
G5, STN will be relabeled BLA . Given the need to
contact mandatory reporters in a timely manner, the Agency proposes
that a field be added to FDA Form 3500A to request an email address for
the mandatory reporter, to supplement the phone number and mailing
address currently included on the form. This change is proposed for
fields E1 and G1.
V. Proposed Addition of Consumer Version of FDA Form 3500
FDA supports and encourages direct reporting to the Agency by
consumers (patients and their caregivers) of suspected serious adverse
outcomes and other product problems associated with human medical
products (https://www.fda.gov/Safety/ReportaProblem/default.htm.) Since
the inception of the MedWatch program, launched in July 1993 by then
FDA Commissioner David Kessler, the program has been promoting and
facilitating voluntary reporting by both the general public and health
care professionals (Ref. 1). FDA has further encouraged voluntary
reporting by requiring inclusion of the MedWatch toll-free telephone
number or the MedWatch Internet address on all outpatient drug
prescriptions dispensed, as mandated by section 17 of the Best
Pharmaceuticals for Children Act (Pub. L. 107-109).
On March 25, 2008, section 906 of the FDA Amendments Act amended
section 502(n) of the FD&C Act and mandated that published direct-to-
consumer advertisements for prescription drugs include the following
statement printed in conspicuous text (this includes vaccine products):
``You are encouraged to report negative side effects of prescription
drugs to the FDA. Visit https://www.fda.gov/medwatch, or call 1-(800)
FDA-1088.'' Most private vendors of consumer medication information,
the drug product-specific instructions dispensed to consumers at
outpatient pharmacies, remind patients to report ``side effects'' to
FDA and provide contact information to permit reporting via the
MedWatch process and FDA Form 3500.
Currently, the non-health care professional public may submit
voluntary reports using FDA Form 3500 (https://www.fda.gov/Safety/MedWatch/HowToReport/ucm053074.htm). This reporting form was created 20
years ago and modeled after an earlier version of the Agency's
reporting form for health care professionals. FDA Form 3500 is provided
in paper and electronic formats (HTML version at https://www.fda.gov/medwatch/report.htm and fillable pdf version at https://www.fda.gov/downloads/Safety/MedWatch/HowToReport/DownloadForms/ucm082725.pdf), and
is used to report to the Agency about serious adverse events, product
problems, product use errors, and therapeutic failure (therapeutic
inequivalence). Reporting is supported for all FDA-regulated human
medical care products, including drugs, biologicals, medical devices,
special nutritional products, dietary supplements, cosmetics, and
nonprescription (OTC) human drug products marketed without an approved
application.
Qualitative assessment by social scientists, and comments and
feedback from the public, have recognized that FDA Form 3500 is written
and formatted at a literacy/comprehensibility level that far exceeds
[[Page 76420]]
the level recommended for the general public by health literacy experts
and does not conform to recommendations in the Plain Writing Act of
2010 (https://www.gpo.gov/fdsys/pkg/PLAW-111publ274/pdf/PLAW-111publ274.pdf).
The proposed consumer version of the voluntary FDA Form 3500 will
request no new data from the voluntary reporter not already included in
the existing FDA Form 3500 that is currently used for reporting from
both health care professionals and consumers (patients). Certain
existing fields not considered essential data for the consumer report
but present on the standard (i.e., health care professional) version of
FDA Form 3500 have been eliminated to facilitate and expedite consumer
submissions and reduce reporting burden. The formatting and plain
language used are compatible with the intent of the Plain Writing Act
and is expected to provide non-health care professionals with a second
option to the existing FDA Form 3500 that will reduce the burden of
reporting by facilitating their understanding of the requested data and
further clarify the voluntary reporting process.
The proposed consumer version of FDA Form 3500 evolved from several
iterations of draft versions, with input from human factors experts,
from other regulatory agencies and with extensive input from consumer
advocacy groups and the general public. The Agency recognizes that many
consumer reporters have a preference for accessing a copy of the
voluntary reporting form on the Internet or submitting to FDA using an
electronic version of the form. The Agency currently supports voluntary
reporting with the forms submitted by mail, by FAX, by telephone via
the toll free 800 number and online at https://www.fda.gov/medwatch/report.htm. It is the Agency's expectation that an approved consumer
version of the voluntary form will be provided for consumer use by
these same channels.
In the Federal Register of September 9, 2011 (76 FR 55919), FDA
published a 60-day notice requesting public comment on the proposed
collection of information. Comments were received from seven
individuals and organizations.
VI. Response to Comments
1. 3500 Form
(Comment 1) One comment observed that it may be difficult for FDA
to identify the pregnancy status of the person experiencing the
reported adverse event and suggested that the Agency add a separate
field for documenting pregnancy status.
