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  • INVIMA FIH Device Classification in Colombia: Decree 4725 Rules That Decide the Protocol Path

    Most INVIMA first-in-human (FIH) delays I see do not start on the Sala Especializada calendar. They start when regulatory affairs copies a U.S. Class II 510(k) letter into the Colombian file and calls it a classification. Decree 4725 of 2005 does not work that way. The manufacturer classifies the device from intended purpose, duration of body contact, invasiveness, and local versus systemic effect, using the Article 7 rules. The most stringent applicable rule wins. If that call is wrong, the technical concept you are waiting for is the wrong concept.

    This is not the INVIMA sanitary-registration checklist. Registro sanitario / permiso de comercialización is a different operating system — uncontrolled Class I/IIa automatic registration versus controlled IIb/III review, legal representative, CCAA importer, UDI-DI under Resolution 1405 of 2022. This article is the classification decision that decides how an investigational, often unregistered, device enters a human protocol in Colombia.

    What INVIMA means by an investigational device

    Decree 4725 Article 2 defines a “dispositivo médico destinado a investigaciones clínicas” as any medical device to be used by a specialist physician in investigations carried out in an adequate human clinical setting. The same article defines a clinical study as any investigation in human beings intended to discover or verify clinical or other effects of medical devices and/or to identify any adverse reaction, in order to confirm safety and/or effectiveness. A “equipo biomédico prototipo” is equipment still in an experimental phase that has not been used in care or demonstration and that lacks a free-sale certificate from the competent authority in the country of origin.

    Article 36 then draws a hard line sponsors blur: a prototype device or controlled-technology biomedical equipment, national or imported, may be authorized only for research and experimentation and may not be used in health care. Import of such prototypes requires an INVIMA technical concept, in accordance with the health-research rules in force. Article 48(b) is the complementary import valve: INVIMA may exceptionally authorize import of a finished device without a sanitary registration when the Ministry or INVIMA has authorized clinical investigation in the country, after the competent specialized room has issued its concept. Article 55(n) requires labeling to state that the device is specifically for clinical and/or performance investigations before market launch. If your cartons look like a commercial shipment, you have already broken the classification story.

    In vitro diagnostics are carved out of Decree 4725 (Article 1, paragraph 1) and sit on Decree 3770 of 2004. Do not force an IVD performance study into the implant classification box. INVIMA’s device clinical-investigation page publishes separate IVD forms (ASS-RSA-FM082, FM083) for that reason.

    The four classes that actually drive the FIH file

    Article 5 of Decree 4725 is the class rule:

    • Class I — low risk, general controls; not intended to protect or sustain life or for a special use in preventing deterioration of health; no unreasonable potential risk of illness or injury.
    • Class IIa — moderate risk, special manufacturing controls to demonstrate safety and effectiveness.
    • Class IIb — high risk, special design and manufacturing controls to demonstrate safety and effectiveness.
    • Class III — very high risk, special controls; intended to protect or sustain life or for a substantial use in preventing deterioration of health, or presenting a potential risk of illness or injury.

    Article 6 says the rules follow intended purpose. Accessories are classified on their own intended purpose when used with another device. Software that drives or influences a device inherits that device’s class. If the device is not intended mainly for one body site, classify on the most critical specified use. If several rules apply, take the highest class.

    Article 7 is where FIH programs actually break. The rules that recur on first-in-human device boards:

    • Rule 6 / 7 — surgically invasive devices. Transient surgical tools default IIa (reusable instruments can be I). Direct contact with the heart or central circulatory system to diagnose, monitor or correct a defect is Class III even for short use. Direct contact with the central nervous system is Class III for short-term surgical invasives (Rule 7).
    • Rule 8 — implants and long-term surgically invasive devices default IIb, and jump to Class III if they contact heart, central circulation or CNS, exert a biological effect or are largely absorbed, or undergo chemical change in the body / administer a medicinal product (teeth placements excepted).
    • Rule 9–11 — active therapeutic and diagnostic devices, and devices that administer or withdraw substances. “Potentially hazardous” energy or delivery is IIb, not IIa.
    • Rule 13 — a device that incorporates, as an integral part, a substance that would be a medicine if used separately, and that substance has an action ancillary to the device, is Class III.
    • Rule 17 — devices manufactured using non-viable animal tissues or derivatives are Class III unless they contact intact skin only.

    A U.S. “non-significant-risk” or 510(k) Class II label is not a Colombian class. A coronary-contact catheter that someone files as IIa because “it is only diagnostic” is still Rule 6(e) / 7(c) territory if the intended purpose is direct contact with the central circulation. Write the Spanish intended-purpose sentence first. Then apply the rule. Then name the class. If clinical, quality, and the Colombian legal representative cannot repeat those three lines, you are not ready to talk to a Comité de Ética en Investigación (CEI).

    How class changes the investigation path — not the registration path

    INVIMA’s Dirección de Dispositivos Médicos y Otras Tecnologías runs device clinical investigation through GICASE (Grupo de Investigación Clínica y Apoyo a Sala Especializada), reorganized under INVIMA Resolution 2022035262 of 20 September 2022. The Agency’s public clinical-investigation page is the index of live forms. For a prototype / unregistered device protocol, the checklist that actually opens the technical-concept request is ASS-RSA-FM085. The specialized-room request form is ASS-RSA-FM172. The CEI is expected to complete ASS-RSA-FM169 on initial evaluation of a device (or other-technology) clinical study. After authorization, serious adverse events go on ASS-RSA-FM171 and periodic study reports on ASS-RSA-FM170.

    That form set is how class becomes operational. A Class III implant FIH is a prototype investigation: Article 36 technical concept, CEI approval under Resolución 8430 de 1993, and an import path that cites the investigation authorization rather than a DM sanitary-registration number. A Class I/IIa tool that is already registered in Colombia for the same intended purpose is a different conversation — you may still need ethics and institutional authorization under 8430, but you are not pretending the unit is a prototype. A registered device studied for a new intended purpose is a new classification exercise, because Article 6 follows the purpose you will actually use in the protocol, not the purpose on last year’s registro.

    Resolución 8430 de 1993 remains the cross-cutting human-research rule INVIMA cites on that same page. Article 6 requires prior laboratory or animal justification, written informed consent, qualified investigators, and authorization from the legal representative of the researching institution, the institution where the work is done, and the institutional research-ethics committee. Article 11 classifies research by risk to the subject. An FIH implant is not “minimal risk.” Do not file it as if it were.

    Resolución 2378 de 2008 adopts Good Clinical Practice and BPC certification for institutions that conduct drug research. INVIMA’s device page cites it as part of the national research furniture. It is not the device-classification statute and it is not a substitute for FM085. If your chosen hospital’s only certificate is a medicines BPC, ask GICASE and the CEI what they will accept for a device protocol. Do not invent a waiver in a slide.

    What the technical file must prove for the class you claimed

    Decree 4725’s commercial dossier rules are still the evidence language reviewers know. Article 18(j)–(k) is the tell: IIa/IIb/III need scientific information supporting safety and a risk analysis; IIb and III need clinical studies on use to demonstrate safety and effectiveness — for a marketed file. For an FIH, you do not yet have those clinical studies. What you must have is the nonclinical justification 8430 Article 6 demands, a risk-management file that matches the Article 7 rule you applied, biocompatibility and bench data for the tissues and duration you claimed, and an investigator brochure whose “expected” harms match the class. If you classified the device IIb under Rule 8 (implant) and the brochure reads like a Class IIa surgical tool, the specialized room will not fix that with a courtesy question. They will stop the concept.

    ISO 14155 is the device GCP you should run to, especially if the same dataset must later support FDA review of foreign data under 21 CFR 812.28. Decree 4725 does not cite ISO 14155 by name. That is not permission to run an FIH without device accountability, investigational labeling (Article 55(n)), or source documents an inspector can reconstruct.

    Import is a classification problem. Article 36 plus Article 48(b) are how unregistered units enter. Quantities should match the protocol. The importer still needs a lawful storage/conditioning posture — commercially, that is the CCAA world of Articles 10–11. Do not park investigational implants in a spare bedroom because “it is not a registro shipment.”

    Eight lines to lock before CEI submission

    1. Intended purpose in Spanish. The sentence that will appear on FM085, the protocol, the brochure, and later — if you commercialize — on the registro. Changing “long-term implant” to “intraoperative aid” after CEI approval is a new class.
    2. Article 7 rule and Class I / IIa / IIb / III. Record why neighboring rules were rejected. Heart, central circulation, CNS, animal tissue, and ancillary drug substance are the usual missed upgrades.
    3. Prototype versus registered-same-indication versus new-indication-on-a-registered-device. Article 36 applies to prototypes. A new purpose on an old number is not a shortcut.
    4. IVD or device. Decree 3770 versus 4725. Wrong form family wastes a Sala cycle.
    5. CEI path under 8430. Institutional authorization plus FM169. Name the committee that will actually meet.
    6. Technical-concept pack. FM085 + FM172, complete, in the language INVIMA will review. English-only annexes are not a strategy.
    7. Import list. Every SKU, spare, and accessory that will move under Article 36 / 48(b), labeled per Article 55(n).
    8. Safety reporting owners. FM171 for serious events, FM170 for periodic reports. Expectedness language lives in the brochure you classified against.

