FprEN ISO 22442-1
(Main)This document applies to medical devices other than in vitro diagnostic medical devices manufactured utilizing materials of animal origin, which are non-viable or have been rendered non-viable. It specifies, in conjunction with ISO 14971, a procedure to identify the hazards and hazardous situations associated with such devices, to estimate and evaluate the resulting risks, to control these risks, and to monitor the effectiveness of that control. Furthermore, it outlines the decision process for the residual risk acceptability, taking into account the balance of residual risk, as defined in ISO 14971, and expected medical benefit as compared to available alternatives. This document is intended to provide requirements and guidance on risk management related to the hazards typical of medical devices manufactured utilizing animal tissues or derivatives such as:
a) contamination by bacteria, moulds or yeasts;
b) contamination by viruses;
c) contamination by agents causing transmissible spongiform encephalopathies (TSE);
d) material responsible for undesired pyrogenic, immunological or toxicological reactions.
For parasites and other unclassified pathogenic entities, similar principles can apply.
This document does not stipulate levels of acceptability which, because they are determined by a multiplicity of factors, cannot be set down in such an international standard except for some particular derivatives mentioned in Annex C. Annex C stipulates levels of TSE risk acceptability for tallow derivatives, animal charcoal, milk and milk derivatives, wool derivatives and amino acids.
This document does not specify a quality management system for the control of all stages of production of medical devices.
This document does not cover the utilization of human tissues in medical devices.
NOTE 1 It is not a requirement of this document to have a full quality management system during manufacture. However, attention is drawn to international standards for quality management systems (see ISO 13485) that control all stages of production or reprocessing of medical devices.
NOTE 2 For guidance on the application of this document, see Annex A.
Tierische Gewebe und deren Derivate, die zur Herstellung von Medizinprodukten eingesetzt werden - Teil 1: Anwendung des Risikomanagements (ISO/FDIS 22442-1:2020)
Dieses Dokument bezieht sich auf Medizinprodukte, mit Ausnahme von in vitro Diagnostika, hergestellt unter Verwendung von Materialien tierischen Ursprungs, die nicht lebensfähig sind oder abgetötet wurden. Es ergibt in Verbindung mit ISO 14971 ein Verfahren zur Identifizierung der Gefahren und gefährlichen Situationen im Zusammenhang mit diesen Produkten, zur Abschätzung und Beurteilung der sich ergebenden Risiken, zur Kontrolle dieser Risiken und zur Überwachung der Wirksamkeit dieser Kontrolle. Zusätzlich umschreibt er den Entscheidungsprozess für die Annehmbarkeit des Restrisikos, indem das Restrisiko, wie in ISO 14971 definiert, abgewägt und der erwartete medizinische Nutzen, verglichen mit verfügbaren Alternativen, einander gegenübergestellt wird. Dieses Dokument legt Anforderungen und Anleitungen für das Risikomanagement in Bezug auf typische Gefährdungen durch Medizinprodukte fest, die unter Verwendung tierischer Gewebe und deren Derivate hergestellt wurden, z. B.
a) Verunreinigungen durch Bakterien, Schimmelpilze oder Hefepilze;
b) Verunreinigungen durch Viren;
c) Verunreinigungen durch Erreger, die übertragbare spongiforme Enzephalopathien (en: transmissible spongiform encephalopathies, TSE) hervorrufen;
d) für ungewünschte pyrogene, immunologische oder toxikologische Reaktionen verantwortliches Material.
Bei Parasiten und anderen nicht klassifizierten pathogenen Einheiten können ähnliche Prinzipien gelten.
Dieses Dokument legt keine Anforderungen für die Akzeptanz fest, weil diese von einer Vielzahl von Faktoren bestimmt und in einer solchen Internationalen Norm nicht festgelegt werden können. Ausgenommen sind bestimmte Derivate, die in Anhang C erwähnt werden. Anhang C legt Grade für die Annehmbarkeit von TSE Risiken bei Talg Derivaten, Kohle aus tierischem Ausgangsmaterial, Milch und Milch Derivaten, Derivaten von Wolle und Aminosäuren fest.
Dieses Dokument legt kein Qualitätsmanagementsystem zur Kontrolle aller Produktionsschritte eines Medizinproduktes fest.
