Section 520(g) of the Federal Food, Drug, and Cosmetic Act (FD&C Act) [21 U.S.C. § 360j(g)] establishes a framework for FDA to a grant a device for investigational use an exemption from certain requirements, such as performance standards or premarket approval, for the purpose of conducting investigations of that device.
This exemption is known as an Investigational Device Exemption (IDE).
FDA is the final arbiter in deciding whether a device study poses a significant or nonsignificant risk and whether an IDE is required.
Sponsors must obtain FDA approval of an IDE application prior to beginning clinical investigations of significant risk devices if the clinical investigation is assessing the safety and effectiveness of the device.
FDA has two primary objectives in reviewing an IDE: (1) to assure safety and appropriate patient protections for device trials and (2) to assure that the risks to the subjects are outweighed by the anticipated benefits to the subjects and the importance of the knowledge to be gained (21 CFR 812.30(b)(4) ).
An IDE is a regulatory submission that permits clinical investigation of devices to determine safety and effectiveness.
An FDA-approved IDE permits a device that otherwise would be required to comply with a performance standard or to have premarket approval to be shipped lawfully for the purpose of conducting investigations of that device (21 CFR 812.1 ).
Guidance on IDEs is provided on the FDA web page .
IDE Regulations are found in Title 21 of the Code of Federal Regulations (CFR), Part 812. Regulations that apply to medical devices are found in 21 CFR as follows:
| 21CFR Part 812 | Investigational Device Exemptions |
| 21CFR Part 814 | Premarket Approval of Medical Devices |
| 21CFR Part 860 | Medical Device Classification Procedures |
| 21CFR Part 58 | Good Laboratory Practice for Nonclinical Laboratory (Animal) Studies |
| 21CFR Part 50 | Protection of Human Subjects |
| 21CFR Part 56 | Institutional Review Boards |
| 21CFR Part 201 | Device Labeling |
| 21CFR Part 54 | Financial Disclosure by Clinical Investigators |
View the ReGARDD decision tree to determine if an IDE is needed
IDEs fall into four categories:
An early feasibility study is a limited clinical investigation of a device early in development, typically before the device design has been finalized, for a specific indication (e.g., innovative device for a new or established intended use, marketed device for a novel clinical application). It may be used to evaluate the device design concept with respect to initial clinical safety and device functionality in a small number of subjects (generally fewer than 10 initial subjects) when this information cannot practically be provided through additional nonclinical assessments or appropriate nonclinical tests are unavailable. Information obtained from an early feasibility study may guide device modifications. An early feasibility study does not necessarily involve the first clinical use of a device.
Early Feasibility/FIH Clinical Considerations
EFS FAQs
A first in human (FIH) study is a type of study in which a device for a specific indication is evaluated for the first time in human subjects. This page only discusses FIH studies that meet the definition of an early feasibility study.
A traditional feasibility study is a clinical investigation that is commonly used to capture preliminary safety and effectiveness information on a near-final or final device design to adequately plan an appropriate pivotal study. Because the study of a near-final or final device design takes place later in development than an early feasibility study, FDA would expect to see more nonclinical (or prior clinical) data in a traditional feasibility study IDE application. A traditional feasibility study does not necessarily need to be preceded by an early feasibility study.
A pivotal study is a clinical investigation designed to collect definitive evidence of the safety and effectiveness of a device for a specified intended use, typically in a statistically justified number of subjects. It may or may not be preceded by an early and/or a traditional feasibility study.