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FDA medical device registration process - getting new products to market in the U.S.

By

Wendy Levine

April 21, 2022

4 min read

FDA device registration overview

Registering a new medical device with the FDA can be a huge undertaking, and understanding the process and all of the requirements as early as possible is important. This article provides a high-level overview of the steps required before marketing and selling a medical device in the United States. We’ve done our best to include relevant links to both FDA documentation and educational materials wherever possible!

FDA medical device registration steps

Classify your medical device

Classifying your medical device should be one of the first steps in any FDA submission. The FDA classification system is a “predicate-based” system in which devices are classified based on similar devices that are already on the market in the U.S.

You may already have an idea as to which of the three device classes your product falls under, but you still need to determine the specific device category described within 21 CFR Parts 862-892. The FDA provides a good overview and listing of device categories that is searchable. This will allow you to determine which specific section of the regulation pertains to your device, which will then define the classification and relevant premarket requirements. While the majority of Class I devices require no premarket notification, the majority of Class II devices require 510(k) premarket notification, and the majority of Class III devices require a premarket authorization submission, however,this is not always the case. 

Medical device manufacturers can request information and guidance from the FDA regarding the classification of a device through a 513(g) request. For the classification of accessories to your device, a pre-submission may be more appropriate (discussed below) 

Collaborate with the FDA prior to your submission   

The FDA encourages pre-submission collaboration meetings and communication as early in the product development process as possible. It is in the best interest of organizations seeking approval of a medical device to have an open dialogue with the FDA, enabling the FDA to advise before and during the submission process, provide direction on Investigational Device Exemption (IDE) applications, and identify any potential concerns that may affect approval or clearance of the device. This is especially important for devices with novel technology.

There are a number of pre-submission activities defined in the FDA’s “Q-Submission” program (these were previously referred to as “pre-ide” meetings). Q-subs provide an organization with the opportunity to obtain feedback from the FDA before a premarket submission is made. The most common Q-subs are:

Pre-submission (pre-sub) requests provide an opportunity for an organization to obtain feedback from the FDA before completing a premarket submission. Pre-sub requests are made in writing to the agency and can involve a meeting if requested by the submitter. The submitter should have specific questions prepared regarding their submission and/or product development prepared for the FDA to review during this meeting. 

Informal Meetings are requests to share information with the FDA with no expectation of feedback. This may be helpful if your team has a variety of submissions planned, or if your company would like to explain the technology of your device. 

Early collaboration determination meetings are requests by a PMA applicant for the FDA’s determination of the type of valid scientific evidence required to demonstrate that the device in question is effective for its intended use.

Early collaboration agreement meetings are used to reach an agreement between the FDA and the submitter on key parameters of the investigational plan.

Results of early collaboration determination and agreement meetings are binding on the agency. For additional information, see “Early Collaboration Meetings Under the FDA Modernization Act: Final Guidance for Industry and for CDRH Staff”

Prepare the appropriate premarket submission for your medical device

Remember that most Class I devices, and some Class II devices require no premarket submission (though they are required to be listed with the FDA).

510(k) Premarket Notification is used for Class II and Class III devices with a medium risk profile for which there is a predicate, substantially equivalent, device on the market that requires a 510(k) submission.

The 510(k) submission is used to demonstrate that the predicate device is substantially equivalent to the new device and, if successful, results in an FDA “clearance” for the new device. You can read more in our FDA 510(K) beginner’s guide.

Premarket Approval (PMA) is used for Class III devices for which the identified predicate device requires a PMA. These are devices which are high risk; defined as a device that supports or sustains human life, is of substantial importance to preventing impairment in human health, or presents a potential and unreasonable risk of illness or injury. Novel devices which have no substantial equivalent on the market also require a PMA by default.

A PMA is intended to prove that a new device is safe and effective for the end user, and is much more detailed and in-depth than a 510(k). Device manufacturers are typically required to present human clinical trial data, in addition to laboratory testing data. A successful PMA results in an FDA “approved” device.