    This week, run a 90-minute huddle with RA, clinical, quality, and the Colombian legal representative. Put the intended-purpose sentence, the Article 7 rule, the class, and a prototype-versus-registered decision on one page. Attach Decree 4725 Articles 2, 5–7, 36 and 48(b), Resolución 8430 Articles 6 and 11, and the current GICASE form list. If those four people cannot sign the page, do not book first-patient week. The calendar you save is not INVIMA’s. It is the quarter you would have spent unscrewing a class you never locked.

  • Costa Rica FIH Activation Calendar: CEC, CONIS Registration, and the 3% Canon

    Most first-in-human (FIH) calendars I see for Costa Rica start on the wrong clock. Teams treat CONIS as a single “ministry approval” and then wonder why first-patient week slips after ethics is already in the file. Costa Rica is a two-gate country: a CONIS-accredited Comité Ético Científico (CEC) must give written approval before an interventional protocol can start, and the approved project is then registered with the Consejo Nacional de Investigación en Salud (CONIS). Those are different legal acts. If you collapse them, you are not planning activation — you are hoping.

    This is an activation calendar, not another “how to run a trial in Costa Rica” tour. It is written for the RA lead who has to put first-patient-in (FPI) on a board that finance and the FDA pre-sub team will actually use. Ranges below are practitioner planning ranges for 2026 device programs. They are not CONIS service-level agreements.

    The legal stack you actually file against

    The statute is Ley N.° 9234, Ley Reguladora de Investigación Biomédica (in force 25 April 2014; SCIJ current text). Article 1 covers biomedical research with human beings in public and private settings. The law creates CONIS as an independent ethical, technical and scientific body attached to the Ministerio de Salud, with maximum deconcentration. Article 46 lets a public or private entity that hosts research constitute a CEC, provided CONIS accredits it. The same article requires the Ministry of Health to constitute a CEC that is responsible for approving Phase I clinical trials nationally, and for protocols from investigators or entities that do not have their own accredited CEC.

    CONIS’s own CEC page repeats those points and cites the implementing reglamento, Decreto Ejecutivo N.° 39061-S, plus the reform Decreto N.° 39533-S. CONIS’s legislation index also lists the organic reglamento of CONIS (Decreto N.° 40884-S), the 22 September 2020 Gaceta repeal of Article 18 of Ley 9234, the CCSS biomedical-research reglamento for Caja sites, and — on the international list — the ICH E6 addendum, CIOMS, Helsinki, and related instruments. For a medical-device FIH, treat ISO 14155 as the device GCP you will later defend to FDA under 21 CFR 812.28; do not assume a drug ICH E6 binder substitutes for a device investigator brochure and risk-management file.

    Ley 9234 is explicit that a protocol needs written approval from an accredited CEC before it starts, and that if the site is a public health institution the corresponding institutional authority must also authorize the work. No public or private authority may waive that sequence. That is why “we already have a U.S. IRB letter” does not start screening in San José.

    What “Phase I” means for a device FIH

    Decreto 39061-S defines Phase I in drug language: first introduction of a medicine into humans. Device sponsors still get caught by the institutional rule in Ley 9234 Article 46: the Ministry of Health CEC is the national Phase I committee. If your protocol is truly first-in-human — novel energy, a first implant, a first intra-cardiac or CNS contact — plan the ethics path as the Ministry CEC unless CONIS or the accredited committee you asked has confirmed in writing that a site CEC may take it. Guessing here is how a four-week ethics slot becomes a resubmission.

    Independent investigators and entities without a CEC may submit to any CONIS-accredited CEC. Site CECs must be independent of the host and resourced to do the job. CONIS publishes the accredited-CEC list; if your chosen committee is not on it, you do not have an ethics clock.

    The sequential activation calendar

    Build the critical path as gates, not as a single “Costa Rica 60–90 days” slogan. The following is a 14–20 week FPI plan for a complete Spanish dossier at a private site that already has an accredited CEC. Public / CCSS sites add an institutional-authorization lane.

    Weeks 0–3 — lock the Spanish file before anyone books a CEC slot. Protocol, investigator brochure, informed-consent forms, insurance certificate, investigational-device description and risk analysis, manufacturing / sterility story, PI CV and GCP training, site feasibility, and the signed budget that will later support the CONIS canon. Ley 9234 requires the CEC to send CONIS a copy of the signed contract when the project is registered. If the budget in the ethics pack and the budget used for the 3% canon do not match, registration stalls after you thought you were approved.

    Weeks 3–8 — CEC review. Decreto 39061-S Article 44 requires a defined submission package before any experimental, clinical or interventional study starts. Subsequent reforms to that reglamento have treated the CEC pronouncement window as one calendar month counted from the business day after a complete filing. Treat “one month” as the first-cycle target only if the file is complete and the committee does not issue queries. Device FIH files that arrive with an English brochure, an unsigned insurance binder, or a consent that does not match the protocol lose that month. Practitioner planning for a first-in-human implant is 4–8 weeks of ethics time including one query cycle — still faster than a U.S. IDE, still not automatic.

    Weeks 5–10 (parallel, not after CEC). Translate and legalize what CONIS will need to register the approved project. Open the insurance policy to Costa Rican law and local claim service. Start site contracts and the investigational-device import / customs file. Costa Rica does not give you a U.S.-style IDE number that magically clears every carton. Label units as investigational, limit quantity to the protocol, and keep the importer of record aligned with the sponsor entity that will appear on the CONIS register.

    Weeks 8–12 — CONIS registration and the 3% canon. Ley 9234 requires the principal investigator, when registering an approved biomedical-research project, to pay CONIS a sum equal to 3% of the total research budget. Decreto 39061-S (canon provisions, as reformed) makes CONIS responsible for verifying that payment and depositing it to the CONIS collection account. Independent, non-commercial research can be treated differently; a sponsored device FIH is not that case. Do not treat the canon as a “CRO fee.” It is a statutory levy on the study budget at registration of the approved project. Build it into the budget before you sign the site. Registration is not a substitute for CEC approval, and CEC approval is not a substitute for registration.

    Weeks 10–14 — institutional green light and site activation. If the site is CCSS or another public provider, Ley 9234’s institutional-authorization requirement is a real gate. The CCSS biomedical-research reglamento sits on CONIS’s legislation list for a reason. Private sites still need the legal representative of the institution to authorize the study — Resolución-style “IRB only” thinking is incomplete. Then SIV, device accountability, EDC, and the first screening visit.

    Weeks 14–20 — FPI. First procedure only after CEC written approval, CONIS registration (and canon), institutional authorization, and release of investigational units. If any one of those four is missing, you do not have an activation date. You have a slide.

    What actually belongs in the CEC package

    Decreto 39061-S Article 44 is the index, not your U.S. IDE table of contents. In practice a device FIH package that survives first review contains:

    • Spanish protocol with a Costa Rican PI who can defend first-human risk, stopping rules, and follow-up.
    • Investigator brochure and IFU that define expected adverse device effects in the same language the consent uses.
    • Informed consent that a CONIS-accredited CEC can read as Ley 9234-compliant, not a translated U.S. IRB form with the letterhead swapped.
    • Insurance that names the Costa Rican site and participants, not only the Delaware sponsor.
    • Device identification (model, lot/serial logic, sterility, remaining risks) consistent with ISO 14155 investigational labeling.
    • Signed budget / contract copy the CEC can forward to CONIS for the canon calculation.
    • Evidence the chosen CEC is CONIS-accredited — or a written path to the Ministry of Health CEC for Phase I.

    CONIS’s international list includes ICH E6. That does not mean a drug monitoring plan is enough for an implant. If you later want FDA to look at the file under 21 CFR 812.28, the study must be scientifically valid, conducted under GCP, and inspectable. Build source documents and device accountability as if an FDA investigator will ask for them. Costa Rica’s law does not forbid that discipline. Sloppy EDC does.

    What slips FPI after “ethics is approved”

    Three failures repeat. First, the sponsor pays the 3% canon on a draft budget and then amends the contract up; CONIS has a different number than the CEC. Second, the site is public and nobody owned the institutional letter. Third, investigational units arrive with commercial labeling or a quantity that does not match the registered protocol. None of those are CONIS “delays.” They are activation defects.

    A fourth defect is quieter: treating Costa Rica as a one-country shop and then changing the intended purpose so the same device can be registered later under RTCR 505:2022. Registration and FIH are different files. If the indication you implant is not the indication you will later put on a Costa Rica Registration Holder dossier, say so now. Do not let the activation calendar inherit a commercial story you have not written.

