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Lean	&	Compliant	
Accelera'ng	Medical	Device	
Product	Development	
SME,	Silicon	Valley	Chapter	98		
May	21,	2015	
1
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Workshop	Presenters	
Aaron	Joseph,	Medical	Devices	Consultant	
20	years	in	new	product	development;	medical	device	product	
validaLon	and	risk	analysis	
aaronanswers@gmail.com		
Geetha	Rao,	Ph.D.,		CEO,	Springborne	Life	Sciences	
25	years	in	high-risk	technologies;	regulatory	strategy,	risk	
management,	medical	device	quality	systems,	business	strategy	
geetha@springborne.com		
Roger	Tang,	Ph.D.,	Principal,	H	R	Tang	ConsulLng	
15	years	in	research	and	new	product	development;	medical	
imaging,	opLcal	technologies,	biotechnology	
		hrogertang@gmail.com		
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Start	 Topic	 Speaker	
1:10	PM	 IntroducLon	 Aaron	Joseph	
1:20	PM	 Myth	BusLng	Regulatory	PerspecLves	 Geetha	Rao	
1:30	PM	 Knowledge-Driven	Product	Development	 Roger	Tang	
1:40	PM	 Exercise:	IdenLfying	Knowledge	Gaps	 Roger	Tang	
1:55	PM	 Reconciling	Lean	with	RegulaLons	 Geetha	Rao	
2:10	PM	 Lean	Product	Development	for	Medical	Devices	 Aaron	Joseph	
2:20	PM	 Knowledge	Capture	and	Management	 Roger	Tang	
2:25	PM	 Exercise:	A3	Method	for	Knowledge	Management	 Roger	Tang	
2:40	PM	 Real	Life	Examples	 Aaron	Joseph	
2:55	PM	 Summary	and	Q&A	 Panel	
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Suggested	Resources	for	Lean	Product	Development	
Websites:	
ā€¢ā€Æ h"p://www.leanprimer.com/downloads/lean_primer.pdf		-	good	overview	of	lean	principles	
wri"en	by	two	soaware	management	consultants	(Craig	Larman	and	Bas	Vodde)	who	include	
aspects	of	soaware	agile	methods	as	well.	
ā€¢ā€Æ www.leantechnologydevelopment.com/		-	lots	of	easy-to-read	arLcles	on	diļ¬€erent	aspects	of	lean	
product	development,	knowledge	management,	and	tacLcs	for	implementaLon	(managed	by	
Katherine	Redeker	of	Whieer	ConsulLng)	
ā€¢ā€Æ h"p://theleanthinker.com/			-	a	blog	by	Mike	Rother	with	lots	of	good	observaLons	and	real-
life	issues	involved	in	changing	an	organizaLon	to	lean	
ā€¢ā€Æ h"p://www.coe.montana.edu/IE/faculty/sobek/A3/index.htm		-	a	short	tutorial	on	the	Toyota	A3	
technique	for	problem	solving	by	Durward	Sobek	
ā€¢ā€Æ h"p://www.lean.org/		-	Lean	Enterprise	InsLtute	(consulLng	ļ¬rm	and	forum);	large	collecLon	of	
arLcles	and	online	forums	discussing	aspects	of	lean	product	development,	lean	mfg,	and	lean	
services	
ā€¢ā€Æ h"p://theleanedge.org/	-	a	forum	for	discussions	of	lean	management	issues	with	contribuLons	
from	many	of	the	thought	leaders	in	the	lean	community		
ā€¢ā€Æ h"p://playbookhq.co/blog/	-	lots	of	good	blog	posLngs	on	concepts	and	methods	for	lean	product	
development;	links	to	lots	of	addiLonal	resources	
4
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Suggested	Resources	for	Lean	Product	Development	
Books:	
ā€¢ā€Æ "Mastering	Lean	Product	Development"	by	Ronald	Mascitelli	-	a	collecLon	of	pracLcal	methods	to	
improve	everything	a	product	development	organizaLon	does	from	product	strategy	to	running	
eļ¬ƒcient	design	reviews	(includes	extensive	bibliography).	
ā€¢ā€Æ "The	Principles	of	Product	Development	Flow"	by	Donald	Reinertsen	-	detailed	explanaLons	of	
key	principles	to	accelerated	product	development,	based	on	Theory	of	Constraints,	queuing	
theory,	and	more.		
ā€¢ā€Æ "Lean	Product	and	Process	Development"	by	Allen	C	Ward	-	a	spirited	presentaLon	of	the	
philosophy	and	techniques	for	lean	product	development	from	the	guy	who	inspired	many	others	
(published	posthumously)	
ā€¢ā€Æ "Ready,	Set,	Dominate"	by	Michael	Kennedy	et	al	-	a	more	evolved	presentaLon	of	the	ideas	from	
Ward's	book,	based	on	the	real-life	experiences	of	Kennedy's	consulLng	clients.	Includes	case	
studies	of	two	companies	going	through	lean	transformaLons.	
ā€¢ā€Æ ā€œManaging	to	Learnā€	by	John	Shook	ā€“	an	excellent	introducLon	to	the	use	of	the	ā€˜A3	methodā€™	for	
problem	solving,	communicaLon,	learning,	and	lean	management.		
ā€¢ā€Æ ā€œThe	Lean	Startupā€	by	Eric	Ries	ā€“	a	must	read	for	entrepreneurs	and	anyone	managing	projects	to	
create	something	new	under	condiLons	of	extreme	uncertainty.	
5
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Introduc'on	
Aaron	Joseph	
Sr.	Consultant,	Product	RealizaLon	Group	
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What	is	ā€œLean	Product	Developmentā€?	
Fewer	Employees	
Very	Aggressive		
Schedules	
Outsourced		
Engineering	
Maximizing	Value	for	the	Customer	
7
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Lean	Methods	Accelerate	Product	
Development	
ā€¢ā€Æ Earlier	product	launch	translates	
into	$millions	more	in	sales	
ā€¢ā€Æ 2-3X	decrease	in	development	
cycle	Lme	
ā€¢ā€Æ 2-4X	decrease	in	development	cost	
ā€¢ā€Æ 2-5X	decrease	in	development	risk	
ā€¢ā€Æ Strong	arguments	for	qualitaLve	
improvements	
8
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Why	Lean	for	Medical	Devices?	