Dieses Dokument gilt nicht für die Verwendung von menschlichen Geweben in Medizinprodukten.
ANMERKUNG 1 Es ist keine Anforderung von diesem Dokument, ein vollständiges Qualitätsmanagementsystem für die Herstellung zu nutzen. Es wird jedoch auf Internationale Normen für Qualitätsmanagementsysteme (siehe ISO 13485) zur Kontrolle aller Schritte der Produktion und Wiederaufarbeitung von Medizinprodukten hingewiesen.
ANMERKUNG 2 Eine Anleitung zur Anwendung dieses Dokuments ist in Anhang A gegeben.
Dispositifs médicaux utilisant des tissus animaux et leurs dérivés - Partie 1: Application de la gestion des risques (ISO/FDIS 22442-1:2020)
Le présent document s'applique aux dispositifs médicaux autres que les dispositifs médicaux de diagnostic in vitro, dans la fabrication desquels entrent des matériaux d'origine animale non viables ou rendus non viables. Associé à l'ISO 14971, il spécifie un mode opératoire permettant d'identifier les dangers et les situations dangereuses associés à de tels dispositifs, d'estimer et d'évaluer les risques qui en découlent, de maîtriser ces risques et de surveiller l'efficacité de cette maîtrise. En outre, il décrit le processus décisionnel relatif à l'acceptabilité du risque résiduel, en tenant compte du rapport entre le risque résiduel, tel que défini dans l'ISO 14971, et le bénéfice médical escompté par rapport aux solutions de remplacement disponibles. Le présent document est destiné à fournir des exigences et des préconisations pour la gestion des risques associée aux dangers typiques des dispositifs médicaux dans la fabrication desquels entrent des tissus ou des dérivés d'origine animale, notamment:
a) la contamination par des bactéries, des moisissures ou des levures;
b) la contamination par des virus;
c) la contamination par des agents responsables d'encéphalopathies spongiformes transmissibles (EST);
d) un matériau provoquant des réactions pyrogènes, immunologiques ou toxicologiques indésirables.
Des principes similaires peuvent s'appliquer aux parasites et autres entités pathogènes non classées.
Le présent document ne stipule pas de niveaux d'acceptabilité qui, du fait qu'ils sont déterminés par de multiples facteurs, ne peuvent s'inscrire dans une telle Norme internationale, excepté pour certains dérivés particuliers mentionnés à l'Annexe C. L'Annexe C stipule des niveaux d'acceptabilité du risque d'EST pour les dérivés du suif, le noir animal, le lait et les dérivés du lait, les dérivés de la laine et les acides aminés.
Le présent document ne spécifie pas un système de management de la qualité permettant le contrôle de toutes les étapes de fabrication de dispositifs médicaux.
Le présent document ne couvre pas l'utilisation de tissus humains dans les dispositifs médicaux.
NOTE 1 Le présent document n'exige pas un système de management de la qualité complet lors de la fabrication. Toutefois, il est préférable de se référer aux Normes internationales relatives aux systèmes de management de la qualité (voir l'ISO 13485) qui contrôlent toutes les étapes de fabrication ou de retraitement des dispositifs médicaux.
NOTE 2 Voir l'Annexe A pour les préconisations relatives à l'application du présent document.
Medicinski pripomočki, ki uporabljajo živalska tkiva in njihove derivate - 1. del: Uporaba obvladovanja tveganja (ISO/DIS 22442-1:2018)
General Information
RELATIONS
Standards Content (sample)
SLOVENSKI STANDARD
oSIST prEN ISO 22442-1:2018
01-november-2018
0HGLFLQVNLSULSRPRþNLNLXSRUDEOMDMRåLYDOVNDWNLYDLQQMLKRYHGHULYDWHGHO
8SRUDEDREYODGRYDQMDWYHJDQMD,62',6Medical devices utilizing animal tissues and their derivatives - Part 1: Application of risk
management (ISO/DIS 22442-1:2018)Tierische Gewebe und deren Derivate, die zur Herstellung von Medizinprodukten
eingesetzt werden - Teil 1: Anwendung des Risikomanagements (ISO/DIS 22442-
1:2018)
Dispositifs médicaux utilisant des tissus animaux et leurs dérivés - Partie 1: Application
de la gestion des risques (ISO/DIS 22442-1:2018)Ta slovenski standard je istoveten z: prEN ISO 22442-1
ICS:
11.040.99 Druga medicinska oprema Other medical equipment
11.100.99 Drugi standardi v zvezi z Other standards related to
laboratorijsko medicino laboratory medicine
oSIST prEN ISO 22442-1:2018 en
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.
