ISO 13485:2016 Requirements Breakdown
This document provides a comprehensive breakdown of ISO 13485:2016 requirements for medical device Quality Management Systems (QMS).
Table of Contents
- Clause 4: Quality Management System
- Clause 5: Management Responsibility
- Clause 6: Resource Management
- Clause 7: Product Realization
- Clause 8: Measurement, Analysis and Improvement
Clause 4: Quality Management System
4.1 General Requirements
4.1.1 QMS Requirements
- Establish, document, implement, and maintain a QMS
- Maintain its effectiveness in accordance with ISO 13485
- Document the QMS processes and their interactions
4.1.2 Process Approach
- Identify processes needed for the QMS
- Determine sequence and interaction of these processes
- Determine criteria and methods for effective operation and control
- Ensure availability of resources and information
- Monitor, measure, and analyze processes
- Implement actions to achieve planned results and maintain effectiveness
4.1.3 Outsourced Processes
- Control any QMS process that is outsourced
- Ensure control is documented in the QMS
- Outsourcing does not relieve the organization of responsibility
4.1.4 General QMS Requirements
- Establish, document, implement, and maintain QMS requirements per ISO 13485
- Include requirements for medical devices and applicable regulatory requirements
- Establish documented procedures for QMS activities
4.1.5 Risk Management
- Establish documented requirements for risk management in product realization
- Maintain risk management records
- Ensure risk management is conducted according to documented requirements
4.1.6 Software Validation
- Validate computer software applications used in QMS
- Validation must be conducted prior to initial use and after changes
- Establish documented approach including:
- Risk associated with the software application
- Validation activities
- Acceptance criteria
- User responsibilities
- Validation records
4.2 Documentation Requirements
4.2.1 General Documentation
QMS documentation must include:
- Quality policy and quality objectives
- Quality manual
- Documented procedures and records required by ISO 13485
- Documents required by organization for effective processes
- Records required by ISO 13485
- Medical device files as required by applicable regulatory requirements
4.2.2 Quality Manual
Establish and maintain a quality manual that includes:
- Scope of the QMS with details and justification for exclusions
- Documented procedures or reference to them
- Description of interaction between QMS processes
- Structure of documentation used in the QMS
4.2.3 Medical Device File
Establish and maintain a medical device file for each type or family that includes:
- General description, intended use/purpose
- Label and instructions for use specifications
- Specifications for product and/or manufacturing
- Specifications for procedures for purchasing, manufacturing, servicing
- Procedures for measuring and monitoring
- Installation requirements (if applicable)
- Risk management file(s)
- Verification and validation information
- Design and development file(s) when applicable
4.2.4 Control of Documents
Establish documented procedure to:
- Approve documents before issue
- Review, update, and re-approve documents
- Ensure changes and current revision status are identified
- Ensure relevant versions are available at points of use
- Ensure documents remain legible and readily identifiable
- Control distribution of documents
- Prevent unintended use of obsolete documents
- Apply suitable identification if retained for any purpose
Document changes must:
- Be reviewed and approved by original function unless otherwise designated
- Have access to pertinent background information
- Be identified in the document or appropriate attachments
4.2.5 Control of Records
Establish documented procedure for:
- Identification, storage, security, integrity, retrieval, retention time, and disposition
- Records must remain legible, readily identifiable, and retrievable
- Changes to records must remain identifiable
- Retention time must be at least the lifetime of the medical device
- Records may be stored on any media but must remain retrievable
Clause 5: Management Responsibility
5.1 Management Commitment
Top management must provide evidence of commitment by:
- Communicating importance of meeting regulatory and customer requirements
- Establishing quality policy
- Establishing quality objectives
- Conducting management reviews
- Ensuring availability of resources
5.2 Customer Focus
- Determine customer requirements and regulatory requirements
- Ensure customer requirements are met to enhance satisfaction
- Maintain documented requirements related to the medical device
5.3 Quality Policy
- Appropriate to the organization
- Includes commitment to meet requirements and maintain QMS effectiveness
- Provides framework for quality objectives
- Communicated and understood within organization
- Reviewed for continuing suitability
5.4 Planning
5.4.1 Quality Objectives
- Establish quality objectives at relevant functions and levels
- Must be measurable and consistent with quality policy
- Objectives must support conformity to product requirements
5.4.2 QMS Planning
- Plan to meet general requirements and quality objectives
- Maintain QMS integrity when changes are planned and implemented
- Document planning
5.5 Responsibility, Authority and Communication
5.5.1 Responsibility and Authority
- Define and communicate responsibilities and authorities
- Document roles that manage, perform, verify QMS work
- Identify interrelation of all personnel
5.5.2 Management Representative
Appoint a member of management who:
- Ensures QMS processes are established, implemented, and maintained
- Reports to top management on QMS performance and improvement needs
- Ensures promotion of awareness of regulatory and customer requirements
5.5.3 Internal Communication
- Ensure communication processes are established
- Ensure communication occurs regarding QMS effectiveness
5.6 Management Review
5.6.1 General
- Review QMS at planned intervals (at least annually)
- Review to ensure continuing suitability, adequacy, and effectiveness
- Include assessment of opportunities for improvement
- Maintain records of management reviews
5.6.2 Review Input
Include:
- Results of audits
- Customer feedback
- Process performance and product conformity
- Status of preventive and corrective actions
- Follow-up actions from previous reviews
- Changes affecting QMS
- Recommendations for improvement
- Applicable new or revised regulatory requirements
5.6.3 Review Output
Include decisions and actions related to:
- Improvements to QMS effectiveness and processes
- Product improvements related to customer requirements
- Resource needs
- Changes necessary to maintain QMS effectiveness
Clause 6: Resource Management
6.1 Provision of Resources
Determine and provide resources needed to:
- Implement and maintain QMS and its effectiveness
- Meet regulatory and customer requirements
6.2 Human Resources
6.2 General
Personnel performing work affecting product quality must be competent based on:
- Education, training, skills, and experience
- Documented evidence of competence
6.3 Infrastructure
Determine, provide, and maintain infrastructure including:
- Buildings, workspace, and associated utilities