ā€¢ā€Æ Product	development	teams	at	medical	device	
companies	are	caught	ā€œbetween	a	rock	and	a	hard	placeā€	
ā€“ā€Æ Increasing	regulatory	scruLny	(in	US	and	overseas	markets)	
ā€“ā€Æ Changes	to	US	healthcare	market	from	ACA	(Obamacare)		
ā€“ā€Æ Greater	compeLLon	(new	products	from	India	and	China)	
ā€“ā€Æ Increasing	challenges	of	managing	globalized	supply	chains	
ā€¢ā€Æ Companies	cannot	pass	along	increased	costs	to	their	
customers	
ā€¢ā€Æ Challenge	to	eļ¬ƒciently	develop	new,	innovaLve	medical	
devices	and	sLll	maintain	rigorous	compliance	
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Can	Lean	Product	Development	work	
for	Medical	Devices?	
ā€¢ā€Æ Medical	devices	are	a	regulated	product	
ā€¢ā€Æ Medical	device	regulaLons	govern:	
ā€“ā€Æ Product	tesLng	
ā€“ā€Æ Product	manufacturing	
ā€“ā€Æ Product	development	(ā€œdesign	controlsā€)	
ā€¢ā€Æ Each	company	decides	how	to	implement	design	
controls	as	part	of	their	quality	system	
ā€¢ā€Æ The	quality	system	procedures	can	either	support	
lean	methods	or	obstruct	them	
10
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Two	Real	Life	Medical	Devices	
New	Product	Development	
11	
30	
Average	
20	 18	
12	
Product	Development	Cycle	Time	(months)	
2-3x	
Average	
1x	 .8x	
Budget	($)	
Record	 Goal	 Lean	 Planned	 Lean	
~$3M	
Addi'onal	
Proļ¬t	 ~$500K	
Cost	
Savings
h"p://smesv.org	
Actual	PracLce	
ā€¢ā€Æ Lean	methods	do	not	conļ¬‚ict	with	the	
requirements	of	FDA	regulaLons,	ISO	13485,	
or	other	standards	
ā€¢ā€Æ Lean	methods	do	conļ¬‚ict	with	the	quality	
systems	of	many	medical	device	companies	
12
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Myth-bus'ng	
ā€œYou	canā€™t	use	lean	methods	to	
develop	a	regulated	productā€	
Geetha	Rao,	Ph.D.	
CEO,	Springborne	Life	Sciences	
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The	infamous	waterfall	
14	
Design	
Plan	
Design	
Transfer
h"p://smesv.org	
Typical	Design	Control	ImplementaLon	
ā€¢ā€Æ Design	Phases	
ā€“ā€ÆInput,	Output,	Veriļ¬caLon,	ValidaLon	
ā€¢ā€Æ Life	Cycle	
ā€“ā€ÆResearch,	Development,	Pre-producLon,	ProducLon	
ā€¢ā€Æ Stage	gates	between	phases	
ā€“ā€ÆComprehensive	phase	review	
ā€“ā€ÆCommi"ee	approval	to	proceed	to	next	stage	
15
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True	or	False?	
ā€¢ā€Æ The	design	control	SOP	must	follow	the	waterfall	
diagram	
ā€¢ā€Æ The	design	team	cannot	proceed	to	the	next	
development	stage	without	compleLon	of	
required	design	and	phase-gate	reviews		
ā€¢ā€Æ Veriļ¬caLon	must	be	completed	before	validaLon	
is	performed	
ā€¢ā€Æ All	product	development	engineers	must	be	
trained	to	the	design	control	SOP	
ā€¢ā€Æ All	product	documentaLon	generated	during	the	
design	process	is	a	controlled	record	
16
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FDAā€™s	comment	on	the	waterfall	
ā€œAlthough	the	Waterfall	Model	is	a	useful	tool	
for	introducing	Design	Controls,	its	usefulness	
in	pracLce	is	limited.	The	model	does	apply	to	
the	development	of	some	simpler	devices.	
However,	for	more	complex	devices,	a	
concurrent	engineering	model	is	more	
representaLve	of	the	design	processes	in	use	
in	the	industry	approach.ā€	
	
h"p://www.fda.gov/MedicalDevices/DeviceRegulaLonandGuidance/GuidanceDocuments/ucm070627.htm	
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Concurrent	Engineering	Deļ¬niLons	
ā€œa	method	of	designing	and	developing	products,	in	
which	the	diļ¬€erent	stages	run	simultaneously,	rather	
than	consecuLvely.	It	decreases	product	
development	Lme	and	also	the	Lme	to	market,	
leading	to	improved	producLvity	and	reduced	
costs.ā€[John	Stark,	1998]	
ā€œintegraLng	a	new	product	development	process	to	
allow	parLcipants	making	upstream	decisions	to	
consider	downstream	and	external	requirements.	
Central	characterisLcs	ā€¦	are	acLvity	overlapping,	
informaLon	transfer	in	small	batches,	and	use	of	
cross-funcLonal	teamsā€	[Gerwin	and	Susman	1996]	
18
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Workļ¬‚ow	in	a	concurrent/lean	approach	
19	
Requirements	
Analysis	
&	Design	
Tes'ng	
Evalua'on	
Planning	
Deployment
h"p://smesv.org	
Cycles	of	Increasing	Knowledge	
20	
Planning	
Requirements	
Analysis	
&	Design	
Tes'ng	
Evalua'on	
Deployment
h"p://smesv.org	
Knowledge-Driven	Product	
Development	
Roger	Tang,	Ph.D.	
