INSIGHT // 70 Emerging Issue

The EU MDR and IVDR Simplification Proposal: What Moves for US Device Makers and What Does Not

Abstract: The European Commission's proposal of 16 December 2025 to simplify the MDR and the IVDR would remove certificate expiry, reclassify clinical software and loosen the clinical-evidence rules, but it is not law, and the transition deadlines of 31 December 2027 and 2028, EUDAMED and a new notified-body timeline regulation all run on the unamended text. Its route around the AI Act is not the one the EU legislator adopted in June 2026 and signed in July, and Switzerland incorporates the MDR at a fixed 2024 version that moves only when Bern moves.
Plain Language Summary

This article examines the European Commission's December 2025 proposal to simplify the EU's Medical Device Regulation (MDR) and In Vitro Diagnostic Medical Devices Regulation (IVDR). Those two laws govern how medical devices and diagnostic tests reach the EU market. The article looks at what the proposal means for US manufacturers while it is still being negotiated. It describes which existing deadlines the proposal leaves in place, and how the proposed changes to certificates, product classification and clinical evidence would operate. It also describes how the proposal interacts with the EU AI Act. Switzerland is not an EU member and applies the MDR through its own ordinance (the Medizinprodukteverordnung, MepV), so it would not change at the same time as the EU.

Table of Contents
  1. A Proposal Is Not a Deadline: The Clocks That Keep Running
  2. What Would Change, and for Whom: Certificates, Classification and Evidence
  3. The AI Act Interface: Two Instruments, Two Tools, One Overlap
  4. Switzerland: The Copy That Does Not Move With Brussels
  5. Strategic Considerations

US device makers closed one regulatory conversion on 2 February 2026, when the QMSR replaced the quality system rules of 21 CFR Part 820 with a text that incorporates ISO 13485:2016 by reference.1FDA, Quality System Regulation Amendments, 89 Fed. Reg. 7496 (2 February 2024), effective 2 February 2026. Seven weeks earlier, on 16 December 2025, the European Commission had proposed to move the EU's device rules in what looks like the same direction. Its proposal is a regulation amending the MDR and the IVDR that would remove the expiry date from notified-body certificates, let surveillance audits stretch from every twelve months to every twenty-four, make class I the default for clinical software, and give a manufacturer thirty days rather than fifteen to report a serious incident.2European Commission, COM(2025) 1023 final (16 December 2025), procedure 2025/0404(COD). The reflex on the US side is to read the two events as convergence and to let the next European dossier wait for the simpler rules. That reading misses three things. The proposal is not law, and the deadlines that bind in 2027 and 2028 are the ones it leaves untouched. Its answer to the overlap with the AI Act is not the answer the EU legislator adopted for that overlap in June 2026 and signed in July. And Switzerland, which most US teams file under Europe, incorporates the MDR through a reference frozen at a 2024 amendment, and moves only when Bern decides to move.

1. A Proposal Is Not a Deadline: The Clocks That Keep Running

The proposal, COM(2025) 1023, runs under the ordinary legislative procedure as file 2025/0404(COD), and as at publication neither co-legislator had adopted a position. The Council's Working Party on Pharmaceuticals and Medical Devices began an article-by-article reading on 23 March 2026. The Cyprus presidency's progress report of 5 June 2026, noted by the EPSCO Council on 16 June, records that delegations welcome the objectives and that additional work to refine and complement the proposal will be necessary before a general approach. Among the open points it names the division of tasks between the EMA and the MDCG, the criteria for well-established technology, the effect of mandated fee reductions on the financial sustainability of notified bodies, the legal scrutiny of new Commission delegated powers, and sector-specific requirements for AI-enabled and cybersecurity-relevant devices. It also records that the Parliament is aiming to vote on its position early in 2027.3Council doc 9801/26 (5 June 2026); SANT draft report PE787.987 (30 June 2026); DSV statement (14 July 2026). The Parliament's rapporteur's draft report, dated 30 June 2026 and presented to the Committee on Public Health on 14 July 2026, opened the amendment stage. A statement by the German social-insurance representation of 14 July 2026 welcomed that draft for tightening the equivalence route and the priority pathways discussed below, an indication of the direction from which parliamentary pressure arrives.3 Under the proposal's own final article most of the text applies six months after entry into force, and entry into force follows publication by twenty days. With no first-reading position on either side in July 2026, general application before 2027 is arithmetically excluded.