- Process equipment (hardware and software)
- Supporting services
Infrastructure maintenance requirements:
- Document requirements including maintenance activities
- Document requirements when maintenance can affect product quality
- Maintain records of maintenance activities
6.4 Work Environment and Contamination Control
6.4.1 Work Environment
- Determine and manage work environment needed for product conformity
- Document requirements for work environment
- Document requirements if work environment can adversely affect product quality
6.4.2 Contamination Control
- When applicable to medical device, document requirements for control of contaminated or potentially contaminated product
- Establish special arrangements for control of contaminated product
Clause 7: Product Realization
7.1 Planning of Product Realization
Plan and develop processes needed for product realization including:
- Quality objectives and requirements for the product
- Need to establish processes, documentation, and resources
- Required verification, validation, monitoring, measurement, inspection, handling, storage, distribution, and traceability
- Records to provide evidence of conformity
Risk management requirements:
- Establish documented requirements for risk management throughout product realization
- Maintain risk management records
7.2 Customer-Related Processes
7.2.1 Determination of Requirements
Determine:
- Requirements specified by customer including delivery and post-delivery
- Requirements not stated but necessary for specified or intended use
- Applicable regulatory requirements
- Any additional requirements determined by organization
7.2.2 Review of Requirements
- Review product requirements before commitment
- Ensure requirements are defined and documented
- Ensure differences are resolved
- Ensure ability to meet requirements
- Maintain records of review results and follow-up actions
7.2.3 Communication
Establish and document effective arrangements for communication with customers concerning:
- Product information
- Inquiry, contract or order handling, amendments
- Customer feedback including complaints
- Advisory notices
7.3 Design and Development
7.3.1 General
- Establish, document, and maintain design and development procedures
- Document design and development plan for each medical device
- Maintain design and development files
7.3.2 Design and Development Planning
Plan and control design and development including:
- Stages of design and development
- Required review, verification, and validation activities
- Responsibilities and authorities
- Resources and interfaces
- Update plans as design progresses
- Document plans
7.3.3 Design and Development Inputs
- Determine inputs relating to product requirements
- Include functional, performance, usability, and safety requirements
- Include applicable regulatory requirements and standards
- Include applicable outputs of risk management
- Include appropriate information from previous similar designs
- Review inputs for adequacy and completeness
- Resolve incomplete, ambiguous, or conflicting requirements
- Maintain records
7.3.4 Design and Development Outputs
Provide outputs that:
- Meet design input requirements
- Provide appropriate information for purchasing, production, and service
- Contain or reference product acceptance criteria
- Specify characteristics essential for safe and proper use
- Document outputs and maintain as records
7.3.5 Design and Development Review
- Conduct systematic reviews at suitable stages
- Evaluate ability to meet requirements
- Identify problems and propose actions
- Include representatives of functions concerned
- Maintain records including results and follow-up actions
7.3.6 Design and Development Verification
- Perform verification per planned arrangements
- Ensure outputs meet input requirements
- Maintain records of verification results and follow-up actions
7.3.7 Design and Development Validation
- Perform validation per planned arrangements
- Ensure product meets specified application or intended use
- Conduct validation before delivery or implementation
- Include validation under defined operating conditions
- Maintain records of validation results and follow-up actions
7.3.8 Design and Development Transfer
- Document procedures for transfer to manufacturing
- Verify manufacturing output meets design output
- Ensure specification for materials, production, QC, servicing are appropriate
- Maintain records
7.3.9 Control of Design and Development Changes
- Identify, document, and control changes
- Review, verify, validate, and approve changes before implementation
- Evaluate effects on constituent parts, in-process product, and delivered product
- Maintain records of changes, review results, and follow-up actions
7.3.10 Design and Development Files
Establish and maintain design and development files for each type or family including:
- Design and development plan
- Design inputs
- Design outputs
- Design review, verification, validation records
- Design change records
- Risk management file
7.4 Purchasing
7.4.1 Purchasing Process
- Ensure purchased product conforms to purchase information
- Establish documented processes for purchasing activities
- Establish criteria for evaluation and selection of suppliers
- Base criteria on ability to supply per organization's requirements
- Monitor supplier performance
- Maintain records of evaluations and follow-up actions
- Establish process for notifying suppliers of changed product requirements
7.4.2 Purchasing Information
Purchasing information must include:
- Requirements for approval of product, procedures, processes, equipment
- Requirements for qualification of personnel
- Quality management system requirements
- Requirements for notification to organization of nonconforming product
- Agreement that suppliers provide notification of changes to purchased product
- Agreement that purchase information be communicated to sub-tier suppliers
7.4.3 Verification of Purchased Product
- Establish and implement inspection or other activities to ensure conformity
- Document extent of verification
- Verify at supplier's premises when customer intends to perform verification at supplier
- Document verification arrangements and method of product release
7.5 Production and Service Provision
7.5.1 Control of Production and Service Provision
Plan and carry out production under controlled conditions including:
- Availability of documented procedures and work instructions
- Availability of suitable infrastructure and work environment
- Availability of monitoring and measuring equipment
- Availability and use of suitable monitoring and measuring activities
- Implementation of product release, delivery, and post-delivery activities
- Implementation of defined operations for labelling and packaging
- Procedures for servicing if applicable
Document requirements for:
- Control of product cleanliness if applicable
- Control during installation and verification if applicable
7.5.2 Cleanliness of Product
Document requirements if:
- Product is cleaned per specified requirements before sterilization and/or use
- Product cannot be cleaned before sterilization
- Product is supplied non-sterile to be cleaned and then sterilized
Establish requirements for product hygiene in manufacturing, handling, and storage.
