Risk Management Specialist
ISO 14971:2019 risk management implementation throughout the medical device lifecycle.
Table of Contents
Risk Management Planning Workflow
Establish risk management process per ISO 14971.
Workflow: Create Risk Management Plan
Define scope of risk management activities:
- Medical device identification
- Lifecycle stages covered
- Applicable standards and regulations
Establish risk acceptability criteria:
- Define probability categories (P1-P5)
- Define severity categories (S1-S5)
- Create risk matrix with acceptance thresholds
Assign responsibilities:
- Risk management lead
- Subject matter experts
- Approval authorities
Define verification activities:
- Methods for control verification
- Acceptance criteria
Plan production and post-production activities:
- Information sources
- Review triggers
- Update procedures
Obtain plan approval
Establish risk management file
Validation: Plan approved; acceptability criteria defined; responsibilities assigned; file established
Risk Management Plan Content
| Section | Content | Evidence |
|---|---|---|
| Scope | Device and lifecycle coverage | Scope statement |
| Criteria | Risk acceptability matrix | Risk matrix document |
| Responsibilities | Roles and authorities | RACI chart |
| Verification | Methods and acceptance | Verification plan |
| Production/Post-Production | Monitoring activities | Surveillance plan |
Risk Acceptability Matrix (5x5)
| Probability \ Severity | Negligible | Minor | Serious | Critical | Catastrophic |
|---|---|---|---|---|---|
| Frequent (P5) | Medium | High | High | Unacceptable | Unacceptable |
| Probable (P4) | Medium | Medium | High | High | Unacceptable |
| Occasional (P3) | Low | Medium | Medium | High | High |
| Remote (P2) | Low | Low | Medium | Medium | High |
| Improbable (P1) | Low | Low | Low | Medium | Medium |
Risk Level Actions
| Level | Acceptable | Action Required |
|---|---|---|
| Low | Yes | Document and accept |
| Medium | ALARP | Reduce if practicable; document rationale |
| High | ALARP | Reduction required; demonstrate ALARP |
| Unacceptable | No | Design change mandatory |
Risk Analysis Workflow
Identify hazards and estimate risks systematically.
Workflow: Conduct Risk Analysis
Define intended use and reasonably foreseeable misuse:
- Medical indication
- Patient population
- User population
- Use environment
Select analysis method(s):
- FMEA for component/function analysis
- FTA for system-level analysis
- HAZOP for process deviations
- Use Error Analysis for user interaction
Identify hazards by category:
- Energy hazards (electrical, mechanical, thermal)
- Biological hazards (bioburden, biocompatibility)
- Chemical hazards (residues, leachables)
- Operational hazards (software, use errors)
Determine hazardous situations:
- Sequence of events
- Foreseeable misuse scenarios
- Single fault conditions
Estimate probability of harm (P1-P5)
Estimate severity of harm (S1-S5)
Document in hazard analysis worksheet
Validation: All hazard categories addressed; all hazards documented; probability and severity assigned
Hazard Categories Checklist
| Category | Examples | Analyzed |
|---|---|---|
| Electrical | Shock, burns, interference | ☐ |
| Mechanical | Crushing, cutting, entrapment | ☐ |
| Thermal | Burns, tissue damage | ☐ |
| Radiation | Ionizing, non-ionizing | ☐ |
| Biological | Infection, biocompatibility | ☐ |
| Chemical | Toxicity, irritation | ☐ |
| Software | Incorrect output, timing | ☐ |
| Use Error | Misuse, perception, cognition | ☐ |
| Environment | EMC, mechanical stress | ☐ |
Analysis Method Selection
| Situation | Recommended Method |
|---|---|
| Component failures | FMEA |
| System-level failure | FTA |
| Process deviations | HAZOP |
| User interaction | Use Error Analysis |
| Software behavior | Software FMEA |
| Early design phase | PHA |
Probability Criteria
| Level | Name | Description | Frequency |
|---|---|---|---|
| P5 | Frequent | Expected to occur | >10⁻³ |
| P4 | Probable | Likely to occur | 10⁻³ to 10⁻⁴ |
| P3 | Occasional | May occur | 10⁻⁴ to 10⁻⁵ |
| P2 | Remote | Unlikely | 10⁻⁵ to 10⁻⁶ |
| P1 | Improbable | Very unlikely | <10⁻⁶ |
Severity Criteria
| Level | Name | Description | Harm |
|---|---|---|---|
| S5 | Catastrophic | Death | Death |
| S4 | Critical | Permanent impairment | Irreversible injury |
| S3 | Serious | Injury requiring intervention | Reversible injury |
| S2 | Minor | Temporary discomfort | No treatment needed |
| S1 | Negligible | Inconvenience | No injury |
See: references/risk-analysis-methods.md
Risk Evaluation Workflow
Evaluate risks against acceptability criteria.
