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Material Characterization (ISO 10993-18)
When it is Needed
How to Satisfy the Requirements
John Iannone
Program Manager/ Technical Specialist
ISO 10993 – Biocompatibility & Characterization
ISO 10993
ISO 10993 consists of the following parts, under the general title
Biological evaluation of medical devices:
–
–
–
–
–
–
–
–

Part 1: Evaluation and testing within a risk management process
Part 2: Animal welfare requirements
Part 3: Tests for genotoxicity, carcinogenicity & reproductive toxicity
Part 4: Selection of tests for interactions with blood
Part 5: Tests for in vitro cytotoxicity
Part 6: Tests for local effects after implantation
Part 7: Ethylene oxide sterilization residuals
Part 9: Framework for identification & quantification of potential
degradation products
– Part 10: Tests for irritation & skin sensitization
– Part 11: Tests for systemic toxicity
– Part 12: Sample preparation & reference materials

2
ISO 10993
ISO 10993 consists of the following parts, under the general title
Biological evaluation of medical devices:
–
–
–
–
–
–
–
–

Part 1: Evaluation and testing within a risk management process
Part 2: Animal welfare requirements
Part 3: Tests for genotoxicity, carcinogenicity & reproductive toxicity
Part 4: Selection of tests for interactions with blood
Part 5: Tests for in vitro cytotoxicity
Part 6: Tests for local effects after implantation
Part 7: Ethylene oxide sterilization residuals
Part 9: Framework for identification & quantification of potential
degradation products
– Part 10: Tests for irritation & skin sensitization
– Part 11: Tests for systemic toxicity
– Part 12: Sample preparation & reference materials

3
Biocompatibility Testing Matrix

Devices
connecting the
internal to the
external/External
communicating
device

Blood Vessels/Blood Path
Indirect

more than a 30 days
less than 24 hours
24 hours to 30 days
more than a 30 days
less than 24 hours
24 hours to 30 days
more than a 30 days
less than 24 hours

Tissue/Bone/Dentin

24 hours to 30 days
more than a 30 days
less than 24 hours

Circulating Blood

24 hours to 30 days
more than a 30 days
less than 24 hours

Internally
implanted
devices/Implant
device

Tissue/Bone

24 hours to 30 days
more than a 30 days
less than 24 hours

Blood

24 hours to 30 days
more than a 30 days






4



























































= Evaluation required by ISO, FDA and MHLW
= Evaluation required by ISO and FDA
=Evaluation required by FDA
=Evaluation required by ISO



























Biodegradation/
Biodegradable



Reproductive/
Developmental




Carcinogenicity






















Chronic Toxicity






















Hemocompatibility


























Implantation

Breached/Compromised
Surface

less than 24 hours
24 hours to 30 days


























Genetic
Toxicity/Genotoxicity

more than a 30 days

Mucous/Mucosal
Membrane


























Supplemental

Sub acute and/or Sub
chronic toxicity

Body Surface
Contact
Device/Surface
Device

24 hours to 30 days

Pyrogenicity

less than 24 hours

Skin

Systemic Toxicity
(Acute)

Contact duration

Irritation/Intracutaneous
Reactivity

Body Contact
Contact

Sensitivity/Sensitization

Category

Initial Evaluation

Cytotoxicity

Device Categories
ISO 10993
ISO 10993 consists of the following parts, under the general title
Biological evaluation of medical devices:
–
–
–
–
–
–
–
–

Part 1: Evaluation and testing within a risk management process
Part 2: Animal welfare requirements
Part 3: Tests for genotoxicity, carcinogenicity & reproductive toxicity
Part 4: Selection of tests for interactions with blood
Part 5: Tests for in vitro cytotoxicity
Part 6: Tests for local effects after implantation
Part 7: Ethylene oxide sterilization residuals
Part 9: Framework for identification & quantification of potential
degradation products
– Part 10: Tests for irritation & skin sensitization
– Part 11: Tests for systemic toxicity
– Part 12: Sample preparation & reference materials

