SIST EN ISO 22442-3:2008

SLOVENSKI STANDARD
01-april-2008
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SIST EN 12442-3:2001
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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 (ISO 22442-3:2007)
Tierische Gewebe und deren Derivate nutzende Medizinprodukte - Teil 3: Validierung
der Abreicherung und/oder Inaktivierung von Viren und Erregern der übertragbaren
spongiösen Enzephalopathie (TSE) (ISO 22442-3:2007)
Tissus animaux et leurs dérivés utilisés dan la fabrication des dispositifs médicaux -
Partie 3: Validation de l'élimination et/ou de l'inactivation des virus et autres agents
responsables d'encéphalopathie spongiforme transmissible (EST) (ISO 22442-3:2007)
Ta slovenski standard je istoveten z: EN ISO 22442-3:2007
ICS:
11.120.01
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.

EUROPEAN STANDARD
EN ISO 22442-3
NORME EUROPÉENNE
EUROPÄISCHE NORM
December 2007
ICS 11.100.20 Supersedes EN 12442-3:2000
English Version
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
(ISO 22442-3:2007)
Dispositifs médicaux utilisant des tissus animaux et leurs Tierische Gewebe und deren Derivate, die zur Herstellung
dérivés - Partie 3: Validation de l'élimination et/ou de von Medizinprodukten eingesetzt werden - Teil 3:
l'inactivation des virus et autres agents responsables Validierung der Eliminierung und/oder Inaktivierung von
d'encéphalopathie spongiforme transmissible (EST) (ISO Viren und Erregern der übertragbaren spongiösen
22442-3:2007) Enzephalopathie (TSE) (ISO 22442-3:2007)
This European Standard was approved by CEN on 14 December 2007.
CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this European
Standard the status of a national standard without any alteration. Up-to-date lists and bibliographical references concerning such national
standards may be obtained on application to the CEN Management Centre or to any CEN member.
This European Standard exists in three official versions (English, French, German). A version in any other language made by translation
under the responsibility of a CEN member into its own language and notified to the CEN Management Centre has the same status as the
official versions.
CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland,
France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal,
Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and United Kingdom.
EUROPEAN COMMITTEE FOR STANDARDIZATION
COMITÉ EUROPÉEN DE NORMALISATION
EUROPÄISCHES KOMITEE FÜR NORMUNG
Management Centre: rue de Stassart, 36  B-1050 Brussels
© 2007 CEN All rights of exploitation in any form and by any means reserved Ref. No. EN ISO 22442-3:2007: E
worldwide for CEN national Members.

Contents Page
Foreword.3

Foreword
This document (EN ISO 22442-3:2007) has been prepared by Technical Committee ISO/TC 194 "Biological
evaluation of medical devices" in collaboration with Technical Committee CEN/TC 316 “Medical devices
utilizing tissues” the secretariat of which is held by NBN.
This European Standard shall be given the status of a national standard, either by publication of an identical
text or by endorsement, at the latest by June 2008, and conflicting national standards shall be withdrawn at
the latest by June 2008.
Attention is drawn to the possibility that some of the elements of this document may be the subject of patent
rights. CEN [and/or CENELEC] shall not be held responsible for identifying any or all such patent rights.
This document supersedes EN 12442-3:2000.
This document has been prepared under a mandate given to CEN by the European Commission and the
European Free Trade Association, and supports essential requirements of EC Directive(s).
This European Standard has been developed for medical devices regulated by the Medical Device Directive
93/42/EC as amended by 2003/32/EC (see Annex ZA). By analogy, it could be applied for active implantable
medical devices regulated by the Active Implantable Medical Device Directive 90/385/EC.
For relationship with EC Directive(s), see informative Annex ZA, which is an integral part of this document.
According to the CEN/CENELEC Internal Regulations, the national standards organizations of the following
countries are bound to implement this European Standard: Austria, Belgium, Bulgaria, Cyprus, Czech
Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia,
Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain,
Sweden, Switzerland and the United Kingdom.
Endorsement notice
The text of ISO 22442-3:2007 has been approved by CEN as a EN ISO 22442-3:2007 without any
modification.
Annex ZA
(informative)
Relationship between this European Standard and the Essential Requirements
of EU Directive 93/42/EEC as amended by Commission Directive 2003/32/EC

