State of Illinois
91st General Assembly
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91_SB1218

 
                                              LRB9100611DJsbB

 1        AN  ACT to amend the Illinois Food, Drug and Cosmetic Act
 2    by changing Section 16.5.

 3        Be it enacted by the People of  the  State  of  Illinois,
 4    represented in the General Assembly:

 5        Section   5.  The Illinois Food, Drug and Cosmetic Act is
 6    amended by changing Section 16.5 as follows:

 7        (410 ILCS 620/16.5)
 8        Sec. 16.5. Single-use surgical devices.
 9        (a)  Legislative findings.  The  General  Assembly  finds
10    that  certain  surgical  devices  are designed to be used for
11    only one surgical procedure. Further, the  reuse,  recycling,
12    and  refurbishing of surgical devices intended for single use
13    have been linked to  cases  of  patient  infection,  chemical
14    injury,  and  mechanical failure. It is therefore the purpose
15    of this Section to protect the public health  and  safety  by
16    prohibiting    the    unregulated   reuse,   recycling,   and
17    refurbishing of single-use surgical devices.
18        (b)  Definitions.  For purposes of this Section:,
19        "Department" means the Department of Public Health.
20        "End-of-life"  means   an   established   time-to-failure
21    period, determined by the original device manufacturer, based
22    upon   reliability   data  and  analysis  to  characterize  a
23    non-repairable product.
24        "Manufacturer" means any person or  entity  who  designs,
25    manufactures,  fabricates, assembles, or processes a finished
26    device. "Manufacturer" includes, but is not limited to, those
27    who  perform  the  functions   of   contract   sterilization,
28    installation,   relabeling,  remanufacturing,  repacking,  or
29    specification  development,  and  initial   distributors   of
30    foreign entities performing these functions.
31        "Recondition"  or "rebuild" means to acquire ownership of
 
                            -2-               LRB9100611DJsbB
 1    used finished devices  and  restore  or  refurbish,  or  both
 2    restore  and  refurbish,  these  to the device manufacturer's
 3    original or current specifications,  or  new  specifications,
 4    for purposes of resale or commercial distribution.
 5        "Refurbish"  or  "reprocess" means to process, condition,
 6    renovate,  or  restore  a  finished  device  which  has  been
 7    previously  distributed  and  has  reached  its   established
 8    end-of-life or is considered to be non-repairable.
 9        "Single-use  surgical  device"  means a cardiac catheter,
10    angioplasty  balloon  catheter,  arthroscopic  knee   surgery
11    blade,  and any other device marketed or sold as a disposable
12    or single-use device, or labeled by its original manufacturer
13    or distributor as being intended or designed  for  use  in  a
14    single  surgical  procedure,  as  determined  by  rule of the
15    Department of Public Health to  be  designed  for  use  in  a
16    single  surgical  procedure  to  avoid risk of infection from
17    improper sterilization or risk of mechanical failure posed by
18    subsequent use.
19        "Substantial compliance" means meeting  the  requirements
20    set  forth  in  this  Section, except for variations from the
21    strict and literal performance of  those  requirements  which
22    result  in  insignificant  omissions  and  defects, given the
23    particular circumstances and the history of the omissions and
24    defects. Omissions and defects that have an adverse impact on
25    public  health   and   safety   shall   not   be   considered
26    insignificant    and    shall   be   considered   substantial
27    noncompliance.
28        (c)  Prohibited  actions.   No  person  or  entity  shall
29    knowingly reuse, recycle, reprocess, or refurbish for  reuse,
30    or  provide  for  reuse of, a single-use surgical device, nor
31    shall  any  person  or  entity  recondition  or   rebuild   a
32    single-use  surgical  device,  unless  each  of the following
33    conditions is met:
34             (1)  If  the  person  or  entity  doing  the  reuse,
 