    A one-page gate before you book travel

    Write eight lines with an owner and a document ID. Do not announce FPI week until each line is true.

    1. Intended purpose in Spanish that will appear in the protocol, brochure, and consent.
    2. Phase I / first-in-human call: Ministry of Health CEC versus a named CONIS-accredited site CEC, in writing.
    3. Complete Article 44 package, in Spanish, with insurance and budget attached.
    4. CEC written approval (and query closure).
    5. Institutional authorization if the site is public or otherwise requires it under Ley 9234.
    6. CONIS registration of the approved project.
    7. 3% canon paid on the same budget the CEC forwarded.
    8. Investigational units released against the registered protocol, labeled as investigational.

    If those eight lines cannot be signed in one sitting, you do not have a Costa Rica activation calendar. You have a hope that “LATAM is faster.” The statute is faster than a U.S. IDE when the file is complete. It is not faster than a missing CEC letter.

  • Adverse event and SUSAR reporting to ANVISA during a FIH trial in Brazil

    Device FIH safety reporting in Brazil is not drug pharmacovigilance with the logo swapped. The clocks are different, the form is different, and “SUSAR” is a useful overlapping idea — not the name of the ANVISA device channel.

    If your FIH data are meant to support a later FDA investigational or marketing file, you still report to ANVISA under device rules. You then keep a narrative and causality trail that an IDE medical officer can read without asking why Brazil used a drug module.

    The statute you actually report under

    Current device clinical-investigation procedure is RDC 837/2023, announced by ANVISA in its December 2023 update. It replaced RDC 548/2021, which had already revoked RDC 10/2015. Chapter VII is the safety-monitoring chapter. Do not write SOPs against RDC 10/2015 clocks, and do not paste RDC 945/2024 drug-trial SUSAR text into a device FIH plan.

    Law 14.874/2024 still applies to the ethics layer. Article 26 requires the sponsor to notify investigators, the institution, ethics bodies, and the sanitary authority of findings that may adversely affect participant safety. Article 55 makes serious adverse events reportable to the CEP that approved the research, and, for clinical trials intended to support sanitary registration, also to the sanitary authority. The law does not replace RDC 837/2023’s device form or day counts.

    NotivisaEC is the device channel; VigiMed is not

    ANVISA’s manual for adverse-event notification and safety monitoring in clinical trials involving investigational medical devices is the operational text. It tells sponsors to notify unexpected serious adverse events to ANVISA on the electronic NotivisaEC form:

    https://pesquisa.anvisa.gov.br/index.php/847543?lang=pt-BR

    The manual is explicit that those notifications go exclusively through that form, and that login is not required to notify. It also states that a SUSAR (suspected unexpected serious adverse reaction) sits inside the criteria for a notifiable serious event — but the RDC criteria are not limited to the drug-style SUSAR definition. If your safety database only flags “SUSAR = yes,” you will miss device cases that are unexpected, serious, and causally possible even when a medical monitor refuses the drug label.

    VigiMed-Pesquisa Clínica is ANVISA’s channel for SUSARs in drug and biologic trials, under the drug clinical-trial framework (currently discussed by the Agency against RDC 945/2024). ANVISA’s own clinical-trial notification page describes VigiMed in that medicine context and requires a study-specific VigiMed registration, including the DEEC expediente. That is not the device DICD file. Do not open a VigiMed-Pesquisa Clínica account as a substitute for NotivisaEC on an implant FIH.

    Post-market technovigilance (commercial devices after registro or notification) is a different duty and a different system generation. Keep investigational NotivisaEC cases out of the commercial technovigilance queue until the unit is actually on the market.

    What is notifiable, in device language

    RDC 837/2023 defines an adverse event as any unfavorable medical occurrence in a participant that is not necessarily causal. A serious adverse event includes death; a life-threatening event; persistent or significant disability; hospitalization or prolongation of hospitalization; congenital anomaly; suspected transmission of an infectious agent via a medical device; or a clinically significant event.

    An event is unexpected when it is not described as an adverse reaction in the investigator brochure or in the instructions for use / operator manual of the investigational device. That is why the brochure is a reporting instrument, not a marketing appendix.

    The sponsor must notify ANVISA of unexpected serious events that occurred in Brazil and whose causality versus the investigational product is possible, probable, or definite. Expected serious events, unrelated events, and non-serious events still belong in the sponsor’s file and in the annual tabulated report. They are not the 7- and 15-day electronic cases.

    Causality is not a hallway opinion. The device manual points sponsors to the WHO-UMC causality scale (possible / probable / certain, plus the lower categories) when classifying every event, including non-serious ones. Train Brazilian investigators on that scale before site initiation. A PI who only knows “related / not related” will force you to re-code under the clock.

    The clocks — investigator, sponsor, ANVISA

    RDC 837/2023 is blunt on time. Count from knowledge, not from “when safety closed the query.”

    • Investigator → sponsor: serious adverse events or death within 24 hours of the investigator becoming aware.
    • Sponsor → ANVISA, fatal or life-threatening, unexpected, causality possible/probable/definite, Brazil: document and notify on the electronic form within 7 calendar days of sponsor awareness. Complementary follow-up goes on the same form within 8 calendar days after that initial notification.
    • Sponsor → ANVISA, all other unexpected serious events meeting the same causality and territory tests: 15 calendar days from sponsor awareness.

    Immediate protective measures are not optional. On a notifiable serious event, the form expects the measures already taken, the plan if the same event recurs, the care location, and identifiers that can trace the event and the participant. Notification is due even if you are in the middle of a brochure update, a protocol amendment, an annual report, or an early termination.

    Temporary safety suspensions of the investigation must be notified to ANVISA within 7 calendar days of the suspension, with reasons, scope, treatment interruption, risk-minimization measures, and recruitment status. Restart waits for ANVISA approval published in the Official Gazette. That is a calendar item, not a medical-monitor footnote.

    DSUR / ICH E2F is not a substitute for the device annual report

    ANVISA publishes the ICH E2F Development Safety Update Report in its medicines clinical-trial library. E2F is a drug-development periodic-safety standard. It is a sensible internal template if the same legal entity also runs an IND. It is not the device annual report that RDC 837/2023 requires.

    For a DICD, the sponsor files an annual follow-up report as a secondary petition to the DICD, covering Brazilian centers only, in tabulated form: title, reference number, recruitment status, amendment history, enrollment by site, deviations and violations by site, and a description of all adverse events in the period, with the case-report-form participant codes. The anniversary is the date of the Brazil start-of-investigation notification. The petition is due within 60 calendar days of that anniversary. Missing the report can cancel the investigation.

    The final report is a different secondary petition, due within 12 months of the investigation’s end date, with demographics, statistical analysis, all events with causality, endpoint results, and any design changes. If you already produce a DSUR for a companion drug or combination product, map the Brazilian device tables into an annex. Do not file the DSUR and assume ANVISA has been served.

    Pivotal high-risk (Class III/IV) designs are expected to constitute a data-monitoring committee. Recommendations go to ANVISA as a DICD addendum within 30 calendar days of the sponsor receiving them. An FIH that is not labeled “pivotal” can still justify a DMC on risk. Write that justification in the plan before first patient, including why you did not constitute one.

    What must stay aligned if the FIH will later support FDA

    FDA device investigations do not use the IND SUSAR clock. They use unanticipated adverse device effect (UADE) rules under 21 CFR 812.150. An investigator reports a UADE to the sponsor and reviewing IRB as soon as possible, and no later than 10 working days after first learning of it. The sponsor evaluates immediately and reports the evaluation to FDA, all reviewing IRBs, and participating investigators within 10 working days of first notice. If the UADE presents an unreasonable risk, termination clocks in 21 CFR 812.46 are 5 working days from that determination and 15 working days from first notice. FDA’s IDE FAQs repeat the same 10-working-day sponsor evaluation report.

    Those clocks will not match Brazil’s 24-hour / 7-calendar / 15-calendar structure. Alignment is not “pick the longer one and hope.” Alignment is a single source narrative:

    • One event identifier from the Brazilian CRF code through NotivisaEC and, if an IDE exists or will exist, through the UADE file.
    • One expectedness baseline — the same brochure version cited in the DICD and in the IDE investigational plan. If Brazil updates the brochure after an unexpected event (RDC 837/2023 requires investigators to be informed and the brochure to be updated), send that version into the FDA file in the same week.
    • One causality sentence that a device reviewer recognizes (device, procedure, disease, concomitant product). Do not let the Brazilian form say “possible” and the IDE memo say “unrelated” without a dated reconciliation.
    • Device identifiers — lot, serial, software version, accessory — on every case. Import traceability under the DICD DOU number is the same data FDA will ask for when the unit later supports a 510(k), De Novo, or PMA.
    • Quality-system evidence that the investigational unit was built under a system you can defend as you move toward the QMSR. A NotivisaEC case that cannot find the device history record is already a future FDA inspection finding.

