Food Drug And Cosmetic Act Of 1938 Pdf Writer
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- Cheers to 80 Years: Celebrating the Anniversary of the Federal Food, Drug, and Cosmetic Act
- Importation of Prescription Drugs
- CATHERINE KARUGA
The Pure Food and Drug Act of was the first of a series of significant consumer protection laws which was enacted by Congress in the 20th century and led to the creation of the Food and Drug Administration. Its main purpose was to ban foreign and interstate traffic in adulterated or mislabeled food and drug products, and it directed the U. Bureau of Chemistry to inspect products and refer offenders to prosecutors. It required that active ingredients be placed on the label of a drug's packaging and that drugs could not fall below purity levels established by the United States Pharmacopeia or the National Formulary.
Cheers to 80 Years: Celebrating the Anniversary of the Federal Food, Drug, and Cosmetic Act
Since the emergence of medical devices, legislation has been developed to allow the Federal Drug Administration FDA to oversee their development, marketing, and usage. Additionally, it discusses both short- and long-term effects with unexpected consequences to U. This allowed the FDA to perform factory inspections and prohibited misbranded marketing of cosmetic and therapeutic medical devices.
In , the Public Health Service Act focused on the expansion of biologics and more formal evaluation of laboratories. In , the Radiation Control for Health and Safety Act focused on regulating devices which utilized radiation or magnetic fields. Theodore Cooper, to chair the Cooper Committee to evaluate the need for medical device legislation.
The Cooper Committee recommended new specific legislation for devices in a risk-stratified manner [ 1 ]. It sought to assure the safety and effectiveness of medical devices. It required devices developed after May 28, , to go through the Premarket Approval PMA and k premarket notification regulatory pathways. It included the Investigational Device Exemption so that new investigational devices could be studied. Additionally, it developed post-market surveillance once a device had entered the market.
Device manufacturers were required to sustain good manufacturing practices and report adverse events to the FDA. If there were concerns with post-market surveillance, the FDA was given the authority to ban a device from the market [ 1 ]. Class I devices are deemed low-risk and are unlikely to cause bodily harm if a malfunction occurs [ 2 ]. They are regulated by general i. Rigorous data-driven FDA approval is not needed for Class I devices, however, if post-marketing surveillance shows a device to be unsafe the FDA is able to remove it from the market.
Common Class I devices include tongue depressors, crutches, and blood pressure cuffs [ 2 ]. Class II devices are deemed moderate-risk devices and are unlikely to lead to preposterous bodily harm if a malfunction occurs [ 2 ]. They are not only regulated by general controls but additionally special i.
Most devices which fall into this category obtain FDA clearance by the premarket notification k process prior to the device entering the market. The k notice must be submitted 90 days prior to the device entering the market [ 4 ]. It does not require the predicate device to be presently on the market, as such, the substantially equivalent device may have been removed from the market due to safety concerns or poor outcomes.
Very few k applications require submission of clinical data as much of the data is oftentimes from rudimentary animal or in vitro experiments. Huerta et al. If upon review the FDA deems it necessary they may require more clinical data although this is relatively uncommon. The k process has recently been controversial and attracted much media attention. It has critically been reviewed where some have deemed it flawed and unreliable [ 3 ]. Examples of Class II devices include cardiac monitors, tampons, surgical drapes, and foreign body retrievers [ 2 ].
Class III devices are deemed high-risk devices and may cause serious injury but are intended to significantly modify patient health [ 2 ]. The PMA is more rigorous than the k process, therefore, device manufactures attempt to bypass it if able [ 3 ]. The FDA critically appraises the clinical data submitted in the PMA to determine if it is safe and effective and should be placed on the market.
Examples of Class III devices include pacemakers, defibrillators, mechanical heart valves, and endovascular stents [ 2 ]. Prior to this, the post-market surveillance was deemed insufficient so modifications were made. The facilities that utilized devices were required to report adverse events. The FDA was also given the ability to mandate post-market surveillance on permanently implanted devices that could cause serious bodily harm or death.