(Response) FDA agrees that documenting pregnancy status is
important; however, FDA does not plan to add an additional checkbox for
pregnancy to the forms at this time. In 2005, FDA proposed adding
checkboxes for both ``Product Used During Pregnancy'' and ``Product
Used During Breast Feeding'' to section B.5 of both forms. FDA received
comments expressing concern that these new data fields introduced
divergence from International Council on Harmonisation standards and
appeared to duplicate information that is usually provided in the
narrative section and in coded adverse event terms. The pregnancy
status data can also be captured in field B7 as ``Other Relevant
History''. FDA agreed with the comments and did not include these
checkboxes with the 2005 revisions; FDA believes these reasons are
still valid.
(Comment 2) One comment encouraged the FDA to use the voluntary
consumer version of the form to allow for electronic filing of reports
and to continue to promote the reporting process to the public, whether
by the traditional paper-based route or electronically.
(Response) FDA agrees with the comment and expects to support both
the promotion of the use of the new consumer version of the voluntary
form and to explore methods of facilitating reporting and reducing
reporter burden by using online and other electronic means of report
submission.
(Comment 3) One comment supported the plan to deploy a consumer
version of the voluntary form and suggested that its use also be
promoted to health care providers for their use. The comment also
encouraged the Agency to expedite a process for converting the paper-
based reporting process to allow for electronic submission of voluntary
reports using the consumer version of the form.
(Response) FDA agrees that support of electronic submissions of
voluntary reports should be supported and facilitated. The new form was
designed as a consumer friendly option for use by non-health care
professionals. The standard FDA Form 3500 will continue to be the
primary form offered to health care professionals. FDA encourages the
continued use of FDA Form 3500 by health care professionals; however,
if a health care professional chooses to submit a report using the
consumer form, it will be accepted by FDA.
(Comment 4) One comment stated that implementing a consumer
friendly version of FDA Form 3500 would not ``serve any value'' and
suggested that instead a more comprehensible form be created that would
be used by health care professionals and consumers.
(Response) The Agency disagrees. The current FDA Form 3500 is
widely known, well accepted, and used by the range of health care
professionals. Assessment of, and feedback from, consumers has
demonstrated the demand and need for a modified form that would serve
those non-health care professional reporters, using both literacy-
appropriate language and formatting that will serve consumers but not
be optimal for health care professional reporting.
(Comment 5) A comment suggested that for the proposed change to
field E4 from ``Other'' to ``Unique Identifier'' that the term used be
``UDI''.
(Response) FDA agrees with this comment.
(Comment 6) One comment supported the development of a consumer
friendly version of the voluntary form but observed that with the
anticipated increase in the number of consumer-initiated reports that
the Agency consider a process for ``broader sharing with industry
sponsors of adverse event reports made directly to FDA.''
(Response) FDA agrees that adverse event report data should be more
readily available to the public (which includes industry). The current
mechanisms that FDA has to share reports with industry are the MedWatch
to Manufacturer Program and through requests to Freedom of Information.
In addition, as part of Phase II of the FDA Transparency Initiative,
FDA is planning to provide the public with online access (in a
searchable format) to public information from adverse event reports
submitted to FDA.
2. 3500A Form
(Comment 7) One comment asked that no changes be made to the FDA
Form 3500A at the present time due to consideration of the costs and
expenditure of resources incurred by mandatory reporters who are often
using electronic systems to do their required reporting to FDA. In
addition, the comment noted that there are several proposed or not yet
finalized rules that might further impact the content of the mandatory
FDA Form 3500. A comment stated that they would ask for a 12-month
implementation time to allow for design, testing, and validation of any
software changes necessary.
(Response) The Agency has considered the impact of implementing
changes to FDA Form 3500A and the need for mandatory reporters to
change their electronic systems to comply with the proposed changes.
FDA will allow
[[Page 76421]]
for sufficient time for design, testing, and validation of any software
changes as a result of any new data requirements that may follow from
new requirements based on final rules and regulations.
(Comment 8) One comment stated that for mandatory reporters the
estimate of burden has been underestimated and fails to take into
consideration the effort by firms to collect facts, prepare
investigations, and evaluate the data.
(Response) The Agency disagrees that the estimate for the average
time to complete a given report is low. This estimate is intended not
to represent the totality of the effort for completing the postmarket
drug and device safety surveillance process mandated by law, rule, and
regulation for application holders but a fair estimate of data
collection, organization, entry, and submission time for a given
``average'' report.
(Comment 9) A comment suggested that for the proposed change to
field D4 from ``Other'' to ``Unique Identifier'' that the term used be
``UDI''.
(Response) FDA agrees with this comment. We recommend changing this
to UDI.