This European Standard has been prepared under a mandate given to CEN by the European Commission
and the European Free Trade Association to provide a means of conforming to Essential Requirements of the
New Approach Directive 93/42/EEC, concerning medical devices, as amended by Commission Directive
2003/32/EC in relation to detailed specifications regarding requirements for medical devices utilizing tissues of
animal origin.
Once this standard is cited in the Official Journal of the European Communities under that Directive and has
been implemented as a national standard in at least one Member State, compliance with the clauses of this
standard given in table ZA confers, within the limits of the scope of this International Standard, a presumption
of conformity with the corresponding Essential Requirements of that Directive and associated EFTA
regulations.
Table ZA — Correspondence between this European Standard and Directive 93/42/EEC as amended by
Commission Directive 2003/32/EC
Clause(s)/subclause(s) of this Essential requirements (ERs) of Qualifying remarks/Notes
International Standard Directive 93/42/EEC as amended
by Commission Directive
2003/32/EC
4, 5, 6, 7, 8, 9, Annex A Annex I, 7.1, 7.2, 8.1, 8.2
4, 5, 6, 7, 8, 9, Annex A Annex of Commission Directive
2003/32/EC
WARNING — Other requirements and other EU Directives may be applicable to the product(s) falling
within the scope of this standard.

INTERNATIONAL ISO
STANDARD 22442-3
First edition
2007-12-15
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
Dispositifs médicaux utilisant des tissus animaux et leurs dérivés —
Partie 3: Validation de l'élimination et/ou de l'inactivation des virus et
autres agents responsables d'encéphalopathie spongiforme
transmissible (EST)
Reference number
ISO 22442-3:2007(E)
©
ISO 2007
ISO 22442-3:2007(E)
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ii © ISO 2007 – All rights reserved

ISO 22442-3:2007(E)
Contents Page
Foreword. iv
Introduction . v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions. 2
4 General requirements. 3
4.1 Risk management . 3
4.2 Sourcing and manufacturing process. 3
4.3 General requirements related to validation . 3
5 Literature review . 4
5.1 Conduct of the literature review. 4
5.2 Application of literature review output. 4
5.3 Viruses . 4
5.4 TSE agents . 4
6 Elimination and/or inactivation study of viruses and TSE agents . 5
6.1 General. 5
6.2 Protocol . 5
6.3 Conduct of the study. 6
6.4 Interpretation of data. 6
7 Final report . 6
8 Review of final report . 6
9 Routine monitoring and control of critical process parameters . 6
Annex A (normative) Requirements related to literature review. 7
Annex B (informative) Guidance on the elimination and/or inactivation study for viruses . 11
Annex C (informative) Guidance on the elimination and/or inactivation study for TSE agents . 16
Annex D (informative) Guidance on scaling down . 17
Annex E (informative) Statistical evaluation of virus titres and reduction factors and assessment
of their validity . 18
Annex F (informative) Calculation of reduction factors . 19
Annex G (informative) Probability of detection of agents at low concentrations. 20
Bibliography . 21

ISO 22442-3:2007(E)
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.
International Standards are drafted in accordance with the rules given in the ISO/IEC Directives, Part 2.
The main task of technical committees is to prepare International Standards. Draft International Standards
adopted by the technical committees are circulated to the member bodies for voting. Publication as an
International Standard requires approval by at least 75 % of the member bodies casting a vote.
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.
ISO 22442-3 was prepared by Technical Committee ISO/TC 194, Biological evaluation of medical devices,
Subcommittee SC 1, Tissue product safety.
ISO 22442 consists of the following parts, under the general title Medical devices utilizing animal tissues and
their derivatives:
⎯ Part 1: Application of risk management
⎯ Part 2: Controls on sourcing, collection and handling
⎯ Part 3: Validation of the elimination and/or inactivation of viruses and transmissible spongiform
encephalopathy (TSE) agents
iv © ISO 2007 – All rights reserved