Principal,	H	R	Tang	ConsulLng	
21
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Knowledge-Driven	Product	Development	
ā€¢ā€Æ Successful	new	product	development	
demands	deep	knowledge	of:	
ā€“ā€ÆProduct	applicaLon	
ā€“ā€ÆProduct	technology	
ā€“ā€ÆManufacturing	process	technology	
22
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Whatā€™s	Usually	Wrong	with	Product	
Development?	
ā€¢ā€Æ Phase-Gate	Development	Process	
ā€¢ā€Æ Design,	Build	and	Test	Paradigm	
Concept	
Phase	
Planning	
Phase	
Design	
Phase	
Test	
Phase	
Launch	
Phase	
Customer	
Use	
23
h"p://smesv.org	
Whatā€™s	Usually	Wrong	with	Product	
Development?	
ā€¢ā€Æ Design,	Build	and	Test	Paradigm	
Concept	
Phase	
Planning	
Phase	
Design	
Phase	
Test	
Phase	
Launch	
Phase	
Customer	
Use	
Diļ¬ƒcult	technical	
work	done	here!	
24
h"p://smesv.org	
Whatā€™s	Usually	Wrong	with	Product	
Development?	
ā€¢ā€Æ Design,	Build	and	Test	Paradigm	
Concept	
Phase	
Planning	
Phase	
Design	
Phase	
Test	
Phase	
Launch	
Phase	
Customer	
Use	
Diļ¬ƒcult	technical	
work	done	here!	
The	Inevitable	Design	Loopbacks	
25
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Whatā€™s	Usually	Wrong	with	Product	
Development?	
ā€¢ā€Æ Design,	Build	and	Test	Paradigm	
Concept	
Phase	
Planning	
Phase	
Design	
Phase	
Test	
Phase	
Launch	
Phase	
Customer	
Use	
Diļ¬ƒcult	technical	
work	done	here!	
In	real	life,	it	can	be	worseā€¦	
26
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Lean	Product	Development	
ā€¢ā€Æ Test	before	Design	Paradigm	
Concept	
Phase	
Planning	
Phase	
Design	
Phase	
Test	
Phase	
Launch	
Phase	
Customer	
Use	
Diļ¬ƒcult	technical	
work	done	here!	
27
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A	Famous	Example*	
The	Wright	Brothers	conquered	manned,	controlled,	
heavier-than-air	powered	ļ¬‚ight	when	countless	
others	failed	
ā€¢ā€Æ When: 	 	1899-1903	
ā€¢ā€Æ Where: 	 	Dayton,	Ohio	
ā€¢ā€Æ EducaLon: 	High	school	
ā€¢ā€Æ OccupaLon: 	Bicycle	sales	and	repair	
ā€¢ā€Æ How?	
*Credit	to	Ron	Marsiglio	
28
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Before	Designing	Their	First	Airplaneā€¦	
ā€¢ā€Æ Began	with	a	knowledge	search	
ā€“ā€Æ Wrote	the	Smithsonian	InsLtuLon	for	available	
informaLon	in	1899	
ā€“ā€Æ Studied	lia	tables	from	O"o	Lilienthal	
ā€“ā€Æ Corresponded	with	Octave	Chanute,	railroad	engineer	and	
leading	aviaLon	expert	
Lilienthal	in	ļ¬‚ight	 Octave	Chanute	
29
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Before	Designing	Their	First	Airplaneā€¦	
ā€¢ā€Æ IdenLļ¬ed	3	key	knowledge	gaps	
	
ā€“ā€ÆLia	
ā€“ā€ÆPropulsion	
ā€“ā€ÆControl	
30
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Before	Designing	Their	First	Airplaneā€¦	
ā€¢ā€Æ Closed	knowledge	gaps	by	performing	analyses	and	
experiments	
Wind	Tunnel	
TesLng	
Model	Kites	
Manned	Gliders	
31
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Before	Designing	Their	First	Airplaneā€¦	
ā€œSomeLmes	the	non-glamorous	lab	work	
is	absolutely	crucial	to	the	success	of	a	
project.ā€	
	
		 	 	 	-Wilbur	Wright	
32
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ā€œSuccess	Assuredā€	
ā€¢ā€Æ December	17,	1903	
Test	before	Design	
	
Especially	if	you	are	the	Test	Pilot!	
33
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Lessons	Learned	
ā€¢ā€Æ Understand	exisLng	knowledge	
ā€¢ā€Æ Divide	challenge	into	logical	subsystems	
ā€¢ā€Æ IdenLfy	key	knowledge	gaps	
ā€¢ā€Æ Perform	analyses	or	experiments	on	components	
ā€¢ā€Æ Validate	design	choices	based	on	knowledge	
ā€¢ā€Æ Only	thenā€¦did	they	design	and	build	the	full	airplane	
34
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Lean	Product	Development	
ā€¢ā€Æ Test	before	Design	Paradigm	
Concept	
Phase	
Planning	
Phase	
Design	
Phase	
Test	
Phase	
Launch	
Phase	
Customer	
Use	
Diļ¬ƒcult	technical	
work	done	here!	
35
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Knowledge	Gaps	
ā€¢ā€Æ If	the	team	canā€™t	solve	the	technical	challenge	of	ā€˜Xā€™	then	all	
other	work	on	the	product	is	useless	(therefore,	focus	all	
resources	early	on	ā€˜Xā€™)		
ā€¢ā€Æ Flow	of	Knowledge:		make	knowledge	easily	available	to	
everyone	who	needs	it	(through	training,	communicaLon,	
documentaLon,	etc.)	