7.5.3 Installation Activities
If applicable:
- Document requirements for installation and verification
- Maintain records of installation and verification
7.5.4 Servicing Activities
If servicing is specified requirement:
- Establish documented procedures, reference materials, and measurements for servicing
- Analyze records of servicing for feedback into post-production phase
- Maintain records of servicing activities
7.5.5 Particular Requirements for Sterile Medical Devices
Maintain records of process parameters for sterilization of each batch.
7.5.6 Validation of Processes
Validate processes where resulting output cannot be verified by subsequent monitoring or measurement, including:
- Defined criteria for review and approval
- Approval of equipment and qualification of personnel
- Use of specific methods, procedures, and acceptance criteria
- Requirements for records
- Revalidation including criteria for revalidation
- Approval of changes to process
Document requirements for validation of:
- Computer software used in production and service provision
- Sterilization processes
- Aseptic processing
- Clean room requirements if applicable
7.5.7 Particular Requirements for Validation of Processes for Sterilization and Sterile Barrier Systems
Maintain records of validation of:
- Sterilization processes for each batch
- Sterile barrier systems
7.5.8 Identification
- Establish documented procedures for product identification throughout realization
- Identify product by suitable means
- Maintain records of identification where traceability is a requirement
7.5.9 Traceability
7.5.9.1 General
Establish documented procedures defining extent of traceability including:
- Distribution and location of medical device
7.5.9.2 Particular Requirements
Document procedures to maintain records of:
- Name and address of shipping package consignee
- Identification of quantity shipped
- Include requirements of applicable regulatory requirements
- Maintain traceability records for defined period
7.5.10 Customer Property
- Exercise care with customer property while under organization's control
- Identify, verify, protect, and safeguard customer property
- Record and report to customer if lost, damaged, or unsuitable
- Maintain records
7.5.11 Preservation of Product
- Preserve product during internal processing and delivery
- Include identification, handling, packaging, storage, and protection
- Apply to constituent parts of product
- Document requirements for special handling if applicable
7.6 Control of Monitoring and Measuring Equipment
- Determine monitoring and measurement to be undertaken
- Determine monitoring and measuring equipment needed
- Establish documented procedures for:
- Calibration or verification at specified intervals before use
- Adjustment or re-adjustment as necessary
- Identification to enable determination of calibration status
- Safeguarding from adjustments that would invalidate calibration
- Protection from damage and deterioration
- Assess and record validity of previous results when found not to conform
- Maintain records of calibration and verification
- Confirm ability of computer software to satisfy intended application when used
- Undertake confirmation before initial use and reconfirm as necessary
Clause 8: Measurement, Analysis and Improvement
8.1 General
- Plan and implement monitoring, measurement, analysis, and improvement processes
- Demonstrate product conformity
- Ensure QMS conformity
- Maintain QMS effectiveness
- Include determination of applicable methods including statistical techniques
8.2 Monitoring and Measurement
8.2.1 Feedback
Establish documented procedure for feedback including early warning system for:
- Post-production information including complaints
- Requirements for reporting to regulatory authorities
- Use as potential input to risk management for monitoring and maintaining product requirements
- Use as potential input for corrective and preventive action
8.2.2 Complaint Handling
Establish documented procedures for timely complaint handling including:
- Requirements and responsibilities for receiving, recording, and evaluating complaints
- Requirements and responsibilities for handling, investigating, and evaluating complaints
- Requirements and responsibilities for reporting complaint information to regulatory authorities
- Requirements for informing customer of organization's actions
- Requirements to ensure complaint information not handled by organization is transferred to organization
- Maintain records of complaints and investigations
8.2.3 Reporting to Regulatory Authorities
Establish documented procedures to:
- Provide notification to regulatory authorities per applicable requirements
- Provide advisory notices per applicable requirements
- Maintain records of reporting
8.2.4 Internal Audit
- Conduct internal audits at planned intervals
- Determine if QMS conforms to ISO 13485 and organization's requirements
- Determine if QMS is effectively implemented and maintained
- Plan audit program considering importance of processes, changes, and previous results