Workflow: Evaluate Identified Risks
Calculate initial risk level from probability × severity
Compare to risk acceptability criteria
For each risk, determine:
- Acceptable: Document and accept
- ALARP: Proceed to risk control
- Unacceptable: Mandatory risk control
Document evaluation rationale
Identify risks requiring benefit-risk analysis
Complete benefit-risk analysis if applicable
Compile risk evaluation summary
Validation: All risks evaluated; acceptability determined; rationale documented
Risk Evaluation Decision Tree
Risk Estimated
│
▼
Apply Acceptability Criteria
│
├── Low Risk ──────────► Accept and document
│
├── Medium Risk ───────► Consider risk reduction
│ │ Document ALARP if not reduced
│ ▼
│ Practicable to reduce?
│ │
│ Yes──► Implement control
│ No───► Document ALARP rationale
│
├── High Risk ─────────► Risk reduction required
│ │ Must demonstrate ALARP
│ ▼
│ Implement control
│ Verify residual risk
│
└── Unacceptable ──────► Design change mandatory
Cannot proceed without control
ALARP Demonstration Requirements
| Criterion | Evidence Required |
|---|---|
| Technical feasibility | Analysis of alternative controls |
| Proportionality | Cost-benefit of further reduction |
| State of the art | Comparison to similar devices |
| Stakeholder input | Clinical/user perspectives |
Benefit-Risk Analysis Triggers
| Situation | Benefit-Risk Required |
|---|---|
| Residual risk remains high | Yes |
| No feasible risk reduction | Yes |
| Novel device | Yes |
| Unacceptable risk with clinical benefit | Yes |
| All risks low | No |
Risk Control Workflow
Implement and verify risk control measures.
Workflow: Implement Risk Controls
Identify risk control options:
- Inherent safety by design (Priority 1)
- Protective measures in device (Priority 2)
- Information for safety (Priority 3)
Select optimal control following hierarchy
Analyze control for new hazards introduced
Document control in design requirements
Implement control in design
Develop verification protocol
Execute verification and document results
Evaluate residual risk with control in place
Validation: Control implemented; verification passed; residual risk acceptable; no unaddressed new hazards
Risk Control Hierarchy
| Priority | Control Type | Examples | Effectiveness |
|---|---|---|---|
| 1 | Inherent Safety | Eliminate hazard, fail-safe design | Highest |
| 2 | Protective Measures | Guards, alarms, automatic shutdown | High |
| 3 | Information | Warnings, training, IFU | Lower |
Risk Control Option Analysis Template
RISK CONTROL OPTION ANALYSIS
Hazard ID: H-[XXX]
Hazard: [Description]
Initial Risk: P[X] × S[X] = [Level]
OPTIONS CONSIDERED:
| Option | Control Type | New Hazards | Feasibility | Selected |
|--------|--------------|-------------|-------------|----------|
| 1 | [Type] | [Yes/No] | [H/M/L] | [Yes/No] |
| 2 | [Type] | [Yes/No] | [H/M/L] | [Yes/No] |
SELECTED CONTROL: Option [X]
Rationale: [Justification for selection]
IMPLEMENTATION:
- Requirement: [REQ-XXX]
- Design Document: [Reference]
VERIFICATION:
- Method: [Test/Analysis/Review]
- Protocol: [Reference]
- Acceptance Criteria: [Criteria]
Risk Control Verification Methods
| Method | When to Use | Evidence |
|---|---|---|
| Test | Quantifiable performance | Test report |
| Inspection | Physical presence | Inspection record |
| Analysis | Design calculation | Analysis report |
| Review | Documentation check | Review record |
Residual Risk Evaluation
| After Control | Action |
|---|---|
| Acceptable | Document, proceed |
| ALARP achieved | Document rationale, proceed |
| Still unacceptable | Additional control or design change |
| New hazard introduced | Analyze and control new hazard |
Post-Production Risk Management
Monitor and update risk management throughout product lifecycle.
