{"id":103,"date":"2016-11-25T23:19:03","date_gmt":"2016-11-25T23:19:03","guid":{"rendered":"http:\/\/tgfrconsulting.com\/blog\/?p=103"},"modified":"2024-01-20T22:32:37","modified_gmt":"2024-01-20T22:32:37","slug":"introduction-to-risk-analysis","status":"publish","type":"post","link":"https:\/\/www.tgfrconsulting.com\/blog\/archived\/introduction-to-risk-analysis\/","title":{"rendered":"Introduction to Risk Analysis"},"content":{"rendered":"<div class=\"entry\">\n<p>Risk analysis based upon the clinical use of the device must be performed prior to concept elaboration (the development of design inputs).&nbsp; Risk Analysis establishes essential requirements, the requirements associated with safety.&nbsp; These essential requirements will be blended with the concept realization to form the basis of the final design inputs.<\/p>\n<p>&nbsp;<\/p>\n<p>The following table describes the inputs and outputs of the Risk Analysis Process<br \/>\n<h2 id=\"tablepress-1-name\" class=\"tablepress-table-name tablepress-table-name-id-1\">Risk Analysis SIPOC<\/h2>\n\n<table id=\"tablepress-1\" class=\"tablepress tablepress-id-1\" aria-labelledby=\"tablepress-1-name\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Inputs<\/th><th class=\"column-2\">Key Activities<\/th><th class=\"column-3\">Outputs<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\"><b>Clinical Use<\/b><br \/>\nThe clinical use of the device<br \/>\n<br \/>\n<br><br \/>\n<b>Clinical Use Error Data<\/b><br \/>\nData on the use errors and rates associated with the data<br \/>\n<br \/>\n<b>Clinical Hazards and Harms <b><br \/>\nThe clinical hazards and harms associated with the therapy<br \/>\n<br \/>\n<\/td><td class=\"column-2\"><b>Hazard\/Harm Identification <\/b><br \/>\nLinking the clinical hazards and harms and assigning probabilities<br \/>\n<br \/>\n<b>Phases and Function Identification <\/b><br \/>\nIdentification of the phases and the associated functions associated with the delivery of a single therapy or exam<br \/>\n<br \/>\n<b>Hazardous Situation Development<\/b><br \/>\nIdentifying the sequence of events and the hazardous situations<br \/>\n<br \/>\n<b>Mitigation Development <\/b><br \/>\nThe development of the essential requirements, the requirements that mitigate risks<br \/>\n<br \/>\n<\/td><td class=\"column-3\"><b>Essential Requirements <\/b><br \/>\nThe mitigations associated with the inherent risks of the therapy<br \/>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-1 from cache --><\/p>\n<p>&nbsp;<\/p>\n<p style=\"padding-left: 150px;\"><strong>&nbsp;<\/strong><\/p>\n<p>Risk analysis identifies the essential requirements, that is, the actions or mitigations that ensure the inherent safety of the therapy or procedure.&nbsp; These essential requirements represent key inputs for concept elaboration and the development of the overall design inputs.&nbsp; The workflow for risk analysis follows the workflow noted in ISO 14971 Annex E&nbsp;(ISO, 2012).&nbsp; The following figure details that workflow<\/p>\n<p style=\"padding-left: 30px;\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-large wp-image-114\" src=\"http:\/\/tgfrconsulting.com\/blog\/wp-content\/uploads\/2016\/11\/ISO-14971-Annex-E-Drawing-1024x582.png\" alt=\"iso-14971-annex-e-drawing\" width=\"640\" height=\"364\" srcset=\"https:\/\/www.tgfrconsulting.com\/blog\/wp-content\/uploads\/2016\/11\/ISO-14971-Annex-E-Drawing-1024x582.png 1024w, https:\/\/www.tgfrconsulting.com\/blog\/wp-content\/uploads\/2016\/11\/ISO-14971-Annex-E-Drawing-300x171.png 300w, https:\/\/www.tgfrconsulting.com\/blog\/wp-content\/uploads\/2016\/11\/ISO-14971-Annex-E-Drawing-768x437.png 768w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<p style=\"padding-left: 120px;\"><strong><em>Risk Analysis Workflow<\/em><\/strong><\/p>\n<p><span style=\"color: #000000; font-family: Arial;\">The following table details the definitions associated with risk analysis<\/span><br \/>\n<h2 id=\"tablepress-2-name\" class=\"tablepress-table-name tablepress-table-name-id-2\">Risk Definitions<\/h2>\n\n<table id=\"tablepress-2\" class=\"tablepress tablepress-id-2\" aria-labelledby=\"tablepress-2-name\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Item<\/th><th class=\"column-2\">Definition<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\">Harm<\/td><td class=\"column-2\">Physical injury or damage to the health of people, or dam-age to property or the environment.<br \/>\n<br \/>\nHarm is established by the Medical team and directly relates to the possible consequences of hazards associated with the therapy or procedure<br \/>\n<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">Severity<\/td><td class=\"column-2\">The quantification\/scaling of the effects of the harm<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">Hazard<\/td><td class=\"column-2\">A potential Source of Harm<\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\">Failure Mode<\/td><td class=\"column-2\">A failure, either of the device or the user, that leads to a hazard<\/td>\n<\/tr>\n<tr class=\"row-6\">\n\t<td class=\"column-1\">Sequence of Events<\/td><td class=\"column-2\">The failure, and subsequent actions\/activities that lead to a hazardous situation<\/td>\n<\/tr>\n<tr class=\"row-7\">\n\t<td class=\"column-1\">Hazardous Situation<\/td><td class=\"column-2\">Circumstance in which people, property, or the environment are exposed to one or more hazard(s).<br \/>\n<br \/>\nA hazardous situation is a composite concept, combining a specific hazard failure mode and sequence of events.