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oSIST prEN ISO 22442-1:2018
DRAFT INTERNATIONAL STANDARD
ISO/DIS 22442-1
ISO/TC 194/SC 1 Secretariat: DIN
Voting begins on: Voting terminates on:
2018-08-09 2018-11-01
Medical devices utilizing animal tissues and their
derivatives —
Part 1:
Application of risk management
Dispositifs médicaux utilisant des tissus animaux et leurs dérivés —
Partie 1: Application de la gestion des risques
ICS: 11.100.20
THIS DOCUMENT IS A DRAFT CIRCULATED
This document is circulated as received from the committee secretariat.
FOR COMMENT AND APPROVAL. IT IS
THEREFORE SUBJECT TO CHANGE AND MAY
NOT BE REFERRED TO AS AN INTERNATIONAL
STANDARD UNTIL PUBLISHED AS SUCH.
IN ADDITION TO THEIR EVALUATION AS
ISO/CEN PARALLEL PROCESSING
BEING ACCEPTABLE FOR INDUSTRIAL,
TECHNOLOGICAL, COMMERCIAL AND
USER PURPOSES, DRAFT INTERNATIONAL
STANDARDS MAY ON OCCASION HAVE TO
BE CONSIDERED IN THE LIGHT OF THEIR
POTENTIAL TO BECOME STANDARDS TO
WHICH REFERENCE MAY BE MADE IN
Reference number
NATIONAL REGULATIONS.
ISO/DIS 22442-1:2018(E)
RECIPIENTS OF THIS DRAFT ARE INVITED
TO SUBMIT, WITH THEIR COMMENTS,
NOTIFICATION OF ANY RELEVANT PATENT
RIGHTS OF WHICH THEY ARE AWARE AND TO
PROVIDE SUPPORTING DOCUMENTATION. ISO 2018
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COPYRIGHT PROTECTED DOCUMENT
© ISO 2018
All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may
be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting
on the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address
below or ISO’s member body in the country of the requester.ISO copyright office
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Published in Switzerland
ii © ISO 2018 – All rights reserved
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Contents Page
Foreword ..........................................................................................................................................................................................................................................v
Introduction ................................................................................................................................................................................................................................vi
1 Scope ................................................................................................................................................................................................................................. 1
2 Normative references ................................................................................................................................... 1
3 Terms and definitions ................................................................................................................................... 2
4 Risk management process .......................................................................................................................... 3
4.1 General ........................................................................................................................................................................................................... 3
4.2 Risk analysis ............................................................................................................................................................3
4.2.1 Identification of qualitative and quantitative characteristics related to the
safety of medical devices .................................................................................................................3
4.2.2 Identification of hazards and hazardous situations .............................................................4
4.3 Risk evaluation.......................................................................................................................................................5
4.4 Risk control .............................................................................................................................................................5
4.4.1 General...................................................................................................................................................................................... 5
4.4.2 Risk control for viruses and TSE agents ....................................................................................5
4.4.3 Risk control of other hazards .........................................................................................................5
4.4.4 Residual risk evaluation ...................................................................................................................6
4.5 Evaluation of overall residual risk acceptability .....................................................................................6
4.5.1 General...................................................................................................................................................................................... 6
4.5.2 Documentation .................................................................................................................................................................. 7
4.6 Production and post-production information system ..........................................................................7
Annex A (informative) Guidance on the application of this document ....................................................... 8
Annex B (informative) Graphical representation of part of the risk management process for
medical devices utilizing animal material ............................................................................................. 9
Annex C (normative) Special requirements for some animal materials considering the risk
management for TSE agents .....................................................................................................................11
Annex D (informative) Information relevant to the management of TSE risk ........................................16
Annex ZA (informative) Relationship between this European Standard and the Essential
Requirements of EU Directive 93/42/EEC as amended by Commission Regulation(EU) No 722/2012 ............................................................................................................................................................................................23
Bibliography .............................................................................................................................................................................................................................25
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Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out
through ISO technical committees. Each member body interested in a subject for which a technical
committee has been established has the right to be represented on that committee. International
organizations, governmental and non-governmental, in liaison with ISO, also take part in the work.
ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of
electrotechnical standardization.The procedures used to develop this document and those intended for its further maintenance are
described in the ISO/IEC Directives, Part 1. In particular the different approval criteria needed for the
different types of ISO documents should be noted. This document was drafted in accordance with the
editorial rules of the ISO/IEC Directives, Part 2 (see www .iso .org/directives).
Attention is drawn to the possibility that some of the elements of this document may be the subject of
patent rights. ISO shall not be held responsible for identifying any or all such patent rights. Details of
any patent rights identified during the development of the document will be in the Introduction and/or
on the ISO list of patent declarations received (see www .iso .org/patents).Any trade name used in this document is information given for the convenience of users and does not
constitute an endorsement.For an explanation on the voluntary nature of standards, the meaning of ISO specific terms and
expressions related to conformity assessment, as well as information about ISO's adherence to the
World Trade Organization (WTO) principles in the Technical Barriers to Trade (TBT) see the following
URL: www .iso .org/iso/foreword .html.This document was prepared by Technical Committee ISO/TC 194, Biological and clinical evaluation of
medical devices, Subcommittee SC 1, Tissue product safety.This third edition cancels and replaces the second edition (EN ISO 22442-1:2015), which has undergone
minor revision.The major changes are:
— Update of weblinks in C.2 Collagen, bullet point 1, C.3.3 Bones s the starting material and C.4.4
Stunning methods;— Update of weblink in D.3.3 Geographical sourcing;
— Update of bibliography;
— Editorial revision.
A list of all parts in the ISO 22442- series can be found on the ISO website.
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Introduction
Certain medical devices utilize materials of animal origin.
Animal tissues and their derivatives are used in the design and manufacture of medical devices to
provide performance characteristics that have been chosen for advantages over non-animal based
materials. The range and quantities of materials of animal origin in medical devices vary. These
materials can comprise a major part of the device (e.g. bovine/porcine heart valves, bone substitutes
for use in dental or orthopaedic applications, haemostatic devices), can be a product coating or
impregnation (e.g. collagen, gelatine, heparin), or can be used in the device manufacturing process
(e.g. tallow derivatives such as oleates and stearates, foetal calf serum, enzymes, culture media).
ISO 14971 is a general standard which specifies a process for a manufacturer by identifying hazards
and hazardous situations associated with medical devices, including in vitro medical devices, to
estimate and evaluate the risks associated with those hazards, to control these risks and to monitor the
effectiveness of the control throughout the life cycle. This document provides additional requirements
and guidance for the evaluation of medical devices manufactured utilizing animal tissues or derivatives
which are non-viable or rendered non-viable.This document is intended to cover medical devices including active implantable medical devices such
as implantable infusion pumps.This document does not apply to in vitro diagnostic devices.
This document can only be used in combination with ISO 14971 and is not a “stand-alone” Standard.
NOTE To show compliance with this document, its specified requirements should be fulfilled. The guidance
given in the Notes and informative annexes is not normative and is not provided as a checklist for auditors.
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DRAFT INTERNATIONAL STANDARD ISO/DIS 22442-1:2018(E)
Medical devices utilizing animal tissues and their
derivatives —
Part 1:
Application of risk management
1 Scope
This document applies to medical devices other than in vitro diagnostic medical devices manufactured
utilizing materials of animal origin, which are non-viable or have been rendered non-viable. It
specifies, in conjunction with ISO 14971, a procedure to identify the hazards and hazardous situations
associated with such devices, to estimate and evaluate the resulting risks, to control these risks,
and to monitor the effectiveness of that control. Furthermore, it outlines the decision process for the
residual risk acceptability, taking into account the balance of residual risk, as defined in ISO 14971, and
expected medical benefit as compared to available alternatives. This document is intended to provide
requirements and guidance on risk management related to the hazards typical of medical devices
manufactured utilizing animal tissues or derivatives such as:a) contamination by bacteria, moulds or yeasts;
b) contamination by viruses;
c) contamination by agents causing Transmissible Spongiform Encephalopathies (TSE);
d) material responsible for undesired pyrogenic, immunological or toxicological reactions.