    If there is no U.S. IDE yet, still write Brazilian cases as if 812.150 will apply later. Reconstructing UADEs from a drug-safety database two years on is how FIH datasets lose credibility.

    Where programs actually break

    The bottleneck is rarely the web form. It is the weekend between the PI’s 24-hour email and a U.S. medical monitor who is still arguing expectedness against an old brochure. Build a Brazil on-call roster that can file NotivisaEC without waiting for California business hours. Give the Brazilian authorized representative and the ORPC (if one is the DICD face) read-only access to the safety tracker. Import holds, ethics queries, and ANVISA inspections all ask for the same case list.

    Second break: treating CEP notification and ANVISA notification as the same send. Law 14.874/2024 sends serious events to the CEP. RDC 837/2023 sends a narrower unexpected-and-related set to ANVISA on NotivisaEC. Your SOP should have two lines, two clocks, two receipts.

    Third break: annual-report amnesia. The 60-day secondary petition is how ANVISA sees aggregate harm. If your data-management lock cannot produce site-level AE tables from Brazilian CRF codes, you will miss a petition that can cancel the DICD — after first patients are already in.

    A practical next step

    Before site initiation, run one tabletop: a fatal unexpected device-related event at 18:00 Brasília on a Friday. Walk the 24-hour investigator notice, the 7-calendar-day NotivisaEC filing, the 8-day follow-up, the CEP notice under Law 14.874/2024, the brochure update, and — if an IDE is live or planned — the 10-working-day UADE evaluation to FDA. If any of those hands is “we’ll figure it out,” rewrite the safety SOP and name the NotivisaEC filer. First-patient week is the wrong time to discover that VigiMed was the only account anyone opened.

  • ANVISA medical device classification rules for FIH studies in Brazil

    Most first-in-human (FIH) delays I see in Brazil do not start on the ANVISA clock. They start earlier, when regulatory affairs treats class as a registration afterthought instead of the decision that decides whether you even file a clinical investigation dossier, what the import petition can carry, and what the investigator brochure must treat as expected.

    This is not another walkthrough of Brazil’s 90-day ANVISA review window, and it is not a recap of Law 14.874/2024. Those calendars matter, but they sit on top of a classification call. If that call is wrong, the clock you are watching is the wrong clock.

    RDC 751/2022 is the class rule, not a slogan

    Collegiate Board Resolution RDC No. 751 of 15 September 2022 is ANVISA’s current framework for medical-device risk classification, labeling and instructions for use, and the notification versus marketing-authorization (registro) regimes. Article 5 places devices in four intrinsic-risk classes:

    • Class I — low risk
    • Class II — medium risk
    • Class III — high risk
    • Class IV — maximum risk

    Articles 6 and 7 then split the premarket path: Classes I and II are subject to notification; Classes III and IV are subject to marketing authorization. ANVISA’s English overview of the same split is on the Agency’s medical devices page.

    Classification is not a marketing preference. It is a rules exercise against the manufacturer’s intended purpose. Annex I of RDC 751/2022 sets the classification rules (duration of use, invasiveness, active energy, implants, special rules). The most stringent applicable rule wins. Software as a medical device is classified on its own intended purpose when it is standalone. In vitro diagnostic devices sit on a separate IVD classification track; do not force an IVD into the same clinical-investigation box as an implant.

    For an FIH program, lock three statements in the same document: intended purpose in Portuguese that will appear on the DICD and later on the registro file; the Annex I rule (or rules) you applied; and the resulting Class I–IV. If clinical, quality, and the Brazilian authorized representative cannot repeat those three lines without hedging, you are not ready to talk about first-patient dates.

    RDC 10/2015 is not the current FIH filing rule

    Sponsors still arrive with “RDC 10/2015” in the regulatory plan. That resolution existed. It is not the current device-investigation statute.

    RDC No. 548 of 30 August 2021 revoked RDC No. 10 of 20 February 2015 (Article 84 of RDC 548/2021). RDC No. 837 of 13 December 2023 then replaced that 2021 text. ANVISA announced the update and the alignment with international practice in its 18 December 2023 notice (in force early January 2024). Article 80 of RDC 837/2023 revokes RDC 548/2021.

    Current device clinical-investigation procedure is RDC 837/2023. Use RDC 10/2015 only as history. Do not cite it as the filing basis for a 2026 FIH.

    How class drives whether you file a DICD

    RDC 837/2023 is explicit about scope. A Dossiê de Investigação Clínica de Dispositivo Médico (DICD) is required for clinical investigations involving Class III or Class IV devices that are not yet registered in Brazil. A registered device studied for an indication different from the indication in the sanitary registration also goes in as a DICD.

    The same resolution carves out investigations that do not go to ANVISA as a DICD, including:

    • clinical performance studies of IVDs;
    • usability/human-factors-only studies (unless the clinical investigation also includes those endpoints among others);
    • investigations of devices already registered in Brazil for the same approved indications;
    • clinical investigations of Class I or Class II devices.

    Class I and II investigations are still expected to follow good clinical practice. RDC 837/2023 points to the Document of the Americas and ISO 14155 as the GCP standard. They still need ethics approval. They do not get a free pass on import controls or on manufacturing quality of investigational units. What they do not get is a DICD as the ANVISA on-ramp.

    That is the classification bottleneck. A U.S. significant-risk implant that an RA lead quietly “simplifies” to Class II to avoid a dossier is not a timeline win. It is a first-patient hold when import, ethics, or a later registro reviewer asks why the intended purpose looks like Rule 8 (long-term surgically invasive / implant) and the file says Class II. The opposite error is also expensive: forcing a true Class II tool through a DICD because someone copied a Class III playbook wastes petition fees and a review cycle you did not owe.

    What the DICD actually has to carry

    When class puts you in DICD scope, RDC 837/2023 consolidates the old two-dossier habit into one submission. The petition typically includes the DICD form, the sanitary-surveillance fee (GRU) or exemption, the investigator brochure, a safety-experience summary (prior human use and any foreign post-market experience), the investigational-device dossier, the clinical investigation plan under GCP, and proof of registration in a WHO ICTRP or ICMJE-recognized trial registry (or that proof at start-date notification if it is not ready at first protocolization).

    ANVISA’s petition checklist for DICD subject 80104 is published in the Agency’s SAT instruction list. Use that list, not a recycled IND table of contents.

    Two operational rules from the same resolution save weeks if you lock them before translators start:

    • The party who files the DICD owns every later secondary petition. Do not let a consultant file “just this once.”
    • An organização representativa de pesquisa clínica (ORPC) may file only when the sponsor has no headquarters or branch in Brazil. If you already have a Brazilian legal presence, that presence is the face of the file.

    RDC 837/2023 gives ANVISA 90 calendar days (dias corridos) to issue a manifestation on the DICD, with a tacit-start path after ethics approval if the Agency is silent. Law 14.874/2024 Article 58 speaks of 90 business days (dias úteis) for primary sanitary analysis of clinical-trial petitions intended to support registration. Those are not the same unit of time. Treat the mismatch as a planning flag; do not invent a hierarchy in a slide. The clock posts already cover activation math. Classification decides whether that math applies to you at all.

    Import, IOR/AR, and QMSR sit on the same class decision

    Investigational units do not enter Brazil on a commercial registro. RDC 837/2023 Chapter IX puts exclusive clinical-use import under sanitary inspection and SISCOMEX release. The importer must cite the Diário Oficial da União resolution number for the DICD grant. Outer packaging must carry that DOU number, storage conditions, and a lot, identification, or serial code that can trace the unit. Quantities are limited to what the investigation needs. Commercialization of those units is prohibited.

    If someone other than the DICD holder imports, both parties sign a delegation-of-import-responsibility document. That is your import authorized representative problem, not a freight problem. The same legal person who will later hold notification or registro as authorized representative should see the investigational import list now. A first-patient kit that is not on the DICD product list will sit on the dock.

    On quality: RDC 837/2023 requires investigational devices, and any placebo or sham, to be manufactured to good manufacturing practice and labeled so they are identifiable as investigational. ANVISA may inspect the manufacturing site against the technical, production, and quality-control story in the DICD. If the same design will later support an FDA marketing file, build those units under the quality system you intend to defend — including the United States Quality Management System Regulation transition — not under a “prototype exception” that you cannot reconstruct.

    What the RA lead must lock before first patient

    Write these eight items as a one-page gate. Do not open the site until each line has an owner and a document ID.

