What Is Risk Mitigation for Medical Device Packaging?

What Is Risk Mitigation for Medical Device Packaging?

Medical device packaging risk mitigation involves evaluating the medical device packaging process, determining where there are gaps or potential opportunities for critical issues to be missed or overlooked, and then identifying the most economical and effective way to ensure that those opportunities are eliminated or minimized.

The most vital areas of the medical device packaging process that must be evaluated include the packaging itself, creation of a seal/sterile barrier, insuring that the correct item(s) are in the pouch, labeling, and the inspection process—all of which are essential for ensuring that the end-user receives the correct product, sterile and intact, with the correct labeling and information. When medical professionals are working in the clinical setting, they need to identify medical devices quickly.

These packages must be sealed in a way that maintains sterility, and they must be visibly, legibly, and correctly labeled. In addition, the packages must be able to be easily opened so that the product can be removed in a controlled manner.

What are the key issues medical device manufacturers need to consider with regard to risk mitigation for medical device packaging?

One of the key issues to consider is validation. The packaging process for medical devices must be validated as robust and repeatable, so that operators can complete the executable actions in the correct order, accurately, over and over again. Because the packaging process typically involves manual steps, however, unforeseen or unexpected interruptions in the flow can occur.

For instance, when an operator packages a medical product into a pouch, they typically pick up the product, and then pick up then pouch. Next, they place the product into the pouch, and then take the pouch to a heat sealer where they apply a seal. Lastly, after the pouch is sealed, they visually inspect the package before putting it into the good disposition bin or placing it onto a take-away conveyor. If the operator is distracted during any one of these steps, errors can occur.

The incorrect product could be put into the pouch, the product could be put into the pouch in the wrong orientation or the wrong pouch could be used. In addition, the seal could be imperfect or missing entirely and/or the packaged could be labeled incorrectly. Engineers need to think through all of these possibilities and determine the best ways to prevent these kinds of mistakes. They need to understand where there are gaps in the packaging process and what the risks of these gaps are, and then work to mitigate those risks.

Why is risk mitigation important?

Risk mitigation is important because if medical devices are not properly packaged, patients can be injured or even die. According to an FDA study, there were more than 1.7 million preventable injuries and nearly 83,000 deaths associated with medical devices over a 10-year period.

Risk mitigation in medical device packaging diminishes significant business risks. If an issue with the packaging process is documented as a recurring issue, the device manufacturer could have to recall the product(s) in question. Recalls are typically costly to conduct, and there are additional costs associated with remediation steps and ensuring that the problem doesn’t happen again. Medical device manufacturers can also suffer loss of sales revenue during remediation and considerable reputational damage.

What aspects of packaging should a medical device manufacturer review to mitigate risk?

Medical device manufacturers need to review several different aspects of packaging in order to mitigate risk. For instance, one of the most critical aspects to review is the seal on the package. Medical devices requiring sterility must be packaged with a hermetic seal. This type of seal creates a barrier that prevents microbes from infiltrating the package during the shelf life of the product. To maintain sterility, the seal cannot be weak or incomplete.

Creating a hermetic seal on pouches involves properly aligning the packaging materials in the sealer and then correctly applying the seal. Likewise, for medical devices sealed in tray, the tray must be properly presented to the sealer and the seal must be correctly applied.

Other aspects that need to be reviewed to mitigate packaging risk include ensuring that the correct product and the correct quantity of product is packaged as well as that the product is identified and labeled accurately. Many companies mitigate packaging risks by conducting a “line clearance” between lot runs. That means they completely clear the line of all products, packages, labels, and IFUs between runs. Then, they bring back in only what is needed for the new run.

What process should engineers follow when designing risk mitigation for medical device packaging?

In some cases, engineers begin the process of mitigating risk by taking a historical approach, comparing a new or proposed packaging process to one that the company already is using successfully.

For instance, if the medical device manufacturer is currently packaging a similar product of similar weight, similar barrier requirements, with similar packaging material, or using the same sterilization methods, it can be beneficial to leverage this history. In other cases, it may be more advantageous to disregard history and instead, evaluate the new or proposed project on its own, without any prior assumptions.

Often, it’s a combination of the two approaches that is most effective. For example, if two different products use the same pouch, it may be helpful to look at historical data regarding how the pouch materials perform under specified sealing conditions. However, if the products differ in weight, the seal performance characteristics are likely to be quite different with each requiring its own unique process.

Choosing A Tray Sealing Vendor

When choosing a packaging equipment vendor, it is critical to look for a company that will listen to your needs and wants and understand, based on their past experience, the challenges you face. The vendor should work with you to overcome those challenges, functioning as a true solutions provider, not just a business that is trying to sell a product.

Second, make sure the tray sealer manufacturer has the flexibility to customize what they offer as a standard product. Rather than be limited by off-the-shelf offerings, you want a vendor that can source a piece of equipment that addresses your specific concerns and packaging challenges.

Lastly, the tray sealer vendor you choose should have a robust customer service and support system for assisting with determining sealing parameters. They do not necessarily need to offer design of experiment (DOE), but they should be knowledgeable enough about medical device packaging to help determine sealing parameters.

Ideally, the vendor you choose will also be able to offer installation support and training, along with field service for troubleshooting and retrofitting as your tray sealing needs change.  

