CE Mark (MDD-European Medical Device Quality Certificate) And FDA

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There are established quality control systems for the use of medical devices all over the world. There are differences between these documents. The most important ones are CE Mark (MDD) used in Europe and FDA Approval used in the United States.

CE Mark (European Medical Device Use Certificate):

It is defined as the use of a medical device or drug in European territory and the quality control system after use. So it's not "just" a permission, it's a quality control system. After the product is put on the market, both clinical research and test results are requested alternately, the certificate must be renewed, if it cannot be renewed, the product is withdrawn from the market.

Its main function is to evaluate the safety and effectiveness of new devices.

  • Obtained through clinical evaluation of published data for available equivalent devices, with necessarily positive results Requires Clinical trial
  • Requires an aftermarket clinical follow-up study, even after CE Marking
  • Valid in all EU countries and recognized almost all over the world (except in the USA, it is not required during the United States FDA Approval process)
  • Compared to the FDA approval system, it imposes more responsibility on the manufacturer and the physician and provides more trust
  • Enables faster delivery of new technology to patients compared to the FDA approval system
  • It leaves the safety and effectiveness of the surgical procedure performed by the device to the responsibility of the physicians and surgeons using the device.
    • FDA Approval (Permit)


    It is a license defined by its name . In other words, the medical device is licensed for use in the United States.

    • The main function is to evaluate the safety and effectiveness of new devices.

    • Requires comparative clinical research or trial

    • Approves narrow parameter range

    • Valid in the United States only

    • Compared to CE Marking, it is more expensive to obtain because the documents required from inspectors are much less efficient, the inspection cycle is about three times longer, and there are almost always more rounds of questions.

    • Indicates that strict criteria are met for clinical application of a drug or device to be safe and effective.

    In conclusion :

  • CE Marking in the European Union and the FDA approval process in the United States perform the same functions as evaluating the safety and efficacy of new devices.
  • Despite differences in CE Marking and FDA approval systems, there are no more product recalls in Europe than in the United States (!). In other words, even if the products pass FDA Approval, recalls and blocking the product are more common in the United States, since poor quality or non-compliance with standards is detected.

    • Companies that do not want to enter the American market do not want to get FDA approval. Because sometimes entering a market can bring investment, cost, labor and risks. However, when a good and quality product cannot enter the American market, the American people are left in a disadvantaged position. There are many examples of this. For this reason, CE Mark is more accepted and is a valid system all over the world. MDD has now been replaced by MDR. Although it forces many companies, it is stated that CE MDR may become superior to FDA and may fall into the "Gold Standard" position in the near future.

    Many Medical Devices (For example Heart Valve) have been used for years in Europe and all over the world, even though they are not FDA Approved. Another Example is Long-acting Insulin which is given to children everywhere, although it is not FDA-approved for ages 0-5 . Although many products of some famous global medical device companies cannot get FDA approval, their sales and use continue all over the world.

    Resources :

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC53191...

    https://crstodayeurope.com/articles/2015-feb/ce-ma...

    https://medcitynews.com/2012/02/ce-mark-or-fda-app...

    https://starfishmedical.com/blog/medical-device-51...

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