The proposal also carries five application dates of its own. Art. 5 of the proposed regulation sets the general rule at six months after entry into force, but the certificate-validity provision in Art. 56 MDR and the paragraphs added to Art. 120 MDR would apply from entry into force itself, the rules on the designation, monitoring and fees of notified bodies twelve months after it, the cybersecurity reporting duty in Art. 87a MDR three years after it, and the reversed presumption on single-use devices in Art. 17 MDR five years after it.4COM(2025) 1023 (n 2), Art. 5(1) to (3). None of those clocks has started, because none can start before an act exists, and the intervals are themselves under negotiation.

The clocks that have started are the ones the proposal does not touch. Under Art. 120(3a) MDR, as amended in 2023, a legacy device certified under the directives may stay on the market until 31 December 2027 if it is a class III device or a class IIb implantable device outside the listed exceptions, and until 31 December 2028 for the other classes that need a notified body. Art. 120(3c) MDR makes both dates conditional on a quality management system and a formal notified-body application in place by 26 May 2024 and a written agreement signed by 26 September 2024.5Regulation (EU) 2017/745 (MDR), Art. 120(3a) to (3c); Regulation (EU) 2017/746 (IVDR), Art. 110(3a) to (3c); Decision (EU) 2025/2371. The Commission's explanatory memorandum calls those extensions a short-term solution, and the enacting text adds paragraphs 14 and 15 to Art. 120 MDR while leaving paragraphs 3a to 3e as they stand. The IVDR's own ladder under Art. 110 IVDR, 31 December 2027 for class D, 2028 for class C and 2029 for class B and sterile class A devices, is likewise untouched. Mandatory use of EUDAMED's first four modules began on 28 May 2026 and continues on the existing legal basis, the subject of Insight 57.5 A device whose transition ends on 31 December 2027 will meet that date under the text as it stands, whatever the co-legislators later agree about certificates that do not yet exist.

The Commission is also legislating under the existing text while proposing to replace parts of it. Implementing Regulation (EU) 2026/977 of 4 May 2026, adopted under Art. 36(3) MDR and Art. 32(3) IVDR, fixes maximum timelines for notified-body work and lays down re-certification procedures for product and quality-system certificates. The timelines are thirty days from a complete application to a signed contract, 120 days for the quality-management-system audit, ninety days for the technical-documentation review of each device or representative device and twenty days for the decision. The Regulation applies from 25 February 2027 to procedures whose written agreement is signed on or after that date, and its re-certification articles reach certificates expiring on or after 25 November 2027.6Commission Implementing Regulation (EU) 2026/977 (4 May 2026), Art. 2(2), Art. 5 to 9. It is an instrument built around the five-year certificate cycle, adopted five months after a proposal that would abolish that cycle, and both are Commission texts. A manufacturer whose certificate expires in early 2028 will be re-certified under the implementing regulation's procedure unless the amending regulation has entered into force by then and the notified body agrees otherwise, and nothing published by July 2026 said which.

That last clause is the proposal's own transitional device, and it makes the choice of regime a term to be negotiated. Under the paragraph 15 that the proposal would add to Art. 120 MDR, where a conformity assessment is pending on the general application date, or a certificate was issued before it, the manufacturer and the notified body may agree to continue applying the regulation in the form applicable before that date until the procedure is finalized or the certificate is renewed.7COM(2025) 1023 (n 2), new Art. 120(15) MDR (election by agreement) and new Art. 35(6a) MDR (dispute mechanism). The provision says who may agree. It does not say what happens when they do not, whether a notified body may condition its agreement, or how the election is recorded. The dispute mechanism the proposal adds in Art. 35(6a) MDR, under which the authority responsible for notified bodies decides within ninety days a substantiated dispute arising from the Annex VII requirements and the notified body's involvement in the assessment, is expressly without prejudice to other remedies, and whether a disagreement about which version of the regulation to apply is a dispute of that kind is left open. Some delegations already find the mechanism challenging as envisaged.7 For a US manufacturer whose European strategy runs through one notified body, the regime under which the next certificate is issued may thus be decided at a contract table rather than in the Official Journal.