36
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Exercise	#1	
IdenLfying	Knowledge	Gaps	in	New	
Product	Development	
1.ā€Æ You	are	responsible	for	planning	the	development	of	a	new	
handheld	x-ray	imager	
2.ā€Æ Read	the	descripLon	of	the	situaLon	on	your	handout	
3.ā€Æ Split	into	teams	of	2-3	people	
4.ā€Æ Together	idenLfy:	
1.ā€Æ Key	knowledge	gaps	for	the	new	product		
2.ā€Æ How	to	address	each	gap	(tesLng	or	other	invesLgaLon)	
37
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Handheld	X-ray	Imaging	Systems	
ā€¢ā€Æ Typical	product	development	
constraints	
ā€“ā€Æ Known	ā€œstandardā€	and	ā€œadvancedā€	
technologies	
ā€¢ā€Æ For	the	purposes	of	this	exercise,	assume	
equal	funcLonal	performance	for	
technologies	and	equal	COGs	
ā€¢ā€Æ Only	diļ¬€erences	are	development	costs	and	
weight	impacts	on	the	ļ¬nal	system	
ā€¢ā€Æ Same	development	Lme	(1	year)	
ā€¢ā€Æ Varying	development	cost	
ā€“ā€Æ Form	factors	and	industrial	design	vary	
(Image	courtesy	of	John	Wells)	 (Image	courtesy	of	Vasile	Cotovanu)	
(Image	courtesy	of	donielle)	
38
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Scenario	
ā€¢ā€Æ You	are	the	product	development	VP	of	ImageX	
ā€¢ā€Æ Your	system	seems	to	be	heavier	than	most	of	the	
compeLLon	
ā€¢ā€Æ This	year,	your	CEO	would	like	to	reduce	the	weight	of	the	
system	to	be	at	least	compeLLve	with	the	exisLng	
compeLLon	
ā€¢ā€Æ You	have	a	limited	development	budget	of	$2M	and	one	year	
to	get	this	new	product	developed	
ā€¢ā€Æ Your	CEO	wants	you	to	develop	a	product	development	plan	
39
h"p://smesv.org	
Exercise	#1	
IdenLfying	Knowledge	Gaps	in	New	
Product	Development	
1.ā€Æ You	are	responsible	for	planning	the	development	of	a	new	
handheld	x-ray	imager	
2.ā€Æ Read	the	descripLon	of	the	situaLon	on	your	handout	
3.ā€Æ Split	into	teams	of	2-3	people	
4.ā€Æ Together	idenLfy:	
1.ā€Æ Key	knowledge	gaps	for	the	new	product		
2.ā€Æ How	to	address	each	gap	(analysis,	tesLng,	or	other	invesLgaLon)	
40
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Exercise	#1	
Knowledge Gaps Means for Closing Gaps
Who are my competitors? Market analysis
How much do their systems weigh? Specs research, acquire systems to test
What components are in the competitive
systems and how much to they weigh?
Specs research, acquire systems to test,
interview customers
What other performance criteria do we need
to meet?
Market/customer analysis
What cost and performance tradeoffs are we
making to get to a lighter weight?
Technical analysis
Do we have the expertise in those
technologies? Can we get it? Develop it?
Technology/capability gap analysis--Can it be
outsourced?
41
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Reconciling	Lean	with	Regula'ons	
Geetha	Rao,	Ph.D.	
CEO,	Springborne	Life	Sciences	
42
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Regulatory	Elements	for	Product	Development	
QSR	&	ISO	13485	
43	
Design	
Plan	
Design	
Transfer	
Design	
Plan	
Design	
Transfer	
User	
Needs	
Design	
Input	
Design	
Output	
Veriļ¬ca'on	
Valida'on	
Review
h"p://smesv.org	
ā€¢ā€Æ	ā€œā€¦the	quality	system	regulaLon	is	premised	on	the	
theory	that	the	development,	implementaLon,	and	
maintenance	of	procedures	designed	to	carry	out	the	
requirements	will	assure	the	safety	and	eļ¬€ecLveness	
of	devices.ā€	
ā€¢ā€Æā€œā€¦the	regulaLon	gives	the	manufacturer	the	
ļ¬‚exibility	to	determine	the	controls	that	are	
necessary	commensurate	with	risk.ā€	
ā€¢ā€Æā€œIt	is	lea	to	manufacturers	to	determine	the	necessity	
for,	or	extent	of,	some	quality	elements	and	to	
develop	and	implement	speciļ¬c	procedures	tailored	
to	their	parLcular	processes	and	devices.ā€	
CFR	820	QSR	preamble	
44
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Lean	Product	Development	
45	
Planning	
Deployment	
Requirements	
Analysis	&	Design	
Tes'ng	
Evalua'on	
=	Design	Output	
=	Veriļ¬ca'on	
=	Planning	
=	Design	Input	 =	Valida'on	
=	Transfer
h"p://smesv.org	
NavigaLng	the	ā€˜Regulatory	Fogā€™	
ā€¢ā€Æ Take	advantage	of	the	shia	to	process	model	for	
requirements	
ā€¢ā€Æ Appropriately	interpret	the	regulatory	speak	
ā€¢ā€Æ Focus	on	understanding	the	intent	more	than	
implemenLng	ā€œthe	required	procedureā€	
ā€¢ā€Æ Treat	the	required	elements	of	design	control	like	
building	blocks	to	be	conļ¬gured	in	a	manner	ā€œsuitable	
to	the	method	and	operaLons	of	the	companyā€	
ā€¢ā€Æ Design	your	SOPs	with	as	much	care	as	you	design	your	
product	
ā€¢ā€Æ OpLmize	knowledge	gain	and	knowledge	transfer	
46
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Knowledge-Driven	Product	
Development	for	Medical	Devices	
Aaron	Joseph	
Sr.	Consultant,	Product	RealizaLon	Group	
47
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Knowledge-Driven	Product	
Development	
ā€¢ā€Æ Lean	product	development	idenLļ¬es	
knowledge	gaps	early	and	tackles	them	
aggressively	
ā€¢ā€Æ How	do	these	lean	principles	apply	to	medical	
device	development?	