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 1        recycling,  reprocessing,  refurbishing  for  reuse,   or
 2        providing  for  the reuse of a single-use surgical device
 3        is a hospital licensed under the Hospital  Licensing  Act
 4        or  the  University  of  Illinois  Hospital  Act, and has
 5        purchased the single-use surgical device for  use  within
 6        the hospital, it shall do all of the following:
 7                  (A)  Certify,   if   the   hospital  is  itself
 8             recycling,   reprocessing,   or   refurbishing   the
 9             single-use  surgical   device,   that   it   is   in
10             substantial    compliance    with    current    good
11             manufacturing  practices (CGMPs) for medical devices
12             under   the   United   States    Food    and    Drug
13             Administration's  Quality  System Regulation (21 CFR
14             820).
15                  (B)  Demonstrate,   whether   the    single-use
16             surgical   device   is   recycled,  refurbished,  or
17             reprocessed by the hospital  itself  or  some  other
18             entity on behalf of the hospital, that:
19                       (i)    the  single-use  surgical device is
20                  capable of withstanding necessary cleaning  and
21                  resterilization techniques and methods;
22                       (ii)   the   physical  characteristics  or
23                  quality of the single-use surgical device  will
24                  not be adversely affected; and
25                       (iii)   the   single-use  surgical  device
26                  remains safe and  effective  for  its  intended
27                  use.
28                  (C)  Ensure  that its employees or other agents
29             who reuse, recycle, refurbish for reuse,  reprocess,
30             or  provide  for  reuse  of  a  single-use  surgical
31             device,    whether    recycled,    reprocessed,   or
32             refurbished  by  the  hospital  or  another  entity,
33             obtain, prior to treating any patient with a reused,
34             recycled,  reprocessed,  or  refurbished  single-use
 
                            -4-               LRB9100611DJsbB
 1             surgical device, a written,  informed  consent  from
 2             the  patient,  or,  if the patient is not competent,
 3             his or her legal guardian, stating that the patient:
 4                       (i)  understands that he or  she  will  be
 5                  treated with a reused, recycled, or refurbished
 6                  device  that was originally designed, marketed,
 7                  and sold as a disposable or single-use device;
 8                       (ii)  is  aware  of  the  potential  risks
 9                  (such as infection from the device's use  on  a
10                  previous    patient,   chemical   injury   from
11                  incomplete    sterilization    processes,    or
12                  malfunction due to mechanical  failure  of  the
13                  device)  and  the potential benefit (lower cost
14                  of the surgical procedure); and
15                       (iii)  does not object, and agrees to  the
16                  use  of  the  reused, recycled, reprocessed, or
17                  refurbished single-use surgical device.
18                  (D)  Bear full responsibility  for  the  safety
19             and   effectiveness   of   the   reused,   recycled,
20             reprocessed,   or  refurbished  single-use  surgical
21             device.
22                  (E)  File a report with the United States  Food
23             and  Drug  Administration,  as  a  manufacturer,  in
24             compliance  with  21  CFR 803, and forward a copy of
25             the report to the Department, whenever the  hospital
26             becomes  aware  of  information that suggests that a
27             single-use  surgical   device   that   was   reused,
28             recycled,   reprocessed,   or   refurbished  by  the
29             hospital,  or  another  entity  on  behalf  of   the
30             hospital, may have:
31                       (i)  caused  or  contributed to a death or
32                  serious injury; or
33                       (ii)  malfunctioned,  and  the  single-use
34                  surgical device or a similar device that  would
 
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 1                  be    reused,    recycled,    reprocessed,   or
 2                  refurbished by the hospital, or another  entity
 3                  on  behalf  of the hospital, would be likely to
 4                  cause  a  death  or  serious  injury   if   the
 5                  malfunction were to recur.
 6                  (F)  Ensure  substantial  compliance  with this
 7             Section,  regardless   of   whether   the   hospital
 8             contracts  or  subcontracts  any  of its obligations
 9             under this Section, including every contractor's and
10             subcontractor's compliance with subdivision (c)(2).
11             (2)  If  the  person  or  entity  doing  the  reuse,
12        recycling,  reprocessing,  refurbishing  for  reuse,   or
13        providing  for  the reuse of a single-use surgical device
14        is not a hospital licensed under the  Hospital  Licensing
15        Act or the University of Illinois Hospital Act, or if any
16        person  or  entity  is  reconditioning  or  rebuilding  a
17        single-use  surgical  device,  it  shall  do  all  of the
18        following:
19                  (A)  Register with the United States  Food  and
20             Drug  Administration  as set forth in section 510 of
21             the Federal Act and 21 CFR 807.20(a).
22                  (B)  Submit to the United States Food and  Drug
23             Administration,  for  each  type  and  brand  of the
24             specific single-use surgical device  it  intends  to
25             recycle,   reprocess,   refurbish,  recondition,  or
26             rebuild, either  (i)  a     pre-market  notification
27             ("510(k)") or (ii) a pre-market approval application
28             (PMA).
29                  (C)  Receive  from  the  United States Food and
30             Drug    Administration,    prior    to    recycling,
31             reprocessing,   refurbishing,   reconditioning,   or
32             rebuilding any single-use  surgical  device,  either
33             (i)  a  determination of substantial equivalence for
34             each submitted pre-market notification ("510(k)") or
 