    1. Intended purpose. The Portuguese indication that will classify the device under RDC 751/2022 Annex I and that will appear in the investigator brochure. Changing “long-term implant” to “intraoperative aid” after ethics approval is a new class, not a wording tweak.
    2. Class and rule. Class I–IV plus the governing Annex I rule. Record why neighboring rules were rejected.
    3. DICD yes/no. Apply RDC 837/2023 Articles 2 and 4. Class I/II, same-indication post-market, IVD performance, and usability-only studies are out of DICD scope. Class III/IV unregistered, and new indications on a registered device, are in.
    4. Filing face. Sponsor legal entity in Brazil versus ORPC. Name the person who will own secondary petitions: start/end dates, amendments, annual report.
    5. Import list. Every investigational SKU, spare, and accessory that will clear SISCOMEX, mapped to the DICD form. No “we’ll add the introducer later.”
    6. Expectedness language. The brochure and operator manual define “unexpected” for later safety notification. If the FIH protocol lists risks the brochure omits, you have built a 7- and 15-day reporting trap.
    7. Ethics path. CEP submission under Law 14.874/2024 in parallel with, not after, the sanitary file when a DICD is in scope. Single-CEP review for multicenter protocols is a legal design, not a courtesy.
    8. Start-date discipline. RDC 837/2023 requires start- and end-date forms as secondary petitions within 30 calendar days of each Brazil date. First patient is a regulatory event, not only a clinical one.

    Amendments after that gate are expensive. Substantial changes to the brochure or device dossier that can affect quality or safety wait for ANVISA manifestation (again, 90 calendar days in RDC 837/2023). Substantial protocol amendments that affect participant safety or scientific value wait the same way, except amendments that remove an immediate risk, which you implement and notify. Classification mistakes tend to surface as those amendments.

    A practical next step

    This week, run a 90-minute classification huddle with RA, clinical, quality, and the Brazilian representative. Put the intended-purpose sentence, the Annex I rule, the Class I–IV result, and a yes/no DICD decision on one page. Attach the RDC 751/2022 English text and the RDC 837/2023 scope articles. If those four people cannot sign the page, do not book first-patient week. The calendar you save is not ANVISA’s — it is the month you would have spent unscrewing a class you never locked.

  • After First Patients: How to Sequence FDA/IDE Data and LATAM Registration

    Most founders treat Latin America as a trial geography until first patients are in, then treat it as a launch geography only after FDA has spoken. The post-FIH question is not “FDA first, then LATAM.” It is: what do you do with the same evidence package while the clock is still cheap?

    You already have ethics approvals, an investigational import path, and a first cohort. Two clocks now compete for the same documents: FDA use of that data (IDE, 510(k), De Novo, or PMA) and sanitary registration at ANVISA, INVIMA, COFEPRIS, and ANMAT. Mixing those clocks is how teams lose a year.

    The split that matters after first patients

    Clinical-trial authorization and sanitary registration are not sequential stamps of the same permit. They are different legal objects, usually held by different local entities, with different import codes and different labeling.

    • Trial authorization lets you treat patients under a protocol. The device arrives as an investigational product. The local face is often an importer of record (IOR) plus a site or CRO, not your future commercial holder.
    • Sanitary registration lets you sell. The device arrives as a commercial product. The local face is an authorized representative / registration holder. The label, IFU, and QMS evidence must match the marketed configuration—not the “we’ll lock it after the last implant” version sitting in the design-history file.

    Converting a trial import into a commercial shipment without a new holder, a new dossier, and a locked configuration is a new problem, not a paperwork update.

    What FDA actually accepts from the FIH you just ran

    OUS FIH data can support an IDE or a device marketing submission. That is not folklore. In February 2018 FDA issued a final rule on acceptance of data from clinical investigations of medical devices. FDA’s own summary is here: Acceptance of Data from Clinical Investigations for Medical Devices.

    The operative text lives in 21 CFR 812.28 (Subpart B). In short:

    1. FDA will accept information from a well-designed, well-conducted investigation conducted outside the United States to support an IDE or a device marketing application or submission if the investigation was conducted in accordance with good clinical practice (GCP) as defined in § 812.28(a)(1).
    2. GCP, as defined there, includes independent ethics committee (IEC) review and approval (or a favorable opinion) before initiation, continuing IEC review, and documented informed consent—except in the narrow life-threatening situations the regulation itself describes.
    3. The sponsor or applicant must submit the supporting information in § 812.28(b) (or a cross-reference to where it lives in the file), including a description of the actions taken to ensure the research conformed to GCP.

    Do not “clean the data later for FDA” while you send a different CSR to Latin America. One evidence room. If the FIH lacked IEC review, consent, monitoring, and traceable source, you have a feasibility anecdote, not a bridge.

    QMSR is the other quiet bottleneck. FDA’s quality-system expectations sit on ISO 13485 architecture. A LATAM holder who cannot produce design controls, CAPA, supplier control, and a PMS plan will stall a registro even when the clinical tables look fine.

    What you are actually waiting on after FIH

    After first patients, the calendar is usually waiting on you—not “the regulator.”

    1. Configuration lock. Registration is for a defined product, models, accessories, software version, and intended use. If you are still iterating the delivery system after patient 6, you are not registration-ready.
    2. A CSR or a disciplined interim. High-risk dossiers want clinical evidence, not a slide. File on a pre-specified locked interim or wait for last-patient-last-visit. That choice drives the country clocks below.
    3. The commercial holder, not the trial IOR. Brazil, Mexico, Colombia, and Argentina all require a local legal person to hold or promote the sanitary authorization. Appointing that holder after you “finish the study” is how you add a quarter you will never get back.
    4. Language and labeling. Portuguese IFU for Brazil. Spanish labeling for Mexico (NOM-137 is the usual label conversation), Colombia, and Argentina. English source files that are still in draft are not a translation problem; they are a lock problem.
    5. Import identity. Investigational import permissions expire with the trial. Commercial import needs a registration number, a holder, and a tariff/sanitary identity that matches the registered product.

    Four country clocks—registration, not trial

    These are market-access clocks. They are not the trial-authorization clocks you already ran.

    ANVISA (Brazil) — notification vs registro

    ANVISA’s English medical-device page states that equipment is premarket-authorized under two regimes: notification for risk Classes I and II, and marketing authorization (registro) for Classes III and IV, under the classification rules in RDC No. 751/2022. See ANVISA: Medical devices and the service page Solicitar registro de dispositivo médico.

    What that means after FIH:

    • The applicant company must already be regularized with ANVISA (CNPJ, Solicita access). A foreign legal manufacturer does not file as itself.
    • For Classes III and IV, ANVISA’s page is explicit that the manufacturing unit must hold a valid GMP certificate issued by ANVISA; the agency may accept a GMP-certification protocol at application, but effective approval depends on publication of the GMP certification. That is often the real Brazil clock—not the clinical tables.
    • The service page cites RDC 751/2022 (devices) and RDC 830/2023 (IVDs) and states that a granted registro is valid for 10 years from publication in the Diário Oficial da União.

    Do not reuse the trial import file for commercial launch. The trial IOR and the Brazil Registration Holder are often different companies. Align them before you translate the CSR.

    INVIMA (Colombia) — I/IIA automatic vs IIB/III prior evaluation

    INVIMA’s device pages describe the sanitary registration as the public document issued under Decreto 4725 de 2005 that authorizes production, import, and commercialization. See INVIMA: Dispositivos médicos y equipos biomédicos.

    The operational split after FIH is class, not “did we already run a trial in Bogotá”:

    • Risk I and IIA: automatic-style sanitary registrations / renewals when the file is complete.
    • Risk IIB and III: prior technical-legal evaluation. INVIMA’s own normograma material on the procedure states that the Institute will process IIB and III sanitary-registration or marketing-permit requests in 90 business days once the technical and legal requirements are complete, and that a single deficiency cycle gives the applicant 90 days to respond or the request is treated as withdrawn.

    FIH data helps the IIB/III file. It does not skip the holder, the unique INVIMA form, or Spanish labeling. A site that wants to keep using the device after the protocol closes has a registration problem, not an amendment.

    COFEPRIS (Mexico) — trial authorization is not registro sanitario

    Mexico is where sponsors most often confuse the two permits. DIGIPRiS is used for both clinical-research filings and device registros. They are still different authorizations.

    COFEPRIS publishes device-authorization material at Autorización de Dispositivos Médicos and the agency home at gob.mx/cofepris. Commercial entry is a registro sanitario promoted by a Mexico Registration Holder, with Spanish labeling and a technical monograph. Equivalence / abbreviated (reliance) routes exist when you already have a reference-authority approval; those routes are not a substitute for having a holder and a Spanish dossier.

    If the next FDA step is still an IDE, Mexico’s equivalence conversation is usually later. Treat trial-to-registration as its own workstream. Do not wait for a 510(k) number unless Mexico is explicitly “abbreviated after FDA.”

    ANMAT (Argentina) — HELENA is the commercial desk

    ANMAT’s product-medical page points commercial filings to Sistema HELENA for electronic registration of productos médicos (including IVDs). See ANMAT: Productos Médicos and the HELENA login at helena.anmat.gob.ar.

