Contains Nonbinding Recommendations Applying Human Factors and Usability Engineering to Medical Devices Guidance for Industry and Food and Drug Administration Staff Document issued on: February 3, 2016 As of April 3, 2016, this document supersedes “Medical Device Use-Safety: Incorporating Human Factors Engineering into Risk Management” issued July 18, 2000. The draft of this document was issued on June 21, 2011. For questions regarding this document, contact the Human Factors Premarket Evaluation Team at (301) 796-5580. U.S. Department of Health and Human Services Food and Drug Administration Center for Devices and Radiological Health Office of Device Evaluation Contains Nonbinding Recommendations Preface Public Comment You may submit electronic comments and suggestions at any time for Agency consideration to http://www.regulations.gov . Submit written comments to the Division of Dockets Management, Food and Drug Administration, 5630 Fishers Lane, Room 1061, (HFA-305), Rockville, MD 20852. Identify all comments with the docket number FDA-2011-D-0469. Comments may not be acted upon by the Agency until the document is next revised or updated. Additional Copies Additional copies are available from the Internet. You may also send an e-mail request to [email protected] to receive a copy of the guidance. Please use the document number 1757 to identify the guidance you are requesting. Contains Nonbinding Recommendations Table of Contents Contents 1. Introduction __________________________________________________________ 1 2. Scope _______________________________________________________________ 1 3. Definitions ___________________________________________________________ 2 3.1 Abnormal use __________________________________________________________ 2 3.2 Critical task ____________________________________________________________ 3 3.3 Formative evaluation ____________________________________________________ 3 3.4 Hazard ________________________________________________________________ 3 3.5 Hazardous situation _____________________________________________________ 3 3.6 Human factors engineering _______________________________________________ 3 3.7 Human factors validation testing ___________________________________________ 3 3.8 Task __________________________________________________________________ 3 3.9 Use error ______________________________________________________________ 3 3.10 Use safety ______________________________________________________________ 3 3.11 User ___________________________________________________________________ 3 3.12 User interface___________________________________________________________ 4 4. Overview ____________________________________________________________ 4 4.1 HFE/UE as Part of Risk Management ______________________________________ 4 4.2 Risk Management _______________________________________________________ 6 5. Device Users, Use Environments and User Interface _________________________ 7 5.1 Device Users ____________________________________________________________ 9 5.2 Device Use Environments ________________________________________________ 10 5.3 Device User Interface ___________________________________________________ 10 6. Preliminary Analyses and Evaluations ___________________________________ 11 6.1 Critical Task Identification and Categorization _____________________________ 12 6.1.1 Failure mode effects analysis _________________________________________________ 12 6.1.2 Fault tree analysis __________________________________________________________ 13 6.2 Identification of Known Use-Related Problems ______________________________ 13 6.3 Analytical Approaches to Identifying Critical Tasks _________________________ 13 6.3.1 Task Analysis _____________________________________________________________ 14 6.3.2 Heuristic Analysis __________________________________________________________ 15 6.3.3 Expert Review_____________________________________________________________ 15 6.4 Empirical Approaches to Identifying Critical Tasks __________________________ 15 6.4.1 Contextual Inquiry _________________________________________________________ 16 6.4.2 Interviews ________________________________________________________________ 16 6.4.3 Formative Evaluations ______________________________________________________ 16 6.4.3.1 Cognitive Walk-Through _________________________________________________ 18 Contains Nonbinding Recommendations 6.4.3.2 Simulated-Use Testing ___________________________________________________ 18 7. Elimination or Reduction of Use-Related Hazards __________________________ 19 8. Human Factors Validation Testing ______________________________________ 20 8.1 Simulated-Use Human Factors Validation Testing ___________________________ 21 8.1.1 Test Participants (Subjects) ___________________________________________________ 21 8.1.2 Tasks and Use Scenarios _____________________________________________________ 23 8.1.3 Instructions for Use _________________________________________________________ 23 8.1.4 Participant Training ________________________________________________________ 24 8.1.5 Data Collection ____________________________________________________________ 24 8.1.5.1 Observational Data _______________________________________________________ 25 8.1.5.2 Knowledge Task Data ____________________________________________________ 25 8.1.5.3 Interview Data __________________________________________________________ 26 8.1.6 Analysis of Human Factors Validation Test Results _______________________________ 26 8.1.7 Residual Risk _____________________________________________________________ 27 8.2 Human Factors Validation Testing of Modified Devices _______________________ 27 8.3 Actual Use Testing _____________________________________________________ 28 9. Documentation ______________________________________________________ 29 10. Conclusion __________________________________________________________ 30 Appendix A: HFE/UE Report _______________________________________________ 31 Appendix B: Considerations for Determining Sample Sizes for Human Factors Validation Testing _______________________________________________________ 35 Appendix C: Analyzing Results of Human Factors Validation Testing ______________ 37 Appendix D: HFE/UE References ___________________________________________ 43 Contains Nonbinding Recommendations Applying Human Factors and Usability Engineering to Medical Devices Guidance for Industry and Food and Drug Administration Staff This guidance represents the Food and Drug Administration's (FDA's) current thinking on this topic. It does not create or confer any rights for or on any person and does not operate to bind FDA or the public. You can use an alternative approach if the approach satisfies the requirements of the applicable statutes and regulations. If you want to discuss an alternative approach, contact the FDA staff responsible for implementing this guidance. If you cannot identify the appropriate FDA staff, call the appropriate number listed on the title page of this guidance. 1. Introduction FDA has developed this guidance document to assist industry in following appropriate human factors and usability engineering processes to maximize the likelihood that new medical devices will be safe and effective for the intended users, uses and use environments. The recommendations in this guidance document are intended to support manufacturers in improving the design of devices to minimize potential use errors and resulting harm. The FDA believes that these recommendations will enable manufacturers to assess and reduce risks associated with medical device use. FDA's guidance documents, including this one, do not establish legally enforceable responsibilities. Instead, guidance documents describe the Agency's current thinking on a topic and should be viewed only as recommendations unless specific regulatory or statutory requirements are cited. The use of the word should in Agency guidance documents means that something is suggested or recommended, but not required. 2. Scope This guidance recommends that manufacturers follow human factors or usability engineering processes during the development of new medical devices, focusing specifically on the user interface, where the user interface includes all points of interaction between the product and the user(s) including elements such as displays, controls, packaging, product labels, instructions for use, etc. While following these processes can be beneficial for optimizing user interfaces in other respects (e.g., maximizing ease of use, efficiency, and user satisfaction), FDA is primarily concerned 1 that devices are safe and effective for the intended users, uses, and use environments. The goal is to ensure that the device user interface has been designed such that use errors that occur during use of the device that could cause harm or degrade medical treatment are either eliminated or reduced to the extent possible. As part of their design controls1, manufacturers conduct a risk analysis that includes the risks associated with device use and the measures implemented to reduce those risks. ANSI/AAMI/ISO 14971, Medical Devices – Application of risk management to medical devices, defines risk as the combination of the probability of occurrence of harm and the severity of the potential harm2. However, because probability is very difficult to determine for use errors, and in fact many use errors cannot be anticipated until device use is simulated and observed, the severity of the potential harm is more meaningful for determining