Duck - It Is A Sandbag - Flying In The MRI Room

Duck! Watch out for that flying sandbag in the MRI room. It turns out some sandbags contain metal, and they can go flying near an MRI maching, reports this FDA Medical Device Safety report, "Danger: "Sandbag" in the MRI Room." According to the article, "a patient underwent magnetic resonance imaging (MRI) while she had a sandbag on her groin to help facilitate hemostasis after a procedure that involved femoral artery puncture. The staff assumed that the bag contained only sand. As the study began, the sandbag was pulled into the MRI coil, damaging the system. Fortunately, the patient wasn’t injured, according to the report." Bottomline, the unlabeled sandbag was found to contain ferromagnetic iron shavings and pellets. This sandbag, originally purchased for use in the hospital’s physical therapy department, shouldn’t have been brought into the MRI room. Additional MRI Safety Resources:

1. Kanal E, Barkovich AJ, Bell C, et al. ACR guidance document for safe MR practices: 2007. AJR AM J Roentgenol. 2007;188(6): 1447-1474
2. Guidance for Industry and FDA Staff: Establishing Safety and Compatibility of Passive Implants in the Magnetic Resonance (MR) Environment. August 21, 2008

Related Posts: FDA Warns - Avoid Burning - MRI and Drug Patch Interaction Are You Safe In An MRI Machine? 

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New FDA Guidance - New Contrast Imaging Indication Considerations

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The FDA has just released this new guidance document, "Guidance for Industry: New Contrast Imaging Indication Considerations for Devices and Approved Drug and Biological Products (pdf)." 

To get quickly up to speed on the gist of the guidance, read this commentary posted on the FDA Law Blog, "FDA Issues Contrast Imaging Draft Guidance; Implements Umbrella Approach to Imaging Device Labeling." 

In a nutshell, here's what the guidance covers . . . The guidance describes a process that allows either the imaging drug or imaging device developers to seek approval of medical imaging contrast indications using an already marketed imaging drug or biological product, including radiopharmaceuticals. 

 1. Device developers should generally submit a marketing application to add a new indication for using an already approved imaging drug under the circumstances described in this guidance. 1a. The data to establish these indications in a device application should include information developed in accordance with FDA existing guidance on Developing Medical Imaging Drug and Biological Products. 1b. For most types of indications as described in this guidance, when submitted to request marketing under a device application, the submission should be a Premarket Application (PMA). 

 2. Drug or biological product application holders of the already marketed imaging drug or biological product should generally submit an efficacy or labeling supplement, as appropriate, to add labeling for the new indication initially developed under a device application. 

 3. Device application holders may continue their current practice to request approval or clearance of labeling revisions for any new indications that may be initially approved in a supplement to the NDA for the imaging drug. 

 4. FDA expects to establish an internal intercenter imaging process to review and evaluate indications to ensure consistency in the development and review of clinical trials to establish the contrast indications that may be in either the drug or device labeling. 

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