    HELENA is not your ethics committee. After FIH you need a locally enabled manufacturer/importer, a class-correct expediente, and Spanish files. Argentina looks “slow” when company habilitation and digital signature start after the CSR.

    A post-FIH sequence that does not fight itself

    A sequence I use when first patients are in and the board wants both a U.S. story and a LATAM revenue story:

    1. Week 0–2 after first-patient-in: freeze the commercial identity. Intended use, models, accessories, software baseline, sterile barrier, and the claims you are willing to put on a label. If the next three patients will change the device, you are still in design, not in registration.
    2. Week 2–6: stand up holders in the countries you will actually sell, not the countries you studied. A Panama or El Salvador FIH does not create an ANVISA or COFEPRIS registration. Pick the commercial four (or a subset) and appoint holders while enrollment continues.
    3. In parallel: FDA use-case for the same data. If the next U.S. step is an IDE, write the IDE as the primary consumer of the FIH package (GCP statement, IEC packet, monitoring, device accountability). If the next U.S. step is 510(k)/De Novo, decide whether FIH is supporting clinical evidence or only human-factors/feasibility color. That choice changes how hard you should push LATAM registration on interim data.
    4. Stagger the four LATAM files by what they wait on, not by national pride.
      • INVIMA I/IIA and ANMAT lower-class HELENA filings can often start as soon as the holder and Spanish admin file exist—clinical depth is lighter.
      • ANVISA III/IV waits on BGMP as much as on the CSR. Start the GMP petition the week you lock the manufacturing site, not the week you lock the tables.
      • COFEPRIS standard registro can start on a complete Spanish monograph; save equivalence/abbreviated for when you actually have a reference-authority approval to lean on.
    5. Do not file four countries on four different device descriptions. One source IFU, four translations. One PMS / tecnovigilancia plan architecture, four local implementations. One complaint-handling owner.

    Three sequencing mistakes I still see after first implants

    1. Using the trial IOR as the future registration holder “to save a contract.” Cheap in month one. Expensive when you want to change distributors, add a second importer, or survive an inspection.
    2. Waiting for FDA clearance before opening any LATAM registro because “reliance will be faster.” Reliance is real in Mexico when you have something to rely on. It is not a reason to delay holder appointment, translations, or Brazil GMP.
    3. Sending LATAM a marketing brochure version of the FIH while sending FDA a GCP package. Reviewers talk. More importantly, your own QMS will not survive two truths about the same study.

    One tactical next step

    This week, build a one-page post-FIH evidence map: FDA plus the LATAM countries you will actually file, and three rows—(1) what is locked (protocol, IEC letters, device version), (2) what is open (CSR date, GMP, holder, translations), (3) the first document each agency is waiting on that is not “more patients.” Share it with regulatory, quality, and the person who signs import paperwork. If those three people cannot point to the same configuration and the same holder, you are hoping, not sequencing.

    Disclosure: I am CEO of bioaccess®, a FIH/EFS medical-device CRO and LATAM launch/in-country-holder group. The sequencing above is how I tell sponsors to think about the calendar; it is not a pitch for a particular vendor to hold your registration.

  • COFEPRIS Medical Device Registration Checklist (Mexico): MRH, Abbreviated Pathway, and Spanish Dossier

    COFEPRIS medical device registration is the ranking laggard for a reason: most English pages either recycle a generic “LATAM registration” outline or talk about manufacturing in Mexico. U.S. RA leads need a holder checklist — who owns the registro sanitario, which pathway you actually qualify for in 2026, and what must be in Spanish before DIGIPRIS will take the fee.

    bioaccess® works from Miami with U.S. MedTech sponsors and keeps trial plus market-access coverage across 19 Latin American and Caribbean markets. Mexico is one market in that footprint, not the only one. Timelines below are experience-based planning ranges for 2026, not COFEPRIS SLAs.

    What COFEPRIS registration is

    COFEPRIS (Comisión Federal para la Protección contra Riesgos Sanitarios) issues the sanitary registration that must appear on Mexican labeling before you commercially import and sell a device. The legal spine is the Ley General de Salud plus the device reglamento and the applicable NOMs — especially NOM-137-SSA1 (labeling) and NOM-241-SSA1 (GMP / good manufacturing and quality practices for devices). Classification is risk-based Class I / II / III (with IIa/IIb language used in some COFEPRIS materials). Classification drives dossier depth and the standard-route calendar.

    A 510(k), De Novo, PMA, or CE certificate is not a Mexican registration. Since September 2025 it can be the ticket onto the abbreviated / equivalence pathway if the authorization comes from an IMDRF- or MDSAP-recognized authority (FDA is the usual U.S. case; Health Canada, TGA, and EU MDR authorizations are the other names reviewers expect). That pathway is a summary dossier plus reliance — not a copy-paste of the FDA decision summary into a Spanish folder with no Mexican holder.

    The Mexico Registration Holder is the asset

    Foreign manufacturers do not hold the registro sanitario. A Mexico Registration Holder (MRH) — a legally constituted Mexican entity, sometimes still called the authorized representative or sanitary correspondent — files, pays the government fee, and typically owns the number in its name. Transfers are possible and slow. If your exclusive distributor is the MRH, a breakup is a regulatory project.

    • Notarized, apostilled letter of representation / power of attorney that states exactly what the MRH may file, modify, renew, and report.
    • MRH corporate standing and, where applicable, the establishment notices COFEPRIS expects for the activities they perform.
    • A written plan for who is importer of record vs. who is MRH vs. who is distributor. One company can wear two hats. Three hats on a thin distributor is how import permits stall when a person leaves.
    • Exit language: how you will transfer the registration if the commercial deal ends. Put it in the appointment, not in a slide.

    Pathways and a hedged calendar

    • Standard route. Full technical dossier. Published planning windows you will hear in 2026: on the order of 20–30 days for many Class I files, 30–60 for Class II, 60–180 for Class III — after a complete filing. Deficiency letters and workload stretch those numbers. Class III implants should not be promised as a 60-day launch.
    • Abbreviated / equivalence route (from 1 September 2025). Summary dossier that leans on a valid FDA or other recognized-market authorization. COFEPRIS has socialized a ~30-day target review across classes. Treat 30 days as a target after completeness, not as door-to-door from the day you hire counsel. Spanish labeling, the MRH pack, and “same device” identity (indications, design, manufacturer) are where abbreviated files die.

    March 2025 simplification measures trimmed some administrative steps and compressed certain low-risk reviews. They did not delete the holder requirement.

    Dossier checklist

    Every pathway

    • Device identity: generic and brand names, models, accessories, intended use, and the Mexican class you are claiming.
    • MRH letter of representation, apostilled; manufacturer corporate documents as required.
    • QMS evidence — ISO 13485 is the practical standard and is the usual way to speak to NOM-241 expectations. MDSAP or a recognized GMP certificate helps; “we are FDA-registered” alone is a thin story.
    • Spanish labels and IFU per NOM-137: generic name, origin, lot/serial, expiry if applicable, manufacturer, importer/MRH, and a reserved field for the registration number.
    • Proof of payment of the COFEPRIS government fee for the correct clave / modality. Fees are published in MXN and change. Do not freeze a USD “all-in” number from a 2023 blog post.

    Standard route extras

    • Full technical description, drawings, materials, and specifications.
    • Risk analysis (ISO 14971 or equivalent).
    • Biocompatibility, electrical, software, and sterility evidence that matches how the device is sold.
    • Clinical evidence appropriate to Class III and to novel Class II claims.

    Abbreviated route extras

    • Certified evidence of the foreign marketing authorization (FDA clearance/approval letter and current listing story, or the equivalent CE/MDR, Health Canada, TGA pack).
    • A “sameness” memo: indications, design, labeling claims, and legal manufacturer must match what the reference authority approved. A Mexico-only indication is not an abbreviated file.
    • Spanish summary of the foreign review story — not 400 pages of untranslated FDA correspondence.

    Validity, renewals, and technovigilance

    First registrations remain a five-year instrument in normal practice. As of January 2026, subsequent renewals can be granted for periods of up to ten years — useful if you are already on the market and your holder is stable. Technovigilance reporting stays with the MRH. If your U.S. complaint system does not forward Mexico-reportable events to the MRH on a defined clock, you have a regulatory gap, not a “local admin” task.

    FAQ-style close

    Can a U.S. company be the registration holder? Not without a Mexican legal entity acting as MRH. Plan the holder before you book the DIGIPRIS slot.

    Does the abbreviated pathway replace the MRH? No. It shortens the technical review when the foreign authorization is real and the device is the same. The holder still files.

    Is this the same as a COFEPRIS clinical-trial authorization? No. Research ethics and trial import of investigational units are a different authorization. Do not send a 510(k) equivalence pack to a trial desk and expect a sanitary registration number.