The De Novo classification process can be used for novel devices for which there is no substantial equivalent on the market, but which have the lower risk profile of a Class I or Class II device. A successful De Novo request is “granted” by the FDA and results in the classification of the device as Class I or Class II. You can read more in our De Novo classification process: a beginner’s guide.

Work with FDA staff during the review process

The more complex your submission to the FDA, the more opportunities you will have to interact with the agency during the review process. Take advantage of these opportunities and be sure to respond to any requests for additional information within the specified time frame. The 510(k) submission process and the PMA submission process both have defined procedures for requesting and submitting additional information during the review process. PMA submissions for devices with new technology may also require interaction with an expert review panel. 

If you need additional clarification from the FDA on your 510(k) or PMA submission, the following options are available: through the Q-submission process:

Submission Issue Requests (SIR) are Q-submission requests for feedback and clarification during a pre-marketing submission including 510(k), De Novo and PMA submissions. These are often held after a submitter receives letters from the FDA asking for additional information or deficiency letters. 

PMA day 100 meetings are Q-submission requests held within 100 days of a PMA submission and are used to discuss any deficiencies in the application, and to begin a conversation on the status of the application. FDA guidance on PMA day 100 meetings can be found here.

Complete a quality system audit

Most Class II and III devices, and some Class I devices will require a premarket quality system inspection. During most of the Covid pandemic, inspections were being conducted remotely, but the FDA resumed domestic onsite inspections in February 2022. 

A compliant quality system demonstrates that your facilities are capable of manufacturing the device as designed to meet its intended purpose, and the FDA will evaluate both design controls and manufacturing controls.

Current quality system requirements are defined in 21 CFR part 820 (quality system regulation or “QSR”), however the FDA is moving to harmonize their requirements with the generally accepted global standards of ISO 13485. In addition, the Medical Device Single Audit Program (MDSAP) can be used as an alternative allowing a single audit that is recognized by regulatory authorities in multiple countries, including the FDA.

Whichever path your inspection takes, it is important to put a strong quality system in place as early as possible.

List your medical device on your establishment registration

Any organization involved in the production or distribution of a medical device intended for use in the United States is required to register annually with the FDA. Establishment registration is defined in 21 CFR Part 807. There is an annual registration fee, which is $5,672 for 2022.

Most establishments that are required to register with the FDA must also list the devices and the activities performed on those devices at the establishment. Registration and listing information must be submitted to the FDA within 30 days of a device being put into commercial distribution. You cannot list your device until it has been cleared or approved through a premarket submission process, if required for your device.

The FDA provides detailed information on the device registration and listing process.

Post-market compliance

We will cover post-market surveillance and compliance in a future post, but here are a few things to keep in mind:

  • If your device was approved via a PMA, expect a post-market inspection 8-12 months after approval.
  • Changes to a cleared or approved product may trigger additional reporting and submissions. The significance of the change will dictate the type of reporting required for both 510(k) cleared devices and PMA approved devices.
  • Your quality system should include a CAPA (corrective and preventive action) tracking system to record and address any issues that arise after the device is on the market.

For additional information on FDA submission processes, see our ebooks which cover the 510(k), and De Novo processes.

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AI

From Regulatory Knowledge to Better Market Decisions: A Conversation with Steve Gens and James Gianoutsos

October 1, 2026

4 min read

AI is moving quickly from experimentation to implementation across life sciences. For regulatory teams, that raises a bigger question than where AI can automate a task:

How can organizations use AI to make better decisions while maintaining the traceability, expert oversight, and confidence regulatory work demands?

That was a central theme when James Gianoutsos, Founder and CEO of Rimsys, joined Steve Gens, Founder and Managing Partner of Gens & Associates, on the Regulatory Executive Podcast.

Their conversation explored the changing role of regulatory intelligence, the introduction of Rimsys Market Access, the importance of transparency in regulatory AI, and what these changes could mean for regulatory teams.