*from	Mastering	Lean	Product	Development	(2011)	by	Ron	Mascitelli	
New	product	development	=	commercializaLon	of	
knowledge*	
48
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Knowledge-Driven	Product	
Development	
ā€¢ā€Æ Successful	new	product	development	
demands	deep	knowledge	of:	
ā€“ā€ÆProduct	applicaLon	
ā€“ā€ÆProduct	technology	
ā€“ā€ÆManufacturing	process	technology	
Medical	Devices:	understand	
the	clinical	environment	and	
the	needs	of	clinicians	
ā€¢ā€Æ For	Medical	Devices:	
ā€“ā€Æ Regulatory	Approval	(approval	process	and	key	
concerns	of	regulators)	
ā€“ā€Æ Compliance	(requirements	of	all	applicable	
regulaLons	and	standards)	
49
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Whatā€™s	special	about	medical	devices?	
ā€¢ā€Æ Product	development	for	2	customers:	clinical	
users	and	FDA	(or	other	regulatory	body)	
ā€¢ā€Æ Challenging	for	product	development	team	to	
fully	understand	the	needs	of	either	group	
(diļ¬€erent	mindset	from	engineeringā€¦)	
ā€¢ā€Æ Late	breaking	problems	with	a	new	product	
trigger	a	cascade	of	issues	for	a	medical	device	
companyā€”can	lead	to	regulatory	problems	on	
top	of	technical	problems	
50
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Whatā€™s	special	about	medical	devices?	
ā€¢ā€Æ Double	challenge:	design	a	successful	new	
product	and	do	it	according	to	approved	
procedures		(quality	system)	
ā€¢ā€Æ ExponenLal	increase	in	compliance/
documentaLon	eļ¬€ort	near	product	launch	
51
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Loopbacks	when	Launching	New	
Medical	Devices	
ā€¢ā€Æ Even	more	expensive	to	ļ¬xā€¦	
Concept	
Phase	
Planning	
Phase	
Design	
Phase	
Test	
Phase	
Launch	
Phase	
Customer	
Use	
Diļ¬ƒcult	technical	
work	done	here!	 With	medical	products,	
loopbacks	can	trigger	even	more	
delays	and	extra	work!	
ValidaLon	
Phase	
52
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Causes	for	Medical	Device	Loopbacks		
Some	examples	parLcular	to	medical	devices:	
ā€¢ā€Æ Device	malfuncLons	aaer	sterilizaLon	
ā€¢ā€Æ Clinicians	ļ¬nd	user	interface	confusing	
ā€¢ā€Æ Device	fails	electrical	safety	tesLng	(leakage)	
ā€¢ā€Æ Incomplete	tesLng	and	documentaLon	for	
intended	markets	
ā€¢ā€Æ InstrucLons	in	user	manual	do	not	match	ļ¬nal	
device	
	
53
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What	knowledge	gaps	need	to	be	closed	...	
ā€¦to	ļ¬‚y?	
Lia	/	Thrust	/	Control	
	
ā€¦to	get	regulatory	approval?	
	
Wind	Tunnel	TesLng	
Model	Kites	
Manned	Gliders	
ā€¢ā€Æ Approval	pathway	(510k,	PMA,	De	
Novo,	etc.)	
ā€¢ā€Æ TesLng	demanded	by	FDA	
ā€“ā€Æ BiocompaLbility	
ā€“ā€Æ Cleaning	and	sterilizaLon	
ā€“ā€Æ Human	Factors	
ā€¢ā€Æ Key	concerns	of	regulators	
54
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Knowledge	Gaps	Lead	to	ā€˜Crashesā€™	
Lack	of	regulatory	approval		
				=	no	commercial	product!	
Failing	an	audit	(serious	compliance	problem)		
				=	stop	producLon!			
				=	recall	product!	
55
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Learning	and	Knowledge	Management	
ā€¢ā€Æ Where	does	knowledge	come	from?	Examples:	
ā€“ā€Æ Studying	customers	
ā€“ā€Æ MeeLng	with	FDA	
ā€“ā€Æ TesLng	
ā€¢ā€Æ Is	there	a	proven	tool	for	knowledge	
management?	
ā€“ā€Æ Tackling	knowledge	gaps	
ā€“ā€Æ CommunicaLng	new	knowledge	
ā€“ā€Æ Storing	and	managing	knowledge	
56
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A3	Method	for		
Knowledge	Management	
Roger	Tang,	Ph.D.	
Principal,	H	R	Tang	ConsulLng	
57
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A3	Tool	
ā€¢ā€Æ ā€œA3ā€	refers	to	size	of	a	single	sheet	of	paper		
ā€¢ā€Æ Facilitates	structured	
ā€“ā€Æ communicaLon	
ā€“ā€Æ problem	solving	
ā€“ā€Æ knowledge	management	
ā€“ā€Æ mentoring	
ā€¢ā€Æ Diļ¬€erent	types	of	A3	templates	for	diļ¬€erent	
purposes	
58
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A3	Example	
(From: Managing to Learn: Using the A3 management process by John Shook) 59
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Exercise	#2	
Knowledge	Management	Using	the	A3	
Method	
1.ā€Æ Work	with	a	neighbor	to	share	ideas	
