Author: Julio Martinez-Clark

• What Defines an Investigator-Initiated Study
• Why Sponsors Support Investigator-Initiated Studies
• The Regulatory Accountability Gap
• Data Ownership and Intellectual Property
• Protocol Design and Endpoint Alignment
• When Investigator-Initiated Studies Work Well
• Investigator-Initiated Studies in Latin America
• Sponsor-Initiated vs. Investigator-Initiated: A Practical Comparison
• What Sponsors Should Require Before Supporting an IIS
• The Role of a CRO in Investigator-Initiated Programs
• Frequently Asked Questions
• Conclusion

Investigator-initiated studies occupy a distinct corner of clinical research that sponsors often misunderstand until a regulatory question forces the issue. When a principal investigator (PI) conceives, designs, and sponsors a study using their own protocol, the accountability structure shifts in ways that affect every downstream decision — from data ownership to FDA submission eligibility. If your device or therapeutic is the subject of an investigator-initiated study, or if you are considering supporting one, the implications for your IDE or IND pathway deserve careful attention before the first patient is enrolled.

This article explains how investigator-initiated studies work, where they fit in early-phase development, what sponsors need to control to protect their regulatory position, and how Latin American execution can change the cost and timeline calculus for both sponsor-initiated and investigator-initiated programs.

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What Defines an Investigator-Initiated Study

An investigator-initiated study (IIS) is one in which the investigator — rather than a commercial sponsor — holds the IND or IDE and takes regulatory accountability for the study. The investigator designs the protocol, selects endpoints, and manages the submission to the relevant regulatory authority.

This is distinct from a sponsor-initiated trial, where a company submits the IDE or IND and retains full control over protocol design, data, and regulatory correspondence. In an IIS, the investigator is simultaneously the PI and the regulatory sponsor. That dual role carries significant operational consequences.

The distinction matters most when the data generated is intended to support a future regulatory submission. If a device company wants to reference an IIS in its IDE or PMA application, that data must meet the same evidentiary standards as sponsor-generated data — ISO 14155 protocol architecture, GCP compliance, and documentation structured under FDA 21 CFR 812.28 for studies conducted outside the United States.

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Why Sponsors Support Investigator-Initiated Studies

Commercial sponsors fund or supply devices for investigator-initiated studies for several legitimate reasons.

Academic investigators often have access to patient populations and clinical expertise that a startup cannot replicate independently. A PI with 20 years of implant experience and an established patient registry can generate early feasibility data that a company's own clinical team would take years to build.

IIS programs can also generate independent clinical evidence. Data produced without direct sponsor control carries a different kind of credibility with payers, guideline committees, and, in some contexts, regulators. For a device seeking reimbursement pathways or clinical society endorsement, investigator-generated evidence carries weight that sponsor-generated data sometimes does not.

For early-stage companies with limited operational infrastructure, supporting an IIS can be a way to generate proof-of-concept data without building out a full clinical operations function. The investigator handles Ethics Committee (EC) submissions, site management, and regulatory filings.

The tradeoff is control — and that tradeoff has direct consequences for how the data can be used.

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The Regulatory Accountability Gap

When an investigator holds the IDE or IND, the sponsor's ability to direct protocol amendments, access source data, or correct deviations is limited by whatever the agreement between the parties specifies. If the investigator makes a protocol change without notifying the sponsor, the sponsor may not learn about it until data review — at which point the deviation is already in the record.

FDA's foreign clinical data framework under 21 CFR 812.28 requires that data submitted to support an IDE or IND be collected under conditions the sponsor can verify. If an IIS was not conducted under GCP, or if source data cannot be audited, FDA may not accept it as supporting evidence.

This is not a theoretical risk. Sponsors who have attempted to incorporate IIS data into regulatory submissions have encountered requests for information that the investigator — not the sponsor — controls. Retrieving that documentation after the fact is time-consuming and sometimes impossible.

The practical implication: if you intend to use IIS data in a regulatory submission, the agreement with the investigator must specify data access rights, audit rights, protocol amendment procedures, and GCP compliance obligations before the study starts. Retrofitting these provisions after enrollment has begun rarely works.

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Data Ownership and Intellectual Property

In most academic settings, ownership of data generated in an investigator-initiated study defaults to the investigator's institution. The sponsor's rights to that data depend entirely on what the agreement says.

If the agreement is silent on data ownership, the sponsor may have no right to include the data in a regulatory submission without the investigator's permission. If the investigator moves institutions, retires, or the relationship deteriorates, access to the data can become contested.

For a startup whose entire regulatory strategy depends on early feasibility data, this is a material risk. The agreement should specify:

• Who owns the raw data and case report forms
• What rights the sponsor has to reference, publish, or submit the data
• What happens to data access if the investigator leaves the institution
• Whether the sponsor can audit source documents independently

These provisions are standard in well-structured clinical trial agreements. They are often missing in agreements drafted by academic legal offices more accustomed to grant-funded research than commercial development.

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Protocol Design and Endpoint Alignment

Investigator-initiated studies are designed to answer the investigator's scientific question — which may not align with the endpoints FDA will require for an IDE or IND submission.