Regulatory knowledge has been difficult and costly to scale

For global medtech organizations, regulatory knowledge has traditionally been highly dependent on people.

A company may have specialists responsible for particular countries or regions, along with local representatives, distributors, consultants, and other experts. Those people develop deep knowledge of local regulations, pathways, and expectations.

The problem is that the knowledge often remains distributed across the organization. And maintaining that market-by-market expertise can become expensive as a company expands its portfolio and geographic footprint.

As James described during the podcast, large manufacturers may rely on dozens or even hundreds of internal employees, third-party distributors, local representatives, and other specialists to understand what it takes to bring products into different markets. Smaller organizations may rely more heavily on outside consultants and partners. Either way, the model can be costly and difficult to scale. 

But the cost isn't limited to what companies spend on expertise.

Steve described the workflow as a series of “start, stop” cycles: ask a local expert, verify whether the regulation is current, gather more information, and repeat. Each cycle consumes regulatory capacity and extends the time it takes to give the business a confident answer.

That creates another potentially more consequential expense: the cost of waiting.

When it takes months to understand what entering a market will require, commercial and product teams have less visibility into when revenue might begin, what resources will be needed, or whether the opportunity is worth pursuing. Regulatory teams spend valuable capacity assembling and validating information rather than applying their expertise to more strategic work.

Ultimately, scaling regulatory knowledge isn't simply an efficiency problem. It affects how quickly and confidently the business can decide where to invest.

The bigger question: Should we enter this market?

That challenge is central to Rimsys Market Access.

Most market-entry research begins with questions such as: How is the product classified? What's the regulatory pathway? What are the requirements?

Those questions establish whether a company can enter a market. But they don't necessarily tell the business whether it should.

Market Access is designed to help regulatory and commercial teams develop an earlier view of what market entry could involve, including classification, regulatory pathway, timeline, cost considerations, requirements and potential gaps. 

For commercial and product leaders, that provides greater predictability before committing budget and resources.

For regulatory leaders, it means starting with a structured plan rather than assembling every market assessment from scratch.

Moving regulatory knowledge from individuals into a shared system

During the conversation, James described one of AI's most significant opportunities as moving knowledge that has historically lived in people's heads into software.

The goal isn't to eliminate regulatory expertise. It's to make that expertise more scalable.

Market Access works from a curated regulatory corpus, allowing market-specific knowledge to be applied across workflows without requiring every initial question to go through the individual who happens to know that jurisdiction. Outputs are designed to trace back to the underlying regulation, guidance, or law. 

That can also change where regulatory professionals spend their time. Rather than focusing as heavily on finding information and assembling initial assessments, they can focus on reviewing the evidence, identifying gaps, applying judgment, and advising the business.

Steve described the concept as a subject-matter-expert assistant. James called it a workforce multiplier. 

Trust requires opening the regulatory AI “black box”

Speed isn't enough when the information is being used to inform regulatory decisions.

James and Steve returned repeatedly to the importance of knowing where an AI-generated answer comes from. As Steve summarized it during the discussion, transparency builds trust.

Market Access is designed around that principle. Its outputs are grounded in a curated regulatory corpus and traceable to the specific regulations, guidance, or laws supporting them. That gives regulatory professionals the ability to verify an answer rather than simply accept it. 

Human judgment remains essential as well. Market Access provides an upfront assessment, not a guarantee of a regulatory outcome. Reviewer interpretation and other factors can still affect what happens during the regulatory process.

The objective isn't to make uncertainty disappear. It's to make what is known, what the sources say, and where uncertainty remains much easier to see.

Connecting the market decision to execution

The discussion also pointed to a broader evolution in regulatory technology: moving from systems that primarily store regulatory information toward systems that help teams act on it.

That's where Market Access and Rimsys RIM play distinct but complementary roles.

Market Access is the planning layer. It helps teams determine whether, when, and how to enter a market.