New iterations of devices were able to submit clinical data from earlier iterations for premarket submissions. This established the De Novo program which allowed new low-to-moderate risk devices to be classified as Class I or II risks [ 1 ]. In , the Medical Device User Fee and Modernization Act allowed the FDA to receive fees for medical device premarket submissions and also allowed certain small business to have reduced fees through the small business determination program.
It used fees as a way to increase efficiency on evaluated devices [ 1 ]. In , the Food and Drug Administration Amendments Act increased the efficiency of the premarket review process, moved the process to an electronic format, and required each device to bear a unique identification number [ 1 ].
In , the Food and Drug Administration Safety and Innovation Act allowed collaboration between the United States and foreign governments regulations. It further simplified new low-to-moderate risk devices to be classified as Class I or II and bypass the k process.
It further streamlined and sped up the review times in addition to making the decisions more transparent to device submitters [ 1 ]. In , the 21st Century Cures Act made it easier for new devices to be approved.
The specific process undertaken by the manufacturer depends on deemed inherent device risk and intended population size. The process undertaken for Class II and III devices was previously discussed, however, there are exceptions for small target populations. In , the 21st Century Cures Act liberalized the requirement from 4, to 8, target individuals [ 4 ]. Unlike PMA, the device manufacturer is not required to submit clinical data due to the difficulty in performing clinical trials with such a limited target patient population.
However, they must prove that it is unlikely to pose a great risk to patients and that there is likely significant clinical benefit when utilized. Once approval is obtained as an HDE, it differs from a PMA approval as it requires a device to be classified as an investigational device and its use is limited to the original indications that were submitted to the FDA.
Clinicians that place these devices must obtain approval from their local internal review board prior to placement. Ventricular Assist Devices are commonly utilized in the adult population to act as a temporizing measure while transplant-list patients await their turns for placement.
In addition to approving medical devices to be marketed, the FDA is also tasked with monitoring devices that have already been placed on the market. The Medical Device Reporting database is easily searchable and shows all reported adverse events associated with a particular device on the market. In addition to this mandated self-reporting, the FDA may require more formal post-market surveillance programs which the device manufacturer must initiate and report to the FDA within 30 days of market entrance [ 2 ].
Abdominal hernia repairs are one of the most commonly performed surgeries in the US with approximately , operations being performed in [ 5 ]. Recurrent abdominal hernias can be a costly complication which led to the development and increased utilization of mesh implants after they were shown to reduce hernia recurrence.
Mesh implants, however, are associated with complications, such as bowel erosion or increased infection rates, which led to the development of biological meshes in the s even though there is no high-level data supporting their usage [ 5 ]. Biologic meshes are Class II devices, and as such, they utilize the k pathway for market entrance.
Originally, these meshes were Class II devices and were substantially equivalent to the Mersilene mesh that was originally developed in the s. Most k filings have no clinical data or outcomes to support their devices benefits and safety profile.
In , reports of vaginal erosions, infections, bladder injury, increased reoperation rates, and organ perforations were associated with these mesh devices. Many manufacturers removed their devices from the market when the FDA required them to submit post-market surveillance data in To this day, very limited data exists to substantiate any benefit from using these mesh devices [ 8 ].
Total hip replacements are one of the most common surgeries performed in the US with approximately , surgeries performed in [ 9 ]. The popularity of Cobalt-alloy metal on metal total hip arthroplasty devices -particularly in younger patients - stems from their reported longevity. This has led to a regained interested in these devices, and popularization in the s, despite robust clinical data after entering the market via the k pathway as Class II devices.
Cobalt-containing hip implants have recently been quite controversial and have attracted substantial media attention. They have been associated with Cobalt toxicity which includes central nervous system impairment [ 9 ], heart disease, and thyroid dysfunction [ 10 ].
There have been multiple case series that have reported removal of these devices due to elevated serum Cobalt levels in patients with psychological alterations confirmed with formal testing [ 9 ].