ISO 22442-3:2007(E)
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 were 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).
It is important to be aware that the exposure to a properly validated and accurately controlled method of viral
and TSE inactivation/elimination is not the only factor associated with demonstrating product safety. Attention
has also to be given to a number of factors including sourcing, collecting, handling, storage, processing,
testing of tissues and/or cells of animal origin, and to the control of the environment in which the product is
manufactured, assembled and packaged. The manufacturer should consider the fact that each manufacturing
phase can contribute to contamination as well as elimination and/or inactivation of viruses and TSE agents.
For the safety of medical devices there are two complementary approaches (see ISO 22442-1) that can be
adopted to control the potential contamination of tissues. These typically are:
a) selecting source material for minimal contamination with viruses and/or TSE agents (see ISO 22442-1
and ISO 22442-2);
b) providing valid scientific evidence to demonstrate the ability of the production processes to eliminate or
inactivate viruses and/or TSE agents (this part of ISO 22442).
Requirements for a quality system for medical devices for regulatory use are specified in ISO 13485. The
standards for quality management systems recognize that, for certain processes used in manufacturing, the
effectiveness of that process cannot be fully verified by subsequent inspection and testing of the product. The
elimination and/or inactivation of viruses and TSE agents is an example of a special process because process
efficacy cannot be verified by inspection and testing of the product. For this reason, the following need to be
considered in particular:
⎯ definition of the process(es) and materials to be used;
⎯ adequate inactivation validation before routine use;
⎯ performance monitoring of the process during manufacture;
⎯ appropriate equipment maintenance;
⎯ staff training, etc.
Historically there have been many instances of unknown or unsuspected viral contamination during
manufacture. For this reason, evaluation of the manufacturing process can provide a measure of confidence
that a wide number of viruses, including unknown pathogenic viruses are eliminated. Similar principles may
apply to TSE agents.
NOTE To show compliance with this part of ISO 22442, 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.

INTERNATIONAL STANDARD ISO 22442-3:2007(E)

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
1 Scope
This part of ISO 22442 specifies requirements for the validation of the elimination and/or inactivation of viruses
and TSE agents during the manufacture of medical devices (excluding in vitro diagnostic medical devices)
utilizing animal tissue or products derived from animal tissue, which are non-viable or have been rendered
non-viable. It applies where required by the risk management process as described in ISO 22442-1. It does
not cover other transmissible and non-transmissible agents.
NOTE 1 Analysis and management of risk is described in ISO 22442-1. Conventional processes used for sterilization,
when used for the treatment of animal tissues for medical devices, have not been shown to be completely effective in
inactivating the causative agents of transmissible spongiform encephalopathy. Selective sourcing is extremely important
(see ISO 22442-1 and ISO 22442-2).
NOTE 2 ISO 11135, ISO 11137, ISO 11737-1, ISO 13408, ISO 14160, ISO 14937 and ISO 17665 may be relevant for
bacteria, moulds and yeast (see Bibliography).
This part of ISO 22442 does not cover the utilization of human tissues in medical devices.
This part of ISO 22442 does not specify a quality management system for the control of all stages of
production of medical devices.
NOTE 3 It is not a requirement of this part of ISO 22442 to have a full quality management system during manufacture,
but it does specify requirements for some of the elements of a quality management system. Attention is drawn to the
standards for quality management systems (see ISO 13485) that control all stages of production or reprocessing of
medical devices. The quality management system elements that are required by this part of ISO 22442 can form part of a
quality management system conforming to ISO 13485.
This part of ISO 22442 does not consider the effect of any method of elimination and/or inactivation on the
suitability of the medical device for its intended use.
2 Normative references
The following referenced documents are indispensable for the application of this document. For dated
references, only the edition cited applies. For undated references, the latest edition of the referenced
document (including any amendments) applies.
ISO 22442-1:2007, Medical devices utilizing animal tissues and their derivatives — Part 1: Application of risk
management
ISO 22442-2, Medical devices utilizing animal tissues and their derivatives — Part 2: Controls on sourcing,
collection and handling
ISO 22442-3:2007(E)
3 Terms and definitions
For the purposes of this document, the terms and definitions given in ISO 22442-1 and the following apply.
3.1
model TSE agent
TSE agent that displays a known resistance to physical and/or chemical processing used as reference by
analogy for the inactivation of relevant TSE agents, and thereby demonstrating the effectiveness of the
process used for inactivation
3.2
model virus
virus that displays a known resistance to physical and/or chemical processing used as reference by analogy
for the inactivation of relevant viruses, and thereby demonstrating the effectiveness of the process used for
inactivation
NOTE This includes viral models (RNA, DNA, enveloped, non-enveloped) and bacteriophage models.
3.3
overall reduction factor
sum of the reduction factors of the individual process steps
3.4
permissive cell
cell that can become infected with the virus under study and in which that virus replicates
3.5
reduction factor
ratio of the virus or TSE agent load in the relevant material used or the device prior to the inactivation or
elimination step and the virus or TSE agent load after the inactivation or elimination step when it is ready for
the next step in the manufacturing process, expressed as the number of ten fold reduction (log )
3.6
relevant TSE agent
TSE agent known to, or likely to, contaminate the source material or other materials used in the manufacturing
process
3.7
relevant virus
virus known to, or likely to, contaminate the source material or other materials used in the manufacturing
process
3.8
revalidation
set of documented procedures to confirm an established validation
3.9
scaled down process
scaling down
process at a specified reduced scale which simulates the performance parameters as used in the full scale
production process
3.10
sterilization
validated process used to render a product free of all forms of viable microorganisms
2 © ISO 2007 – All rights reserved

