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Wednesday, 10/10/2012 1:25:21 PM

Wednesday, October 10, 2012 1:25:21 PM

Post# of 330443
Just found this comment opposed to classII for biel, etc...
This gives an idea of what they're up against. It sounds like they have no clue as to what BIEL has, but they are against it, and are asking them for the reports/studies they provided for fda.
I wonder where this group gets their funding from,lol. I will bold my favorite parts...

Division of Dockets Management
Food and Drug Administration
5630 Fishers Lane, Room 1061 (HFA-305)
Rockville, Maryland 20852
October 4, 2012
Comments of Patient and Consumer Coalition
On proposed rule
“Requirement for Premarket Approval for Shortwave Diathermy for All Other Uses”
[Docket No. FDA-2012-N-0378]
Members of the Patient, Consumer, and Public Health Coalition strongly support the FDA’s
proposed rule to require Premarket Approval Application (PMA) for the Class III
preamendments device Shortwave Diathermy (SWD) for all other uses except for the treatment
of malignancies. However, we oppose FDA’s proposal to allow a Product Development
Protocol (PDP) instead of a PMA for this device because PDPs are for devices where a sponsor
comes to an “early agreement with FDA as to what would be done to demonstrate the safety and
effectiveness of a new device.”1 FDA has stated unequivocally that SWD devices “have not
been shown to be safe and effective”2 therefore, the devices have no public health benefits, and
that also rules out the use of a PDP.
We strongly oppose the petitions by BioElectronics Corporation; Diapulse Corporation of
America; and MEDicept, Incorporated requesting that the FDA change the classification of
SWDs to Class II devices. SWDs pose significant health risks to patients, but provide no
measureable benefits. We would like to examine the “new information relevant to the
classification of the device”2 that the companies are supposed to provide, but it is not available.
The companies state the information is restricted and “not for public view.”3 However, the
missing information directly affects public health and it should be made available.
FDA’s Physical Medicine Device Classification Panel identified four health risks from SWD
devices: cellular or tissue injury, pacemaker interference, tissue necrosis and burns, and electrical
2
shock. Adverse events reported to the Manufacturer and User Facility Device Experience
(MAUDE) confirms the Panels’ concerns. MAUDE reports regarding SWDs include blisters,
third degree burns, shock sensations, and interference with a pacemaker.4
FDA notes that SWDs are associated with burns and “research has demonstrated that such
devices [non- thermal SWDs] do have a thermal effect and a direct correlation between pulse
rate and thermal sensation exists.”2 Studies have shown that SWDs can “cause heating of
implanted wire leads,”2 which can cause thermal injuries to patients even when the implanted
device is not turned on or has been removed from the patient’s body but the metal leads are left
in-place.
FDA is also aware of radiation hazards caused by SWDs, not only to patients but to the operator
of the SWD because “the majority of SWD units in clinical use do not have shielded leads to
transmit the high frequency generated to the applicator.”2 FDA is rightly concerned about the
health of SWD operators, especially if they treat several patients a day.
Another concern cited by FDA, is that abnormal cell growth caused by non-thermal SWDs has
been reported in in vitro studies in human and rat cell lines. FDA notes that, “The effects of
cellular changes by the electromagnetic field of the SWD devices require further clinical study to
show that the magnetic fields do not produce harmful effects on the cells.”2
SWDs are used to treat joint pain and muscle strain, and are used for postoperative pain relief in
superficial soft tissue. Alternative treatments to SWD devices are available. These include
everything from opioid and anti-inflammatory medications to therapeutic ultrasound,
interferential therapy, and transcutaneous electrical nerve stimulators (TENS).
The FDA notes that submitting a PMA application would cost manufacturers of a SWD device
an estimated $2.6 million, but the only alternative that would save companies money would be to
down classify the device to Class II. However, “FDA has determined that it has insufficient
information to implement adequate general and specials controls”2 for SWD devices to be
cleared by the 510(k) process. In these difficult economic times, we do not wish to add
unnecessary burdens to device manufacturers. But if SWD devices are not safe and effective,
then hospitals, patients, the government and insurance companies will be paying for an
ineffective product. Even more important, the FDA’s main mission is to protect the public
health, and that is not possible if the FDA continues to allow potentially dangerous devices of
questionable effectiveness on the market.
SWDs should be Class III devices because they have serious adverse health consequences (third
degree burns and shocking of patients with pacemakers or implanted defibrillators) and unproven
effectiveness. SWD for all other uses should require a PMA, which requires valid scientific
evidence to demonstrate reasonable assurance of the safety and effectiveness of the device.
For the above reasons, we strongly support FDA’s proposed rule to classify the SWD for all
other uses as a Class III device, which will require a PMA; we do not support a PDP for this
device. We agree with FDA that a PMA for these devices “should also include a detailed
3
discussion of the risks identified previously, as well as a discussion of the effectiveness of the
device.”2
American Medical Women’s Association
Connecticut Center for Patient Safety
Consumers Union
National Research Center for Women & Families
THE TMJ Association
Truth in Medicine
U.S. PIRG
WoodyMatters
For more information, contact Paul Brown at (202) 223-4000 or pb@center4research.org1 Food and Drug Administration (2012). Medical Devices – PMA Applications Methods (Web site).
http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/HowtoMarketYourDevice/PremarketSubmissio
ns/PremarketApprovalPMA/ucm048168.htm
2 Federal Register (July 6, 2012). Effective Date of Requirement for Premarket Approval for Shortwave Diathermy
for All Other Uses [Docket No. FDA-2012-N-0378].
3 Regulations.gov (2012). Change in Classification Petition for BioElectronics Corporation, Diapulse Corporation
of America, and MEDicept, Inc. See Docket No. FDA-2012-N-0378.
4 Manufacturer and User Facility Device Experience (MAUDE) search for Produce Code ILX (Diathermy,
Shortwave, For Use Other Than Applying Therapeutic Deep Health) from January 2001 through September 2012.