ISO 10993

The ISO 10993 set entails a series of standards for evaluating the biocompatibility of medical devices to manage biological risk. These documents were preceded by the Tripartite agreement and is a part of the international harmonisation of the safe use evaluation of medical devices.^[1] For the purpose of the ISO 10993 family of standards, biocompatibility is defined as the "ability of a medical device or material to perform with an appropriate host response in a specific application".

ISO 10993-1:2009 & FDA endpoints for consideration

The following table provides a framework for the development of a biocompatibility evaluation. Different biological endpoints may require evaluation for particular medical devices, including either additional or fewer endpoints than indicated. If it is unclear in which category a device falls, consulting device-specific guidances or contacting the appropriate US Food and Drug Administration (FDA) review division for more information is possible. The table "Endpoints to be addressed in a biological risk assessment" was revised by the 2018 edition of ISO 10993-1. The selection of endpoints for the biocompatibility evaluation is determined by the nature of body contact (e.g. implant device) and contact duration (e.g. long term contact of more than 30 days).

Medical device categorization by			Biological Effect
Nature of Body Contact		Contact Duration A-limited (≤24 h) B-prolonged (>24 h to 30 d) C-permanent (> 30 d)	Cytotoxicity	Sensitization	Irritation or Intracutaneous Reactivity	Acute Systemic Toxicity	Material-Mediated Pyrogenicity	Subacute/Subchronic Toxicity	Genotoxicity	Implantation	Hemocompatibility	Chronic Toxicity	Carcinogenicity	Reproductive/Developmental Toxicity	Degradation
Category	Contact		Cytotoxicity	Sensitization	Irritation or Intracutaneous Reactivity	Acute Systemic Toxicity	Material-Mediated Pyrogenicity	Subacute/Subchronic Toxicity	Genotoxicity	Implantation	Hemocompatibility	Chronic Toxicity	Carcinogenicity	Reproductive/Developmental Toxicity	Degradation
Surface device	Intact skin	A	X	X	X
		B	X	X	X
		C	X	X	X
	Mucosal membrane	A	X	X	X
		B	X	X	X	O	O	O		O
		C	X	X	X	O	O	X	X	O		O
	Breached or compromised surface	A	X	X	X	O	O
		B	X	X	X	O	O	O		O
		C	X	X	X	O	O	X	X	O		O	O
External communicating device	Blood path, indirect	A	X	X	X	X	O					X
		B	X	X	X	X	O	O				X
		C	X	X	O	X	O	X	X	O	X	O	O
	Tissue/bone/dentin	A	X	X	X	O	O
		B	X	X	X	X	O	X	X	X
		C	X	X	X	X	O	X	X	X		O	O
	Circulating blood	A	X	X	X	X	O		O		X
		B	X	X	X	X	O	X	X	X	X
		C	X	X	X	X	O	X	X	X	X	O	O
Implant device	Tissue/bone	A	X	X	X	O	O
		B	X	X	X	X	O	X	X	X
		C	X	X	X	X	O	X	X	X		O	O
	Blood	A	X	X	X	X	O		O	X	X
		B	X	X	X	X	O	X	X	X	X
		C	X	X	X	X	O	X	X	X	X	O	O

X = ISO 10993-1:2009 recommended endpoints for consideration
O = Additional FDA recommended endpoints for consideration

List of the standards in the 10993 series

Part 1: Evaluation and testing within a risk management process

Part 2: Animal welfare requirements

Part 3: Tests for genotoxicity, carcinogenicity and reproductive toxicity

Part 4: Selection of tests for interactions with blood

Part 5: Tests for in vitro cytotoxicity.

Part 6: Tests for local effects after implantation

Part 7: Ethylene oxide sterilization residuals

Part 8: Selection of reference materials (withdrawn)

Part 9: Framework for identification and quantification of potential degradation products

Part 10: Tests for skin sensitization

Part 11: Tests for systemic toxicity

Part 12: Sample preparation and reference materials (available in English only)

Part 13: Identification and quantification of degradation products from polymeric medical devices

Part 14: Identification and quantification of degradation products from ceramics

Part 15: Identification and quantification of degradation products from metals and alloys

Part 16: Toxicokinetic study design for degradation products and leachables

Part 17: Establishment of allowable limits for leachable substances

Part 18: Chemical characterization of medical device materials within a risk management process

Part 19: Physico-chemical, morphological and topographical characterization of materials

Part 20: Principles and methods for immunotoxicology testing of medical devices

Part 22: Guidance on nanomaterials

Part 23: Tests for irritation

Part 33: Guidance on tests to evaluate genotoxicity

References

^ "Use of International Standard ISO-10993, 'Biological Evaluation of Medical Devices Part 1: Evaluation and Testing' (blue book memo)" (PDF). fda.gov. FDA. Retrieved 23 January 2017.

[1] "Use of International Standard ISO-10993, 'Biological Evaluation of Medical Devices Part 1: Evaluation and Testing' (blue book memo)" (PDF). fda.gov. FDA. Retrieved 23 January 2017.

[1]

ISO 10993-1:2009 & FDA endpoints for consideration

List of the standards in the 10993 series

See also

References