For parasites and other unclassified pathogenic entities, similar principles can apply.
This document does not stipulate levels of acceptability which, because they are determined by a
multiplicity of factors, cannot be set down in such an International Standard except for some particular
derivatives mentioned in Annex C. Annex C stipulates levels of TSE risk acceptability for tallow
derivatives, animal charcoal, milk and milk derivatives, wool derivatives and amino acids.
This document does not specify a quality management system for the control of all stages of production
of medical devices.This document does not cover the utilization of human tissues in medical devices.
NOTE 1 It is not a requirement of this document to have a full quality management system during manufacture.
However, attention is drawn to International Standards for quality management systems (see ISO 13485) that
control all stages of production or reprocessing of medical devices.NOTE 2 For guidance on the application of this document see Annex A.
2 Normative references
The following documents, in whole or in part, are normatively referenced in this document and are
indispensable for its application. For dated references, only the edition cited applies. For undated
references, the latest edition of the referenced document (including any amendments) applies.
ISO 10993-1, Biological evaluation of medical devices — Part 1: Evaluation and testing within a risk
management processISO 14971, Medical devices — Application of risk management to medical devices
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ISO 22442-2:2015, Medical devices utilizing animal tissues and their derivatives — Part 2: Controls on
sourcing, collection and handlingISO 22442-3:2007, Medical devices utilizing animal tissues and their derivatives — Part 3: Validation of the
elimination and/or inactivation of viruses and transmissible spongiform encephalopathy (TSE) agents
3 Terms a nd definiti onsFor the purposes of this document, the terms and definitions given in ISO 14971 and the following apply.
ISO and IEC maintain terminological databases for use in standardization at the following addresses:
— IEC Electropedia: available at http: //www .electropedia .org/— ISO Online browsing platform: available at http:/ /www .iso .org/obp
3.1
animal
any vertebrate or invertebrate [including amphibian, arthropod (e.g. crustacean), bird, coral, fish,
reptile, mollusc and mammal] excluding humans (Homo sapiens)3.2
cell
smallest organized unit of any living form which is capable of independent existence and of replacement
of its own substance in a suitable environment3.3
derivative
substance obtained from an animal material by a manufacturing process which is directly involved in
the production of the medical device or which is a final part of the medical device
EXAMPLE Hyaluronic acid, collagen, gelatine, monoclonal antibodies, chitosan, albumin.
3.4elimination
removal
process by which the number of transmissible agents is reduced
Note 1 to entry: The effectiveness of the process for the elimination of viruses and TSE agents should be expressed
mathematically in terms of a reduction factor (see C.2 and ISO 22442-3:2007, Annex F).
Note 2 to entry: Elimination aims to prevent infection or pathogenic reaction caused by transmissible agents.
3.5inactivation
process by which the ability to cause infection or pathogenic reaction by a transmissible agent is reduced
Note 1 to entry: The effectiveness of the process for inactivation of viruses and TSE agents should be expressed
mathematically in terms of a reduction factor (see ISO 22442-3:2007, Annex F).Note 2 to entry: Inactivation aims to prevent infection by, and replication of, transmissible agents.
3.6medical device
any instrument, apparatus, implement, machine, appliance, implant, in vitro reagent or calibrator,
software, material or other similar or related article, intended by the manufacturer to be used, alone or
in combination, for human beings for one or more of the specific purpose(s):— diagnosis, prevention, monitoring, treatment or alleviation of disease;
— diagnosis, monitoring, treatment, alleviation of, or compensation for, an injury;
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— investigation, replacement, modification, or support of the anatomy or of a physiological process;
— supporting or sustaining life;— control of conception;
— disinfection of medical devices;
— providing information for medical purposes by means of in vitro examination of specimens derived
from the human body;and which does not achieve its primary intended action in or on the human body by pharmacological,
immunological or metabolic means, but which may be assisted in its intended function by such means
[40]Note 1 to entry: This definition has been developed by the Global Harmonization Task Force (GHTF).
