Information Collection Request

Medical Devices; Medical Device Reporting; Manufacturer Reporting; Importer Reporting, User Facility Reporting, Distributor Reporting

ICR 201507-0910-011 · OMB 0910-0437 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 3419 User Facility Annual Reporting FDA Form 3419 Form and Instruction Modified Available
eMDR--ICR SS--07-28-15.doc Supporting Statement A Uploaded 2015-07-31 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
6116 Manufacturer Reporting Modified
202637 Importer Reporting, Death and Serious Injury Modified
202636 MDR Files Modified
202635 MDR Procedures Modified
202634 Supplemental Reports Modified
202633 Importer Reporting, Death and Serious Injury Modified
202632 User Facility Annual Reporting FDA Form 3419 Form and Instruction Modified
202631 User Facility Reporting Modified
202630 Exemptions Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2018 36 Months From Approved 08/31/2015
361,185 0 374,090
46,446 0 391,526
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 361,185 374,090 0 -12,905 0 0
Annual Time Burden (Hours) 46,446 391,526 0 -345,080 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No