This article deals with the latest rules of Physical Support as a Medical Device in India – Non Notified Medical Device Registration. Indian healthcare regulators at the Central Drugs Standard Control Organization (CDSCO) have issued substantial new risk-based classification lists for Physical Support and Medical Device in India. All Physical Support Products now need to be registered in order to comply with the latest Medical Device Rules in India ( i.e 30th September, 2021).  Below is a table which helps manufacturers classify their products and apply with the Indian Health Ministry Accordingly. The total number of Devices classified are 38. 

Table: Physical Support As Medical Device India

S.NoName of the MedicalDeviceIntended useClassification
1Ankle continuous passivemotion exerciserElectrical device intended tocontinuously move the ankle joint (e.g.,flexion, inversion/eversion) withoutpatient assistance during continuouspassive motion (CPM) exercisetherapy usually following surgery ortrauma to the joint.B
2Ankle/foot orthosisIntended to encompass the ankle joint,or the ankle and foot, to support, align,prevent, or correct orthopaedicdeformities/injuries or to improvefunction of the ankle and/or foot; it mayalso be intended to offload andredistribute foot pressures that affectpedal circulation to improve blood flowand help heal diabetic foot ulcers orpostsurgical wounds.A
3Balance boardIntended to train patient with difficultiesin balance (e.g., a paraplegic or astroke victim) walks for balancetraining.A
4Bed traction frameIntended to treat patients with fracturesand other orthopaedic disorders (e.g.,of the lower or cervical spine, hip).A
5Body arch traction tableIntended to support the body of apatient and provide traction for theback muscles and spine by flexing thepatient into a reverse supine bodyarch.A
6Canalith repositioningprocedure chair, manualIntended to treat balance disorders[e.g., benign paroxysmal positionalvertigo (BPPV), canalithiasis] causedby displaced canaliths (otoconia) in theinner ear of the patientA
7Cervical spine collarIntended to support or immobilize thecervical spine to treat deformities,fractures, sprains, or strains (often totreat whiplash resulting from anautomobile accident).A
8Cervical spineimmobilization head ringIntended to be fixed to the skull of apatient at brow level using pointed,steel, threaded bolts (typically four)that are adjusted to penetrate the outerbone of the skull.D
9Cervicothoracic spineorthosisIntended to support or immobilizedeformities, fractures, sprains, orstrains of the cervicothoracic spine.A
10Cervicothoracolumbosacralspine orthosisIntended to encompass thecervicothoracolumbosacral spineregion of the neck and trunk.A
11Chest-oscillation airwaysecretion clearing systemIntended to rapidly inflate and deflateagainst the chest wall of the patient forpromoting airway clearance bycreating high frequency chest walloscillation (HFCWO), resulting in themobilization of bronchial secretions.B
12Collar and cuff arm slingmaterialFabric and form composite materialintended to immobilize forearm, elbow,humerus or shoulder injuries.A
13Cranial orthosisIntended to be worn on the head of aninfant with an abnormal head shape(e.g., due to plagiocephaly,brachycephaly, scaphocephaly), orafter craniosynostosis repair surgery,to apply pressure to the cranium andimprove cranial symmetry/shapeduring growth over a period of months.A
14Elbow orthosisIntended to encompass the elbow jointto support, align, prevent, or correctdeformities/injuries or to improvefunction of the elbow.A
15Finger orthosisIntended to encompass the whole orpart of the finger to support, align,prevent, or correct deformities/injuriesor to improve function of the finger.A
16Flotation therapy bed,adultIntended to minimize pressure pointson a patient’s body by providingcontact with as much of the bodysurface as possible, typically through amattress that contains a large volumeof constantly moving media, e.g.,water, air, or mud that lifts the patientto simulate a floating effect.B
17Flotation therapy bed,neonatalIntended to minimize pressure pointson neonatal patient’s body byproviding contact with as much of thebody surface as possible, typicallythrough a mattress that contains alarge volume of constantly movingmedia, e.g., water, air, or mud that liftsthe patient to simulate a floating effect.B
18Foot orthosisIntended to encompass the whole orpart of the foot, or designed as aplantar insert, and intended to providerigid or semi-rigid correction of the footfor persons with orthopaedicdeformities/injuries of the feetA
19Hand orthosisIntended to encompass the whole orpart of the hand to support, align,prevent, or correct deformities/injuriesor to improve function of the hand.A
20Hand/finger splintIntended to immobilize an injured handto protect injuries to, e.g., the digits,metacarpals, and wrist during thehealing process.A