- Define audit criteria, scope, frequency, and methods
- Establish documented procedure for audits including responsibilities, requirements, and reporting
- Select objective and impartial auditors
- Maintain records of audits and results
- Identify need for corrections or corrective actions
- Conduct follow-up activities to verify implementation and effectiveness
8.2.5 Monitoring and Measurement of Processes
- Apply suitable methods for monitoring and measurement of QMS processes
- Demonstrate ability to achieve planned results
- Implement corrections and corrective actions when planned results not achieved
- Maintain records
8.2.6 Monitoring and Measurement of Product
- Monitor and measure product characteristics to verify conformity
- Conduct at appropriate stages per planned arrangements
- Maintain records showing conformity to acceptance criteria
- Record authority responsible for release
- Ensure product release and delivery not proceed until planned arrangements completed
- Allow release by relevant authority and customer when applicable
8.3 Control of Nonconforming Product
8.3.1 General
- Ensure nonconforming product is identified and controlled
- Establish documented procedures for:
- Identification, documentation, evaluation, segregation, and disposition
- Notification to external parties
- Review of nonconforming product
- Maintain records of nonconformities and subsequent actions including concessions
8.3.2 Actions in Response to Nonconforming Product Detected Before Delivery
Deal with nonconforming product by:
- Taking action to eliminate detected nonconformity
- Authorizing use, release, or acceptance under concession per applicable regulatory requirements
- Taking action to preclude original intended use or application
- Taking action appropriate to effects of nonconformity when detected after delivery or use
Maintain records of concessions and identify authority making concession.
8.3.3 Actions in Response to Nonconforming Product Detected After Delivery
When nonconforming product detected after delivery or use:
- Take action appropriate to effects of nonconformity
- Establish documented procedure including notification requirements to regulatory authorities
- Maintain records
8.3.4 Rework
Establish documented procedures for rework including:
- Requirements to evaluate potential effects on medical device
- Approval before implementation
- Records of results and actions including nonconformities and rework
- Re-verification after rework
- Documentation of rework procedure before rework begins
8.4 Analysis of Data
- Determine, collect, and analyze appropriate data from monitoring and measurement
- Evaluate where continual improvement of QMS effectiveness can be made
- Establish documented procedures for:
- Analysis of data to provide information on customer satisfaction
- Analysis of conformity to product requirements
- Analysis of characteristics and trends of processes and products including preventive action opportunities
- Analysis of suppliers
- Analysis of other relevant data including feedback and output from risk management
- Include use of statistical techniques if necessary
- Maintain records of analysis results
8.5 Improvement
8.5.1 General
- Identify and implement changes to ensure and maintain QMS effectiveness
- Include use of quality policy, objectives, audit results, data analysis, corrective and preventive actions, and management review
8.5.2 Corrective Action
- Establish documented procedures to:
- Review nonconformities including complaints
- Determine causes of nonconformities
- Evaluate need for actions to ensure nonconformities do not recur
- Plan and document actions needed and implement
- Document results of actions taken
- Review effectiveness of corrective actions taken
- Maintain records including investigation results and follow-up
8.5.3 Preventive Action
- Establish documented procedures to:
- Determine potential nonconformities and their causes
- Evaluate need for action to prevent occurrence
- Plan and document actions needed and implement
- Document results of actions taken
- Review effectiveness of preventive actions taken
- Use appropriate sources of information including:
- Work processes and operations affecting product quality
- Concessions
- Analysis of data and risk management outputs
- Medical device performance data
- Records of nonconformities
- Maintain records including investigation results and follow-up
Key Regulatory Updates
FDA QMSR Harmonization (Effective February 2, 2026)
- FDA 21 CFR Part 820 has been harmonized with ISO 13485:2016
- Renamed to QMSR (Quality Management System Regulation)
- Medical Device File (MDF) replaces separate DHF, DMR, and DHR
- Organizations should prepare for transition to unified documentation approach
References and Resources
This requirements breakdown is based on ISO 13485:2016, which was last reviewed and confirmed in 2025.
For additional guidance, refer to:
- ISO 13485:2016 standard document
- FDA Quality Management System Regulation (QMSR)
- Applicable regional regulatory requirements (EU MDR, Health Canada, etc.)