A proposal to abolish certificate expiry does not extend a single certificate that expires before the proposal becomes law.

2. What Would Change, and for Whom: Certificates, Classification and Evidence

Under Art. 56(2) MDR as it stands, a certificate is valid for the period it indicates, which may not exceed five years, and may be extended for further periods of up to five years on a re-assessment. The proposal replaces that with a certificate whose validity is not limited in time unless the notified body, in exceptional cases and on duly justified grounds, limits it. It adds a paragraph 2a under which the notified body carries out surveillance during the certificate's life, including periodic reviews proportionate to the risk class, and it widens Art. 56(3) MDR from restrictions on intended purpose and mandated PMCF studies to conditions on validity generally.8COM(2025) 1023 (n 2), Art. 56, Annex VII, Section 4.11, Annex IX, Sections 3.3 and 3.4 MDR as proposed; MDR (n 5), Art. 56(2), Art. 58. In Annex IX the surveillance audit stays annual by default but may fall to every twenty-four months where previous results justify it and post-market data raise no concern, may be remote on justified grounds, and unannounced audits become for-cause. The difference from a PMA, which is not re-approved on a calendar either, is where the discretion sits. The interval of the periodic review, the grounds that make a case exceptional and the conditions attached to validity are the notified body's to set. A manufacturer whose certificate carries a condition it cannot meet on time faces Art. 56(4) MDR, suspension or withdrawal, rather than a renewal it can plan for. A certificate without an end date is also a certificate without a natural moment at which a manufacturer changes notified body, and Art. 58 MDR on voluntary change is not amended.

Classification is where the proposal reaches furthest into US portfolios, because it reaches software. Rule 11 of Annex VIII MDR, as it stands, puts software intended to provide information used to take decisions with diagnosis or therapeutic purposes in class IIa by default, rising to class IIb or class III with the severity of the harm a wrong decision may cause, with all other software in class I. The proposal inverts the default. Software intended to generate an output that confers a clinical benefit and is used for diagnosis, treatment, prevention, monitoring, prediction, prognosis, compensation or alleviation of a disease or condition would be class I. Where the output is intended for a disease or condition in a critical situation, the software would be class III. Where it is intended for a disease or condition in a serious situation, or to drive clinical management in a critical one, it would be class IIb. Where it is intended for a disease or condition in a non-serious situation, to drive clinical management in a serious one, or to inform clinical management in a critical or serious one, it would be class IIa.9COM(2025) 1023 (n 2), Annex VIII, Rule 11 as proposed, new Art. 2, point 72 and Art. 51a MDR; MDR (n 5), Rule 11, Art. 52(7); 21 U.S.C. § 360j(o)(1)(E). A US counsel will hear the inform-and-drive vocabulary of the IMDRF and think of the clinical-decision-support carve-out that section 520(o)(1)(E) of the FD&C Act made from the device definition. The EU version is not a carve-out. The software stays a device under the MDR's general safety and performance requirements. What changes is that a class I device is self-declared under Art. 52(7) MDR, without a notified body and without a certificate. A classification dispute, which the proposal's new Art. 51a MDR routes to a competent authority, then becomes a dispute about whether a notified body is involved at all. The proposal also lowers reusable surgical instruments to class I and replaces the device lists in Art. 18, 52 and 61 MDR with a defined term whose criteria the Council's progress report says need further refinement and clarification.9 Which side of each line a product falls on is a question of intended purpose as written, and the proposal moves the lines without changing a word on the label.

