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Reportable Event?




             The University of Iowa
             Human Research
             Protection Program
New Procedures for
Reportable Events
Martha F. Jones, MA, CIP
IRB Chair, (IRB-01/IRB-02) and
Director, Human Subjects Office

Suzanne Bentler, MS
IRB Administrator

Office of the Vice President for Research
The University of Iowa

http://www.research.uiowa.edu/hso/
Overview/Key Changes
   April 1, 2006: New procedures begin
       Use of new forms including expanded reporting requirements
       “Old” AE forms in HawkIRB no longer available (except as update
        function)
       Projects still in paper will continue to use “old” paper reporting
        forms.
   ALL documentation must be submitted in electronic format. We
    will no longer accept hard copy documentation for REF forms.
   Unique identifier for each event – you must use the UPDATE
    function
   Updated procedures available on HSO website in Investigator’s
    Guide (Chapter 7.C):
    http://www.research.uiowa.edu/hso/
                                   The University of Iowa
                                   Human Research
                                   Protection Program
What are the regulatory
reporting requirements?
   Different requirements for
       Sponsors
       Investigators
       IRBs
   Different requirements depending on type of
    study and funding
       FDA
            Drug
         
             Device
       Federal         The University of Iowa
       Others?         Human Research
                        Protection Program
IRB Reporting Requirements:
DHHS & FDA
   Institution (IRB) must follow written
    procedures for prompt reporting to the IRB,
    institutional officials, FDA, department/agency
    heads of
       Unanticipated problems involving risks to subjects
        or others
       Serious or continuing noncompliance with
        regulations or the requirements or determinations
        of the IRB
       Suspension or termination of IRB approval
                              The University45 CFR 46.103(b)(5)
                                       DHHS: of Iowa
                                       FDA: 21 CFR 56.108(b)
                              Human Research
                              Protection Program
Investigator Reporting
FDA – Drug Studies
   21 CFR 312.64(b)
       An investigator shall promptly report to the
        sponsor any adverse effect that may
        reasonably be regarded as caused by, or
        probably caused by, the drug. If the
        adverse effect is alarming, the investigator
        shall report the adverse effect immediately.
                          The University of Iowa
                          Human Research
                          Protection Program
Sponsor Reporting
FDA – Drug Studies
   21 CFR 312.32(c)
       The sponsor shall notify FDA and all participating
        investigators in a written IND safety report of:
            (A) Any adverse experience associated with the use of
             the drug that is both serious and unexpected; or
            (B) Any finding from tests in laboratory animals that
             suggests a significant risk for human subjects including
             reports of mutagenicity, teratogenicity, or carcinogenicity.


                                   The University of Iowa
                                   Human Research
                                   Protection Program
FDA Drug Definitions
   Associated with the use of the drug
       There is a reasonable possibility that the
        experience may have been caused by the
        drug




                         The University of Iowa
                         Human Research
                         Protection Program
FDA Drug Definitions (continued)
   Serious adverse drug experience
       Any adverse drug experience occurring at any dose that
        results in any of the following outcomes:
            Death
            A life-threatening adverse drug experience (immediate risk of
             death)
            Inpatient hospitalization or prolongation of existing
             hospitalization
            A persistent or significant disability/incapacity
            A congenital anomaly/birth defect
            Important medical events not resulting in the above may be
             serious when, based upon the appropriate medical judgment,
             they may jeopardize the patient or subject and may require
             medical or surgical intervention to prevent oneIowa outcomes
                                      The University of of the
             listed above.
                                    Human Research
                                    Protection Program
FDA Drug Definitions (continued)
   Unexpected adverse drug experience
       Any adverse drug experience, the specificity or
        severity of which is not consistent with the current
        investigator brochure or risk information described
        in the general investigational plan or elsewhere in
        the current application
   Refers to NOT PREVIOUSLY OBSERVED
   Do not interpret as “not anticipated”, for
    example based on pharmacological
                         The University of Iowa
    properties           Human Research
                             Protection Program
Investigator Requirements
FDA – Device Studies
   21 CFR 812.150(a)(1)
       An investigator shall submit to the sponsor
        and to the reviewing IRB a report of any
        unanticipated adverse device effect
        occurring during an investigation



                          The University of Iowa
                          Human Research
                          Protection Program
Sponsor Requirements
FDA – Device Studies
   21 CFR 812.150(b)(1)
       A sponsor who conducts an evaluation of
        an unanticipated adverse device effect
        under 21 CFR 812.46(b) shall report the
        results of such evaluation to FDA and to all
        reviewing IRB’s and participating
        investigators
                          The University of Iowa
                          Human Research
                          Protection Program
FDA Device Definition
   Unanticipated adverse device effect
       Any serious adverse effect on health or safety or
        any life-threatening problem or death caused by,
        or associated with, a device, if that effect, problem,
        or death was not previously identified in nature,
        severity, or degree of incidence in the
        investigational plan or application…or any other
        unanticipated serious problem associated with a
        device that relates to the rights, safety, or welfare
        of subjects.          The University of Iowa
                              Human Research
                              Protection Program
What is NOT Required?
   Immediate reporting of IND safety
    reports/outside safety reports UNLESS
       The report itself or the interpretation of the
        report by the UI PI represents a change in
        the risks or potential benefit associated
        with the study
         
             Unanticipated problem (e.g. new risk)
                              The University of Iowa
                              Human Research
                              Protection Program
What if Sponsor requires
additional reporting?
   Indicate the IRB does NOT act as the DSMB
    for any study
   Policy will be posted on HSO website
       Reports not required by regulation or UI IRB policy
        will NOT be accepted by UI IRBs
       Sponsor must provide the federal regulation (not
        guidance) for requiring IRB review if disagree
   Summary of non-reportable events may be
                        The University of Iowa
    submitted with Continuing Research
                        Human
                               Review
                            Protection Program
The REF Forms