1---2name: iso-13485-2016-requirements-breakdown3description: This document provides a comprehensive breakdown of ISO 13485:2016 requirements for medical device Quality Management Systems (QMS).4---5# ISO 13485:2016 Requirements Breakdown67This document provides a comprehensive breakdown of ISO 13485:2016 requirements for medical device Quality Management Systems (QMS).89## Table of Contents10111. [Clause 4: Quality Management System](#clause-4-quality-management-system)122. [Clause 5: Management Responsibility](#clause-5-management-responsibility)133. [Clause 6: Resource Management](#clause-6-resource-management)144. [Clause 7: Product Realization](#clause-7-product-realization)155. [Clause 8: Measurement, Analysis and Improvement](#clause-8-measurement-analysis-and-improvement)1617## Clause 4: Quality Management System1819### 4.1 General Requirements2021#### 4.1.1 QMS Requirements22- Establish, document, implement, and maintain a QMS23- Maintain its effectiveness in accordance with ISO 1348524- Document the QMS processes and their interactions2526#### 4.1.2 Process Approach27- Identify processes needed for the QMS28- Determine sequence and interaction of these processes29- Determine criteria and methods for effective operation and control30- Ensure availability of resources and information31- Monitor, measure, and analyze processes32- Implement actions to achieve planned results and maintain effectiveness3334#### 4.1.3 Outsourced Processes35- Control any QMS process that is outsourced36- Ensure control is documented in the QMS37- Outsourcing does not relieve the organization of responsibility3839#### 4.1.4 General QMS Requirements40- Establish, document, implement, and maintain QMS requirements per ISO 1348541- Include requirements for medical devices and applicable regulatory requirements42- Establish documented procedures for QMS activities4344#### 4.1.5 Risk Management45- Establish documented requirements for risk management in product realization46- Maintain risk management records47- Ensure risk management is conducted according to documented requirements4849#### 4.1.6 Software Validation50- Validate computer software applications used in QMS51- Validation must be conducted prior to initial use and after changes52- Establish documented approach including:53 - Risk associated with the software application54 - Validation activities55 - Acceptance criteria56 - User responsibilities57 - Validation records5859### 4.2 Documentation Requirements6061#### 4.2.1 General Documentation62QMS documentation must include:63- Quality policy and quality objectives64- Quality manual65- Documented procedures and records required by ISO 1348566- Documents required by organization for effective processes67- Records required by ISO 1348568- Medical device files as required by applicable regulatory requirements6970#### 4.2.2 Quality Manual71Establish and maintain a quality manual that includes:72- Scope of the QMS with details and justification for exclusions73- Documented procedures or reference to them74- Description of interaction between QMS processes75- Structure of documentation used in the QMS7677#### 4.2.3 Medical Device File78Establish and maintain a medical device file for each type or family that includes:79- General description, intended use/purpose80- Label and instructions for use specifications81- Specifications for product and/or manufacturing82- Specifications for procedures for purchasing, manufacturing, servicing83- Procedures for measuring and monitoring84- Installation requirements (if applicable)85- Risk management file(s)86- Verification and validation information87- Design and development file(s) when applicable8889#### 4.2.4 Control of Documents90Establish documented procedure to:91- Approve documents before issue92- Review, update, and re-approve documents93- Ensure changes and current revision status are identified94- Ensure relevant versions are available at points of use95- Ensure documents remain legible and readily identifiable96- Control distribution of documents97- Prevent unintended use of obsolete documents98- Apply suitable identification if retained for any purpose99100Document changes must:101- Be reviewed and approved by original function unless otherwise designated102- Have access to pertinent background information103- Be identified in the document or appropriate attachments104105#### 4.2.5 Control of Records106Establish documented procedure for:107- Identification, storage, security, integrity, retrieval, retention time, and disposition108- Records must remain legible, readily identifiable, and retrievable109- Changes to records must remain identifiable110- Retention time must be at least the lifetime of the medical device111- Records may be stored on any media but must remain retrievable112113## Clause 5: Management Responsibility114115### 5.1 Management Commitment116Top management must provide evidence of commitment by:117- Communicating importance of meeting regulatory and customer requirements118- Establishing quality policy119- Establishing quality objectives120- Conducting management reviews121- Ensuring availability of resources122123### 5.2 Customer Focus124- Determine customer requirements and regulatory requirements125- Ensure customer requirements are met to enhance satisfaction126- Maintain documented requirements related to the medical device127128### 5.3 Quality Policy129- Appropriate to the organization130- Includes commitment to meet requirements and maintain QMS effectiveness131- Provides framework for quality objectives132- Communicated and understood within organization133- Reviewed for continuing suitability134135### 5.4 Planning136137#### 5.4.1 Quality Objectives138- Establish quality objectives at relevant functions and levels139- Must be measurable and consistent with quality policy140- Objectives must support conformity to product requirements141142#### 5.4.2 QMS Planning143- Plan to meet general requirements and quality objectives144- Maintain QMS integrity when changes are planned and implemented145- Document planning146147### 5.5 Responsibility, Authority and Communication148149#### 5.5.1 Responsibility and Authority150- Define and communicate responsibilities and authorities151- Document roles that manage, perform, verify QMS work152- Identify interrelation of all personnel153154#### 5.5.2 Management Representative155Appoint a member of management who:156- Ensures QMS processes are established, implemented, and maintained157- Reports to top management on QMS performance and improvement needs158- Ensures promotion of awareness of regulatory and customer requirements159160#### 5.5.3 Internal Communication161- Ensure communication processes are established162- Ensure