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Appendixes
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A
Study Origins and Activities
The Medical Device User Fee and Modernization Act of 2002 (P.L. 107–250) called for the Institute of Medicine (IOM) to conduct a study of postmarket surveillance of pediatric medical devices. IOM appointed a committee of 13 experts to oversee the study. Its task was to develop a report that specifically examined the system under the Federal Food, Drug, and Cosmetic Act for postmarket surveillance of medical devices to assess whether the system as administered by the U.S. Food and Drug Administration provides adequate safeguards for the use of devices in children. As called for in the legislation, the study committee assessed
the U.S. Food and Drug Administration’s monitoring and use of adverse reaction reports, registries, clinical studies, and other postmarket surveillance activities to identify unsafe or ineffective products;
the adequacy of the agency’s monitoring of commitments for further clinical studies made by manufacturers at the time of approval of specific medical devices;
the adequacy of postmarket surveillance studies to evaluate how children’s active lifestyles may affect implant failure rates and longevity; and
the length of studies, including whether they continue long enough to evaluate the impact of children’s growth and development given the expected length of time that a child will have an implant.
The committee met five times between April 2004 and March 2005. It organized two advisory panels to provide additional technical guidance on clinical and technical issues. It commissioned two background papers. The
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committee conducted three meetings with public sessions, including one to hear the views of family support and advocacy organizations and health care groups (with written statements invited from additional organizations). The committee also met with parents and young people who had personal experiences with implants or other complex medical devices. The agendas and participants for the public meetings are listed below.
INSTITUTE OF MEDICINE
Committee on Postmarket Surveillance of Pediatric Medical Devices
Room 204, The Keck Center, National Academy of Sciences
500 Fifth Street NW, Washington, DC
Public Session—April 15, 2004
1:00
Welcome and introductions
1:10
FDA Context and Perspectives
Donna-Bea Tillman, Ph.D.
Deputy Director, Office of Device Evaluation
Center for Devices and Radiological Health
U.S. Food and Drug Administration
Rockville, MD
Thomas Gross, M.D.
Director, Division of Postmarket Surveillance
Center for Devices and Radiological Health
U.S. Food and Drug Administration
Rockville, MD
2:40
Break
3:00
Research on Postmarket Surveillance: Experience of Duke Center for Education and Research on Therapeutics
Judith M. Kramer, M.D.
Principal Investigator, Duke Center for Education and
Research on Therapeutics
Duke University Medical Center
Durham, NC
4:00
Analysis of FDA Adverse Event Reports
Mark Bruley, B.Sc.
Vice President, ECRI
Plymouth Meeting, PA
5:15
Adjourn
* * *
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INSTITUTE OF MEDICINE
Committee on Postmarket Surveillance of Pediatric Medical Devices
Room 100, The Keck Center, National Academy of Sciences
500 Fifth Street NW, Washington, DC
Public Session—June 24, 2004
1:00
Welcome and introductions
1:10
Update from CDRH/FDA: Thomas Gross, M.D.
Briefing on Legislative Interest in Pediatric Medical Devices: Vipul Mankad, M.D. (Robert Wood Johnson Foundation fellow with Senate Health, Education, Labor and Pensions Committee)
1:30
Discussion with Clinical Advisory Panel
Jonathan Abramson, M.D.
Professor and Chair, Department of Pediatrics
Wake Forest University
Winston Salem, NC
Francis Sessions Cole, III, M.D.
Vice Chair and Park J. White Professor of Pediatrics
Washington University School of Medicine
Director, Division of Newborn Medicine
St. Louis Children’s Hospital
St. Louis, MO
Barbara Fivush, M.D.
Professor of Pediatrics
Johns Hopkins School of Medicine
Division Chief, Pediatric Nephrology
Johns Hopkins Hospital
Baltimore, MD
Susan T. Iannaccone, M.D., F.A.A.N.
Director, Neuromuscular Disease and Neurorehabilitation
Texas Scottish Rite Hospital for Children
Professor of Neurology
UT Southwestern Medical Center
Dallas, TX
John K. Niparko, M.D.
George T. Nager Professor
Director, Division of Otology, Neurotology & Skull Base Surgery
Johns Hopkins School of Medicine
Baltimore, MD
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Ramon L. Ruiz, D.M.D., M.D.