21Hand/wrist continuouspassive motion exerciserA mains electricity (AC-powered)deviceIntenedd to continuously movethe metacarpal/interphalangeal joints(e.g., flexion and extension) withoutpatient assistance during continuouspassive motion (CPM) exercisetherapy usually following surgery ortrauma to the joints.B
22Hip/knee continuouspassive motion exerciserA mains electricity (AC-powered)device Intended to provide continuouspassive motion (CPM) exercisetherapy for the hip and/or knee,typically following joint surgery/traumato promote healing; some types mayalso operate with patient assistanceunder controlled active motion (CAM).B
23Horizontal non-poweredtraction systemNon powered device intended to beattached to a table for the applicationof constant horizontal traction forces tothe cervical or lumbar vertebrae bymeans of attached harnesses whilstthe patient typically lies in a supineposition on the table during treatment.A
24Incentive spirometerIntended to be used in respiratorytherapy to encourage and motivatedeep-breathing manoeuvres, typicallyfor the postsurgical treatment andprevention of atelectasis (lungcollapse) and to help facilitate airwayopening and clearing.A
25Intermittent traction systemIt is an AC powered electronic device.Intended to apply and relieve pre-settraction forces from a motor throughharnesses typically attached to thecervical or lumbar vertebrae.B
26Kinetic bedIntend to enable continuous change ofthe patient’s lying position, e.g., it cantilt the entire bed mattress supportsystem (this includes the mattress, theframework that supports the mattress,and the bedding) lengthways,sideways or to a near vertical tilt.A
27Knee immobilizerIntended to temporarily render theknee immovable, either preoperativelyor following injury or arthroscopy.A
28Neuro-controlledambulation exoskeletonIntended to assist a patient with awalking disability (neurogenic,muscular, or osseous in origin) regainlost motor function by transmission ofthe patient’s residual nerve function,via cutaneous electrodes, to the devicemotor assembly.C
29Orthopaedic bedIntended to provide support for skeletaltraction to stabilize fracture sites.A
30Paediatric dorsiflexionslant boardIntended to be used in the treatment ofvarious medical conditions (e.g.,congenital, neurological, post-traumatic) in paediatrics, where tendontightness and muscle contractureaffect the ability to dorsiflex the foot,possibly leading to an abnormal gaitA
31Parapodium walking frameIntended to encompasses and providesupport for the body of a patient who isunable to stand unassisted to helpthem move (walk) by changing theircentre of gravity (COG).A
32Physical therapy massagerElectrically powered device intended toprovide therapeutic massage to alarger area than hand-held massagingdevices.B
33Shoulder continuouspassive motion exerciserIt is a mains electricity (AC-powered)device Intended to continuously movethe shoulder joint (e.g., flexion,rotation, adduction/abduction) withoutpatient assistance during continuouspassive motion (CPM) exercisetherapy usually following surgery ortrauma to the joint.B
34Shoulder immobilizerIntended to temporarily immobilize orlimit abduction of the shoulder joint tosupport healing of an injury or asurgical wound.A
35Swivel-walkerIntended to encompasses and providesupport for the body of a patient who isunable to stand unassisted, to helpthem move (walk) by rocking sideways(shifting their weight from side-to-sidewith a shoulder movement) whichmakes the footplate of the deviceswivel so that it “walks” forward.A
36Toe separatorIntended to space the toes of the footto relieve pain, pressure/frictionbetween toes, and/or to facilitaterealignment of the toes to a naturalposition.A
37Traction table, line-poweredIntended to support a patient and toprovide traction for the back musclesand spine (e.g., lumbar, cervical) by amotorized mechanical manipulation ofthe spine.B
38Wrist immobilizerIntended to temporarily render thewrist immovable as therapy for non-displaced fractures, strains, sprains,and muscle injuries of the wrist.A

Conclusion

The above article is taken from S.O 648(E) & G.S.R 102(E) which mentions that all Medical Devices will be regulated in a phase manner. The CDSCO has classified the MDR in India as Appendix A based on the Intended Use, Risks Associated and Other Parameters Specified with the device. The above table has the general intended use against each device, however if any specific intended use for a particular device, it has to be mentioned by the manufacturer. The list is dynamic and is subject to changes. To obtain MDR in India, contact Morulaa. We at Morulaa will help you understand the latest rules for Physical Support  As a Medical Device India. We are a turnkey solution provider with an in-house Medical Device Consultancy team to conduct registrations of Medical Devices in India. In order to comply with the deadline 30th September of Physical Support as a Medical Device in India contact us at admin@morulaa.com. You can also subscribe to our website to learn about the Latest Rules and Medical Regulations.