communication occurs regarding QMS effectiveness163164### 5.6 Management Review165166#### 5.6.1 General167- Review QMS at planned intervals (at least annually)168- Review to ensure continuing suitability, adequacy, and effectiveness169- Include assessment of opportunities for improvement170- Maintain records of management reviews171172#### 5.6.2 Review Input173Include:174- Results of audits175- Customer feedback176- Process performance and product conformity177- Status of preventive and corrective actions178- Follow-up actions from previous reviews179- Changes affecting QMS180- Recommendations for improvement181- Applicable new or revised regulatory requirements182183#### 5.6.3 Review Output184Include decisions and actions related to:185- Improvements to QMS effectiveness and processes186- Product improvements related to customer requirements187- Resource needs188- Changes necessary to maintain QMS effectiveness189190## Clause 6: Resource Management191192### 6.1 Provision of Resources193Determine and provide resources needed to:194- Implement and maintain QMS and its effectiveness195- Meet regulatory and customer requirements196197### 6.2 Human Resources198199#### 6.2 General200Personnel performing work affecting product quality must be competent based on:201- Education, training, skills, and experience202- Documented evidence of competence203204#### 6.3 Infrastructure205Determine, provide, and maintain infrastructure including:206- Buildings, workspace, and associated utilities207- Process equipment (hardware and software)208- Supporting services209210Infrastructure maintenance requirements:211- Document requirements including maintenance activities212- Document requirements when maintenance can affect product quality213- Maintain records of maintenance activities214215### 6.4 Work Environment and Contamination Control216217#### 6.4.1 Work Environment218- Determine and manage work environment needed for product conformity219- Document requirements for work environment220- Document requirements if work environment can adversely affect product quality221222#### 6.4.2 Contamination Control223- When applicable to medical device, document requirements for control of contaminated or potentially contaminated product224- Establish special arrangements for control of contaminated product225226## Clause 7: Product Realization227228### 7.1 Planning of Product Realization229Plan and develop processes needed for product realization including:230- Quality objectives and requirements for the product231- Need to establish processes, documentation, and resources232- Required verification, validation, monitoring, measurement, inspection, handling, storage, distribution, and traceability233- Records to provide evidence of conformity234235Risk management requirements:236- Establish documented requirements for risk management throughout product realization237- Maintain risk management records238239### 7.2 Customer-Related Processes240241#### 7.2.1 Determination of Requirements242Determine:243- Requirements specified by customer including delivery and post-delivery244- Requirements not stated but necessary for specified or intended use245- Applicable regulatory requirements246- Any additional requirements determined by organization247248#### 7.2.2 Review of Requirements249- Review product requirements before commitment250- Ensure requirements are defined and documented251- Ensure differences are resolved252- Ensure ability to meet requirements253- Maintain records of review results and follow-up actions254255#### 7.2.3 Communication256Establish and document effective arrangements for communication with customers concerning:257- Product information258- Inquiry, contract or order handling, amendments259- Customer feedback including complaints260- Advisory notices261262### 7.3 Design and Development263264#### 7.3.1 General265- Establish, document, and maintain design and development procedures266- Document design and development plan for each medical device267- Maintain design and development files268269#### 7.3.2 Design and Development Planning270Plan and control design and development including:271- Stages of design and development272- Required review, verification, and validation activities273- Responsibilities and authorities274- Resources and interfaces275- Update plans as design progresses276- Document plans277278#### 7.3.3 Design and Development Inputs279- Determine inputs relating to product requirements280- Include functional, performance, usability, and safety requirements281- Include applicable regulatory requirements and standards282- Include applicable outputs of risk management283- Include appropriate information from previous similar designs284- Review inputs for adequacy and completeness285- Resolve incomplete, ambiguous, or conflicting requirements286- Maintain records287288#### 7.3.4 Design and Development Outputs289Provide outputs that:290- Meet design input requirements291- Provide appropriate information for purchasing, production, and service292- Contain or reference product acceptance criteria293- Specify characteristics essential for safe and proper use294- Document outputs and maintain as records295296#### 7.3.5 Design and Development Review297- Conduct systematic reviews at suitable stages298- Evaluate ability to meet requirements299- Identify problems and propose actions300- Include representatives of functions concerned301- Maintain records including results and follow-up actions302303#### 7.3.6 Design and Development Verification304- Perform verification per planned arrangements305- Ensure outputs meet input requirements306- Maintain records of verification results and follow-up actions307308#### 7.3.7 Design and Development Validation309- Perform validation per planned arrangements310- Ensure product meets specified application or intended use311- Conduct validation before delivery or implementation312- Include validation under defined operating conditions313- Maintain records of validation results and follow-up actions314315#### 7.3.8 Design and Development Transfer316- Document procedures for transfer to manufacturing317- Verify manufacturing output meets design output318- Ensure specification for materials, production, QC, servicing are appropriate319- Maintain records320321#### 7.3.9 Control of Design and Development Changes322- Identify, document, and control changes323- Review, verify, validate, and approve changes before implementation324- Evaluate effects on constituent parts, in-process product, and delivered product325- Maintain records of changes, review results, and follow-up actions326327#### 7.3.10 Design and Development Files328Establish and maintain design and development files for each type or