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FDA Labeling
for Medical Devices in the
Age of Social Media
Joyce Lee, MD, MPH
Associate Professor
University of Michigan
Twitter: @joyclee
Disclosures
Social Media/Web Editor
of JAMA Pediatrics
Google Life Sciences
Agenda
•  FDA Guidelines for Promotional Labeling using
Social Media with Limited Characters
–  Case Study
•  Iceberg Tweets
–  Case Study
•  Opportunities
Agenda
•  FDA Guidelines for Promotional Labeling using
Social Media with Limited Characters
–  Case Study
•  Iceberg Tweets
–  Case Study
•  Opportunities
Display Benefits and Risks Together
If you can’t do it, don’t post!
Benefits
Accurate and non-misleading
Must include the indicated use of the product
Likely to be read and understood by the ordinary
individual under customary conditions of
purchase and use
Risks
Most serious risks
Hyperlink to more information about risks
(necessary but not sufficient)
Presented with a prominence and readability
reasonably comparable to claims about drug
benefits
FDA Warning Letter
“OMG. Have you heard about this? As you guys know my
#morningsickness has been pretty bad. I tried changing
things about my lifestyle, like my diet, but nothing helped,
so I talked to my doctor. He prescribed me #Diclegis, and I
felt a lot better and most importantly, it’s been studied and
there was no increased risk to the baby. I’m so excited and
happy with my results that I’m partnering with Duchesnay
USA to raise awareness about treating morning sickness. If
you have morning sickness, be safe and sure to ask your
doctor about the pill with the pregnant woman on it and
find out more www.diclegis.com;
www.DiclegisImportantSafetyInfo.com
Omission of Material Fact
Did not provide information about it’s full approved
indication
No studies or indication for women with hyperemesis
gravidarum
FDA Warning Letter
Omission of All Risk Information
Did not list any of the major risks:
Contraindicated in women with known hypersensitivity to doxylamine
succinate, other ethanolamine derivative antihistamines, pyridoxine
hydrochloride or any inactive ingredient in the formulation, as well as in
women who are taking monoamine oxidase inhibitors (MAOIs).
Warnings and Precautions regarding activities requiring mental alertness and
concomitant medical conditions.
The most common adverse reaction was somnolence.
Hyperlink unacceptable for risk communication
FDA Warning Letter
Agenda
•  FDA Guidelines for Promotional Labeling using
Social Media with Limited Characters
–  Case Study
•  Iceberg Tweets
–  Case Study
•  Opportunities
A tweet is so much
more than 140
characters
Iceberg Tweeting
@craigmod Link
Text
Text
Date, Time
Text
Photo/Video
Date, Time
Text
Date, Time
Retweet
Favorite
Photo/Video
Text
Date, Time
Retweet
Favorite
Individuals
Photo/Video
Replies
Hashtag
Quote Tweet
Tag
Tweetstorm (pork.io)
Metadata
“Invisible data”
Summary Card Summary Card
(Large Photo)
Photo Card Panel Card
Player Card Product CardApp Card
No risks outlined on the
Youtube Twitter Card metatags!
Agenda
•  FDA Guidelines for Promotional Labeling using
Social Media with Limited Characters
–  Case Study
•  Iceberg Tweets
–  Case Study
•  Opportunities
Take advantage of the Twitter iceberg?
Use metadata?
Use images?
Use cards?
Use hashtags?
Be a good citizen on
social media?
Use social media to help
Tap into hashtag trends
Throwback Thursday!
http://twittersuperuser.com/
http://www.doctorasdesigner.com/
joyclee@umich.edu

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