5
ISO 10993
ISO 10993 consists of the following parts, under the general title
Biological evaluation of medical devices:
–
–
–
–
–
–
–
–

Part 1: Evaluation and testing within a risk management process
Part 2: Animal welfare requirements
Part 3: Tests for genotoxicity, carcinogenicity & reproductive toxicity
Part 4: Selection of tests for interactions with blood
Part 5: Tests for in vitro cytotoxicity
Part 6: Tests for local effects after implantation
Part 7: Ethylene oxide sterilization residuals
Part 9: Framework for identification & quantification of potential
degradation products
– Part 10: Tests for irritation & skin sensitization
– Part 11: Tests for systemic toxicity
– Part 12: Sample preparation & reference materials

6
ISO 10993 (continued)
ISO 10993 consists of the following parts, under the general title
Biological evaluation of medical devices:
– Part 13: Identification & quantification of degradation products from
polymeric medical devices
– Part 14: Identification quantification of degradation products from
ceramics
– Part 15: Identification & quantification of degradation products from
metals & alloys
– Part 16: Toxicokinetic study design for degradation products &
leachables
– Part 17: Establishment of allowable limits for leachable substances
– Part 18: Chemical characterization of materials
– Part 19: Physico-chemical, morphological & topographical
characterization of materials
– Part 20: Principles & methods for immunotoxicology testing of
medical devices
7
Leachate Migration/ Extraction

Polymer

Migration

Extraction Solution
Environment of Concern

8
So what are Extractables & Leachables?
EXTRACTABLES & LEACHABLES
» Extractables:
Extractables are compounds that migrate from the contact surface
under more aggressive conditions such as elevated temperature,
extended contact time, or aggressive solvent system. Any component
that is added to or pulled from the device or the materials used to
make the device, including degradants and residuals.
What CAN come out.

» Leachables:
Leachables are compounds that migrate from the contact surface
under normal conditions of exposure. Leachables are usually subset
of extractables.
What DOES come out.
10
Extractable/Leachable Relationship
Extractables/Leachables
» LEACHABLES are typically a SUBSET of EXTRACTABLES

» NOT ALL LEACHABLES are EXTRACTABLES
11
When do I Need E&L Testing?
When Do I Need or Want E&L Testing?
» Failed or Interesting Biocompatibility Results
– Determine source
– Examine applicability
» Evaluate Changes in Mfg Processes/ Material Supplier
– Compare Extraction Profiles pre & post change
(profile MUST be sufficiently comprehensive!)

» Novel Device (i.e. combination products)
– Is standard Biocompatibility sufficient testing?
» Obtain Well Understood Extraction Profile
– May reduce testing needs & risk  Colorants, Implants, etc.

13
When do I perform an E&L Study?

14
How do I satisfy the Requirements?
With so Many Devices… What is one to do?

16

CONFIDENTIAL
Understand what is happening
Extractable Testing
» Identify the potential compounds extracted into model solvents
under aggressive conditions
» Determine which, if any, compounds may affect patient or product

Leachable Testing
» Measure actual amount of leached compounds as a
function of time
» Determine How Much of What is present and:
Does exposure to the patient affect safety?  Tox Assessment

17
How do I perform an E&L Study?
» Extraction Ratios
• Sensitive enough to evaluate relevant exposure
• ISO 10993-12
• Lifetime exposure

» Extraction Solutions
• Consider the environment of concern

• Body Contact (ISO 10993-12: polar & apolar)
• Drug product formulation

» Extraction Temperature
• Simulated (Leachables) or Aggressive (Extractables)
• Body Contact, Storage Conditions
» Extraction Duration
• Exhaustive, Simulated, Accelerated, Asymptotic Behavior

» Sufficiently Comprehensive Trace Analysis
• If you don’t look for it, you won’t find it!
18
But my material is used to make devices all the time!
SOURCES OF LEACHATES
» Polymer Additives
 Antioxidants, Slip Agents, UV Stabilizers, Plasticizers, Colorants