A PI interested in a device's mechanism of action may design a study around exploratory biomarker endpoints. A sponsor preparing for a pivotal trial needs safety data, device performance metrics, and adverse event documentation structured to ICH-GCP and ISO 14155 standards. These are not always the same study.

Before supporting an IIS, sponsors should evaluate whether the proposed primary and secondary endpoints will generate data that is directly usable in a regulatory submission. Misaligned endpoints mean the sponsor may fund a study that produces scientifically interesting but regulatorily insufficient evidence.

This is where a Pre-Submission (Pre-Sub) meeting with FDA becomes valuable. A Pre-Sub allows the sponsor to confirm which endpoints and data formats FDA will accept before the study is designed, not after. Structuring the IIS protocol to satisfy those requirements — even if the investigator retains regulatory sponsorship — protects the sponsor's downstream regulatory position.

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When Investigator-Initiated Studies Work Well

Not every IIS is a regulatory liability. When the structure is right, investigator-initiated studies can accelerate early-phase development in ways that sponsor-initiated programs cannot match.

The conditions under which IIS programs work well include:

• The investigator has deep domain expertise and an established patient population
• The sponsor has negotiated data access, audit rights, and IP provisions upfront
• The protocol endpoints are aligned with FDA's early feasibility study (EFS) guidance
• The study is conducted under ISO 14155 and GCP, with documentation sufficient for regulatory submission
• The sponsor is not relying solely on IIS data for its IDE or IND, but using it as supplementary evidence alongside sponsor-controlled studies

In this configuration, the IIS generates independent clinical evidence while the sponsor runs a parallel, fully controlled early feasibility study. The combination is often more persuasive to FDA than either dataset alone.

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Investigator-Initiated Studies in Latin America

Latin American academic medical centers run investigator-initiated studies under the same general framework as their US counterparts, but the regulatory environment introduces additional variables sponsors need to understand.

In Colombia, a study conducted under INVIMA oversight requires ethics committee approval from an institutional committee recognized by the national authority. If an investigator-initiated study is conducted without proper INVIMA registration, the data cannot be used in a Colombian regulatory filing — and its admissibility in a US IDE submission becomes questionable.

The same principle applies across the region. Studies conducted in Panama under MINSA/CNBI oversight, in Chile under ISP/MINSAL, or in El Salvador under SRS/CNEIS must follow the applicable national regulatory framework to generate data that is defensible in a US submission.

This is where the distinction between a well-structured IIS and an informal academic study becomes critical. An investigator at a Latin American academic center may have excellent clinical skills and a relevant patient population, but if the study is not registered, if the EC approval is not documented, and if source data is not maintained to GCP standards, the data is not usable for regulatory purposes.

Sponsors supporting IIS programs in Latin America should require the same documentation standards they would require of a sponsor-initiated study. The Cook Group's multi-site first-in-human study in Colombia — which involved 142-plus INVIMA regulatory submissions — illustrates the documentation depth that a properly structured Latin American clinical program requires. That level of regulatory rigor applies whether the sponsor or the investigator holds the IDE.

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Sponsor-Initiated vs. Investigator-Initiated: A Practical Comparison

The choice between supporting an IIS and running a sponsor-initiated early feasibility study has direct implications for timeline, cost, data quality, and regulatory risk.

Sponsor-initiated studies give the company full control over protocol design, endpoint selection, data management, and regulatory correspondence. The sponsor can structure the study to satisfy FDA's Pre-Sub feedback and ensure every data element is collected in a format that supports the IDE submission. The tradeoff is that the sponsor bears the full operational burden.

Investigator-initiated studies offload operational responsibility to the investigator but introduce data access risk, endpoint misalignment risk, and IP risk. They work best as supplementary evidence — not as the primary dataset for a regulatory submission.

For seed-to-Series-B MedTech companies with 12 to 24 months until first human data is needed, the operational burden of a sponsor-initiated study is often more manageable than the regulatory risk of relying on IIS data. A structured FIH program run by an experienced in-country CRO — with single-team accountability across protocol development, site activation, patient enrollment, and data management — eliminates the data access and endpoint alignment risks that IIS programs introduce.

The i-Lumen Scientific retinal therapy program and the CelonOva Biosciences coronary stent study are examples of sponsor-initiated early feasibility programs where full control over protocol design and data management produced submission-ready evidence packages. The difference in regulatory certainty compared to a loosely structured IIS is substantial.

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What Sponsors Should Require Before Supporting an IIS

If you decide to support an investigator-initiated study, the following provisions should be non-negotiable in the clinical trial agreement.

Data access and audit rights. The sponsor must have the right to access source documents, case report forms, and adverse event records at any time during or after the study. This right should survive the investigator's departure from the institution.

Protocol amendment notification. Any amendment to the protocol must be communicated to the sponsor before submission to the ethics committee or regulatory authority. The sponsor should have the right to review and comment on amendments that affect primary endpoints or safety reporting.

GCP compliance obligations. The agreement should specify that the study will be conducted under ICH-GCP and, for device studies, ISO 14155. The investigator should agree to allow GCP audits by the sponsor or a designated third party.