(Comment 10) A comment disagreed with requesting an email address
from the reporter in field E1, and a second comment expressed similar
reservations but suggested that, if used, the initial reporter
understand that this information is optional.
(Response) FDA recognizes that an email address is one of several
elements in the contact information that may assist FDA and others in
effective postmarket safety surveillance and followup inquiries. The
reporter is not compelled to complete the information in this field in
order for the report to be considered complete and registered in the
appropriate database. A statement that this information is optional
will be made clear in the instructions for completing the form.
(Comment 11) A comment disagreed with the proposed change in the
Section H heading from ``Device Manufacturers Only'' to ``Manufacturers
Only''.
(Response) FDA agrees that this title should not be changed.
Section H should be titled ``Device Manufacturers Only'' as it
currently appears.
(Comment 12) Two comments recommended the addition of a new
checkbox field in Section/field H2 named ``Final report'' that would be
used to ``reflect the best efforts of the manufacturer to retrieve and
analyze information pertaining to the reported event''.
(Response) FDA disagrees that ``Final report'' should be added to
Section H2. This information can be added as part of the text narrative
in Section H10.
(Comment 13) Two comments disagreed with the removal of field H1's
``Other'' checkbox and stated that there are rare examples of events
that do not meet the regulatory definition of death, serious injury, or
malfunction but are considered by the mandatory reporting entity to be
necessary and required reports. One comment suggested that if the
checkbox is removed, that specific instruction be provided for handling
reports that would have been compatible with an ``Other'' designation.
(Response) FDA disagrees. FDA recommends removal of the ``Other''
checkbox. In lieu of the checkbox, FDA proposes that rare events that
fit the definition of ``Other significant adverse device experiences''
as specified in FD&C Act section 519(a)(3) can be submitted to the FDA
using the mailing address identified in 21 CFR 803.12(a).
(Comment 14) One comment suggested changing the title of field B4
from ``Date of This Report'' to ``Date of First Contact With Initial
Reporter''.
(Response) FDA disagrees. On August 21, 2009, FDA published a
proposed rule (74 FR 42203) to amend part 803 to require manufacturers,
importers, and user facilities to submit medical device reports to the
Agency in an electronic format (i.e., the 2009 proposed rule). Section
II(4)(D)(2) of the 2009 proposed rule specified that in the final rule,
FDA specifically proposed to change Sec. Sec. 803.32(b)(4),
803.42(b)(4), and 803.52(b)(4) from ``date of report by the initial
reporter'' to ``date of this report''. Further it states, ``This change
would make part 803 consistent with the way that other FDA Centers
interpret FDA Form 3500A, Block B4 and how Block B4 appears on FDA Form
3500A.''
FDA estimates the burden of this collection of information as
follows:
Table 1--Estimated Annual Reporting Burden \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
Number of
FDA Center FDA Form (21 CFR Section) Number of responses per Total annual Average burden per response Total hours
respondents respondent responses
--------------------------------------------------------------------------------------------------------------------------------------------------------
Center for Biologics Evaluation and Research/
Center for Drug Evaluation and Research:
Form 3500................................. 28,952 1 28,952 0.60............................ 17,371
(36 minutes).................... ................
Form 3500A (Sec. Sec. 310.305, 314.80, 599 96 57,504 1.10............................
314.98, and 600.80).
Center for Devices and Radiological Health:
Form 3500................................. 4,585 1 4,585 0.60............................ 2,751
(36 minutes).................... ................
Form 3500A (Sec. 803)................... 1,485 225 334,125 1.10............................ 367,538
(66 minutes)....................
Center for Food Safety and Applied Nutrition:
Form 3500................................. 297 1 297 0.6............................. 178
(36 minutes)....................
Form 3500A................................ 1,039 1 1,039 1.10............................ 1,143
(66 minutes)....................
Total................................. ................ ................ ................ ................................ 452,234
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ There are no capital costs or operating and maintenance costs associated with this collection of information.
[[Page 76422]]
VII. Reference
The following reference has been placed on display in the Division
of Dockets Management (HFA-305), Food and Drug Administration, 5630
Fishers Lane, rm. 1061, Rockville, MD 20852, and may be seen by
interested persons between 9 a.m. and 4 p.m., Monday through Friday.
1. Kessler, D.A., ``Introducing MEDWatch: A New Approach to
Reporting Medication and Device Adverse Effects and Product
Problems,'' Journal of the American Medical Association, 269: 2765-
2768, 1993.
Dated: December 1, 2011.
Leslie Kux,
Acting Assistant Commissioner for Policy.
[FR Doc. 2011-31341 Filed 12-6-11; 8:45 am]
BILLING CODE 4160-01-P