Rimsys RIM is the execution layer. It manages the registrations, submissions, regulatory changes, and ongoing regulatory work required to act on that plan. 

Together, they create a path from the initial market decision through regulatory execution rather than leaving planning and execution disconnected.

A new role for AI in regulatory work

One of the most interesting themes from Steve and James's conversation was that AI's impact may ultimately be less about replacing individual tasks and more about expanding what regulatory teams can accomplish.

Better access to market-specific knowledge can help professionals work across more markets, spend less time gathering information, and devote more capacity to the judgment and strategic work that requires their expertise.

The technology is changing quickly, but the fundamentals of regulatory work remain: reliable information, domain expertise, transparency, and human judgment.

The opportunity is to apply those fundamentals at greater scale while giving the business a clearer answer to the question that comes before execution:

Not simply, “Can we enter this market?”

But, “Should we?”

Listen to the full conversation

Hear the complete discussion between Steve Gens, Founder and Managing Partner of Gens & Associates, and James Gianoutsos, Founder and CEO of Rimsys, on the Regulatory Executive Podcast for more on regulatory AI, market-entry planning, transparency, and the changing role of regulatory teams.

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AI

How Market Access Builds Trust in Regulatory Intelligence

By

Bethaney Lentz

September 18, 2026

4 min read

Why source traceability, regulatory specificity, and human judgment matter when AI informs a market-entry decision.

Regulatory professionals are not short on AI options. General-purpose tools can answer questions quickly and often sound convincing. But in medtech, a convincing answer is not the same thing as a decision you can defend.

That distinction matters most before a company commits to a new market. Teams need to understand how a product is classified, which pathway applies, how long entry may take, what it may cost, where the important gaps are, and what uncertainty still remains. Commercial leaders need that visibility to decide whether the opportunity is worth pursuing. Regulatory leaders need to know that the assessment is grounded in sources they can verify.

That is the trust standard behind Rimsys Market Access. It is not simply about producing regulatory information faster. It is about helping medtech teams decide whether, when, and how to enter a market before committing budget and resources, with outputs linked back to the regulations, guidance, and laws behind them.

Why fluency is not enough for regulatory work

A general AI tool can be useful for brainstorming, summarizing, and exploring a topic. The challenge comes when an answer has real regulatory consequences. A plausible response may still be incomplete, based on the wrong designation, or disconnected from the current source that should govern the decision.

Medtech makes this especially difficult because the same product can be treated differently across markets and product designations. Medical device, IVD, cosmetic, consumer, OTC, and combination-product considerations can change the regulatory read. A market-entry assessment has to account for that context rather than assume one answer travels cleanly from one jurisdiction to another.

For regulatory teams, the natural next question is: Where did this answer come from? If the system cannot show the underlying authority, the expert still has to rebuild the research before trusting the result. That limits the value of the speed AI was supposed to create in the first place.

Trust starts with a decision you can verify

Market Access is designed around a different outcome. The goal is not to give teams another stream of regulatory information to interpret. It is to provide a source-linked market plan that helps them answer the bigger business question: should we enter this market, not just can we?

For a market assessment, that can include classification, regulatory pathway, timeline, cost considerations, key requirements and potential gaps. The output is designed to give commercial and product leaders an earlier, more defensible view of the opportunity while giving regulatory professionals the detail they need to review the basis for the assessment.

Trust comes from being able to inspect that basis. Market Access works from a curated regulatory corpus spanning more than 200 markets rather than relying on the open web. Answers are linked to the specific regulation, guidance, or law behind them, so a regulatory professional can verify the source instead of being asked to accept an AI-generated conclusion on faith.

Three things make regulatory intelligence more defensible

1. Source traceability

A regulatory answer is more useful when the person reviewing it can follow the evidence. Market Access links outputs back to their underlying regulatory sources. That changes the review process from “Do I trust the AI?” to a more practical question: “Does the cited source support this conclusion for our product and situation?”