How Tray Sealers Are Validated

Statistical terms used in tray sealing: CPK and standard deviation

Process capability (CPK) is a statistical measurement that describes the accuracy and repeatability of a tray sealing process. Using an archery target as a metaphor, an ideal tray sealing process is like getting a tight grouping of arrows in the bullseye. A tight clustering of arrows on the target, but not on the bullseye, shows repeatability, but not accuracy.

An occasional arrow on the bullseye shows some accuracy, but little repeatability. The best tray sealing processes are both accurate and repeatable. Historically, the medical device industry has assigned that goal a CPK value of 1.3. The medical device industry is now moving away from a minimum required CPK to a CPK of what is the maximum achievable given a package’s design.

Standard deviation is another statistical measurement that describes the amount of variation or dispersement in a set of values. It provides another way of looking at process capability (CPK). Manufacturer continually eye process improvements to be able to defend the highest possible CPK, not just what is an acceptable CPK.

 

 

 

 

Processes used for validating tray sealers: IQ, OQ, and PQ

The processes that are used for validating a tray sealer are installation qualification (IQ), operation qualification (OQ), and process qualification (PQ). The IQ process enables a user to verify that their tray sealer is installed correctly according to the vendor’s instructions. Then during the OQ process, the user can verify that the tray sealer is operating in a reliable, repeatable manner and producing the expected output.

Finally, during the PQ process,  operator actions for interfacing with the equipment are assessed. Many heat sealer vendors can offer IQ and OQ documents, or at least some level of support documentation. It is difficult for them to offer PQs because key components of the PQ are the package itself and operator functions, both of which are independent of the vendor.

Tray sealer validation is an ongoing process

In the medical device industry, tray sealers must be validated for repeatability and accuracy. The industry standard is that this validation process happens annually when the sealers are calibrated. At that time, any margin of error that has creeped into the system is corrected, so that from year to year, the output is stable. Most medical device manufacturers validate their tray sealers annually. Others calibrate their tray sealers every six months or so.

Creating and Testing a Hermetic Seal

Creating and testing a hermetic seal

The most important elements needed to create a hermetic seal between a tray and lid are temperature, time, and pressure—and for tray sealing of medical devices, those three elements must be applied consistently, with little to no variability.

To determine the optimal temperature, time, and pressure to use, manufacturers must first conduct a design of experiment (DOE) in which different temperatures, pressures, and dwell times are tried on a 3D model. Then, destructive testing is used to determine which combination of temperature, pressure, and time is best. After that, the tray sealer must also be periodically validated to ensure that it is applying those optimal parameters repeatably, with little to no variability.

Types of destructive testing for sealed trays

Destructive testing on tray sealing applications in the medical device industry is typically conducted using tensile testing, burst testing, or dye penetration testing.

These tests are used to establish that the sealed tray has reached minimum barrier system properties. For example, tensile testing applies tensile (pulling) forces to determine the minimum pounds required to break the seal. Burst testing pressurizes the package until the seal is broken and can be used to identify the weakest point on the lid, tray, or seal. Dye penetration is a qualitative test of the seal; if dye penetrates to the inside of the package, then the seal is not sufficient.

Repeatedly creating a hermetic seal

Tray sealers must be carefully designed and properly installed to meet the medical device industry’s standards for accuracy and repeatability.

For example, both the top and bottom heating elements of the sealer must be under tight control to ensure that the sealing temperature is maintained within a very narrow window. In many instances, the top heating element is maintained at the sealing temperature and the bottom part of that system is unheated; however, over many cycles, heat can build up on the bottom side. That means the bottom side must be repeatedly cooled.

Any deviation in the temperature, pressure, or time used to create the hermetic seal increases the risk of lowering accuracy and repeatability.

 

 

 

The Benefits of Sealed Trays and Upward Trends

The benefits of sealed trays compared to pouches and clamshells

Sealed trays offer benefits that pouches and clamshell packaging cannot. The major advantage is product protection. A sealed tray protects a medical device for the entirety of its shelf life—through the sterilization process, shipping and distribution, storage, and ultimately, until the product is opened under sterile conditions and used in a medical setting.

For instance, many medical devices have to be unsealed and presented in a controlled manner by scrub nurses to surgeons in the operating room. Sealed trays are much better suited for this compared to flexible pouches. With a sealed tray, the nurse can peel off the lid to expose the medical device positioned in a rigid, robust platform. In certain instances, the sealed tray is designed so that the medical device can be presented in a specific way. In other instances, once the tray is opened it becomes part of the product preparation, serving as an area for mixing chemicals before a stent is placed in an artery, for example.

Pouches and clamshell packages cannot be used in the same way. Pouches do not have the rigid structure of a tray, and clamshells cannot maintain product sterility, nor offer easy opening. The main disadvantage to tray sealing is the cost. Sealed trays usually cost more than pouches.

Why the use of tray sealing is trending upward

The use of tray sealing is trending upward for two main reasons.

First, compared to pouches, sealed trays can offer better protection over a product’s entire shelf life. Second, many manufacturers are moving to tray sealing because there is a growing perception that products packaged in trays have a higher value than those packaged in pouches. Of course, manufacturers that want to move to tray sealing will need to re-evaluate their heat sealers. Achieving a hermetic bond between the lid and the tray requires an exceptionally flat and parallel sealing platform, as well as the highly regulated and consistent application of temperature and pressure.