Regulatory roadmap: FDA Class III medical device, United States

6 phases · 37 steps

This is the order in which Normiq organises market access for the market "United States" and the category "FDA Class III medical device". Each step has a detailed guide — how to proceed, best practices, common mistakes, reference articles — reserved for Normiq accounts.

  1. Phase 1

    Classification and regulatory strategy (FDA)

    Determine which regulation number and class the device falls under, whether a premarket submission is due, and through which route to request it.

    1. Establish the class and the generic type

      required · 10 d

      The class follows from the generic type the device belongs to, and from the controls FDA deemed necessary for that type.

    2. Identify the product code

      required · 5 d

      The code by which FDA designates the generic category of the device. It governs registration, listing and the search for a predicate.

    3. Check exemptions, and their limits

      required · 10 d

      Some devices escape premarket submission, others good manufacturing practices. No exemption is unconditional.

    4. Request FDA feedback before submitting (Q-Submission)

      recommended · 90 d

      A voluntary channel to validate a testing strategy or an acceptability question before filing. Nothing compels it, and nothing binds FDA.

    5. Qualify a software function

      recommended · 10 d

      Five families of software functions are excluded from the device definition. The exclusion attaches to the function, not to the product.

  2. Phase 2

    Establishment, listing and US agent (FDA)

    Register with FDA, list the devices, and appoint the US agent without whom a foreign manufacturer does not exist for the agency.

    1. Appoint a US agent

      required · 20 d

      Every foreign establishment appoints one, and only one. Informing the agent is equivalent to informing the manufacturer.

    2. Register the establishment

      required · 30 d

      Initial registration within thirty days of starting operations, then annual renewal between 1 October and 31 December.

    3. List the devices

      required · 10 d

      Listing declares which devices are placed in distribution, under which submission number and from which establishment.

    4. Identify the initial importer

      recommended · 5 d

      Three capacities the regulation separates and practice confuses: initial importer, importer, and person who imports.

    5. Apply for small business status

      recommended · 60 d

      A fee reduction, subject to turnover thresholds, to be requested each fiscal year. One of the two windows closes before the other.

  3. Phase 3

    Quality management system — QMSR (FDA)

    Since 2 February 2026, 21 CFR 820 incorporates ISO 13485:2016 by reference and adds its own requirements. An ISO certificate is not enough.

    1. Measure the gap between ISO 13485 and the QMSR

      required · 90 d

      What 21 CFR 820 adds to the standard: four cross-references, mandated records, and control of labelling.

    2. Apply design controls

      required · 60 d

      Classes II and III, plus any software-driven device and five named product codes — including in class I.

    3. Handle complaints and link them to vigilance

      required · 30 d

      Seven mandatory fields per complaint, and two mandated bridges to adverse event reporting and advisory notices.

    4. Prepare for an FDA inspection

      required · 30 d

      Since February 2026 the inspection method has changed, and documents once shielded no longer are.

    5. Secure electronic records

      recommended · 45 d

      Part 11 applies as soon as a record required by regulation exists in electronic form.

  4. Phase 4

    Premarket submission (FDA)

    The 510(k), the De Novo, the PMA: which route, which evidence, which timelines, and what each decision actually authorises.

    1. Choose the predicate and show substantial equivalence

      recommended · 30 d

      One predicate carries the demonstration. The 2014 guidance sets out six successive decisions, and forbids mixing two devices.

    2. Assemble the performance data

      required · 120 d

      A staircase: description, bench testing, animal and biocompatibility studies, then clinical data — which fewer than one dossier in ten carries.

    3. Document a software function

      recommended · 45 d

      Two documentation levels, Basic and Enhanced, and ten elements of which only three change from one level to the other.

    4. Meet the cybersecurity obligations (524B)

      recommended · 60 d

      Three statutory obligations for a « cyber device ». The definition is broader than it looks: a USB port is enough.

    5. File the 510(k) through eSTAR

      recommended · 30 d

      Since 1 October 2023 a 510(k) is filed in eSTAR format through the CDRH Portal. The content remains that of 807.87.

    6. Follow the review and wait for the order

      recommended · 90 d

      Two ninety-day deadlines coexist and do not mean the same thing. No marketing before the equivalence order.

    7. Decide whether a change requires a new submission

      required · 15 d

      Two criteria, and a threshold that turns on the potential of the change, not on its demonstrated effect.

    8. Request a De Novo classification

      recommended · 120 d

      The route for a device with no predicate. Fifteen days for acceptance, one hundred and twenty for the decision, and the result becomes a predicate.

    9. File a premarket approval application (PMA)

      required · 180 d

      The class III route. Forty-five days to filing, one hundred and eighty to the decision. Structure laid down, to be deepened.

    10. Run a clinical investigation (IDE)

      required · 60 d

      FDA silence at thirty days is enough to begin. But the significant-risk question must have been settled first. Structure laid down.

    11. Apply for a humanitarian device exemption (HDE)

      recommended · 75 d

      A route reserved for conditions affecting no more than eight thousand people, which waives proof of effectiveness — not of safety. Structure laid down.

    12. Have a test categorised under CLIA

      recommended · 60 d

      A regime distinct from FDA authorisation, which decides in which laboratories a test may be run.

  5. Phase 5

    Labelling, instructions and unique device identifier (FDA)

    What the label must carry, what the instructions must say, and the unique identifier to be submitted to the GUDID database.

    1. Compose the labelling

      required · 30 d

      Name and place, directions a layman can follow, symbols under conditions, and a date format that is imposed.

    2. Label an in vitro diagnostic

      recommended · 20 d

      Nine items on the label, fifteen headings in the insert — and in the order the regulation fixes.

    3. Apply the unique identifier and populate the GUDID

      required · 45 d

      Two forms on the label, direct marking for reusables, and a submission to the database no later than the labelling date.

    4. Control promotion and advertising

      recommended · 15 d

      Advertising is not neutral: it contributes to establishing the intended use of the device, and hence its regime.

  6. Phase 6

    Vigilance and post-market obligations (FDA)

    Report adverse events, notify corrections and removals, run a recall, and keep the annual registration current.

    1. Report adverse events (Medical Device Reporting)

      required · 30 d

      Thirty calendar days for a death, serious injury or malfunction; five working days where remedial action is called for.

    2. Report corrections and removals

      required · 10 d

      Ten working days to report a correction or removal intended to reduce a risk. An improvement without a violation is exempt.

    3. Run a recall, or recognise an enhancement

      required · 30 d

      A recall is voluntary; it is FDA that classifies it. The decisive criterion is not risk but the existence of a violation.

    4. Answer a surveillance order (section 522)

      recommended · 30 d

      An obligation born of an FDA order, never of itself. Thirty days to propose a plan.

    5. Set up ordered device tracking

      recommended · 30 d

      Like surveillance, device tracking arises from an FDA order. The patient may refuse to appear in it.

    6. Renew the registration and the listing

      required · 10 d

      Every year, from 1 October to 31 December, and confirmation is due even where nothing has changed.

The detailed guide for each step — how to proceed, best practices, common mistakes — is reserved for Normiq accounts.

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