Riehmann Morten
Department of Urology, Lund University Hospital, S-221 85 Lund, Sweden.
Dan Med Bull. 2005 Feb;52(1):11-7.
Through the past decades, new medical devices have been introduced at an increasing pace at the urge primarily of manufacturers, clinicians, and patients. Whereas it is mandatory to assess and approve new pharmaceuticals before their widespread use is allowed, innovations in medical devices generally have not been subject to the same restrictions. The European Community's program on completion of the Internal Market has generated a series of three Directives regulating the safety, reliability, and marketing of practically all non-pharmaceutical medical products. Once CE-marked, devices are available throughout the Union, an area constituted of nearly half a billion citizens after the expansion to 25 Member States. Before the European Union Directives were implemented, Boneloc was introduced to commercial distribution in the beginning of the nineties as a new and promising bone cement to be utilized in joint arthroplasty prostheses. While promptly gaining wide acceptance in most of the Nordic countries, Boneloc was after few years and about 5,500 implanted Scandinavian patients withdrawn from the market abruptly because of inferior fixation properties. Utilizing Boneloc as a test case, the present study critically examined whether a comparable incident could occur after the implementation of the European Union Directives and what strategies can be applied to avoid equivalent future misconduct.
在过去几十年里,主要在制造商、临床医生和患者的推动下,新的医疗设备以越来越快的速度被引入。虽然在允许广泛使用新药品之前必须对其进行评估和批准,但医疗设备的创新通常不受同样的限制。欧洲共同体关于完成内部市场的计划产生了一系列三项指令,对几乎所有非药品医疗产品的安全性、可靠性和销售进行监管。一旦获得CE标志,设备即可在整个欧盟使用,在扩大到25个成员国后,这一区域有近5亿公民。在欧盟指令实施之前,BoneLoc在九十年代初作为一种用于关节置换假体的有前途的新型骨水泥被引入商业销售。虽然BoneLoc很快在大多数北欧国家获得了广泛认可,但几年后,在大约5500名斯堪的纳维亚患者植入后,由于固定性能较差,它突然从市场上撤出。本研究以BoneLoc为测试案例,批判性地研究了在欧盟指令实施后是否可能发生类似事件,以及可以采用哪些策略来避免未来类似的不当行为。