2.ā€Æ You	are	the	VP	of	Product	Development	
3.ā€Æ There	are	some	data	and	compeLLve	analyses	in	your	
handout	(done	by	your	markeLng	and	R&D	team)	
4.ā€Æ With	the	informaLon	you	know,	please	try	to	complete	the	
rest	of	the	secLons	of	the	A3	
ā€“ā€Æ AlternaLves	
ā€“ā€Æ AcLon	Plan	
ā€“ā€Æ Follow-up	Plan	
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Handheld	X-ray	Imaging	Systems	
ā€¢ā€Æ Typical	product	development	
constraints	
ā€“ā€Æ Known	ā€œstandardā€	and	ā€œadvancedā€	
technologies	
ā€¢ā€Æ For	the	purposes	of	this	exercise,	assume	
equal	funcLonal	performance	for	
technologies	and	equal	COGs	
ā€¢ā€Æ Only	diļ¬€erences	are	development	costs	and	
weight	impacts	on	the	ļ¬nal	system	
ā€¢ā€Æ Same	development	Lme	(1	year)	
ā€¢ā€Æ Varying	development	cost	
ā€“ā€Æ Form	factors	and	industrial	design	vary	
(Image	courtesy	of	John	Wells)	 (Image	courtesy	of	Vasile	Cotovanu)	
(Image	courtesy	of	donielle)	
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Scenario	
ā€¢ā€Æ You	are	the	product	development	VP	of	ImageX	
ā€¢ā€Æ Your	system	seems	to	be	heavier	than	most	of	the	
compeLLon	
ā€¢ā€Æ This	year,	your	CEO	would	like	to	reduce	the	weight	of	the	
system	to	be	at	least	compeLLve	with	the	exisLng	
compeLLon	
ā€¢ā€Æ You	have	a	limited	development	budget	of	$2M	and	one	year	
to	get	this	new	product	developed	
ā€¢ā€Æ Your	CEO	wants	you	to	develop	a	ra'onal	product	
development	plan	in	an	A3	format	
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Background
Handheld X-ray Imaging Product Releases
December 2027
0
0.5
1
1.5
2
2.5
3
3.5
4
General
Fusion
CareDev Engage Focus
Imaging
Domain Abler ImageX Baseline
Imaging
Estimated Development Cost [$M]
Weight[kg]
6.3 3.5 1.8 1.33.5 3.8 3.33.8
Improvement Objective
Objectives:
ā€¢ Lower system weight by 25% (target 1-kg reduction)
ā€¢ Spend no more than $2M for development
Current State
Functions ImageX Technologies
Power "A-Type" Battery Pack
Materials Lead Body
Form Factor Integrated Sensor
Source Electron gun-based X-ray
Display/Readyout OLED Display
Thermal Control "Zero-Energy" Cooler
Detection Einsteinum-based Detectors
=$1.8M to develop
ā€¢ Based on competition, there appear to be lighter options for most functions
Alternatives
Company
Total
Dev Cost
[$M]
Total
Weight
[kg]
Fusion
Reactor
Unobtainium
Body
Tethered
Sensor
"Accelotron"
X-ray
Retinal
Projector
"Zero-
Energy"
Cooler
Einsteinium-
based
Detectors
General Fusion
CareDev
Engage
Focus Imaging
Domain
Abler
ImageX
Baseline Imaging
Key Advanced Technologies
Action Plan
ā€¢ Collect key technology information
ā€¢ Quantify costs and benefits
ā€¢ Conduct tradeoff studies: development cost vs. potential benefit in weight reduction
ā€¢ Experiment if needed
ā€¢ Finalize top alternatives to implement in next iteration
Follow-up Plan
Results
ImageX
PRODUCT
DEVELOPMENT PLAN
Version:
2
Date Last Revised:
1/15/2028
Subject:
Reduce Handheld X-ray Imaging System Weight by >25%
Keywords:
2028 Plan, Technology Tradeoff
Author: Roger Veep Date:
Reviewed: Joe Ceo Date:
63
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Exercise	#2	
Knowledge	Management	Using	the	A3	
Method	
1.ā€Æ Work	with	a	neighbor	to	share	ideas	
2.ā€Æ You	are	the	VP	of	Product	Development	
3.ā€Æ There	are	some	data	and	compeLLve	analyses	in	your	
handout	(done	by	your	markeLng	and	R&D	team)	
4.ā€Æ With	the	informaLon	you	know,	please	try	to	complete	the	
rest	of	the	secLons	of	the	A3	
ā€“ā€Æ AlternaLves	
ā€“ā€Æ AcLon	Plan	
ā€“ā€Æ Follow-up	Plan	
64
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Exercise	#2	
Knowledge	Management	Using	the	A3	
Method	
1.ā€Æ Work	with	a	neighbor	
2.ā€Æ One	of	you	plays	the	role	of	CEO	
3.ā€Æ Ask	your	VP	these	quesLons	about	the	A3	
ā€“ā€Æ Is	it	clear	what	needs	to	be	achieved?		Is	it	measurable?	
ā€“ā€Æ Is	the	problem	and	opportunity	clear	(and	visual)?	
ā€“ā€Æ Did	you	talk	to	others,	go	to	Gemba,	gather	appropriate	data?	
ā€“ā€Æ Are	the	root	causes	backed	up	with	data?	
ā€“ā€Æ Does	the	acLon	plan	make	sense	based	on	the	knowledge	and	data?	
ā€“ā€Æ Have	you	jumped	to	soluLons	without	enough	data?	
