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Submission Requirements for Terminally Sterilized Medical Devices

This guidance focuses on reviewing 510(k) submissions for devices labeled as sterile that undergo industrial terminal sterilization processes based on microbial inactivation (e.g., radiation, steam, ethylene oxide, new technology sterilization processes). It excludes sterilizers themselves, microbial exclusion processes, sterilization of devices with animal/human tissues, liquid chemical sterilants, and reprocessing of single-use or reusable devices.

  1. Determine if your sterilization method is “Established Category A,” “Established Category B,” or “Novel”
  2. Prepare comprehensive sterilization documentation package including:
    • Description of sterilization method and validation approach
    • SAL determination and justification
    • Pyrogenicity testing plan if applicable
    • Package integrity validation plan
  3. For novel methods:
    • Prepare for facility inspection
    • Compile complete validation data package
    • Consider pre-submission meeting with FDA
  4. Ensure labeling complies with pyrogenicity terminology requirements
  5. Verify compliance with appropriate sterilization standards
  6. Document sterilant residuals and their safety justification for chemical sterilization methods
  7. Implement appropriate batch testing for endotoxins if required
  8. Prepare packaging validation protocol and documentation

Key Considerations

Non-clinical testing

  • Validation of sterilization cycle using appropriate methods (e.g., half-cycle method)
  • Sterility Assurance Level (SAL) of 10-6 required for most devices (10-3 acceptable for devices contacting only intact skin)
  • For chemical sterilants: maximum residual levels must be determined and justified
  • For established Category B and novel methods: complete validation protocol and data required

Labelling

  • Must indicate if device is non-pyrogenic
  • Recommend using “non-pyrogenic” or “meets pyrogen limit specifications” instead of “pyrogen free”

Biocompatibility

  • Pyrogenicity testing required for:
    • Implants
    • Devices contacting cardiovascular system, lymphatic system, or cerebrospinal fluid
    • Devices labeled non-pyrogenic
  • Endotoxin limits: 20 EU/Device for general medical devices, 2.15 EU/Device for CSF-contacting devices

Safety

  • Package integrity testing required to ensure sterility maintenance
  • For novel sterilization methods: comprehensive process description and validation data required
  • Manufacturing facility inspection required for novel sterilization methods

Other considerations

  • ISO 10993-7: Biological Evaluation of Medical Devices – Part 7: Ethylene Oxide Sterilization Residuals
  • ISO 22441: Sterilization of health care products - Low temperature vaporized hydrogen peroxide
  • ANSI/AAMI ST72: Bacterial endotoxins – Test methods, routine monitoring, and alternatives to batch testing
  • AAMI/ANSI/ISO 11607: Packaging for terminally sterilized medical devices

Original guidance

  • Submission Requirements for Terminally Sterilized Medical Devices
  • HTML / PDF
  • Issue date: 2024-01-08
  • Last changed date: 2024-01-08
  • Status: FINAL
  • Official FDA topics: Medical Devices, 510(k), Premarket
  • ReguVirta summary file ID: ba734ea546d9fa04fef7fa81d80c0c5a
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