» Polymer Degradation Products
 Sterilization, Storage, Processing

» Residues
 Monomers, Catalyst, Solvents

» Manufacturing Impurities
 Cleaners, Lubricants

» Migration from Secondary Contacting Material
 Adhesive, Ink, Multi-film, Nonhomogeneous Material, Packaging
19
Extractable/Leachable Sources

Potential
Inorganic
Compounds
of concerns

Metals

If you don’t look for it, you won’t find it!
20
Leachable Sources
Volatile Organic Compounds:
»
»
»
»

21

Monomer Residues
Solvent Residues from Production steps
residues from polymer treatments (e.g. washing)
Small Polymer Breakdown products
Leachable Sources
Semi-Volatile Organic Compounds:
»
»
»
»
»

22

Lubricants
Plasticizers
Antioxidants
Polymer degradation products
Solvents with an elevated boiling point
Leachable Sources
Non-Volatile Organic Compounds:
»
»
»
»
»

23

Fillers
Plasticizers
Antioxidants
Polymerization or Hydrogenation Catalysts
Anti-slip agents
Leachable Sources
Inorganic
Metal base complexes or compounds with metals
in their molecular structure

»
»
»

Fillers
Pigments
Catalyst Residues
Potential
Inorganic
Compounds
of concerns

Metals

ICP

24
Analytical Methods for E&L Determination
“FIRST PASS” Testing for Extractable Studies
Try to Fully Characterize the Extraction Profile of material, using:
Standard Analytical Equipment, e.g.
1. Headspace GC/MS
2. GC/MS
3. LC/MS
4. ICP
5. FTIR
Optimized Procedures & Procotols
» Leverage Compound Database (ie:TOX-RAY) for First Pass Analytical
Techniques built on years of expertise & high volume of studies 
high probability of ID in First Pass
Analytical Methods for E&L Determination
LEACHABLES testing
Select Targets, based upon
» Extraction Studies
» TOX-RITE information or other
Toxicological Assessment information
Ensure Adequate Quantitation of Relevant Compounds!
Adequate Quantitation Impacted by:
» The dosing regimen (frequency, volume)
» The complexity of the Matrix
» The toxicity of compounds
Risk Assessment of Medical Devices
ISO 10993-17
Used as a follow-up to extractables and/or leachables testing
(ISO 10993-18)

» Review safety information for all identified compounds
» Set limits of safe exposure
» Compare limits to amounts seen in E&L data
Anything can be poison/safe... It just depends on the dose
•
•
•
•
•
27

Compound Toxicity Data?
Route of Administration?
How Much Delivered?
How Often?
How Long?
CONFIDENTIAL
Conclusion
Materials used in device design are utilized in more sensitive
and unique configurations

Biocompatibility Assays assess various mechanisms that
may produce a reaction in the patient
Chemical Characterization provides Key Information
» Required to better design complicated/integrated systems
» Understand how various interactions will ultimately affect the patient
» Conduct a proper risk assessment of the total system

Ensuring the product will do what it was set out to do:
IMPROVE PATIENT CARE
28
THANK YOU

John Iannone
Program Manager /Technical Specialist

john.iannone@toxikon.com

15 Wiggins Ave, Bedford, MA 01730
800-458-4141 x142
29
Analytical Methods for E&L Determination
“SECOND PASS” Testing
Utilize Specialized Analytical Equipment for further identification of any
unknown compounds
High End Analytical Equipment, e.g.
1.
2.
3.
4.
5.

LC/MS Orbitrap
GC-ToF (often in combination with derivatization)
FT-MS
NMR
SEM-EDXA

Project Related Second Pass Testing
»
»

Evaluate the need to identify unknowns on a case by case basis
Is it Toxicologically & Physiologically Relevant?