65
h"p://smesv.org	
Background
Handheld X-ray Imaging Product Releases
December 2027
0
0.5
1
1.5
2
2.5
3
3.5
4
General
Fusion
CareDev Engage Focus
Imaging
Domain Abler ImageX Baseline
Imaging
Estimated Development Cost [$M]
Weight[kg]
6.3 3.5 1.8 1.33.5 3.8 3.33.8
Improvement Objective
Objectives:
ā€¢ Lower system weight by 25% (target 1-kg reduction)
ā€¢ Spend no more than $2M for development
Current State
Functions ImageX Technologies
Power "A-Type" Battery Pack
Materials Lead Body
Form Factor Integrated Sensor
Source Electron gun-based X-ray
Display/Readyout OLED Display
Thermal Control "Zero-Energy" Cooler
Detection Einsteinum-based Detectors
=$1.8M to develop
ā€¢ Based on competition, there appear to be lighter options for most functions
Alternatives
Company
Total
Dev Cost
[$M]
Total
Weight
[kg]
Fusion
Reactor
Unobtainium
Body
Tethered
Sensor
"Accelotron"
X-ray
Retinal
Projector
"Zero-
Energy"
Cooler
Einsteinium-
based
Detectors
General Fusion 6.3 1.25 1 1 1 1 1 1
CareDev 3.5 2 1 1 1 1 1
Engage 3.8 2.25 1 1 1
Focus Imaging 3.5 2.5 1 1 1 1 1
Domain 3.8 2.75 1 1 1 1
Abler 3.3 2.75 1 1 1 1
ImageX 1.8 3.5 1 1
Baseline Imaging 1.3 3.75 1
Key Advanced Technologies
From Analysis and/or Experiments
ā€¢ Standard Technology Development Cost = $0.3
ā€¢ Standard Technology Weight = 3.75 kg
Standard Technology Advanced Technology
Extra Dev
Cost [$M]
rWeight
[kg]
"A-Type" Battery Pack Fusion Reactor 2 1
Lead Body Unobtainium Body 0.2 0.25
Integrated Sensor Tethered Sensor 1 0.5
Electron gun-based X-ray "Accelotron" X-ray 0.5 0.5
OLED Display Retinal Projector 1 0.25
TEC Cooler "Zero-Energy" Cooler 1 0
Semiconductor Detectors Einsteinium-based Detectors 0.5 0.25
Action Plan
ā€¢ Use Standard Technologies as starting set
Proposed Advanced
Technologies
rCost
[$M]
rWeight
[kg]
Unobtainium Body 0.2 0.25
Tethered Sensor 1 0.5
"Accelotron" X-ray 0.5 0.5
Total Extra Cost [$M] 1.7
Total Weight Reduction [kg] 1.25
+Standard cost and weight 0.3 3.75
Totals Dev Cost and Weight $2M 2.5kg
Follow-up Plan
ā€¢ Complete development and launch by December (Roger Veep)
ā€¢ Gather relevant data at next year's tradeshow (Roger Veep and Joe Ceo)
ā€¢ Analyze data (Product Development Team and Roger Veep)
o Verify weight reduction against competitors
o Look for potential improvements for following year (relative to competition)
ā€¢ Create new plan for next year (Roger Veep)
Results
ā€¢ TBD
ImageX
PRODUCT
DEVELOPMENT PLAN
Version:
5
Date Last Revised:
1/27/2028
Subject:
Reduce Handheld X-ray Imaging System Weight by >25%
Keywords:
2028 Plan, Technology Tradeoff
Author: Roger Veep Date: 1/27/2028
Reviewed: Joe Ceo Date: 1/27/2028
Hypothesize that
we will meet
objectives with this
plan!
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Lean	&	Compliant:		
Real	Life	Examples	
Aaron	Joseph	
Sr.	Consultant,	Product	RealizaLon	Group	
ā€œSounds	good,	but	will	this	really	work	for	medical	device	product	development?ā€	
67
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TradiLonal	Product	Development	
ā€¢ā€Æ How	well	does	the	tradiLonal	approach	work	for	
medical	devices?	
ā€¢ā€Æ What	does	a	loopback	look	like	for	a	real	medical	
device	project?	
ā€¢ā€Æ How	bad	could	it	be?	
68
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Zap!		RF	Cautery	Catheter	Design	Flaw	
ā€¢ā€Æ design	completed	and	V&V	tesLng	underwayā€”
failed	electrical	tesLng	(insuļ¬ƒcient	insulaLon	due	
to	capaciLve	coupling)	
ā€¢ā€Æ Eļ¬€ect	(giant	loopback!):		switch	to	teļ¬‚on-based	
design	which	triggered	ā€¦		
ā€“ā€Æ change	in	sterilizaLon	method	(EtO	instead	of	
Gamma)	which	triggered	ā€¦	
ā€“ā€Æ re-do	of	sterilizaLon	validaLon	and	funcLonal	tesLng	
(DVT)	which	triggered	ā€¦	
ā€“ā€Æ expensive	build	(expedited)	of	new	test	arLcles	
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CircuVentTM	
HME/HCH	Bypass	
Successful	Product	Launch	(unLl	ā€¦):	
DHD	is	pleased	to	announce	the	addiLon	of	CircuVentTM	ā€¦.	
UnLl	now,	providing	aerosolized	medicaLons	to	
mechanically	venLlated	paLents	meant	removing	the	HME/
HCH	-	a	procedure	that	can	increase	the	risk	of	alveolar	
derecruitment,	drying	of	airway	secreLons,	and	
contaminaLon	to	both	paLents	and	clinicians.	Now	you	can	
reduce	these	risks	with	new	CircuVent	-	the	breakthrough	
device	that	lets	you	provide	aerosol	without	breaking	the	
circuit!		
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URGENT:	MEDICAL	DEVICE	RECALL	
ā€¢ā€Æ ā€¦	there	is	a	chance	that	a	few	units	may	have	been	shipped	to	
the	ļ¬eld	with	labels	applied	incorrectly	ā€¦			
ā€¢ā€Æ When	the	label	is	applied	incorrectly,	the	unit	will	indicate	that	
airļ¬‚ow	in	the	venLlator	circuit	is	directed	through	the	HME,	
when	it	is	actually	directed	through	the	bypass	around	the	
HME.		
ā€¢ā€Æ This	defect	would	not	be	obvious	or	readily	detectable	by	the	
clinician	and	could	lead	to	improper	therapy.	
ā€¢ā€Æ We	have	decided	to	recall	all	CircuVent	product,	Part	Number	
68-1000	ā€¦		
ā€¢ā€Æ Further	distribuLon	of	this	product	should	cease	immediately.	
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Lean	Product	Development	Success	Story	-	Arthrex	
ā€¢ā€Æ Arthrex	produces	tools	for	minimally	invasive	surgery	(arthroscopy)		
ā€¢ā€Æ They	needed	to	develop	a	next-generaLon	endoscopic	imaging	system	in	record	Lme	(<	10	
months)	to	debut	at	annual	surgical	conference	
ā€¢ā€Æ Product	team	incorporated	mulLple	lean	techniques	to	speed	development	and	maximize	
predictability	of	launch	date	(ā€œno	late	surprises!ā€)	
ā€¢ā€Æ Learned	Quickly	by	Failing	Fast	
ā€¢ā€Æ Earlier	InformaLon	is	More	Valuable	
ā€¢ā€Æ Minimized	Batch	Size	/	Maximized	IteraLons	
ā€¢ā€Æ Leveraged	Clinical	Training	FaciliLes	(for	early	feedback	from	clinical	users)	
ā€¢ā€Æ Sytem	Architecture:		High	Risks	are	isolated;	modular	design	for	ļ¬‚exibility	and	testability	
ā€¢ā€Æ CriLcal	Chain	Project	Mgmt	
ā€“ā€Æ Schedule	opLmized	for	speed	
ā€“ā€Æ CriLcal	path	and	resources	are	clear	
ā€“ā€Æ Shared	schedule	buļ¬€ers	promote	teamwork	
ā€¢ā€Æ SystemaLc	management	of	project	risks	(ā€œknowledge	gapsā€):		
ā€“ā€Æ characterizaLon	(high/med/low),		
ā€“ā€Æ MiLgaLon	and	tracking	
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Lean	Product	Development	Success	Story	-	Arthrex	
Product	team	was	successful!	