Additionally, clinical data has revealed increased revision rates when compared to other implants [ 3 , 8 ]. The aforementioned legislation has led to widespread changes in health care. Positive benefits have included a robust expansion of available medical technology and increased treatment options. New areas of medicine have been developed around medical devices such as functional neurosurgery, endovascular neurosurgery, interventional radiology, and interventional cardiology, to name a few.
Previous disease processes which were difficult to treat are not associated with as much morbidity or mortality that plagued previous generations.
Modifications and improvements to existing devices are able to be promptly performed via the k process. Development of life-saving devices for small target populations, such as pediatric ventricular assist devices, is continually being performed with improvement in quality of life.
This legislation, however, has received much criticism. Many concerns have emerged for medical device manufacturers due to the lack of oversight and unexpected loopholes. The lack of clinical data required to obtain k clearance, mass usage of predicate devices that have been removed from the market, and poor post-market surveillance have all surfaced as possible concerns.
Widespread use of new expensive devices with questionable benefits may be contributing to soaring U. The emergence of new medical devices lacking profound benefits dominates discussions surrounding current and future legislation to modify the current process. Since the emergence of medical devices in health care, legislation has been developed to allow the FDA to oversee the development, marketing, and usage of medical devices.
While this legislation has allowed for vigorous growth in the medical device sector it has also resulted in insufficient oversight when approving many devices. Loopholes have been exploited by industry to bring more devices to the market in the pathway of least resistance in the swiftest and cheapest fashion. Modifications to current legislation should be sought to modernize medical device pathways to market and ensure patient safety. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein.
All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus. The authors have declared that no competing interests exist. National Center for Biotechnology Information , U. Journal List Cureus v. Published online May 9.
Abraham Schlauderaff 1 and Kaleigh C Boyer 2. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Abraham Schlauderaff ude. Received Mar 15; Accepted May 8.
Importation of Prescription Drugs
In , a Tennessee drug company marketed elixir sulfanilamide for use in children as a new sulfa drug. The untested drug killed over people, including children. Among the many legislative acts passed over the years, the following are of particular relevance to current developments:. Over the last few years, FDA has felt the impact of and the need to respond to several societal developments. The country is calling for the government to address drug prices and to gain better control over access to drugs containing controlled substances, such as opioids.
Since the emergence of medical devices, legislation has been developed to allow the Federal Drug Administration FDA to oversee their development, marketing, and usage. Additionally, it discusses both short- and long-term effects with unexpected consequences to U. This allowed the FDA to perform factory inspections and prohibited misbranded marketing of cosmetic and therapeutic medical devices. In , the Public Health Service Act focused on the expansion of biologics and more formal evaluation of laboratories. In , the Radiation Control for Health and Safety Act focused on regulating devices which utilized radiation or magnetic fields. Theodore Cooper, to chair the Cooper Committee to evaluate the need for medical device legislation. The Cooper Committee recommended new specific legislation for devices in a risk-stratified manner [ 1 ].
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Share this page. Follow Ballotpedia. This law, together with the Meat Inspection Act of , split federal food regulation between two agencies: the Bureau of Chemistry which would become the Food and Drug Administration was primarily responsible for enforcement of the Pure Food and Drug Act, and the Bureau of Animal Industry a division of the U. Department of Agriculture was responsible for meat inspections. The Pure Food and Drug Act provided for federal agencies to involve themselves in "preventing the manufacture, sale, or transportation of adulterated or misbranded or poisonous or deleterious foods drugs, medicines, and liquors.
Its regulatory authority covers most food products other than meat and poultry , human and animal drugs, therapeutic agents of biological origin, medical devices, radiation-emitting products for consumers, medical, and occupational use, cosmetics and animal feed. The Pure Food and Drug Act of Act was enacted to prevent the manufacture, sale or transportation of adulterated or misbranded foods, drugs, medicines and liquors. It vested enforcement power in the Bureau of Chemistry, of the U.
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