The MDR mandates that medical devices may only be offered on the European market if they have a CE mark. ‘CE’ is short for Conformitée Européene, which means the product has shown to comply to the European legislation applicable to that specific product group. To obtain a CE mark for medical devices, the manufacturer or developer of the medical device must be able to demonstrate that their medical device, or medical device software, complies with the MDR.

For example, the MDR prescribes the safety and performance requirements that the device and its manufacturing processes must meet, as well as that the manufacturer or developer of the device must have appropriate processes in place for quality assurance through a quality management system. 

ISO 13485 is an international standard for manufacturers, suppliers and distributors of medical devices. It sets a standard for quality management and is intended to help meet requirements of legislation for medical devices. 

In essence, an ISO certification helps demonstrate that an organization can continually evaluate and improve its processes, products and services. ISO certificates apply at the organizational level, not at a product level (unlike the CE- mark does, which does apply at a product level). 

To obtain ISO certification, the organization must meet all requirements of the ISO standard. The assessment and issuing of certificates is performed by independent external certification bodies. These certification bodies are (in the Netherlands) accredited and monitored by the Council for Accreditation. 

ISO certification is not mandatory, so even obtaining an ISO 13485 certification is not required to comply with the MDR. It may nonetheless be helpful to the process of complying with the MDR. For all of the implementation processes we’ve been involved with, we found that the ISO 13485 is easier to understand and a helpful tool in the overall goal of obtaining a CE-mark.

One of the main requirements of the MDR is that the manufacturer must establish and maintain a quality management system. The manufacturer is required to do this in order for the medical device to eventually be CE marked. 

Such a quality management system, which must be appropriate and proportionate to the risk classification and type of medical device, shows that the device and the processes for its design and manufacture maintain a high level of quality. Although ISO 13485 certification is not mandatory, acting in line with this standard is recommended to ensure that the quality management system is appropriate. 

Finally, to fully comply with the MDR requirements and be able to place a CE mark on the medical device, the manufacturer must go through a so-called conformity assessment procedure. 

Depending on the risk class of the medical device, this procedure involves self-certification (Class I) or assessment by an independent third party: a Notified Body (Class IIa or higher). Notified bodies are designated by the European Commission to carry out conformity assessments according to the MDR.  

After such a procedure has been successfully completed, the medical may receice a CE-mark and be offered on the European market.