ISO 22442-3:2007(E)
3.11
validation
documented procedure for obtaining, recording and interpreting the results required to establish that a process
will consistently yield product complying with predetermined specifications
[ISO/TS 11139:2006, definition 2.55]
4 General requirements
4.1 Risk management
Analysis and management of risk shall be carried out in accordance with ISO 22442-1.
Due account shall be taken of manufacturing processes that are considered to be effective for certain animal
materials as discussed in Annex C of ISO 22442-1:2007.
4.2 Sourcing and manufacturing process
A documented system shall be established and maintained to control the source of raw materials of animal
origin. ISO 22442-2 shall be used to meet this requirement as far as applicable.
The manufacturing process shall be established to minimize the load of viruses and TSE agents in starting
materials, intermediate products and finished products.
Appropriate documented protocols and procedures shall be established to ensure that the validated
processing parameters will be applied during the routine manufacturing processes.
NOTE Employing a quality management system complying with ISO 13485 could be used to meet the requirements
of this subclause.
4.3 General requirements related to validation
4.3.1 Documented procedures
The documented procedures and requirements of this part of ISO 22442 shall be implemented.
Documentation and records shall be reviewed and approved by designated personnel (see 4.3.2).
Procedures for any literature review and/or any inactivation study shall be documented and records shall be
retained for a period defined by the manufacturer.
4.3.2 Personnel
Responsibility for the implementation of this part of ISO 22442 shall be assigned to qualified personnel.
The requirements for the qualification, training or experience of personnel shall be documented and
appropriate to the individual’s work, responsibility and authority.
NOTE The level of qualification, training and experience required by personnel at various levels depends upon the
activities being performed.
4.3.3 Calibration
An effective system shall be established, documented and maintained for the calibration of all controlling,
indicating and recording instruments used for validation.
ISO 22442-3:2007(E)
4.3.4 Equipment
Appropriate equipment as specified in a protocol shall be used. All equipment requiring planned maintenance
shall be maintained in accordance with documented procedures. Records of maintenance shall be retained.
In particular, any equipment shall be capable of delivering its intended process within defined limits. In
addition, if the equipment used during validation is not identical to that used in normal production cycles,
adequate documentation shall be available to demonstrate that the performance parameters are equivalent to
those used in the production cycle.
4.3.5 Experimental systems
Additional parts of the experimental systems used for validation studies such as chemicals, cell systems and
laboratory animals shall be adequately identified, justified, controlled and documented.
5 Literature review
5.1 Conduct of the literature review
A literature review shall be performed as specified in Annex A, in order to identify and analyse data on the
elimination and/or inactivation of viruses and TSE agents.
5.2 Application of literature review output
Technical information from the literature review shall be used in optimizing the design of an inactivation and/or
elimination study.
Any extrapolation based on the inactivation of viruses and TSE agents shall be justified and documented.
Intrinsic variability of materials of animal origin utilized in medical devices and of manufacturing processes can
lead to misinterpretation of the validity of published data and shall be taken into account.
5.3 Viruses
The manufacturer shall demonstrate whether the literature review provides an indication of which inactivation
and/or elimination steps are likely to be effective. A literature review is a prerequisite to performing a viral
inactivation study. In exceptional cases, if a manufacturer chooses not to perform a study, this shall be
justified and documented.
If the available information does not support the elimination and/or inactivation of viruses, then an alternative
risk management strategy shall be implemented (see ISO 22442-1).
5.4 TSE agents
The literature review shall consider which of the published methods for elimination and/or inactivation of TSE
agents are likely to be suitable for the medical device under consideration. In particular, the materials of
animal origin and manufacturing processes referred to in the literature shall be comparable to those used for
the medical device under consideration (see Annex A). A validated inactivation study shall be performed when
the comparability of materials and processes cannot be demonstrated or specific claims are made for
inactivation of TSE agents by the manufacturer (see Clause 6).
If the available information does not support the elimination and/or inactivation of TSE agents, then an
alternative risk management strategy shall be implemented (see ISO 22442-1).
Special considerations for the manufacture of some animal materials are provided in ISO 22442-1:2007,
Annex C.
4 © ISO 2007 – All rights reserved