Clinical evidence moves in the same direction and creates a problem for the manufacturer whose evidence it is. Under Art. 61(5) MDR a manufacturer may rely on equivalence to another manufacturer's marketed device, to avoid running a clinical investigation, only where the two have a contract that explicitly allows the second manufacturer full access to the technical documentation on an ongoing basis and the original clinical evaluation complied with the regulation. The proposal narrows the investigation requirement in Art. 61(4) MDR to implantable class IIb and class III devices and deletes the contract. The second manufacturer would need only to provide clear evidence to the notified body that the original clinical evaluation was performed in compliance with the regulation.10COM(2025) 1023 (n 2), Art. 61(4), (5), (10) and Art. 2, point 48 MDR as proposed; MDR (n 5), Art. 61(5), Annex XIV, Art. 109. How a competitor is to evidence the compliance of a clinical evaluation it has no right to see is not addressed, and Art. 109 MDR still binds the notified body to confidentiality toward the first manufacturer. The same amendment extends clinical data to literature that is not necessarily peer-reviewed and expands Art. 61(10) MDR so that conformity may be justified on non-clinical methods alone, in silico testing among them.10 For a US manufacturer with a predicate-based FDA file the point to hold onto is that EU equivalence remains the technical, biological and clinical test of Annex XIV MDR, not substantial equivalence, and that the manufacturer whose device becomes the reference acquires no contractual position from which to control that use.

Five timelines around one device: what the proposal moves and what it does not Five horizontal timelines against a year scale from 2026 to 2030. The first, the legacy transition under Art. 120 MDR and Art. 110 IVDR, marks 31 December 2027 for class III and implantable class IIb devices and IVD class D, 31 December 2028 for other class IIb, class IIa and sterile or measuring class I devices and IVD class C, and 31 December 2029 for IVD class B and sterile class A devices, and notes that the proposal does not move them. The second, instruments adopted under the 2017 text, marks mandatory EUDAMED use from 28 May 2026, the application of Implementing Regulation (EU) 2026/977 from 25 February 2027 and its re-certification rules reaching certificates expiring from 25 November 2027. The third, the proposal COM(2025) 1023, marks the Council progress report and the Parliament draft report of June 2026, then a dashed line with no adoption date, listing entry into force twenty days after publication, general application six months later, notified-body rules after twelve months, cybersecurity reporting after three years and reprocessing after five years, with certificate validity and orphan grandfathering applying from entry into force. The fourth, the AI Act interface, marks the signature of the Digital Omnibus on AI on 8 July 2026 with publication pending, delegated acts limiting Section A requirements due by 2 August 2027, and the Annex I route applying from 2 August 2028, and notes that the proposal would move the MDR and IVDR to Section B on an open date. The fifth, Switzerland, marks the swissdamed registration duty from 1 July 2026 and the mirrored Art. 101 MepV deadlines of 31 December 2027 and 2028, and notes that the MepV incorporates the MDR as amended by Regulation (EU) 2024/1860, caps certificates at five years under Art. 26 MepV, and that the MRA devices chapter remains undated. Five timelines around one device: what the proposal moves, and what it does not 2026 2027 2028 2029 2030 Legacy transition Art. 120 MDR Art. 110 IVDR 31 Dec 2027: class III, IIb implantable, IVD class D 31 Dec 2029: IVD class B, A sterile 31 Dec 2028: other IIb, IIa, I sterile or measuring, IVD class C not moved by the proposal Adopted under the 2017 text EUDAMED Impl. Reg. 2026/977 28 May 2026: EUDAMED mandatory 25 Feb 2027: Impl. Reg. (EU) 2026/977 applies 25 Nov 2027: re-certification rules reach expiring certificates The proposal COM(2025) 1023 June 2026: Council progress report, Parliament draft report Adoption: no date at publication, then entry into force 20 days after publication From entry into force: certificate validity, orphan grandfathering + 6 months: general application. + 12 months: notified-body rules + 3 years: cyber reporting (Art. 87a MDR). + 5 years: reprocessing (Art. 17 MDR) AI Act interface Annex I, Art. 2(2) 8 Jul 2026: Digital Omnibus on AI signed, publication pending 2 Aug 2027: delegated acts limiting Section A requirements due 2 Aug 2028: Annex I route applies (as adopted) proposal: MDR, IVDR to Section B (Art. 2(2) AI Act regime as rewritten), date open Switzerland MepV (SR 812.213) 1 Jul 2026: swissdamed registration duty 31 Dec 2027 and 2028: Art. 101 MepV, mirrored from the MDR MDR as amended by Reg. 2024/1860. Art. 26 MepV: five-year cap. MRA devices chapter: undated
Timelines reaching one device on the EU and Swiss markets as at July 2026. Shown are the legacy transition dates the proposal leaves in place, the instruments adopted under the unamended text, the proposal's own schedule without a start date, the AI Act's Annex I route as amended by the adopted but unpublished Digital Omnibus on AI, and the Swiss ordinance, which incorporates the MDR at a fixed version.