Note: Be sure to collect data and further develop database from
2nd Pass testing to improve subsequent 1st Pass testing
Analytical Methods for E&L Determination
ACCELERATED LEACHABLES testing
In some cases: a SIMULATION study
»

As a step in between an Extraction
Study & a “Formal Leachable” Study

»

Understanding the real risk of which
extractable compounds may become leachable

»

Account for unexpected leachables and for secondary leachables

»

Using screening methodologies, not optimized for the specific
matrix.

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Material characterization per ISO 10993-18: When is it needed & how do I satisfy the requirements?

  • 1. Material Characterization (ISO 10993-18) When it is Needed How to Satisfy the Requirements John Iannone Program Manager/ Technical Specialist
  • 2. ISO 10993 – Biocompatibility & Characterization
  • 3. ISO 10993 ISO 10993 consists of the following parts, under the general title Biological evaluation of medical devices: – – – – – – – – Part 1: Evaluation and testing within a risk management process Part 2: Animal welfare requirements Part 3: Tests for genotoxicity, carcinogenicity & reproductive toxicity Part 4: Selection of tests for interactions with blood Part 5: Tests for in vitro cytotoxicity Part 6: Tests for local effects after implantation Part 7: Ethylene oxide sterilization residuals Part 9: Framework for identification & quantification of potential degradation products – Part 10: Tests for irritation & skin sensitization – Part 11: Tests for systemic toxicity – Part 12: Sample preparation & reference materials 2
  • 4. ISO 10993 ISO 10993 consists of the following parts, under the general title Biological evaluation of medical devices: – – – – – – – – Part 1: Evaluation and testing within a risk management process Part 2: Animal welfare requirements Part 3: Tests for genotoxicity, carcinogenicity & reproductive toxicity Part 4: Selection of tests for interactions with blood Part 5: Tests for in vitro cytotoxicity Part 6: Tests for local effects after implantation Part 7: Ethylene oxide sterilization residuals Part 9: Framework for identification & quantification of potential degradation products – Part 10: Tests for irritation & skin sensitization – Part 11: Tests for systemic toxicity – Part 12: Sample preparation & reference materials 3
  • 5. Biocompatibility Testing Matrix Devices connecting the internal to the external/External communicating device Blood Vessels/Blood Path Indirect more than a 30 days less than 24 hours 24 hours to 30 days more than a 30 days less than 24 hours 24 hours to 30 days more than a 30 days less than 24 hours Tissue/Bone/Dentin 24 hours to 30 days more than a 30 days less than 24 hours Circulating Blood 24 hours to 30 days more than a 30 days less than 24 hours Internally implanted devices/Implant device Tissue/Bone 24 hours to 30 days more than a 30 days less than 24 hours Blood 24 hours to 30 days more than a 30 days     4                                             = Evaluation required by ISO, FDA and MHLW = Evaluation required by ISO and FDA =Evaluation required by FDA =Evaluation required by ISO                Biodegradation/ Biodegradable  Reproductive/ Developmental   Carcinogenicity                     Chronic Toxicity                     Hemocompatibility                         Implantation Breached/Compromised Surface less than 24 hours 24 hours to 30 days                         Genetic Toxicity/Genotoxicity more than a 30 days Mucous/Mucosal Membrane                         Supplemental Sub acute and/or Sub chronic toxicity Body Surface Contact Device/Surface Device 24 hours to 30 days Pyrogenicity less than 24 hours Skin Systemic Toxicity (Acute) Contact duration Irritation/Intracutaneous Reactivity Body Contact Contact Sensitivity/Sensitization Category Initial Evaluation Cytotoxicity Device Categories