      Reportable Event Form



             The University of Iowa
             Human Research
             Protection Program

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Re frollout

  • 1. Reportable Event? The University of Iowa Human Research Protection Program
  • 2. New Procedures for Reportable Events Martha F. Jones, MA, CIP IRB Chair, (IRB-01/IRB-02) and Director, Human Subjects Office Suzanne Bentler, MS IRB Administrator Office of the Vice President for Research The University of Iowa http://www.research.uiowa.edu/hso/
  • 3. Overview/Key Changes  April 1, 2006: New procedures begin  Use of new forms including expanded reporting requirements  “Old” AE forms in HawkIRB no longer available (except as update function)  Projects still in paper will continue to use “old” paper reporting forms.  ALL documentation must be submitted in electronic format. We will no longer accept hard copy documentation for REF forms.  Unique identifier for each event – you must use the UPDATE function  Updated procedures available on HSO website in Investigator’s Guide (Chapter 7.C): http://www.research.uiowa.edu/hso/ The University of Iowa Human Research Protection Program
  • 4. What are the regulatory reporting requirements?  Different requirements for  Sponsors  Investigators  IRBs  Different requirements depending on type of study and funding  FDA  Drug  Device  Federal The University of Iowa  Others? Human Research Protection Program
  • 5. IRB Reporting Requirements: DHHS & FDA  Institution (IRB) must follow written procedures for prompt reporting to the IRB, institutional officials, FDA, department/agency heads of  Unanticipated problems involving risks to subjects or others  Serious or continuing noncompliance with regulations or the requirements or determinations of the IRB  Suspension or termination of IRB approval The University45 CFR 46.103(b)(5) DHHS: of Iowa FDA: 21 CFR 56.108(b) Human Research Protection Program
  • 6. Investigator Reporting FDA – Drug Studies  21 CFR 312.64(b)  An investigator shall promptly report to the sponsor any adverse effect that may reasonably be regarded as caused by, or probably caused by, the drug. If the adverse effect is alarming, the investigator shall report the adverse effect immediately. The University of Iowa Human Research Protection Program
  • 7. Sponsor Reporting FDA – Drug Studies  21 CFR 312.32(c)  The sponsor shall notify FDA and all participating investigators in a written IND safety report of:  (A) Any adverse experience associated with the use of the drug that is both serious and unexpected; or  (B) Any finding from tests in laboratory animals that suggests a significant risk for human subjects including reports of mutagenicity, teratogenicity, or carcinogenicity. The University of Iowa Human Research Protection Program
  • 8. FDA Drug Definitions  Associated with the use of the drug  There is a reasonable possibility that the experience may have been caused by the drug The University of Iowa Human Research Protection Program
  • 9. FDA Drug Definitions (continued)  Serious adverse drug experience  Any adverse drug experience occurring at any dose that results in any of the following outcomes:  Death  A life-threatening adverse drug experience (immediate risk of death)  Inpatient hospitalization or prolongation of existing hospitalization  A persistent or significant disability/incapacity  A congenital anomaly/birth defect  Important medical events not resulting in the above may be serious when, based upon the appropriate medical judgment, they may jeopardize the patient or subject and may require medical or surgical intervention to prevent oneIowa outcomes The University of of the listed above. Human Research Protection Program
  • 10. FDA Drug Definitions (continued)  Unexpected adverse drug experience  Any adverse drug experience, the specificity or severity of which is not consistent with the current investigator brochure or risk information described in the general investigational plan or elsewhere in the current application  Refers to NOT PREVIOUSLY OBSERVED  Do not interpret as “not anticipated”, for example based on pharmacological The University of Iowa properties Human Research Protection Program
  • 11. Investigator Requirements FDA – Device Studies  21 CFR 812.150(a)(1)  An investigator shall submit to the sponsor and to the reviewing IRB a report of any unanticipated adverse device effect occurring during an investigation The University of Iowa Human Research Protection Program
  • 12. Sponsor Requirements FDA – Device Studies  21 CFR 812.150(b)(1)  A sponsor who conducts an evaluation of an unanticipated adverse device effect under 21 CFR 812.46(b) shall report the results of such evaluation to FDA and to all reviewing IRB’s and participating investigators The University of Iowa Human Research Protection Program
  • 13. FDA Device Definition  Unanticipated adverse device effect  Any serious adverse effect on health or safety or any life-threatening problem or death caused by, or associated with, a device, if that effect, problem, or death was not previously identified in nature, severity, or degree of incidence in the investigational plan or application…or any other unanticipated serious problem associated with a device that relates to the rights, safety, or welfare of subjects. The University of Iowa Human Research Protection Program
  • 14. What is NOT Required?  Immediate reporting of IND safety reports/outside safety reports UNLESS  The report itself or the interpretation of the report by the UI PI represents a change in the risks or potential benefit associated with the study  Unanticipated problem (e.g. new risk) The University of Iowa Human Research Protection Program
  • 15. What if Sponsor requires additional reporting?  Indicate the IRB does NOT act as the DSMB for any study  Policy will be posted on HSO website  Reports not required by regulation or UI IRB policy will NOT be accepted by UI IRBs  Sponsor must provide the federal regulation (not guidance) for requiring IRB review if disagree  Summary of non-reportable events may be The University of Iowa submitted with Continuing Research Human Review Protection Program
  • 16. The REF Forms Reportable Event Form The University of Iowa Human Research Protection Program