FDA Decides Regulating Implantable Defibrillator Medical Devices a "Political Hot Potato"; Demurs

<div style="font-family: inherit;">Well, not exactly, but they <span style="font-style: italic;">have</span> decided regulation of another medical device is a political hot potato, and demurred on enforcing regulation:<span style="font-size: 100%;"><span class="instructions"><span style="font-weight: bold;"> </span></span></span></div><div style="font-family: inherit;"><br /></div><div style="font-family: inherit;"><span style="font-size: 100%;"><span class="instructions"><span style="font-weight: bold;">Health IT.</span> </span></span></div><div style="font-family: inherit;"><br /></div><div style="font-family: inherit;"><span style="font-size: 100%;"><span class="instructions">Health IT are medical devices.</span></span></div><div style="font-family: inherit;"><br /></div><div style="font-family: inherit;"><span style="font-size: 100%;">FDA's Chair of the Center for Device and Radiological Health, Jeffrey Shuren, MD JD, stated this explicitly on Feb. 25, 2010 (see testimony to the HHS Health Information Technology HIT Policy Committee at <a href="http://web.archive.org/web/20120320111030/http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_11673_910717_0_0_18/3Shuren_Testimony022510.pdf" target="_blank">this PDF</a>) that:</span></div><div style="font-family: inherit;"><span style="font-size: 100%;"><br /></span> </div><div dir="ltr" style="font-family: inherit;"><span style="font-size: 100%;"> </span></div><blockquote dir="ltr" style="font-family: inherit; margin-right: 0px;"><div dir="ltr"><span style="font-size: 100%;">... Under the <a href="http://www.fda.gov/regulatoryinformation/legislation/federalfooddrugandcosmeticactfdcact/default.htm">Federal, Food, Drug, and Cosmetic Act</a>, <b><span style="color: red; font-style: italic;">[that regulates all drug, medical devices, etc. in the United States - ed.]</span> HIT software is a medical device</b>. Currently, the FDA mandates that manufacturers of other types of software devices comply with the laws and regulations that apply to more traditional medical device firms. These products include devices that contain one or more software components, parts, or accessories (such as electrocardiographic (ECG) systems used to monitor patient activity), as well as devices that are composed solely of software (such as laboratory information management systems).</span></div></blockquote><br /><div dir="ltr" style="font-family: inherit;"><span style="font-size: 100%;">That leaves no doubt that these are medical devices. However, he also stated:</span><br /><span style="font-size: 100%;"><br /></span></div><div dir="ltr" style="font-family: inherit;"><span style="font-size: 100%;"> </span></div><blockquote dir="ltr" style="font-family: inherit; margin-right: 0px;"><div dir="ltr"><span style="font-size: 100%;"><b>To date, FDA has largely refrained from enforcing our regulatory requirements with respect to HIT devices.</b></span></div></blockquote><div dir="ltr" style="font-family: inherit;"><span style="font-size: 100%;"> </span></div><div dir="ltr" style="font-family: inherit;"><br /><span style="font-size: 100%;">In other words, this medical device receives special accommodation over all others,such as heart stents, defibrillators, spine and knee implants, etc., all of which have been in the news in recent years for major defects and malfunctions, up to and including causing patient deaths. The extent would have likely been far, far worse had these gadgets been unregulated.</span><br /><br /><span style="font-size: 100%;">One should ask: <span style="font-weight: bold;">why the special accommodation for health IT medical devices? </span>What are the underlying politics, and who is behind them? Especially when FDA is <a href="http://hcrenewal.blogspot.com/2010/08/smoking-gun-internal-fda-memorandum-of.html">aware of potential risks</a> that may only be the "<a href="http://hcrenewal.blogspot.com/2010/02/fda-on-health-it-adverse-consequences.html">tip of the iceberg</a>?"</span><br /><br /><span style="font-size: 100%;">The selective reluctance to enforce the FD&C Act persists to this day. See for example this link regarding his statements just a few days ago here in Philadelphia: <a href="http://healthcare-informatics.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=611B2533503749379725490812695CE6">Will FDA Regulate EHR's?</a> :</span><br /><span style="font-size: 100%;"><br /></span></div><div dir="ltr" style="font-family: inherit;"><span style="font-size: 100%;"> </span></div><blockquote dir="ltr" style="font-family: inherit; margin-right: 0px;"><div dir="ltr"><span style="font-size: 100%;">Speaking at the first annual PharmEHR Summit in Philadelphia on April 7, Jeffrey Shuren, M.D., J.D., director of the Center for Devices and Radiological Health at the FDA, said his agency could change its traditional hands-off approach to EHRs, but he acknowledged that the potential of FDA regulation raises serious clinical issues <span style="color: red; font-style: italic; font-weight: bold;">[the only clinical issues I can think of are in holding vendors accountable for patient injury - ed.]</span> and is a <b>“political hot potato.” </b>“<b>As of right now we’re not regulating EHRs, and it may turn out that we won’t,” he said.</b></span></div></blockquote><div dir="ltr" style="font-family: inherit;"><span style="font-size: 100%;"><br /><i><b>A "political hot potato"</b> as the reason for an FDA hands-off policy?</i><b>  Remarkable.</b> </span><br /><br /><br /><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiI2QShfTWCl06lqXyCcaehfFzoJSLu3_OtMxVB-bnVuGhQWn_7i4yvFeTnCeLsNjh8whx23eZ0byDmduGxPfJKX249d8tVtAX2-yVjFcjfwEeY52suLsiHJJo6whxMI7_AWbFQUqh5pGvg/s1600/hot_potato.gif" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="277" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiI2QShfTWCl06lqXyCcaehfFzoJSLu3_OtMxVB-bnVuGhQWn_7i4yvFeTnCeLsNjh8whx23eZ0byDmduGxPfJKX249d8tVtAX2-yVjFcjfwEeY52suLsiHJJo6whxMI7_AWbFQUqh5pGvg/s320/hot_potato.gif" width="320" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Tossing away political hot potatoes and ... patients.</td></tr></tbody></table><br /><br /><span style="font-size: 100%;">Likely translation: FDA regulation of health IT will never happen.</span><br /><br /><span style="font-size: 100%;">One implication is that health IT quality, safety, efficacy, privacy, security, and other issues about these systems will remain subject to HHS and industry caprice.</span><br /><br /><span style="font-size: 100%;">While we're at it, let's deregulate <a href="http://www.aboutlawsuits.com/zimmer-nexgen-knee-lawsuit-filed-17178/">knee implants</a> too...<br /><br />-- SS<br /><br /><b>Addendum April 19, 2011:</b><br /><br />Roy Poses observes that:</span><br /><blockquote><span style="font-size: 100%;"><br /></span>Here is a great example of <span style="font-weight: bold;">regulatory capture</span>. The health care IT industry has amassed such political clout that it now has impunity to regulation. Once again, combined economic and political power trumps patients' and the public's health and safety. We will not be able to really reform health care until we can provide for honest, independent health care regulation to uphold patients' and the public's health.</blockquote><br /><span style="font-size: 100%;">-- SS</span></div>

FDA Decides Regulating Implantable Defibrillator Medical Devices a "Political Hot Potato"; Demurs

Well, not exactly, but they have decided regulation of another medical device is a political hot potato, and demurred on enforcing regulati...

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