  • 6. ISO 10993 ISO 10993 consists of the following parts, under the general title Biological evaluation of medical devices: – – – – – – – – Part 1: Evaluation and testing within a risk management process Part 2: Animal welfare requirements Part 3: Tests for genotoxicity, carcinogenicity & reproductive toxicity Part 4: Selection of tests for interactions with blood Part 5: Tests for in vitro cytotoxicity Part 6: Tests for local effects after implantation Part 7: Ethylene oxide sterilization residuals Part 9: Framework for identification & quantification of potential degradation products – Part 10: Tests for irritation & skin sensitization – Part 11: Tests for systemic toxicity – Part 12: Sample preparation & reference materials 5
  • 7. ISO 10993 ISO 10993 consists of the following parts, under the general title Biological evaluation of medical devices: – – – – – – – – Part 1: Evaluation and testing within a risk management process Part 2: Animal welfare requirements Part 3: Tests for genotoxicity, carcinogenicity & reproductive toxicity Part 4: Selection of tests for interactions with blood Part 5: Tests for in vitro cytotoxicity Part 6: Tests for local effects after implantation Part 7: Ethylene oxide sterilization residuals Part 9: Framework for identification & quantification of potential degradation products – Part 10: Tests for irritation & skin sensitization – Part 11: Tests for systemic toxicity – Part 12: Sample preparation & reference materials 6
  • 8. ISO 10993 (continued) ISO 10993 consists of the following parts, under the general title Biological evaluation of medical devices: – Part 13: Identification & quantification of degradation products from polymeric medical devices – Part 14: Identification quantification of degradation products from ceramics – Part 15: Identification & quantification of degradation products from metals & alloys – Part 16: Toxicokinetic study design for degradation products & leachables – Part 17: Establishment of allowable limits for leachable substances – Part 18: Chemical characterization of materials – Part 19: Physico-chemical, morphological & topographical characterization of materials – Part 20: Principles & methods for immunotoxicology testing of medical devices 7
  • 10. So what are Extractables & Leachables?
  • 11. EXTRACTABLES & LEACHABLES » Extractables: Extractables are compounds that migrate from the contact surface under more aggressive conditions such as elevated temperature, extended contact time, or aggressive solvent system. Any component that is added to or pulled from the device or the materials used to make the device, including degradants and residuals. What CAN come out. » Leachables: Leachables are compounds that migrate from the contact surface under normal conditions of exposure. Leachables are usually subset of extractables. What DOES come out. 10
  • 12. Extractable/Leachable Relationship Extractables/Leachables » LEACHABLES are typically a SUBSET of EXTRACTABLES » NOT ALL LEACHABLES are EXTRACTABLES 11
  • 13. When do I Need E&L Testing?
  • 14. When Do I Need or Want E&L Testing? » Failed or Interesting Biocompatibility Results – Determine source – Examine applicability » Evaluate Changes in Mfg Processes/ Material Supplier – Compare Extraction Profiles pre & post change (profile MUST be sufficiently comprehensive!) » Novel Device (i.e. combination products) – Is standard Biocompatibility sufficient testing? » Obtain Well Understood Extraction Profile – May reduce testing needs & risk  Colorants, Implants, etc. 13
  • 15. When do I perform an E&L Study? 14
  • 16. How do I satisfy the Requirements?
  • 17. With so Many Devices… What is one to do? 16 CONFIDENTIAL
  • 18. Understand what is happening Extractable Testing » Identify the potential compounds extracted into model solvents under aggressive conditions » Determine which, if any, compounds may affect patient or product Leachable Testing » Measure actual amount of leached compounds as a function of time » Determine How Much of What is present and: Does exposure to the patient affect safety?  Tox Assessment 17
  • 19. How do I perform an E&L Study? » Extraction Ratios • Sensitive enough to evaluate relevant exposure • ISO 10993-12 • Lifetime exposure » Extraction Solutions • Consider the environment of concern • Body Contact (ISO 10993-12: polar & apolar) • Drug product formulation » Extraction Temperature • Simulated (Leachables) or Aggressive (Extractables) • Body Contact, Storage Conditions » Extraction Duration • Exhaustive, Simulated, Accelerated, Asymptotic Behavior » Sufficiently Comprehensive Trace Analysis • If you don’t look for it, you won’t find it! 18