The proposal borrows two US labels and attaches different consequences to them. Section 515B of the FD&C Act lets a sponsor request breakthrough designation from the FDA for a device that offers more effective treatment or diagnosis of a life-threatening or irreversibly debilitating condition, and the humanitarian-use device rules turn on a condition manifested in not more than 8,000 individuals in the United States per year.11COM(2025) 1023 (n 2), new Art. 52a and Art. 120(14) MDR; 21 U.S.C. § 360e-3; 21 CFR 814.3(n); DSV statement (n 3). The proposal's Art. 52a MDR defines a breakthrough device by a high degree of novelty in the Union and a significant positive clinical impact for a life-threatening or irreversibly debilitating disease, and an orphan device by a disease or condition presenting in not more than 12,000 individuals in the Union per year with insufficient alternatives or an expected clinical benefit over them. Designation comes not from a regulator but from a published expert-panel opinion, requested by the manufacturer or the notified body. The notified body then prioritizes the assessment, may apply a rolling review, and may certify on limited clinical data where the benefit of immediate availability outweighs the risk of the missing data or the manufacturer commits to post-market clinical follow-up, limiting the certificate's validity and attaching conditions as it does so.11 For legacy orphan devices a new Art. 120(14) MDR would let a legacy device under Art. 120(3a) or (3b) MDR stay on the market past the 2027 and 2028 dates on an expert-panel opinion, subject to conditions. Among them are an annual PSUR to the competent authority, no CE marking without a valid certificate, and a renewed opinion at least every ten years.11 A device sold under a declaration that it is an orphan device placed on the market under a transitional provision is a category no distribution agreement drafted before 2026 describes. The statement of 14 July 2026 welcomed what it described as the draft report's five-year limit on both pathways' certificates, so the pathways may end narrower than proposed.

The post-market changes read as relief, and each carries a second clause. Art. 87(3) MDR would give a manufacturer thirty days rather than fifteen to report a serious incident, the same thirty calendar days that 21 CFR 803.50 allows a US manufacturer. But the two-day clock for a serious public-health threat and the ten-day clock for death or an unanticipated serious deterioration in Art. 87(4) and (5) MDR are not amended. Art. 86(1) MDR would require class IIb and class III manufacturers to update the PSUR within the first year after certification and every two years thereafter, or when the benefit-risk determination changes significantly, and class IIa manufacturers only when necessary.12COM(2025) 1023 (n 2), Art. 86, 87, new Art. 87a, Annex VII, Section 4.9 MDR; MDR (n 5), Art. 86(1), 87(3) to (5); Regulation (EU) 2024/2847 (CRA); 21 CFR 803.50, 803.53; 21 U.S.C. § 360e-4. The new Art. 87a MDR then adds a duty the existing text does not carry. It requires a report within thirty days of an actively exploited vulnerability, or of a severe incident within the meaning of the Cyber Resilience Act, filed through EUDAMED to the coordinating CSIRTs and to ENISA, applying three years after entry into force and running beside, not instead of, the Art. 87 MDR vigilance report and the reporting clocks examined in Insight 67. In Annex VII the notified body's procedures and contracts would have to distinguish changes that need not be reported, changes reported without prior approval and changes requiring prior approval, and the notified body and the manufacturer would agree, where appropriate, a predetermined change control plan letting the manufacturer implement planned changes without prior information.12 That is the vocabulary of section 515C of the FD&C Act, but an FDA plan is approved by an agency and an EU plan would be agreed with a private body as a term of a contract.