    How should we budget? Government fees are only the clave. Translations, apostilles, MRH retainers, and one likely deficiency cycle are the project. Hedge the calendar; do not sell the board a single flat USD fee.

    Where does a multi-country register-and-hold model live? If the devices are already FDA-cleared (510(k)/PMA) or CE-marked and you want an independent holder rather than a distributor-owned number, bioaccess® describes that separately on the LATAM Launch Subscription market-access page. Mexico is usually sequenced with the abbreviated pack and a holder who is not also your only commercial bet.

  • INVIMA Device Approval in Colombia: Registration Checklist

    INVIMA page-one rankings for “approval” still convert poorly when the article is about a clinical trial. This checklist is the other file: registro sanitario / market authorization for a medical device you intend to import and sell in Colombia — holder, importer, Spanish dossier, UDI — not a first-in-human CEI/INVIMA trial pack.

    bioaccess® is U.S.-anchored in Miami and supports U.S. MedTech sponsors on both clinical execution and market access across 19 Latin American and Caribbean markets. The ranges below are planning ranges from that work in 2026. They are not INVIMA guarantees, and they are not a promise that a new decree will freeze today’s clocks.

    What INVIMA registration is

    INVIMA (Instituto Nacional de Vigilancia de Medicamentos y Alimentos) is Colombia’s Level 4 PAHO/WHO authority and an IMDRF participant. Device market access still sits primarily on Decree 4725 of 2005 (devices) and Decree 3770 of 2004 (IVDs), with Resolution 1405 of 2022 driving UDI-DI and semantic reporting. A modernization decree to replace 4725 has been in motion through 2026 (IMDRF-aligned safety/performance language, ISO 13485 as the explicit GMP reference, personalized-device language). Until that decree is in force, plan against 4725 and treat “the new decree will save us a quarter” as speculation.

    Two structural facts U.S. RA teams get wrong. First, the manufacturer remains the owner of the sanitary registration even without a Colombian office — unlike Mexico, where the local holder typically owns the number. Second, you still cannot operate the file yourself: you appoint a Colombia-domiciled Legal Representative (representante legal) and you identify an importer that already holds a valid CCAA (Certificado de Capacidad de Almacenamiento y Acondicionamiento).

    Classification: uncontrolled vs controlled

    Colombia’s four-class scheme (I, IIa, IIb, III) tracks EU-style risk rules more closely than FDA’s three classes. Borderline products should be classified in Colombia, not copied from a 510(k) letter.

    • Uncontrolled (Class I and IIa). A complete application can receive immediate certificate issuance. You may import while INVIMA reviews the technical file after the number exists. That is not “no review.” Ignore a post-approval information request and the registration can be wound back.
    • Controlled (Class IIb and III). Full pre-market technical review. Practitioner calendars of 6–8 months of INVIMA time are common; 8–12 months start-to-number is a safer sponsor calendar once translations and CFS lead time are included. Clinical and performance evidence are expected, not optional appendices.

    Holder and importer checklist (do this before tramites.invima.gov.co)

    • Legal Representative appointment. Mandatory under 4725 for foreign manufacturers. The RL submits, receives oficio, and owns the response clock. Switching RL after approval is a formal modification, not a vendor swap.
    • Importer with a live CCAA. Storage and conditioning capacity is a licensed activity. Name the importer in the application. If your commercial distributor’s CCAA lapses, your import lane lapses with it.
    • Decide whether RL and importer are the same entity. Combining them is operationally simple and strategically sticky. Splitting them costs more coordination and protects you when the commercial relationship changes.
    • Keep manufacturer ownership visible in the power of attorney and in how labeling shows the legal manufacturer vs. the importer.

    Dossier checklist (Spanish, not “English plus a cover letter”)

    Evidence INVIMA actually blocks on

    • CFS or CFG from the country of origin or a recognized reference market (United States, Europe, Canada, Japan, Australia). This is the document that slips the calendar — FDA export certificates and notified-body paperwork have their own queues.
    • ISO 13485 (or equivalent QMS) covering the legal manufacturer and the device scope you are registering.
    • Technical file in Spanish: description, intended use, classification rationale, specifications, manufacturing overview.
    • Risk management consistent with ISO 14971 thinking.
    • Test reports expected for IIa and required in practice for IIb/III (bench, biocompatibility, electrical, software — whatever the device actually is).
    • Clinical evidence for IIb/III: investigation reports, clinical evaluation, or a literature-based CER that can survive a reviewer who has seen EU MDR files.
    • Spanish labeling and IFU, with space for the INVIMA registration number and the importer identity.
    • RL authorization / power of attorney and the importer’s CCAA evidence.

    UDI-DI and semantic reporting (2026 is not “upcoming”)

    Resolution 1405/2022 is in force. Holders obtain UDI-DI codes from a recognized issuing agency (GS1, HIBCC, ICCBBA, and the other agencies INVIMA lists) and complete semantic reporting on INVIMA’s platform. The deferred deadline for many Class I / IIa / Category I IVD records ran through early February 2026. If you already have a Colombian number and you have not closed UDI-DI plus the semantic report, treat commercialization as at risk — INVIMA has been explicit that noncompliant records should not be sold against. New registrations should build UDI into the launch pack, not a “phase 2.”

    Fees, validity, and the calendar

    INVIMA government fees are published in Colombian pesos and change. Recent practitioner tables put device application tariffs roughly in the COP 3.9–4.4 million band by uncontrolled vs. controlled pathway (IVDs somewhat lower). That is the state tariff, not the project. Legal-representative retainers, certified translations, and controlled-pathway deficiency cycles are the real budget. There is no honest single “$5,500 all-in Colombia registration” number that survives contact with a Class III implant and a stale CFS.

    Certificates are typically valid 10 years. File renewal on the order of three months before expiry. Technovigilance is continuous: serious incidents and field actions route through the RL into INVIMA’s program. Quarterly discipline beats a once-a-year “PMS cleanup.”

    FAQ-style close

    Is INVIMA registration the same as INVIMA clinical-trial authorization? No. Trial submissions, CEI/IRB, and import of investigational units are a different operating system. This checklist is for a device you will commercialize.

    Does FDA or CE mark create automatic INVIMA approval? No formal equivalency pathway like Mexico’s abbreviated route. A U.S. or EU CFS/CFG is mandatory evidence, not a stamp that skips the file.

    Who holds the number? The manufacturer owns the registration. The RL and the CCAA importer operate it. Write those contracts so a distributor change does not hold your sanitary registration hostage.

    Where does this sit in a multi-country launch? Colombia is often the Andean first filing because of the uncontrolled path for I/IIa and a 10-year certificate. Sequence CFS procurement first. If you already have FDA-cleared or CE-marked devices and want a register-and-hold model across LATAM rather than a one-off INVIMA project, the structured offer is on bioaccess®’s market-access / LATAM Launch Subscription page.

  • ANMAT Medical Device Registration Checklist (Argentina): Holder, HELENA Dossier, and 2026 Calendar

    If you searched “medical device registration in Argentina (ANMAT),” you are not looking for a first-in-human protocol. You are looking for a holder problem: who files in HELENA, who signs as legal representative and technical director, which Spanish dossier ANMAT actually reads, and how long the calendar runs after the Certificate of Free Sale leaves FDA or your notified body. This is that checklist — registration and market authorization, not an Argentine clinical trial.

    bioaccess® is a U.S.-anchored MedTech partner (Miami) that works with U.S. sponsors across trials and market access in 19 Latin American and Caribbean markets. Argentina is one of those markets. The notes below are experience-based planning ranges for 2026, not guaranteed clocks or a government fee table you can paste into a board deck without checking ANMAT’s current aranceles.

    What ANMAT registration is (and is not)

    ANMAT (Administración Nacional de Medicamentos, Alimentos y Tecnología Médica) records devices in the Registry of Producers and Products of Medical Technology (RPPTM / RPPMT). The backbone remains the Mercosur registration framework (GMC Res. 40/00, incorporated via Disposición 2318/02) plus later ANMAT dispositions — including 727/2013, 9688/2019, 11467/2024, and the 2025–2026 modernization package (notably Disposición 64/2025, 8799/2025, and 4446/2025). HELENA is the electronic product-registration portal. GEMHA is the establishment-enablement track for manufacturers and importers. Those are different queues. Mixing them is a common calendar killer.

    A U.S. 510(k), PMA, or CE mark does not become an Argentine registration. It becomes evidence — typically a Certificate of Free Sale / Certificate to Foreign Government from a recognized reference market — that your in-country holder attaches to a Spanish dossier. ANMAT still classifies the product under its own Class I–IV (devices) or A–D (IVD) rules and still reviews what you filed.