family including:329- Design and development plan330- Design inputs331- Design outputs332- Design review, verification, validation records333- Design change records334- Risk management file335336### 7.4 Purchasing337338#### 7.4.1 Purchasing Process339- Ensure purchased product conforms to purchase information340- Establish documented processes for purchasing activities341- Establish criteria for evaluation and selection of suppliers342- Base criteria on ability to supply per organization's requirements343- Monitor supplier performance344- Maintain records of evaluations and follow-up actions345- Establish process for notifying suppliers of changed product requirements346347#### 7.4.2 Purchasing Information348Purchasing information must include:349- Requirements for approval of product, procedures, processes, equipment350- Requirements for qualification of personnel351- Quality management system requirements352- Requirements for notification to organization of nonconforming product353- Agreement that suppliers provide notification of changes to purchased product354- Agreement that purchase information be communicated to sub-tier suppliers355356#### 7.4.3 Verification of Purchased Product357- Establish and implement inspection or other activities to ensure conformity358- Document extent of verification359- Verify at supplier's premises when customer intends to perform verification at supplier360- Document verification arrangements and method of product release361362### 7.5 Production and Service Provision363364#### 7.5.1 Control of Production and Service Provision365Plan and carry out production under controlled conditions including:366- Availability of documented procedures and work instructions367- Availability of suitable infrastructure and work environment368- Availability of monitoring and measuring equipment369- Availability and use of suitable monitoring and measuring activities370- Implementation of product release, delivery, and post-delivery activities371- Implementation of defined operations for labelling and packaging372- Procedures for servicing if applicable373374Document requirements for:375- Control of product cleanliness if applicable376- Control during installation and verification if applicable377378#### 7.5.2 Cleanliness of Product379Document requirements if:380- Product is cleaned per specified requirements before sterilization and/or use381- Product cannot be cleaned before sterilization382- Product is supplied non-sterile to be cleaned and then sterilized383384Establish requirements for product hygiene in manufacturing, handling, and storage.385386#### 7.5.3 Installation Activities387If applicable:388- Document requirements for installation and verification389- Maintain records of installation and verification390391#### 7.5.4 Servicing Activities392If servicing is specified requirement:393- Establish documented procedures, reference materials, and measurements for servicing394- Analyze records of servicing for feedback into post-production phase395- Maintain records of servicing activities396397#### 7.5.5 Particular Requirements for Sterile Medical Devices398Maintain records of process parameters for sterilization of each batch.399400#### 7.5.6 Validation of Processes401Validate processes where resulting output cannot be verified by subsequent monitoring or measurement, including:402- Defined criteria for review and approval403- Approval of equipment and qualification of personnel404- Use of specific methods, procedures, and acceptance criteria405- Requirements for records406- Revalidation including criteria for revalidation407- Approval of changes to process408409Document requirements for validation of:410- Computer software used in production and service provision411- Sterilization processes412- Aseptic processing413- Clean room requirements if applicable414415#### 7.5.7 Particular Requirements for Validation of Processes for Sterilization and Sterile Barrier Systems416Maintain records of validation of:417- Sterilization processes for each batch418- Sterile barrier systems419420#### 7.5.8 Identification421- Establish documented procedures for product identification throughout realization422- Identify product by suitable means423- Maintain records of identification where traceability is a requirement424425#### 7.5.9 Traceability426427##### 7.5.9.1 General428Establish documented procedures defining extent of traceability including:429- Distribution and location of medical device430431##### 7.5.9.2 Particular Requirements432Document procedures to maintain records of:433- Name and address of shipping package consignee434- Identification of quantity shipped435- Include requirements of applicable regulatory requirements436- Maintain traceability records for defined period437438#### 7.5.10 Customer Property439- Exercise care with customer property while under organization's control440- Identify, verify, protect, and safeguard customer property441- Record and report to customer if lost, damaged, or unsuitable442- Maintain records443444#### 7.5.11 Preservation of Product445- Preserve product during internal processing and delivery446- Include identification, handling, packaging, storage, and protection447- Apply to constituent parts of product448- Document requirements for special handling if applicable449450### 7.6 Control of Monitoring and Measuring Equipment451- Determine monitoring and measurement to be undertaken452- Determine monitoring and measuring equipment needed453- Establish documented procedures for:454 - Calibration or verification at specified intervals before use455 - Adjustment or re-adjustment as necessary456 - Identification to enable determination of calibration status457 - Safeguarding from adjustments that would invalidate calibration458 - Protection from damage and deterioration459- Assess and record validity of previous results when found not to conform460- Maintain records of calibration and verification461- Confirm ability of computer software to satisfy intended application when used462- Undertake confirmation before initial use and reconfirm as necessary463464## Clause 8: Measurement, Analysis and Improvement465466### 8.1 General467- Plan and implement monitoring, measurement, analysis, and improvement processes468- Demonstrate product conformity469- Ensure QMS conformity470- Maintain QMS effectiveness471- Include determination of applicable methods including statistical techniques472473### 8.2 Monitoring and Measurement474475#### 8.2.1 Feedback476Establish documented procedure for feedback including early warning system for:477- Post-production information including complaints478- Requirements for reporting to regulatory authorities479- Use as potential input to risk management