<br \/>\n<\/td>\n<\/tr>\n<tr class=\"row-8\">\n\t<td class=\"column-1\">Risk<\/td><td class=\"column-2\">The probability of occurrence of harm and the consequences of that harm<\/td>\n<\/tr>\n<tr class=\"row-9\">\n\t<td class=\"column-1\">Residual Risk<\/td><td class=\"column-2\">The risk remaining after the application of risk control measures<\/td>\n<\/tr>\n<tr class=\"row-10\">\n\t<td class=\"column-1\">Risk Evaluation<\/td><td class=\"column-2\">The determination of the acceptability of the residual risk<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-2 from cache --><br \/>\nMost previous approaches to implementing the concepts of ISO 14971 Annex E have taken a device centric approach relative to the identification of hazardous situations and harms.&nbsp; But as shown in the following figure, the device centric approach does not address the full range of possible hazardous situations associated with the therapy or procedure<\/p>\n<p style=\"padding-left: 60px;\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-113\" src=\"http:\/\/tgfrconsulting.com\/blog\/wp-content\/uploads\/2016\/11\/Device-versus-Therapy-Procedure-Risk-Analysis-1024x677.png\" alt=\"device-versus-therapy-procedure-risk-analysis\" width=\"578\" height=\"382\" srcset=\"https:\/\/www.tgfrconsulting.com\/blog\/wp-content\/uploads\/2016\/11\/Device-versus-Therapy-Procedure-Risk-Analysis-1024x677.png 1024w, https:\/\/www.tgfrconsulting.com\/blog\/wp-content\/uploads\/2016\/11\/Device-versus-Therapy-Procedure-Risk-Analysis-300x198.png 300w, https:\/\/www.tgfrconsulting.com\/blog\/wp-content\/uploads\/2016\/11\/Device-versus-Therapy-Procedure-Risk-Analysis-768x508.png 768w\" sizes=\"auto, (max-width: 578px) 100vw, 578px\" \/><\/p>\n<p style=\"padding-left: 90px;\"><strong><em>Device Centric versus Therapy\/Procedure Centric Analysis<\/em><\/strong><\/p>\n<p>The therapy or procedure centric approach aligns well with the safety case approaches put forth by the FDA in recent years.&nbsp; The FDA&nbsp;(Chapman, 2012) defines a safety case as the following<\/p>\n<p><em>A structured argument, supported by a body of evidence, that provides a compelling, comprehensible and valid case that a system is safe for a given application in a given environment<\/em><\/p>\n<p>Safety cases focus on whether or not the therapy or procedure is safe, and that the device performs as a part of the overall therapy or procedure.&nbsp;&nbsp; In addition, the FDA &nbsp;(FDA, 2014) stress that the safety claims associated with the safety case analysis should focus upon the mitigation of the following types of hazardous situations<\/p>\n<ul>\n<li>User interface and human factors related<\/li>\n<li>Software-related<\/li>\n<li>Electrical<\/li>\n<li>Mechanical<\/li>\n<li>Operational<\/li>\n<li>Environmental,<\/li>\n<li>Biological<\/li>\n<li>Chemical,<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Clearly, a device centric approach cannot address the full scope of mitigations associated with safety case analysis.<\/p>\n<p>In addition to developing an approach that meets the needs of safety case analysis, the approach to risk analysis requires addressing an increased focus on usability and use errors.&nbsp;&nbsp; Standards such as IEC 62366-1:2015 (IEC, 2015) stress an approach that analyzes the clinical application to identify situations of misuse.&nbsp; These foreseeable misuse situations must be addressed by the design.<\/p>\n<p>The therapy centric risk process detailed in the following sections derives from what has been come to be known as criticality analysis&nbsp;(IEC, 2006).&nbsp; Criticality analysis, in keeping with its linkage to military actions, focuses on steps needed to execute a \u201cmission\u201d and the failures that can impact the execution.&nbsp; As defined in criticality analysis, a failure is linked to the impact upon the overall \u201cmission\u201d. &nbsp;The same failure can have different criticality based upon what mission activity or operational phase is associated with the failure. This establishes the following linkage.<\/p>\n<p style=\"padding-left: 90px;\"><strong><em>Failure&nbsp; -&gt; <\/em><\/strong><strong><em>Mission Activity&nbsp; -&gt; <\/em><\/strong><strong><em>Mission Impact<\/em><\/strong><\/p>\n<p>In a therapy centric approach to risk analysis, the \u201cmission\u201d is the delivery of a single therapy or execution of a single procedure.&nbsp; Mission impact is the harm to which the patient may be exposed.&nbsp;&nbsp; In the context of ISO 14971 definitions, criticality analysis systematically maps failures to hazards, hazardous situations and the overall therapy.&nbsp; The basic flow follows that of the ISO 14971 workflow, specifically<\/p>\n<ol>\n<li>Identify the Hazards and Harms for the device<\/li>\n<li>Identify all of the hazardous situations using the concept of operational phases<\/li>\n<li>Assign risk to each hazardous situation based upon the operational phase<\/li>\n<li>Identify mitigations when necessary<\/li>\n<\/ol>\n<p>In subsequent posts each of these activities will be examined in detail.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Risk analysis based upon the clinical use of the device must be performed prior to concept elaboration (the development of design inputs).&nbsp; Risk Analysis establishes essential requirements, the requirements associated with safety.&nbsp; These essential requirements will be blended with the concept realization to form the basis of the final design inputs. &nbsp; The following table &#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[61,8],"tags":[20,21],"class_list":{"0":"post-103","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-archived","7":"category-risk-management","8":"tag-iso-174971","9":"tag-medical-device-risk","10":"anons"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.0 - 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