The chapter US readers will search for first is the shortest. A new section after Art. 108 MDR would commit the Commission to international regulatory cooperation, name the IMDRF and the MDSAP among the fora in which it participates, and let it join reliance mechanisms under Art. 108b MDR that enable the use of assessments, inspections and other regulatory decisions of third-country authorities, on condition of an equivalent level of protection and effective arrangements for information exchange, transparency and oversight. The mechanisms would fall to be taken into consideration by competent authorities, economic operators and notified bodies, and their detailed rules would be left to implementing acts.13COM(2025) 1023 (n 2), new Art. 108a to 108c MDR; Council doc 9801/26 (n 3), para 18. Nothing in that text makes an FDA clearance, an MDSAP audit report or a QMSR inspection a substitute for a notified-body certificate. The implementing acts that would give the phrase content do not exist, and the Council's report records that most delegations support the aim while recalling the procedures of the Treaties and the prerogatives of the Council. A US strategy that assumes the FDA file will one day travel is assuming a decision the Commission has reserved to itself and the Member States have flagged.

3. The AI Act Interface: Two Instruments, Two Tools, One Overlap

An AI-enabled device reaches the AI Act's high-risk category through Art. 6(1) AI Act, which requires both that the AI system be a product, or the safety component of a product, covered by the Union harmonization legislation in Annex I and that the product undergo third-party conformity assessment under that legislation. The MDR and the IVDR are points 11 and 12 of Section A of that Annex, and for Section A products Art. 43(3) AI Act carries the requirements of Chapter III, Section 2 AI Act into the product's own conformity assessment. For products under the Section B list, aviation, vehicles, marine equipment and rail among its entries, Art. 2(2) AI Act applies only Art. 6(1), Art. 102 to 109 and Art. 112 AI Act, a list the Digital Omnibus on AI examined below rewrites, as adopted, to Art. 6(1), Art. 60a and Art. 102 to 112 AI Act.14Regulation (EU) 2024/1689 (AI Act), Art. 2(2), Art. 6(1), Art. 43(3), Annex I, Annex III, point 5(d); COM(2025) 1023 (n 2), Art. 4, recital 23; Council doc 9801/26 (n 3), para 19. Art. 4 of the proposal deletes points 11 and 12 from Section A and adds the MDR and the IVDR to Section B as points 21 and 22. Recital 23 says why. It reasons that the parallel application of the two regimes could lead to overlaps and stifle innovation, and that the AI Act's application to devices should therefore be limited to the provisions Art. 2(2) AI Act names, with the Commission free to lay down AI-specific requirements under the MDR by implementing or delegated act and with notified bodies that assess high-risk AI under the MDR expected to meet Art. 31 AI Act.14 As proposed, the AI Act's high-risk requirements would cease to apply to medical devices as AI Act obligations and would return, if at all, as MDR requirements written by the Commission. The two texts do not even share a numbering. The adopted Omnibus deletes point 1 of Section A and assigns point 21 of Section B to the Machinery Regulation, the same point number the proposal reserves for medical devices.15Digital Omnibus on AI, COM(2025) 836, adopted 29 June 2026 and signed 8 July 2026: Art. 113, Art. 2(13), Art. 111(2) and Art. 6(1a) to (1c) AI Act as amended.