Note 2 to entry: This document does not apply to in vitro diagnostic devices.3.7
non-viable
having no potential for metabolism or multiplication
3.8
technical agreement
binding contract between two or more parties that assigns responsibilities for technical requirements
3.9tissue
organization of cells and/or extra-cellular constituents
3.10
transmissible agents
bacteria, mould, yeast, parasites, viruses, TSE agents and unclassified pathogenic entities
4 Risk management process4.1 General
The manufacturer shall justify the use of animal material (including the choice of animal species and
tissues) based on the residual risk acceptability, taking into account the balance of residual risk and
expected medical benefit, as compared to available alternatives.The requirements of ISO 14971 apply. Compliance with these requirements shall be verified by
inspection of the risk management file.NOTE Further discussion of medical benefits and the risk/benefit analysis can be found in ISO 14971.
4.2 Risk analysis4.2.1 Identification of qualitative and quantitative characteristics related to the safety of
medical devices4.2.1.1 Does the device come into contact with the patient or other persons?
The quantity of material, the contact surface area and the type(s) of the material coming into contact
with body tissues or fluids as well as the type of body tissue or fluid it comes into contact with, shall be
addressed in the risk analysis. For TSE, guidance can be found in D.3.7.NOTE 1 Medical devices such as orthopaedic shoes or components such as leather straps that come into
contact only with intact skin represent a low infective risk.© ISO 2018 – All rights reserved 3
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NOTE 2 The quantity of material coming into contact is one of the factors in producing biological effects. See
ISO 10993 (all parts) for the evaluation of such effects.NOTE 3 The structure of animal tissues being processed can affect the inactivation and/or elimination of
transmissible agents, and the potential for retaining viable cells can be affected by the structure of the animal
tissues and derivatives being processed.4.2.1.2 What materials and/or components are incorporated in the medical device or are used
with, or are in contact with, the medical device?The following factors shall be addressed, if applicable:
a) if viable animal materials are utilized in the manufacture of the medical device, verification that
the final medical device contains no viable animal material;b) the intended use of any animal tissue or derivative;
c) geographical source, species, age and feeding (including use of animal-derived protein) of animals;
d) veterinary control, conditions under which the animal materials are recovered, potential for cross-
contamination;e) the type and anatomical source of tissue;
f) the production process, particularly if it uses materials pooled from more than one animal;
g) the nature of material utilized in the medical device, (e.g. intact tissue, highly purified derivative);
h) the method of utilization or incorporation into the medical device.In the case of medical devices utilizing several relevant constituents (e.g. from various species, origin
or tissues) or several similar types of constituents produced using different methods, each individual
constituent should be analysed separately.4.2.1.3 Is the device supplied sterile or intended to be sterilized by the user or are other
microbiological controls applicable?Given the biological nature of animal tissues or derivatives, variations in the bioburden of bacteria,
mould and yeast of the animal material shall be estimated.NOTE See also ISO 11737-1 and ISO 14160.
4.2.1.4 Are there unwanted outputs of substances?
The possible presence of toxic residue related to the manufacturing process utilized or degradation
by-products shall be addressed taking into account the physical characteristics (e.g. porosity,
heterogeneity) and chemical composition of animal tissues or derivatives.NOTE See also ISO 10993-1, ISO 10993-9, ISO 10993-17, ISO 10993-18 and ISO 10993-19.
4.2.2 Identification of hazards and hazardous situ ationsThe possible hazards associated with animal tissues or derivatives shall be identified and documented.
Particular attention shall be applied to possible hazards posed by animal tissues or derivatives with
regard to:— potential contamination by transmissible agents and their susceptibility to elimination and/or
inactivation during processing;— potential for contaminants on the finished material which can cause an undesired pyrogenic,
immunological or toxicological reaction;4 © ISO 2018 – All rights reserved
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— potential for the finished material itself to cause an undesired pyrogenic, immunological or
toxicological reaction.4.3 Risk evaluation
In accordance with ISO 14971, all identified risks shall be evaluated. Biological safety shall be evaluated
in accordance with ISO 10993-1. Risk evaluation for transmissible agents shall be implemented by
separately addressing the risks related to different categories of transmissible agents. Annex B
identifies the main categories of risk that should be considered. Regarding the TSE risk, compliance
with requirements specified in Annex C for certain animal materials can indicate risk acceptability.