    The bottleneck is the holder, not the PDF

    A foreign manufacturer without an Argentine legal entity must appoint an Argentina Authorized Representative (AAR). The AAR is the registration holder and ANMAT’s only official counterpart. A Technical Director (director técnico) must also be named. HELENA filings are PDFs digitally signed by both. If you appoint your exclusive distributor as AAR, you have just tied the sanitary registration to a commercial contract. Changing distributors later is a transfer, not a courtesy email.

    Importer-of-record is a related but separate role. Low-risk import rules moved in 2025 (Disposición 4446/2025): many Class I/II shipments shifted from per-shipment authorization toward a sworn notification model. Class III/IV and used/refurbished product (Disposición 224/2026) still need prior thinking. Do not assume the AAR, the IOR, and the commercial distributor are the same company unless you designed it that way.

    Classification and pathway (plan the calendar here)

    • Class I / II — Declaration of Conformity route. Administrative review of a DoC plus supporting file. Published ANMAT review windows are often cited at 15–30 working days after a complete HELENA package. End-to-end calendar (translations, apostilles, AAR enablement, deficiency loops) is commonly 60–120 working days in practice.
    • Class III / IV — full technical review. Safety, performance, GMP evidence, risk file. Published review windows are often cited at 60–110 working days. Sponsors who treat that as “three months to first sale” under-plan. Deficiency rounds and GMP questions routinely push the working calendar toward a year for higher-risk implants.
    • IVDs. Separate classification (A–D) and a review window often cited at 60–90 working days. Do not reuse a device Class I playbook on a Class C infectious-disease assay.

    Before formal review, the Medical Device Registry office typically runs a completeness check (about 10 consecutive days). Incomplete HELENA uploads reset the clock. That is the cheapest delay to avoid.

    Dossier checklist for the Argentine holder

    Legal and holder pack

    • AAR appointment / power of attorney, apostilled (or consularized) and translated by a certified public translator (traductor público) where required.
    • Manufacturer incorporation evidence and manufacturing-site list that matches the CFS and ISO certificate.
    • Technical Director identification and digital-signature readiness in HELENA.
    • GEMHA (or applicable establishment) enablement if the importer/AAR is not already habilitated for your product type. Disposición 8799/2025 created a simplified sworn-declaration track (THEMIS) for some low-risk establishments — confirm whether you actually qualify before you skip GEMHA.

    Technical pack (class-dependent)

    • Spanish device description, intended use, and ANMAT classification rationale (do not paste the FDA product code and hope).
    • Certificate of Free Sale / CFG from a recognized authority (commonly U.S., EU, Canada, Japan, or Australia), recent enough for ANMAT’s “issued within the last 24 months” style expectation, apostilled.
    • ISO 13485 / GMP evidence. ANMAT-MDS is aligned with ISO 13485:2016; a current certificate covering the exact legal manufacturer and scope beats a generic brochure.
    • Risk-management file (ISO 14971) — expected for Class II+ and for implants, IUDs, and blood bags even when the class looks “low.”
    • Essential safety and performance evidence under current ANMAT rules (see Disposición 11467/2024), plus test reports appropriate to class.
    • Labeling and IFU in Spanish, mapped to ANMAT labeling dispositions (2318/02 Annex III.B and later 727/2013 rules). Leave space for the Argentine registration number; do not print a draft ANMAT number you do not have.
    • Declaration of Conformity for the Class I/II route; full technical file upload for Class III/IV.

    Translations, legalizations, and government fees

    Spanish is not a “nice to have.” HELENA wants PDFs the reviewer can read. Apostille plus traductor público is the usual foreign-document path. Budget calendar time for the CFS and ISO legalizations first; they sit on other agencies’ desks, not ANMAT’s.

    Government fees (aranceles) are published in Argentine pesos by class and move with ANMAT’s fee resolutions and FX. Practitioner ranges you will see quoted in 2026 sit in the low hundreds of U.S. dollars per product for the ANMAT tariff itself — not the total market-entry cost. AAR retainers, certified translations, dossier assembly, and deficiency responses dwarf the tariff. Do not plan around a single invented “flat fee.” Verify the current ANMAT arancel before you lock a purchase order.

    After the number: five-year clock and technovigilance

    Registrations are typically valid five years. Revalidation is due in the 90 days before expiry (Disposición 2318/02 / 727/2013 practice). Miss it and you are not “a little late” — you are often back to a new inscription. Post-market, Disposición 8194/2023 (good technovigilance practices) sits on the holder. Field actions and serious incidents do not wait for the U.S. weekend.

    FAQ-style close

    Does FDA clearance register the device in Argentina? No. It supports the CFS/CFG and the technical story. ANMAT still issues its own inscription.

    Can we file without a local holder? Not if you have no Argentine legal presence. The AAR is the applicant ANMAT recognizes.

    Is this the same as an ANMAT clinical-trial submission? No. Trial authorizations (and provincial ethics layers) are a different pathway. Do not reuse a trial SOP as a registration dossier.

    How should a U.S. sponsor sequence Argentina against other LATAM filings? Lock classification, CFS freshness, and an independent holder before you promise a launch quarter. Then run translations and GEMHA/HELENA access in parallel. If you already hold FDA or CE authorization and want a structured register-and-hold model rather than a one-off distributor filing, bioaccess® publishes that offer separately on the LATAM Launch Subscription / market-access page.

  • Where to run a neurovascular first-in-human study outside the US

    Neurovascular first-in-human is a hospital procedure study with a stroke or aneurysm case mix, not a Phase 1 unit problem. When founders ask where to go outside the US, they usually mean “where can I get ten clean cases without waiting a year for an IDE.” That is a fair question. The unfair version is picking a country first and hoping the operators exist.

    What the site has to already do

    The lab must already treat the target lesion at volume. A center that does occasional coiling is not a stroke-thrombectomy FIH site. You need documented case mix, 24-hour coverage if the indication is acute, and imaging that can be reconstructed later — DSA, CT, MR — under a protocol, not “whatever the night tech ran.”

    You also need a neuro IR or dual-trained operator who will tell you when the device should not go in. Early feasibility in this category fails when the first cases are the wrong anatomy and nobody recorded why.

    OUS options that are actually used

    Australia and selected European centers if the protocol is already written for an English or EU ethics workflow and you need FDA-facing documentation more than enrollment speed.

    Colombia and other high-volume LATAM neurovascular programs when the constraint is case mix and cost, and you are willing to design INVIMA or the local authority, the CEI, and investigational import as one calendar. Stroke and aneurysm volume in large public and private systems is the asset. The risk is treating that volume as if it were an IDE site on day one without locking imaging and device accountability.

    Avoid any destination whose pitch is regulatory speed and whose case list cannot show the lesion you need. A fast ethics letter on the wrong anatomy is not a first-in-human. It is a delay with radiation.

    Design the study so FDA can use it

    OUS neurovascular data can support a later IDE conversation only if inclusion, imaging, and device deficiencies were defined for that use. Write the protocol once. Then pick the two labs that can run it. Country, importer of record, and ethics are how you open those labs — they are not the scientific question.

  • Best countries for structural heart early feasibility studies

    Structural heart early feasibility is not a country-agnostic first-in-human. You need implanting volume, echo and CT that can be read the same way twice, and a site that already treats the disease you are studying. The wrong shortlist is “any fast LATAM ethics committee.” The right shortlist is a handful of hospitals that already do TAVR, TEER, or tricuspid work at a pace your sample size can survive.

    What has to be true in the country you pick

    • Operators who already perform the index procedure, not a general cath lab learning it on your device.
    • Imaging that can feed a core lab or at least a locked acquisition protocol. EFS failures in this category are often echo quality, not device quality.
    • An ethics and regulator path that can iterate. Early feasibility is supposed to change. A country that treats every protocol tweak as a new filing will erase the point of EFS.
    • Investigational import that can handle a device family, not a single serial, because you will iterate hardware.

    How I rank the usual options

    United States is still the gold standard when you already have an IDE conversation and the right sites. It is also the slowest and most expensive way to learn whether the device should even go there yet.

    Australia works when the protocol is English-native and the implanting volume exists. It is a poor default if your constraint is mitral or tricuspid enrollment speed.

    Colombia is often the first LATAM conversation for US sponsors: INVIMA plus CEI, strong cardiovascular hospitals, and a cost base that survives a 15-to-30-patient series. The calendar is the CEI and the import, not the science.

    Brazil has depth. ANVISA plus CONEP is a longer stack. Use it when you need volume and a later commercial story, not when you need the first ten patients this quarter.

    Panama and selected private systems in Mexico can be the right tactic when import and ethics are designed up front and the operator already has the volume. They are the wrong tactic when someone picked them from a map.

    The decision that actually matters

    Write the EFS protocol for the question FDA will ask next — design, procedure, or safety signal — then pick the two sites that can generate that imaging and those implants. Country is how you get those sites open. It is not the strategy.

    If a slide says “LATAM is faster” without naming the implanting physician, the imaging protocol, and the importer of record, it is not a country recommendation. It is a brochure.