A European regulatory pathway for Tidepool loop following clearance in the United States?

Author:

Downey Laura1,O'Donnell Shane12,Melvin Tom3,Quigley Muireann1

Affiliation:

1. Birmingham Law School University of Birmingham Birmingham UK

2. College of Business University College Dublin Dublin Ireland

3. School of Medicine, Trinity College University of Dublin Dublin Ireland

Abstract

AbstractThe recent clearance by the United States Food and Drug Administration of Tidepool Loop sets an important precedent within the medical device landscape. For the first time, an automated insulin delivery mobile application—based on an algorithm initially designed and developed by users —has been recognised as safe and effective by a regulatory body. The aim of this paper is twofold: firstly, we map out the regulatory pathways and processes that were navigated by Tidepool, the non‐profit behind Tidepool Loop, in order to make this landmark moment possible. Secondly, we set out potential approvals processes in the European Union and United Kingdom with a view to examining the challenges to obtaining regulatory clearance for Tidepool Loop in these jurisdictions. In so doing, we highlight the significant differences, not only between the United States and European systems but also between the European Union and Great Britain systems. We conclude by arguing that the complexity encountered when seeking to introduce an innovative solution in different regulatory systems has the potential to act as a disincentive to open source developers from seeking regulatory approvals for such technologies in the future.

Funder

Wellcome Trust

Research England

Publisher

Wiley

Subject

Endocrinology,Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference41 articles.

1. Tidepool. 501(k) Summary.https://drive.google.com/file/d/1gEewNzwPmBQ6spn02EAigiRmp83t4t42/view. Accessed 21 September 2023.

2. Why #WeAreNotWaiting—Motivations and Self-Reported Outcomes Among Users of Open-source Automated Insulin Delivery Systems: Multinational Survey

3. ClealB LangstrupH GarfinkelJ.Living on the loop—agency skill and (re)enchantment in DIY artificial pancreas system use.2021.http://francisconunes.me/RealizingAIinHealthcareWS/papers/Cleal2021.pdf. Accessed 14 August 2023.

4. The First Regulatory Clearance of an Open-Source Automated Insulin Delivery Algorithm

5. A Real-World Prospective Study of the Safety and Effectiveness of the Loop Open Source Automated Insulin Delivery System

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