That is an important shift for regulatory teams. Instead of assembling every market assessment from a blank page, they can review a structured, sourced plan, challenge assumptions, and focus their expertise on the places where judgment matters most.

2. Regulatory specificity

Trust also depends on context. Market Access is purpose-built for medtech regulatory complexity and supports cross-designation classification. The objective is to evaluate the product in the context of the market and the applicable regulatory framework, then carry that context into the pathway, requirements, timeline, cost considerations, and gaps that shape the market-entry decision.

This is where a purpose-built market-planning platform differs from a generic chat experience. The value is not an impressive answer in isolation. It is a connected assessment that helps the team understand what entering the market is likely to require and whether the opportunity still makes sense once those requirements are visible.

3. Human judgment stays in control

No system can remove every area of uncertainty from regulatory work. Reviewer interpretation and expert judgment still affect outcomes, and Market Access is not designed to promise approval.

Instead, Market Access is designed to make uncertainty more manageable. Regulatory professionals review and validate the work before it moves into execution. They can verify sources, assess the gaps, and apply company and product context that software cannot fully replace. The technology accelerates the research and planning. The regulatory professional remains responsible for the judgment.

What trust looks like in a market-entry decision

Imagine a team evaluating several markets for a new product. The commercial question is not simply whether registration is technically possible. The team needs to know which markets deserve investment now, which may require more evidence or resources, and which could put the revenue window at risk because the pathway is longer or more complex than expected.

Regulatory has a different, but connected, need. They have to understand the classification and pathway, identify the requirements most likely to slow the submission, and confirm that the plan reflects the relevant regulatory sources.

Market Access brings those views together. Commercial and product leaders get earlier visibility into timing, cost considerations, requirements, and risk so they can build a stronger business case. Regulatory teams get a source-linked plan they can review rather than a collection of unsupported conclusions. Both groups are working from the same market-entry picture before significant resources are committed.

Trust is not the end goal. Better decisions are.

It is easy for a conversation about regulatory AI to become a conversation about models, agents, or architecture. Those details matter, but they are not the business outcome.

The real value of trustworthy regulatory intelligence is what it lets a team do next. It can help a commercial leader defend a market investment. It can help regulatory surface issues earlier. It can give both groups a more predictable view of the work ahead before budget, R&D capacity, or launch timing is locked in.

And once the decision is made, the work does not have to stop at an intelligence report. Market Access is the market-planning layer. Rimsys RIM is the execution layer for registrations, submissions, regulatory changes, and ongoing regulatory work. Each can stand on its own, and together they create a path from the market-entry decision into controlled execution.

A more useful standard for regulatory AI

The question for medtech teams should not be whether AI can produce a regulatory answer. It can. The better question is whether that answer is specific enough, traceable enough, and reviewable enough to support a real decision.

Market Access is built around that standard: a defensible view of whether, when, and how to enter a market, grounded in curated regulatory sources and kept under human review. Because when the decision affects revenue, resources, and regulatory strategy, sounding right is not enough. Teams need to see why the answer is right, where uncertainty remains, and what it means for the decision in front of them.

Company

Product Updates

Rimsys Announces AI-Native Market Access for Regulated Products

By

Bethaney Lentz

September 1, 2026

4 min read

New software gives regulatory and commercial leaders a source-linked, actionable view of market viability, requirements, timing, and risk before committing resources

PITTSBURGH, PA, September 1, 2026 - Rimsys, the heart of medtech regulatory operations, today announced Market Access, a new AI-native product designed to help companies determine whether a market is worth entering and what it will take to get there. Market Access will be available in beta beginning September 1, 2026, with general availability to be announced separately.

Market Access replaces what can be a 6-to-9-month research and assessment process with a same-day, actionable read on market viability. It gives regulatory and commercial leaders the classification, pathway, timeline, cost considerations, and potential regulatory gaps they need to make a more defensible investment decision before committing budget and resources.