ISO 22442-3:2007(E)
6 Elimination and/or inactivation study of viruses and TSE agents
6.1 General
If the need for an elimination and/or inactivation study is identified (see 5.3 and 5.4) this shall be performed so
that it substantiates the effectiveness for the selected steps of manufacture against selected agents
(see Annexes B and C).
If the manufacturer uses sterilization processes that have been validated for bacteria, moulds and yeast, these
processes shall also be supported by relevant validation data for the elimination and/or inactivation of viruses
and TSE agents.
6.2 Protocol
The protocol for a study to demonstrate the elimination and/or inactivation of viruses and TSE agents during
manufacture shall detail the following including, if applicable, values and acceptability criteria:
a) the identified risks associated with the tissue concerned (see ISO 22442-1);
b) identification of the relevant agent(s);
c) the rationale for the choice of the particular combinations of model agents: the models for an elimination
and/or inactivation study shall be chosen by the manufacturer; the justification for the choice of model(s)
shall be documented;
NOTE 1 Such models include viral models (RNA, DNA, enveloped, non-enveloped, see also Table B.1), and TSE
agent models.
NOTE 2 As part of the studies, it is possible to use bioassay of TSE agents (mouse or hamster models) for the
validation of the inactivation of agents by the manufacturing process(es) of the medical device or components. Such
studies have been considered to be predictive of inactivation efficacy for TSE agents which may cause disease, e.g.
bovine spongiform encephalopathy, scrapie and Creutzfeldt-Jacob disease.
d) identification and definition of the manufacturing stage(s) chosen to eliminate and/or inactivate the
relevant viruses and TSE agents;
e) documentation of any scaling down, including demonstration of the validity of the scaled down version of
the manufacturing process;
NOTE 3 Guidance on scaling down is given in Annex D.
NOTE 4 Consideration should be given to the potential for one processing stage to have an adverse effect on the
inactivation/elimination efficacy of subsequent processing stages. Reliance on literature information on individual
processing stage efficacy might be inappropriate if the available information does not relate to the same sequence of
processes intended for use by the manufacturer.
NOTE 5 The overall reduction factor is unlikely to equal the sum of the reduction factors from individual processing
stages which use similar physical, chemical, enzymatic or thermal mechanisms or reagents to reduce the viral or TSE
agent load. There may be a loss of efficacy in subsequent application of the same processing stage.
f) the methods of calculation for the reduction factors;
g) the method of the estimation of reduction kinetics, if applicable (see Annexes E and F).
NOTE 6 Careful consideration should be given to the statistical and physical limitations in sampling, and limits of
sensitivity of detection methods (see also B.3.5 and Annexes C, E and F).
ISO 22442-3:2007(E)
6.3 Conduct of the study
The study shall be conducted in accordance with the protocol.
6.4 Interpretation of data
The reduction factor shall be determined (see B.3.5 and Annexes C, E and F). The efficacy of the identified
manufacturing steps for the elimination and/or inactivation of viruses and TSE agents shall be reviewed.
Scaling down and other variables which may influence the results shall be addressed.
NOTE Reduction factors are typically calculated for each step within a controlled study.
7 Final report
A final report shall be compiled containing:
⎯ the literature review (see Clause 5 and Annex A);
⎯ and/or a critical evaluation of the data obtained during any elimination;
⎯ and/or inactivation study undertaken (see Clause 6);
⎯ an overall conclusion;
⎯ reference to this part of ISO 22442.
The report shall identify manufacturing parameters that are critical to the effectiveness of the inactivation or
elimination process. Acceptable limits shall be determined and specified for such parameters.
An overview shall be given showing all relevant processing steps with a statement of agent reduction factors
(see B.3.5 and Annex C).
NOTE This can take the form of a flow chart.
The report shall be signed by persons designated as responsible for its preparation, review and approval. The
report shall be retained and included in the risk management file [for revalidation(s), see Clause 8].
8 Review of final report
Procedures for a review of the final report by persons designated as responsible shall be documented.
A review of the final report shall be conducted when significant changes in the manufacturing process(es)
occur and/or when relevant information not previously considered in the final report, becomes available, e.g.
valid scientific evidence, scientific literature and authoritative publications. If necessary, corrective actions
and/or additional studies shall be undertaken and reported to revalidate the manufacturing process.
Records of any review of the final report shall be retained.
9 Routine monitoring and control of critical process parameters
The manufacturer shall assure that all critical parameters identified in the final report are monitored and
controlled during manufacture.
6 © ISO 2007 – All rights reserved