ā€“ā€Æ New	imaging	system	was	ready	in	Lme	for	conference	
ā€“ā€Æ Company	made	millions	more	in	sales	with	on-Lme	launch	
ā€¢ā€Æ More	informaLon	is	available	at		
ā€“ā€Æ h"p://playbookhq.co/case-studies/		
ā€“ā€Æ h"p://www.arthrex.com		
ā€¢ā€Æ (or	search	online	for	ā€œCraig	Speierā€	and	ā€œLean	Product	Developmentā€)	
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Lean	&	Compliant	Summary	
Aaron	Joseph	
Sr.	Consultant,	Product	RealizaLon	Group	
74
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Lean	&	Compliant	Medical	Device	
Development	
ā€¢ā€Æ If	the	team	canā€™t	solve	the	technical	challenge	of	ā€˜Xā€™	then	
all	other	work	on	the	product	is	useless	(focus	all	
resources	early	on	ā€˜Xā€™)		
ā€¢ā€Æ If	the	team	is	not	conļ¬dent	of	geeng	regulatory	approval	
then	all	other	work	on	the	product	is	useless		
ā€¢ā€Æ Flow	of	Knowledge:		make	knowledge	easily	available	to	
everyone	who	needs	it	(through	training,	communicaLon,	
documentaLon,	etc.)	
ā€¢ā€Æ IteraLons	during	early	development	can	improve	
compliance	
ā€“ā€Æ everyone	learns	more	about	the	quality	system	processes	
ā€“ā€Æ make	sure	the	ļ¬nal	output	is	complete	and	consistent	
ā€“ā€Æ reļ¬ne	procedures	as	needed	before	product	is	ļ¬nalized	
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Dos	and	Donā€™ts		
Knowledge	
ā€¢ā€Æ Do:	SystemaLcally	manage	knowledge	for	every	product	
development	project	and	apply	to	future	projects		
ā€¢ā€Æ Donā€™t:	Throw	away	precious	knowledge!		
Project	Risk	
ā€¢ā€Æ Do:	IdenLfy	project	risks	(technical,	regulatory,	
manufacturing,	etc.)	early	and	tackle	them	aggressively	
ā€¢ā€Æ Donā€™t:	Allow	project	risks	to	conLnue	to	late	stages	of	
project	(leave	unresolved	knowledge	gaps)		
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Dos	and	Donā€™ts		
Itera'on	
ā€¢ā€Æ Do:	Become	eļ¬ƒcient	at	repeaLng	tasks	and	execuLng	parLal	
tasks	and	incorporate	agile	soaware	development	into	
product	development	
ā€¢ā€Æ Donā€™t:	Assume	key	tasks	will	be	done	only	once	(i.e.	building	
prototypes,	product	tesLng)			
Tes'ng	
ā€¢ā€Æ Do:	Test	early	and	repeatedly;	invest	in	test	equipment	and	
test	beds/parLal	prototypes;	(ā€œtest	then	designā€)	;	
incorporate	testability	into	the	HW	and	SW	architecture	
ā€¢ā€Æ Donā€™t:	Wait	unLl	end	of	development	to	do	most	tesLng			
77
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Dos	and	Donā€™ts		
Documenta'on	
ā€¢ā€Æ Do:	Incorporate	agile	methods	for	documentaLon	(examples:	write	user	
manual	early	and	repeatedly;	begin	compiling	contents	of	510k	
submission	early	and	communicate	gaps/risks	to	team	early)		
ā€¢ā€Æ Donā€™t:	Leave	documentaLon	to	be	compiled	at	late	stages	of	product	
development	(ā€œdo	the	paperwork	at	the	endā€)		
Project	Management	
ā€¢ā€Æ Do:	Develop	new	products	iteraLvely	to	idenLfy	problems	early	and	
aggressively	resolve	them;		Use	progressive	design	freeze	to	allow	
maximum	ļ¬‚exibility	to	the	project	team	to	make	design	changes	up	to	
the	ā€œlast	responsible	momentā€		
ā€¢ā€Æ 	Donā€™t:	Expect	product	development	to	be	sequenLal	and	insLtute	
batched	hand-oļ¬€s	(via	rigid	phase	gates)	where	lots	of	work	and	lots	of	
knowledge	is	transferred	at	one	Lme	across	groups	
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Lean	&	Compliant	
1.ā€Æ Lean	methods	accelerate	product	development	
2.ā€Æ For	medical	devices,	lean	methods	are	not	only	possible,	but	
preferable	
3.ā€Æ Knowledge-driven	product	development	means	decisions	are	
based	on	knowledge	instead	of	ā€˜wishful	thinkingā€™	
4.ā€Æ If	the	team	canā€™t	solve	the	technical	challenge	of	ā€˜Xā€™	then	all	
other	work	on	the	product	is	useless		
5.ā€Æ Lean	=	Learning,	not	cueng	corners	
6.ā€Æ Minimizing	tesLng	=	minimizing	knowledge	gained	
79
h"p://smesv.org	
Q	&	A		
Aaron	Joseph,	Medical	Devices	Consultant	
Geetha	Rao,	Ph.D.,		CEO,	Springborne	Life	Sciences	
Roger	Tang,	Ph.D.,	Principal,	H	R	Tang	ConsulLng	
80

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