Assistant Professor, Oral/Maxillofacial Surgery & Pediatrics
University of North Carolina at Chapel Hill
Director, Pediatric Oral/Maxillofacial Surgery
North Carolina Children’s Hospital
Chapel Hill, NC
Frederick J. Schoen, M.D., Ph.D.
Professor of Pathology and Health Sciences and Technology
Harvard Medical School
Executive Vice Chairman, Department of Pathology
Brigham and Women’s Hospital
Boston, MA
3:45
Break
4:00
Discussion with Methods Advisory Panel
Elizabeth B. Andrews, Ph.D., M.P.H.
Vice President
Pharmacoepidemiology and Risk Management
RTI Health Solutions
Research Triangle Park, NC
Roselie A. Bright, Sc.D.
Epidemiologist
Division of Postmarket Surveillance
Office of Surveillance and Biometrics
Center for Devices and Radiological Health
U.S. Food and Drug Administration
Rockville, MD
Robert T. Chen, M.D., M.A.
Chief, Immunization Safety Branch
National Immunization Program
Centers for Disease Control and Prevention
Atlanta, GA
Harry A. Guess, M.D., Ph.D.
Professor of Epidemiology
School of Public Health
University of North Carolina at Chapel Hill
Chapel Hill, NC
5:30
Adjourn
* * *
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INSTITUTE OF MEDICINE
Committee on Postmarket Surveillance of Pediatric Medical Devices
Lecture Room, National Academy of Sciences
2101 Constitution Avenue, NW, Washington, DC
Public Session—August 31, 2004
8:20
Welcome
8:30
Advanced Medical Technology Association
Susan Alpert, M.D.
Vice President, Chief Quality and Regulatory Officer
Medtronic
Minneapolis, MN
9:00
American College of Cardiology, Congenital Heart Disease and Pediatric Cardiology Committee
Mark Boucek, M.D.
Director of Pediatric Heart Failure and Transplant Research Programs
The Children’s Hospital Denver
University of Colorado School of Medicine
Denver, CO
Pediatric Section, American Thoracic Society
Ann C. Halbower, M.D.
Assistant Professor of Pediatrics and Medical Director of Pediatric Sleep Disorders Program
Johns Hopkins University
Baltimore, MD
9:45
American Academy of Pediatrics
Jon Abramson, M.D.
Weston L. Kelsey Chair of Pediatrics
Wake Forest University Baptist Medical Center
Winston-Salem, NC
Pediatric Orthopedic Society of North America
Michael Vitale, M.D., M.P.H.
Chair, Evidence Analysis Work Group and Assistant Professor in the Division of Pediatric Orthopaedic Surgery Columbia University
New York, NY
10:30
Break
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10:50
National Association of Children’s Hospitals and Related Institutions1
Joelle Mast, M.D., Ph.D.
Chief Medical Officer and Chief of Pediatrics
Blythedale Children’s Hospital
Valhalla, NY
Edwin Simpser, M.D.
Executive Vice President and Chief Medical Officer
St. Mary’s Hospital for Children
Assistant Professor of Clinical Pediatrics
New York University School of Medicine
New York, NY
11:30
National Consumers League
Alison Rein
Assistant Director, Food and Health Policy
Washington, DC
12:00
Adjourn
NOTE: The following organizations endorsed the statement of the American Academy of Pediatrics: Ambulatory Pediatric Association, American Pediatric Society, Association of Medical School Pediatric Department Chairs, Society for Pediatric Research. Additional written statements were provided by: Section on Neurological Surgery (of the American Academy of Pediatrics); Society for Pediatric Anesthesia; American Pediatric Surgical Association; and Anthony D. Slonim, M.D., M.P.H. (of Children’s National Medical Center, Washington, DC).
* * *
INSTITUTE OF MEDICINE
Committee on Postmarket Surveillance of Pediatric Medical Devices
Lecture Room, National Academy of Sciences
2101 Constitution Avenue, NW, Washington, DC
Public Session—August 31, 2004 (afternoon)
Meeting with Families
Wendy Baskins
Nancy Harder and Ben Harder
1
Statements are those of guest speakers who represent member hospitals of NACHRI but who are not speaking for NACHRI.
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Donya Hartley
Melisande Statz-Hill and Benjamin Hill
Penny Hill and Amanda Hill
Kim L. Katka
Karen Marston
Representative terms from entire chapter:
adverse events