ISO 22442-3:2007(E)
Annex A
(normative)
Requirements related to literature review
A.1 General
NOTE ISO 14155 contains relevant information on literature review. Developments in the revision of that document
will be kept under review.
The literature review shall identify investigations into the elimination and/or inactivation capacity of the
manufacturing process for viruses and TSE agents. The literature review shall be carried out by person(s)
suitably qualified in the relevant field, knowledgeable in the “state of the art” and able to demonstrate
objectivity.
A.1.1 Methodology
A.1.1.1 General
A precise definition of the questions to be answered shall be established. This shall include at least:
⎯ identification of the relevant viruses and TSE agents that will be the basis for the search (see Annexes B
and C);
⎯ identification of the manufacturing steps which may inactivate and/or eliminate the relevant viruses and
TSE agents;
⎯ identification of effects of preceding manufacturing steps on process efficacy;
⎯ identification of the relevant parameters of the manufacturing steps;
⎯ review of the potential efficacy of the process for the elimination and/or inactivation of viruses and TSE
agents;
⎯ evaluation of the effect of the animal tissue or derivative on the efficacy of the process.
A protocol for the identification, selection and review of relevant reports shall be written and preferably be
based on recognised practice for systematic review for literature.
A.1.1.2 Objective
The objective of the literature review shall be clearly defined. The types of report which are relevant to the
objective of the literature review shall be specified.
A.1.1.3 Identification of data
Data shall be taken from scientific publications, e.g. valid scientific evidence, scientific literature and
authoritative publications. A systematic search of the literature shall be conducted in order to reduce the risk
of introducing bias. Unpublished data shall also be taken into account.
The literature review shall identify:
⎯ the sources of data and the extent of the searches of databases or other sources of information;
ISO 22442-3:2007(E)
⎯ the rationale for the selection/relevance of the published literature;
⎯ the rationale for concluding that all relevant references, both favourable and unfavourable, have been
identified;
⎯ the criteria for exclusion of particular references together with a justification for this exclusion.
NOTE Possible data sources for a systematic literature review are, for example:
⎯ medical and paramedical databases;
⎯ technical papers from relevant Standards Committees;
⎯ foreign language literature;
⎯ “grey literature” (theses, internal reports, non-peer-reviewed journals, the internet, industry files);
⎯ references listed in primary sources;
⎯ other unpublished sources known to experts in the field (obtained by personal communication);
⎯ raw data from published trials (obtained from personal communication).
A.1.1.4 Relevance of data
A literature review shall clearly establish the extent to which the literature relates to the specific characteristics
and features relating to the manufacturing process for the device under consideration.
If included published reports do not directly refer to the manufacturing process for the device under
consideration, the following shall apply.
The manufacturer shall demonstrate equivalence of the manufacturing process which is the subject of the
published reports in relation to that applied to the device under consideration. This includes demonstration of:
⎯ same tissue;
⎯ same geometry;
⎯ same quality of material;
⎯ same process conditions (e.g. time, temperature, concentration, pH, pressure, scale, solvents),
unless differences can be justified.
A.1.1.5 Assessment
The literature review shall make clear the significance that is attached to particular references based on a
number of factors. These include:
⎯ the relevance of the author’s background and expertise in relation to the particular device and/or
manufacturing process involved;
⎯ whether the author’s conclusions are substantiated by the available data;
⎯ whether the literature reflects the current practice and the generally acknowledged “state of the art”
technologies;
NOTE Historical studies that no longer reflect the state of the art sometimes contain relevant information.
8 © ISO 2007 – All rights reserved