The EU legislator dealt with the same overlap by a different instrument while the proposal was being read. The Digital Omnibus on AI, proposed on 19 November 2025, was adopted by the Council on 29 June 2026 and signed on 8 July 2026. At publication the Official Journal had yet to carry it. As adopted, it moves the application date for Annex I high-risk systems, the route a regulated device travels, to 2 August 2028. It inserts an Art. 2(13) AI Act under which the requirements of Art. 9 to 15 and Art. 17 to 25 AI Act may be limited, by delegated acts due by 2 August 2027, for Art. 6(1) AI Act systems where and to the extent that the Section A product legislation provides an equivalent or higher level of protection, and it narrows the safety-component gateway in Art. 6(1a) to (1c) AI Act.15 That mechanism presupposes that medical devices remain in Section A, because Art. 2(13) AI Act is written for Section A legislation. The proposal presupposes that they leave it. Two texts, one adopted and awaiting publication and one under negotiation, resolve the same overlap by opposite routes. The adopted one keeps the AI Act's requirements and lets the Commission subtract from them where the MDR already protects. The proposed one removes them and lets the Commission add back under the MDR. The cybersecurity analysis in Insight 67 was written on the first footing, as any analysis had to be in July 2026. A compliance program built to Art. 15 AI Act for 2028 may be building to a requirement that a 2027 delegated act narrows, that a later MDR amendment removes, or that survives both.

The classification change compounds it from the other side. Art. 6(1)(b) AI Act attaches high-risk status only where the product must undergo third-party conformity assessment. Clinical software that the proposed Rule 11 moves to class I is self-declared under Art. 52(7) MDR, so an AI system inside it fails the second limb of Art. 6(1) AI Act and is not high-risk on the Annex I route at all, whichever Section the MDR sits in, unless it separately falls within Annex III AI Act, whose point 5(d) reaches emergency-healthcare patient triage systems and little else in medicine.14 The same reclassification therefore removes the notified body from the device and the AI Act from the model in one step, for software whose intended purpose has not changed. Conversely, a device that keeps its class and its notified body and is certified in 2027 with the AI Act's requirements built into that assessment under Art. 43(3) AI Act is reassessed only on a substantial modification. Art. 111(2) AI Act, as amended by the Digital Omnibus on AI, brings systems already on the market into the AI Act only on a significant change in design after 2 August 2028.15 Which version of the interface a device certified in 2027 lives under is thus a question of its certification date, its change history and two acts whose relationship to each other neither text describes.

4. Switzerland: The Copy That Does Not Move With Brussels

Switzerland is not an EU Member State, and the MDR has no direct effect there. The Swiss device ordinance, the MepV, incorporates the MDR rather than restating it, and the mechanism of incorporation decides everything that follows. Art. 4(1)(f) MepV defines the EU-MDR, in a footnote, as Regulation (EU) 2017/745 as last amended by Regulation (EU) 2024/1860, and Art. 5(2) MepV provides that references to the EU-MDR are references to the version fixed in that footnote. Only the Commission acts adopted under the EU-MDR provisions listed in Annex 4 MepV apply in Switzerland in their EU version, and Art. 95(1) MepV directs Swissmedic to take the Commission's implementing acts into account in enforcement.16Medizinprodukteverordnung (MepV) (SR 812.213), Art. 4(1)(f), 5(2), 15, 23, 25(4), 26, 51, 95, 101, 108, Annex 4; Swissmedic notice of 1 July 2026. An amending regulation of the Parliament and the Council is neither. It reaches Switzerland when the Federal Council amends the MepV and its footnote, as it did on 29 September 2023, with effect from 1 November 2023, when Art. 101 MepV received the same 31 December 2027 and 2028 dates as Art. 120(3a) MDR.16 Until that happens for the simplification regulation, whenever it is adopted, the Swiss text is the MDR of 2024.

Three divergences follow for a US manufacturer that sells into both markets, and each opens on the day the EU text changes. Art. 26(1) MepV states that certificates are valid for a maximum of five years, extendable by at most five years at a time on re-assessment, a Swiss rule that does not depend on Art. 56(2) MDR and would not fall with it. Certificates of EU-designated notified bodies are accepted in Switzerland under Art. 25(4) MepV on the condition, to be credibly shown, that the procedures applied satisfy the Swiss requirements and that the body's qualification is equivalent. The Swiss requirements are, under Art. 23 MepV, Art. 52 and 54 and Annexes IX to XI MDR in the incorporated version.16 A certificate without an end date, or one issued after a procedure with a single representative device for a portfolio, remote audits and surveillance every twenty-four months, would have to be shown equivalent to a text that still assumes five years and annual audits. Nothing published by July 2026 said how Swissmedic would read that. Classification is the sharpest of the three. Art. 15 MepV classifies devices by Annex VIII of the incorporated EU-MDR, so software that the proposed Rule 11 moves to class I in the EU would remain class IIa in Switzerland, and the Swiss market would go on asking for the notified-body certificate the EU market had stopped asking for.16