NOTE Annex C combines elements of risk evaluation and risk control.4.4 Risk control
4.4.1 General
The risk control options shall be documented and justified.
The flowchart in Annex B gives an overview of the risk management process. If additional risks are
identified when using this document, the medical device manufacturer may choose to follow any other
relevant standard or any other route. The decision should be justified and documented.
4.4.2 Risk control for viruses and TSE agentsRisk control shall be implemented by separately addressing the risks related to different categories
of viruses and TSE agents. After defining the characteristics of the product, the medical device
manufacturer shall comply with the relevant requirements of both ISO 22442-2 and ISO 22442-3,
except where either the animal species is such that manufacturers cannot fully meet the requirements
of ISO 22442-2 or an inactivation process in accordance with ISO 22442-3 would cause unacceptable
degradation.Tallow derivatives, animal charcoal, and amino acids that are acceptable for TSE risk as discussed in
Annex C, due to their processing and not their sourcing, shall also be considered to have acceptable risk
regarding viruses.Regarding TSE risk, risk control measures specified in Annex C for certain animal materials shall be
applied where relevant. If the manufacturer considers any requirement not to be relevant, the rationale
and justification shall be documented.For medical devices where an inactivation process causes unacceptable degradation, manufacturers
may rely on ISO 22442-2 in order to meet the requirements of this document.If the animal species is such that manufacturers cannot fully meet the requirements of ISO 22442-2, they
shall demonstrate that the level of inactivation of transmissible agents in a validated manufacturing
process, as required in ISO 22442-3, is sufficient to achieve an acceptable level of risk.
NOTE Criteria and principles relevant to the management of TSE risks are described in Annex D. Annex D
contains information on relevant risk control measures.4.4.3 Risk control of other hazards
Risk control related to bacteria, moulds and yeasts, as well as undesired pyrogenic, immunological and
toxicological reactions shall be implemented according to available standards.Tallow derivatives, animal charcoal, and amino acids that are acceptable for TSE risk as discussed in
Annex C, due to their processing and not their sourcing, shall also be considered to have acceptable risk
regarding bacteria, moulds and yeasts, subject to maintenance of proper storage conditions.
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The manufacturer shall conduct periodic microbiological studies to identify and quantify the initial
bioburden of the incoming animal material for the production of the medical device.
NOTE The following International Standards may be relevant:a) ISO 11135, ISO 11137, ISO 11737-1, ISO 13408, ISO 14160, ISO 14937, ISO 17664 and ISO 17665-1, which can
be relevant for bacteria, moulds and yeasts (see References [19] to[33]);b) all relevant parts of ISO 10993, which can be used to manage risks related to undesired pyrogenic,
immunological or toxicological reactions (see References [1] to[18]).The use of these International Standards is illustrated in Annex B.
4.4.4 Residual risk evaluation
4.4.4.1 General
Residual risk evaluation shall be performed for each risk.
4.4.4.2 TSE risk
The TSE risk may be judged acceptable if the following criteria are both met, taking into account the
availability of alternative materials:a) the residual risk estimate indicates that the TSE risk has been controlled at an acceptable level;
b) the medical benefit arising from the intended use of the device is judged to outweigh the residual
risk estimate.NOTE Guidance on risk management applicable to TSE agents is given in Annex D. Acceptability can be based
on conformity with requirements specific to some animal materials given in Annex C or requirements relevant to
sourcing, collection and handling of bovine materials given in ISO 22442-2:2015, Annex A.
Regarding the TSE residual risk, specific considerations are provided in Annex C. Some derivatives such
as tallow derivatives, animal charcoal, milk derivatives, wool derivatives and amino acids manufactured
according to conditions mentioned in Annex C are considered as presenting an acceptable TSE risk.
Where the TSE risk has not been controlled at a level that presents an acceptable level of risk to users
or recipients, the overall risk may only be judged acceptable when balanced by exceptional benefit and
feasibility considerations.4.5 Evaluation of overall residual risk acceptability
4.5.1 General
The evaluation of the overall residual risk acceptability shall take into account the balance between
the residual risk after implementation of all risk control measures and the ex...
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