ISO 22442-3:2007(E)
⎯ whether references are taken from recognized scientific publications;
⎯ whether or not they have been reported in peer-reviewed journals;
⎯ the extent to which the published literature is the outcome of a study/studies that have followed scientific
principles in relation to design, for example, in having demonstrable and appropriate endpoints, and
identifying an appropriate statistical plan of analysis.
If “grey literature” or unpublished data are being included in the assessment, the literature review needs to
weigh the significance that is attached to each report. When such information is used, sufficient scientific
information (which may be a summary) shall be included from controlled studies that allow for a scientific
review.
The evidence shall not consist of:
a) reports lacking sufficient detail to permit scientific evaluation (including lack of accepted and validated
statistical design if this is relevant to the design of the intended study);
b) unsubstantiated opinions.
A.1.2 Critical evaluation
The literature review shall contain a critical evaluation of the literature. This critical evaluation shall:
⎯ be written by a person suitably qualified in the relevant field, knowledgeable in the “state of the art” and
able to demonstrate objectivity;
⎯ contain a short description of the medical device;
⎯ contain an analysis of all the available data considered, both favourable and unfavourable;
⎯ establish the extent to which the literature relates to the specific characteristics and features of the tissue
being assessed, taking due account of the extent of similarity between the tissue(s) covered by the
literature and the device under assessment;
⎯ analyse the identified hazards, the associated risks and the appropriate safety;
⎯ contain a description of the methods of weighting of different papers; in order to avoid overweighting,
particular attention should be given in circumstances where there are repeated publications by the same
authors;
⎯ contain a list of publications appropriately cross-referenced in the evaluation;
⎯ if the data relate to an equivalent device, contain a statement that equivalence with all the relevant
characteristics has been demonstrated.
The critical evaluation shall be signed and dated by the author.
A.2 Conclusions
As a result of a literature review, the manufacturer needs to be able to answer the following questions.
⎯ Are the stated conclusions valid?
⎯ Are the data sufficient to demonstrate compliance with the relevant essential requirements?
ISO 22442-3:2007(E)
A.3 Report
The results of the literature review shall be compiled in a report. This shall include a critical evaluation of the
literature, conclusions and all relevant information as required in this annex (see Clause 7).
NOTE Insufficient content or quality in any of the above steps or the availability of relevant new information logically
results in re-examination of the information and, if necessary, a return to an appropriate earlier stage, making the
necessary adjustments and repeating the process.

10 © ISO 2007 – All rights reserved

ISO 22442-3:2007(E)
Annex B
(informative)
Guidance on the elimination and/or inactivation study for viruses
B.1 General
Elimination and/or inactivation of viruses is assumed to follow probabilistic concepts and it is therefore not
possible to guarantee absolute freedom of contamination in products.
All testing suffers from the inherent limitation of quantitative virus assays, when the ability to detect low virus
concentrations depends, for statistical reasons, on the size of the sample (see Annex G).
Establishing the freedom from relevant viruses in or on tissue will not derive solely from direct testing for their
presence but also from a demonstration that the manufacturing steps are capable of inactivating or removing
them.
B.2 Selection of viruses
B.2.1 The selection of viruses to be used when performing the elimination and/or inactivation study is critical.
Whenever possible the relevant virus should be included. If the use of relevant viruses does not demonstrate
a wide range of properties where required, then validation should be performed with model viruses.
B.2.2 Model viruses for elimination and/or inactivation studies should be chosen to represent as closely as
possible the relevant viruses which may contaminate the product and to represent as wide a range of physico-
chemical p
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