  • 20. But my material is used to make devices all the time! SOURCES OF LEACHATES » Polymer Additives  Antioxidants, Slip Agents, UV Stabilizers, Plasticizers, Colorants » Polymer Degradation Products  Sterilization, Storage, Processing » Residues  Monomers, Catalyst, Solvents » Manufacturing Impurities  Cleaners, Lubricants » Migration from Secondary Contacting Material  Adhesive, Ink, Multi-film, Nonhomogeneous Material, Packaging 19
  • 22. Leachable Sources Volatile Organic Compounds: » » » » 21 Monomer Residues Solvent Residues from Production steps residues from polymer treatments (e.g. washing) Small Polymer Breakdown products
  • 23. Leachable Sources Semi-Volatile Organic Compounds: » » » » » 22 Lubricants Plasticizers Antioxidants Polymer degradation products Solvents with an elevated boiling point
  • 24. Leachable Sources Non-Volatile Organic Compounds: » » » » » 23 Fillers Plasticizers Antioxidants Polymerization or Hydrogenation Catalysts Anti-slip agents
  • 25. Leachable Sources Inorganic Metal base complexes or compounds with metals in their molecular structure » » » Fillers Pigments Catalyst Residues Potential Inorganic Compounds of concerns Metals ICP 24
  • 26. Analytical Methods for E&L Determination “FIRST PASS” Testing for Extractable Studies Try to Fully Characterize the Extraction Profile of material, using: Standard Analytical Equipment, e.g. 1. Headspace GC/MS 2. GC/MS 3. LC/MS 4. ICP 5. FTIR Optimized Procedures & Procotols » Leverage Compound Database (ie:TOX-RAY) for First Pass Analytical Techniques built on years of expertise & high volume of studies  high probability of ID in First Pass
  • 27. Analytical Methods for E&L Determination LEACHABLES testing Select Targets, based upon » Extraction Studies » TOX-RITE information or other Toxicological Assessment information Ensure Adequate Quantitation of Relevant Compounds! Adequate Quantitation Impacted by: » The dosing regimen (frequency, volume) » The complexity of the Matrix » The toxicity of compounds
  • 28. Risk Assessment of Medical Devices ISO 10993-17 Used as a follow-up to extractables and/or leachables testing (ISO 10993-18) » Review safety information for all identified compounds » Set limits of safe exposure » Compare limits to amounts seen in E&L data Anything can be poison/safe... It just depends on the dose • • • • • 27 Compound Toxicity Data? Route of Administration? How Much Delivered? How Often? How Long? CONFIDENTIAL
  • 29. Conclusion Materials used in device design are utilized in more sensitive and unique configurations Biocompatibility Assays assess various mechanisms that may produce a reaction in the patient Chemical Characterization provides Key Information » Required to better design complicated/integrated systems » Understand how various interactions will ultimately affect the patient » Conduct a proper risk assessment of the total system Ensuring the product will do what it was set out to do: IMPROVE PATIENT CARE 28
  • 30. THANK YOU John Iannone Program Manager /Technical Specialist john.iannone@toxikon.com 15 Wiggins Ave, Bedford, MA 01730 800-458-4141 x142 29
  • 31. Analytical Methods for E&L Determination “SECOND PASS” Testing Utilize Specialized Analytical Equipment for further identification of any unknown compounds High End Analytical Equipment, e.g. 1. 2. 3. 4. 5. LC/MS Orbitrap GC-ToF (often in combination with derivatization) FT-MS NMR SEM-EDXA Project Related Second Pass Testing » » Evaluate the need to identify unknowns on a case by case basis Is it Toxicologically & Physiologically Relevant? Note: Be sure to collect data and further develop database from 2nd Pass testing to improve subsequent 1st Pass testing
  • 32. Analytical Methods for E&L Determination ACCELERATED LEACHABLES testing In some cases: a SIMULATION study » As a step in between an Extraction Study & a “Formal Leachable” Study » Understanding the real risk of which extractable compounds may become leachable » Account for unexpected leachables and for secondary leachables » Using screening methodologies, not optimized for the specific matrix.