Intellectual property provisions. The agreement should specify who owns the data, who has the right to publish, and what rights the sponsor has to reference the data in regulatory submissions.

Regulatory submission rights. The sponsor should have an explicit right to reference the IIS data in its IDE, IND, or PMA submission without requiring additional consent from the investigator or the institution at the time of submission.

Adverse event reporting. The agreement should specify how serious adverse events are reported to the sponsor and what the sponsor's obligations are under 21 CFR 812 or 21 CFR 312 upon receiving that information.

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The Role of a CRO in Investigator-Initiated Programs

A contract research organization can add meaningful value to an investigator-initiated study in ways that protect the sponsor's regulatory position without displacing the investigator's scientific leadership.

A CRO can review the protocol to ensure the study design is consistent with FDA's early feasibility study guidance and that data collection instruments will generate submission-ready evidence. It can provide GCP training to the investigator's site team, implement electronic data capture systems that meet 21 CFR Part 11 requirements, and conduct ongoing monitoring visits to identify and correct deviations before they become regulatory problems.

In Latin America, where regulatory frameworks vary by country and the documentation requirements for INVIMA, MINSA, ISP, and other authorities differ from US norms, CRO oversight of an IIS is particularly valuable. An investigator with strong clinical skills may not have the regulatory infrastructure to maintain documentation to the standard required for a US IDE submission. An in-country CRO with established regulatory expertise can fill that gap.

bioaccess® structures all studies under ISO 14155 and FDA 21 CFR 812.28 — whether sponsor-initiated or investigator-supported — across a network of 50-plus pre-qualified clinical trial sites in 19 Latin American and Caribbean markets. Ethics and regulatory approvals in Panama, El Salvador, Chile, and the Dominican Republic have been observed in 30 to 90 days, which changes the timeline calculus for sponsors who need early feasibility data before their next funding round. Learn more at bioaccessla.com.

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Frequently Asked Questions

What is an investigator-initiated study?
An investigator-initiated study is one in which the PI, rather than a commercial company, holds the IND or IDE and takes regulatory accountability for the study. The investigator designs the protocol, manages the regulatory submission, and is responsible for GCP compliance. A commercial sponsor may fund or supply devices for the study but does not hold the regulatory sponsorship.

Can data from an investigator-initiated study be used in an FDA IDE submission?
Yes, but only if the data was collected under conditions that meet FDA's standards. For foreign clinical data, this means the study must have been conducted under ISO 14155 and structured per FDA 21 CFR 812.28. The sponsor must also have documented access to source data and audit rights. Data from an IIS that lacks GCP documentation or audit trails is unlikely to be accepted by FDA as supporting evidence.

What are the main risks of supporting an investigator-initiated study?
The primary risks are data access limitations, endpoint misalignment, and IP disputes. If the clinical trial agreement does not specify the sponsor's rights to access data, audit the study, and reference the data in regulatory submissions, the sponsor may find that data it funded cannot be used in its regulatory program.

How does an investigator-initiated study differ from a sponsor-initiated early feasibility study?
In a sponsor-initiated study, the company holds the IDE or IND, controls the protocol, and owns the data. In an IIS, the investigator holds the regulatory sponsorship and the institution typically owns the data by default. Sponsor-initiated studies carry more operational burden but eliminate the data access and endpoint alignment risks that IIS programs introduce.

What should a clinical trial agreement for an IIS include?
At minimum: data access and audit rights that survive the investigator's departure, protocol amendment notification procedures, GCP compliance obligations, IP and data ownership provisions, explicit regulatory submission rights for the sponsor, and adverse event reporting procedures aligned with 21 CFR 812 or 21 CFR 312.

Can investigator-initiated studies be run in Latin America for FDA submissions?
Yes. Studies conducted in Latin American countries under the applicable national regulatory framework — with GCP compliance and documentation structured per ISO 14155 and 21 CFR 812.28 — can support US IDE and IND submissions. The key is ensuring the investigator's institution has the regulatory infrastructure to maintain documentation to the required standard, which often requires in-country CRO oversight.

When is a sponsor-initiated study preferable to supporting an IIS?
When the sponsor's regulatory strategy depends on the data, a sponsor-initiated study is almost always the stronger choice. Full control over protocol design, endpoint selection, data management, and regulatory correspondence eliminates the risks that IIS programs introduce. For seed-to-Series-B MedTech companies with a defined FDA milestone, a structured FIH program with single-team CRO accountability is typically the more reliable path to a submission-ready evidence package.

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Conclusion

Investigator-initiated studies can generate valuable early clinical evidence, but their utility for regulatory submissions depends entirely on how the agreement is structured before the study starts. Data access rights, GCP compliance obligations, and endpoint alignment are not administrative details. They determine whether the data you fund can be used in your IDE or IND application.

If your development timeline requires first human data within 12 to 24 months and your regulatory strategy depends on that data, a sponsor-initiated early feasibility study with full protocol control and CRO oversight is the more defensible path. If you choose to support an IIS, treat the clinical trial agreement as a regulatory document — not an administrative formality — and engage CRO expertise to ensure the data meets submission standards from day one.