for monitoring and maintaining product requirements480- Use as potential input for corrective and preventive action481482#### 8.2.2 Complaint Handling483Establish documented procedures for timely complaint handling including:484- Requirements and responsibilities for receiving, recording, and evaluating complaints485- Requirements and responsibilities for handling, investigating, and evaluating complaints486- Requirements and responsibilities for reporting complaint information to regulatory authorities487- Requirements for informing customer of organization's actions488- Requirements to ensure complaint information not handled by organization is transferred to organization489- Maintain records of complaints and investigations490491#### 8.2.3 Reporting to Regulatory Authorities492Establish documented procedures to:493- Provide notification to regulatory authorities per applicable requirements494- Provide advisory notices per applicable requirements495- Maintain records of reporting496497#### 8.2.4 Internal Audit498- Conduct internal audits at planned intervals499- Determine if QMS conforms to ISO 13485 and organization's requirements500- Determine if QMS is effectively implemented and maintained501- Plan audit program considering importance of processes, changes, and previous results502- Define audit criteria, scope, frequency, and methods503- Establish documented procedure for audits including responsibilities, requirements, and reporting504- Select objective and impartial auditors505- Maintain records of audits and results506- Identify need for corrections or corrective actions507- Conduct follow-up activities to verify implementation and effectiveness508509#### 8.2.5 Monitoring and Measurement of Processes510- Apply suitable methods for monitoring and measurement of QMS processes511- Demonstrate ability to achieve planned results512- Implement corrections and corrective actions when planned results not achieved513- Maintain records514515#### 8.2.6 Monitoring and Measurement of Product516- Monitor and measure product characteristics to verify conformity517- Conduct at appropriate stages per planned arrangements518- Maintain records showing conformity to acceptance criteria519- Record authority responsible for release520- Ensure product release and delivery not proceed until planned arrangements completed521- Allow release by relevant authority and customer when applicable522523### 8.3 Control of Nonconforming Product524525#### 8.3.1 General526- Ensure nonconforming product is identified and controlled527- Establish documented procedures for:528 - Identification, documentation, evaluation, segregation, and disposition529 - Notification to external parties530 - Review of nonconforming product531- Maintain records of nonconformities and subsequent actions including concessions532533#### 8.3.2 Actions in Response to Nonconforming Product Detected Before Delivery534Deal with nonconforming product by:535- Taking action to eliminate detected nonconformity536- Authorizing use, release, or acceptance under concession per applicable regulatory requirements537- Taking action to preclude original intended use or application538- Taking action appropriate to effects of nonconformity when detected after delivery or use539540Maintain records of concessions and identify authority making concession.541542#### 8.3.3 Actions in Response to Nonconforming Product Detected After Delivery543When nonconforming product detected after delivery or use:544- Take action appropriate to effects of nonconformity545- Establish documented procedure including notification requirements to regulatory authorities546- Maintain records547548#### 8.3.4 Rework549Establish documented procedures for rework including:550- Requirements to evaluate potential effects on medical device551- Approval before implementation552- Records of results and actions including nonconformities and rework553- Re-verification after rework554- Documentation of rework procedure before rework begins555556### 8.4 Analysis of Data557- Determine, collect, and analyze appropriate data from monitoring and measurement558- Evaluate where continual improvement of QMS effectiveness can be made559- Establish documented procedures for:560 - Analysis of data to provide information on customer satisfaction561 - Analysis of conformity to product requirements562 - Analysis of characteristics and trends of processes and products including preventive action opportunities563 - Analysis of suppliers564 - Analysis of other relevant data including feedback and output from risk management565- Include use of statistical techniques if necessary566- Maintain records of analysis results567568### 8.5 Improvement569570#### 8.5.1 General571- Identify and implement changes to ensure and maintain QMS effectiveness572- Include use of quality policy, objectives, audit results, data analysis, corrective and preventive actions, and management review573574#### 8.5.2 Corrective Action575- Establish documented procedures to:576 - Review nonconformities including complaints577 - Determine causes of nonconformities578 - Evaluate need for actions to ensure nonconformities do not recur579 - Plan and document actions needed and implement580 - Document results of actions taken581 - Review effectiveness of corrective actions taken582- Maintain records including investigation results and follow-up583584#### 8.5.3 Preventive Action585- Establish documented procedures to:586 - Determine potential nonconformities and their causes587 - Evaluate need for action to prevent occurrence588 - Plan and document actions needed and implement589 - Document results of actions taken590 - Review effectiveness of preventive actions taken591- Use appropriate sources of information including:592 - Work processes and operations affecting product quality593 - Concessions594 - Analysis of data and risk management outputs595 - Medical device performance data596 - Records of nonconformities597- Maintain records including investigation results and follow-up598599## Key Regulatory Updates600601### FDA QMSR Harmonization (Effective February 2, 2026)602- FDA 21 CFR Part 820 has been harmonized with ISO 13485:2016603- Renamed to QMSR (Quality Management System Regulation)604- Medical Device File (MDF) replaces separate DHF, DMR, and DHR605- Organizations should prepare for transition to unified documentation approach606607## References and Resources608609This requirements breakdown is based on ISO 13485:2016, which was last reviewed and confirmed in 2025.610611For additional guidance, refer to:612- ISO 13485:2016 standard document613- FDA Quality Management System Regulation (QMSR)614- Applicable regional regulatory requirements (EU MDR, Health Canada, etc.)