                            -6-               LRB9100611DJsbB
 1             (ii) an    approval  of  each  submitted  pre-market
 2             approval  application  (PMA).   The person or entity
 3             also  shall  provide  a  copy  of  the   appropriate
 4             documentation to the Department.
 5                  (D)  Certify   that   it   is   in  substantial
 6             compliance with current good manufacturing practices
 7             (CGMPs) for medical devices under the United  States
 8             Food   and   Drug  Administration's  Quality  System
 9             Regulation (21 CFR 820).
10                  (E)  File a report with the United States  Food
11             and  Drug  Administration,  as  a  manufacturer,  in
12             compliance  with  21  CFR 803, and forward a copy of
13             the report to the Department, whenever the person or
14             entity doing  the  reuse,  recycling,  reprocessing,
15             refurbishing for reuse, providing for the reuse of a
16             single-use   surgical   device,  reconditioning,  or
17             rebuilding  a  single-use  surgical  device  becomes
18             aware of information that suggests that a single-use
19             surgical   device   that   was   reused,   recycled,
20             reprocessed, refurbished, reconditioned, or  rebuilt
21             by the person or entity may have:
22                       (i)  caused  or  contributed to a death or
23                  serious injury; or
24                       (ii)  malfunctioned,  and  the  single-use
25                  surgical device or a similar device that  would
26                  be    reused,    recycled,    reprocessed,   or
27                  refurbished by the hospital, or another  entity
28                  on  behalf  of the hospital, would be likely to
29                  cause  a  death  or  serious  injury   if   the
30                  malfunction   were   to  recur.  However,  this
31                  Section does not apply to persons who  utilize,
32                  recycle   or   reprocess  for  utilization,  or
33                  provide for utilization a  single-use  surgical
34                  device  that  has been reprocessed by an entity
 
                            -7-               LRB9100611DJsbB
 1                  or person registered with and regulated by  the
 2                  United  States  Food and Drug Administration or
 3                  reprocessed by a hospital  licensed  under  the
 4                  Hospital  Licensing  Act  or  the University of
 5                  Illinois Hospital Act.
 6        (d)  Labeling. Any single-use  surgical  device  that  is
 7    recycled, reprocessed, refurbished, reconditioned, or rebuilt
 8    in  accordance  with this Section must be labeled with all of
 9    the following:
10             (1)  The  name   and   address   of   the   original
11        manufacturer of the device.
12             (2)  All  original  labeling applied by the original
13        manufacturer of the device.
14             (3)  The name and address of the hospital  or  other
15        entity    conducting    the    recycling,   reprocessing,
16        refurbishing,  reconditioning,  or  rebuilding   of   the
17        single-use surgical device.
18             (4)  The    date    of    recycling,   reprocessing,
19        refurbishing,  reconditioning,  or  rebuilding   of   the
20        single-use surgical device.
21             (5)  The  number  of  times  the specific single-use
22        surgical   device   has   been   recycled,   reprocessed,
23        refurbished, reconditioned, or rebuilt.
24             (6)  All labeling as specified by the United  States
25        Food  and  Drug  Administration  in  a cleared pre-market
26        submission.
27             (7)  A statement indicating that the device has been
28        recycled,  reprocessed,  refurbished,  reconditioned,  or
29        rebuilt.
30        (e)  Penalties.
31             (1)  The   reuse,   recycling,   reprocessing,    or
32        refurbishing  of a single-use surgical device in a manner
33        contrary to the requirements of this Section renders  the
34        device  adulterated  within the meaning of Section 14 and
 
                            -8-               LRB9100611DJsbB
 1        misbranded within the meaning of Section 15.
 2             (2)  Failure to comply with the provisions  of  this
 3        Section  is prima facie evidence that the surgical device
 4        is unreasonably dangerous and unfit for its intended use.
 5        
 6             (3)  A person or entity convicted of violating  this
 7        subsection  is  guilty of a business offense and shall be
 8        fined not less than $1,000 for the  first  violation  and
 9        not   less   than  $2,000  for  a  second  or  subsequent
10        violation.
11        (f)  Hearings.  If  any  fine  is  imposed  pursuant   to
12    subdivision  (e)(3),  the  person  or entity against whom the
13    fine is imposed may request a hearing in accordance with this
14    Act and the Department's rules.
15    (Source: P.A. 90-398, eff. 1-1-98.)

16        Section 99.  Effective date.  This Act takes effect  upon
17    becoming law.

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