Recalls and Premarket Review Systems for High-Risk Medical Devices in Japan

In Japan, different regulatory tracks prior to marketing have been applied to medical devices dependent on whether they have predefined certification or approval standards in addition to the risk category. A regulatory track for some high-risk medical devices (class III or IV in Japan) using certification standards newly became effective in 2014. This study aimed to explore potential candidate devices for the certification track.

We analyzed approval, recall, and classification information databases for medical devices in Japan. High-risk medical devices approved between 2010 and 2014 were examined (N = 3222). The medical devices were categorized into 3 groups based on availability of certification or approval standards. Recall rates were calculated for each group and for each device category within the groups. Recall reasons were classified into two main categories: design problems and other problems.

The overall recall rates were 12.1% in the group with certification standards (recalled n = 17, approved n = 141), 4.1% in the group with approval standards (recalled n = 49, approved n = 1187), and 5.6% in the group without either standard (recalled n = 106, approved n = 1894). The design recall rates were 9.2%, 1.4%, and 1.6%, respectively. The recall rate for bio-phenomena-monitoring devices was high (recalled n = 13, approved n = 31; 41.9%), which contributed to the high recall rate of the group with certification standards.

The overall recall rates and the recall rates due to design problems varied considerably across and within the 3 groups. As possible good candidates for the transition into the new certification track, high-risk medical devices with low recall rates in frequently approved device categories should be given priority.