Predictability is at the core of Market Access. Rather than simply identifying a regulatory pathway, it helps teams understand what to expect, which requirements or gaps are most likely to slow down a submission, and where uncertainty remains. Every answer traces back to the specific regulation, guidance, or law behind it, allowing regulatory professionals to verify the underlying source rather than simply trust an AI-generated response.

Key features and benefits include:

  • Same-day market assessment: Provides an actionable read on whether a market is worth entering, replacing research and assessment that can take 6 to 9 months.
  • Cross-designation classification: Evaluates products across medical device, IVD, cosmetic, consumer, and OTC designations, so the same product receives the appropriate regulatory read regardless of how a given market classifies it.
  • Clear market-entry requirements: Provides classification, regulatory pathway, timeline, cost considerations, and key requirements before teams commit resources.
  • Earlier visibility into regulatory gaps: Surfaces the specific requirements and gaps most likely to slow down a submission and helps teams understand their potential severity.
  • Greater predictability: Provides visibility into anticipated regulatory response windows, risks, and areas of uncertainty so teams can better plan for what lies ahead.
  • Source-linked intelligence: Traces answers to the underlying regulations, guidance, and laws so regulatory professionals can verify the basis for an assessment.
  • AI with human oversight: Uses Rimsys AI and Market Manager Agents to accelerate complex regulatory research while keeping regulatory professionals in control of review and validation.
  • Connected planning and execution: Complements RIM, connecting market-entry decisions with the registrations, submissions, regulatory changes, and ongoing compliance required to execute them.

“Regulatory knowledge has traditionally been highly dependent on individual expertise and market-by-market research,” said James Gianoutsos, Founder and CEO of Rimsys. “Market Access gives companies greater predictability before they make a market investment. Teams can understand whether an opportunity is worth pursuing, what it will take to enter, where regulatory challenges are likely to emerge, and what uncertainty remains. And because every answer is tied to its regulatory source, experts can verify the recommendation rather than simply trust the AI.”

Market Access is powered by Rimsys AI, which works from a curated regulatory corpus spanning more than 200 markets, not the open web. Its Market Manager Agents are AI agents with market-specific regulatory knowledge, including pathways, requirements, and documentation, that support market assessments and global launch planning. The product is also designed to acknowledge areas where reviewer interpretation and expert judgment can affect regulatory outcomes rather than presenting those outcomes as more predictable than they are.

Market Access expands the Rimsys product portfolio from regulatory execution into market planning. Market Access helps regulatory and commercial leaders determine where to compete, while RIM manages the registrations, submissions, regulatory changes, product data, and ongoing compliance required to enter and remain in those markets. Together, they turn regulatory intelligence into coordinated action, helping regulatory teams accomplish more in every hour while giving business leaders greater visibility into opportunities, risk, and the work required to protect and grow revenue.

Beta Availability

Market Access will be available in beta beginning September 1, 2026. During the beta period, Rimsys will continue validating product capabilities and refining workflows ahead of broader commercial availability. 

Organizations interested in learning more about Market Access or participating in the beta program can visit rimsys.io/products/market-access.

About Rimsys

Rimsys is the heart of regulatory operations, connecting AI-native market planning with AI-embedded regulatory execution, giving medtech manufacturers one living system from market-entry decision to execution. 

Rimsys Market Access is the planning layer, answering not just whether a market can be entered, but whether it should be, returning classification, pathway, timeline, and cost before a team commits budget or resources to finding out. Rimsys RIM is the execution layer, managing registrations, submissions, regulatory changes, and compliance so teams can act on that plan with confidence.

Trusted by 6 of the top 12 global MedTech manufacturers and certified to ISO 27001 and SOC 2, with ISO 42001 certification for AI management systems underway, Rimsys keeps regulatory intelligence, product data, approvals, and change management continuously connected so teams can enter new markets with speed and assurance. Learn more at rimsys.io.

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