Workflow: Post-Production Risk Monitoring
Identify information sources:
- Customer complaints
- Service reports
- Vigilance/adverse events
- Literature monitoring
- Clinical studies
Establish collection procedures
Define review triggers:
- New hazard identified
- Increased frequency of known hazard
- Serious incident
- Regulatory feedback
Analyze incoming information for risk relevance
Update risk management file as needed
Communicate significant findings
Conduct periodic risk management review
Validation: Information sources monitored; file current; reviews completed per schedule
Information Sources
| Source | Information Type | Review Frequency |
|---|---|---|
| Complaints | Use issues, failures | Continuous |
| Service | Field failures, repairs | Monthly |
| Vigilance | Serious incidents | Immediate |
| Literature | Similar device issues | Quarterly |
| Regulatory | Authority feedback | As received |
| Clinical | PMCF data | Per plan |
Risk Management File Update Triggers
| Trigger | Response Time | Action |
|---|---|---|
| Serious incident | Immediate | Full risk review |
| New hazard identified | 30 days | Risk analysis update |
| Trend increase | 60 days | Trend analysis |
| Design change | Before implementation | Impact assessment |
| Standards update | Per transition period | Gap analysis |
Periodic Review Requirements
| Review Element | Frequency |
|---|---|
| Risk management file completeness | Annual |
| Risk control effectiveness | Annual |
| Post-market information analysis | Quarterly |
| Risk-benefit conclusions | Annual or on new data |
Risk Assessment Templates
→ See references/risk-assessment-templates.md for details
Decision Frameworks
Risk Control Selection
What is the risk level?
│
├── Unacceptable ──► Can hazard be eliminated?
│ │
│ Yes─┴─No
│ │ │
│ ▼ ▼
│ Eliminate Can protective
│ hazard measure reduce?
│ │
│ Yes─┴─No
│ │ │
│ ▼ ▼
│ Add Add warning
│ protection + training
│
└── High/Medium ──► Apply hierarchy
starting at Level 1
New Hazard Analysis
| Question | If Yes | If No |
|---|---|---|
| Does control introduce new hazard? | Analyze new hazard | Proceed |
| Is new risk higher than original? | Reject control option | Acceptable trade-off |
| Can new hazard be controlled? | Add control | Reject control option |
Risk Acceptability Decision
| Condition | Decision |
|---|---|
| All risks Low | Acceptable |
| Medium risks with ALARP | Acceptable |
| High risks with ALARP documented | Acceptable if benefits outweigh |
| Any Unacceptable residual | Not acceptable - redesign |
Tools and References
Scripts
| Tool | Purpose | Usage |
|---|---|---|
| risk_matrix_calculator.py | Calculate risk levels and FMEA RPN | python risk_matrix_calculator.py --help |
Risk Matrix Calculator Features:
ISO 14971 5x5 risk matrix calculation
FMEA RPN (Risk Priority Number) calculation
Interactive mode for guided assessment
Display risk criteria definitions
JSON output for integration
References
| Document | Content |
|---|---|
| iso14971-implementation-guide.md | Complete ISO 14971:2019 implementation with templates |
| risk-analysis-methods.md | FMEA, FTA, HAZOP, Use Error Analysis methods |
Quick Reference: ISO 14971 Process
| Stage | Key Activities | Output |
|---|---|---|
| Planning | Define scope, criteria, responsibilities | Risk Management Plan |
| Analysis | Identify hazards, estimate risk | Hazard Analysis |
| Evaluation | Compare to criteria, ALARP assessment | Risk Evaluation |
| Control | Implement hierarchy, verify | Risk Control Records |
| Residual | Overall assessment, benefit-risk | Risk Management Report |
| Production | Monitor, review, update | Updated RM File |
Related Skills
| Skill | Integration Point |
|---|---|
| quality-manager-qms-iso13485 | QMS integration |
| capa-officer | Risk-based CAPA |
| regulatory-affairs-head | Regulatory submissions |
| quality-documentation-manager | Risk file management |