Information Collection Request

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

ICR 201508-0910-002 · 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
0437_eMDR--ICR SS.doc Supporting Statement A Uploaded 2015-08-31 Available

IC Document Collections

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

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2018 36 Months From Approved 08/31/2018
361,185 0 361,185
46,446 0 46,446
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 361,185 361,185 0 0 0 0
Annual Time Burden (Hours) 46,446 46,446 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No