The Swiss constants remain. A manufacturer without a seat in Switzerland needs a Swiss authorized representative under Art. 51 MepV, whose mandate must be in writing and whose rights and duties follow Art. 11 MDR. From 1 July 2026 devices placed on the Swiss market must be registered in swissdamed, Swissmedic's database, no later than 31 December 2026 and at once where a serious incident, a field safety corrective action or a trend has to be reported. And the medical-devices chapter of the Swiss-EU mutual recognition agreement, which stopped delivering recognition on 26 May 2021, is not restored by the protocols signed on 2 March 2026, whose realignment of that chapter is left to an undated decision of the agreement's Committee, a matter Insight 53 takes up.17Swiss-EU MRA (SR 0.946.526.81), Annex 1, ch 4; protocols signed 2 March 2026; Botschaft of 13 March 2026. A US group whose European entry runs through a Swiss subsidiary, or whose CH-REP is the same entity as its EU authorized representative, will hold two files that were identical in 2024 and stop being identical on the day the EU text changes, on an interval set by a Federal Council calendar that nobody in Brussels controls.

5. Strategic Considerations

The questions that decide exposure are not the ones a simplification headline answers. Whether to lodge the next notified-body application before or after the amending regulation applies, and whether to elect under the proposed Art. 120(15) MDR to finish a pending assessment under the old text, turns on the notified body's capacity, its willingness to agree and the device's position on the transition ladder. Whether a software product changes class under the proposed Rule 11 depends on how its intended purpose describes the situation, critical, serious or non-serious, and whether its output informs or drives clinical management. The same words then decide whether the product keeps its notified body, whether the AI Act reaches its model and whether Switzerland classifies it differently from the EU. Whether a competitor may build a clinical evaluation on a manufacturer's own device without a contract, and what the manufacturer can do about it, is a question of trade-secret law and of what a notified body will accept as clear evidence, and the proposal supplies neither.

Behind those sit questions that depend on facts only the company holds. What the distribution and supply agreements assume about certificate renewals, and whether a certificate that never expires but carries conditions is a certificate for their purposes. What the group's Swiss file says that the EU file will stop saying, and which entity signs the CH-REP mandate. What the risk factors of a US-listed parent describe when they describe EU regulatory simplification as relief, given that the deadlines of 2027 and 2028 are unmoved and that the AI Act obligations on the device route are set, for the moment, by an act written for a Section A in which medical devices still sit.

Whether a given device sits on the right side of each of these lines depends on its class as written, its certificate dates, its notified body's designation and appetite, the contracts around its clinical evidence and the group's Swiss footprint. Those are questions of fact and of drafting, and they require analysis tailored to the device, the entities involved and the commercial context.

REFERENCES

01
Food and Drug Administration, 'Medical Devices; Quality System Regulation Amendments' (Final Rule) 89 Fed. Reg. 7496 (2 February 2024), amending 21 CFR Part 820 by incorporating ISO 13485:2016 by reference and establishing the Quality Management System Regulation (QMSR), effective 2 February 2026; technical amendments at 'Medical Devices; Quality Management System Regulation Technical Amendments' (4 December 2025).
02
European Commission, Proposal for a Regulation of the European Parliament and of the Council amending Regulations (EU) 2017/745 and (EU) 2017/746 as regards simplifying and reducing the burden of the rules on medical devices and in vitro diagnostic medical devices, and amending Regulation (EU) 2022/123 as regards the support of the European Medicines Agency for the expert panels on medical devices and Regulation (EU) 2024/1689 as regards the list of Union harmonisation legislation referred to in its Annex I, COM(2025) 1023 final (16 December 2025), procedure 2025/0404(COD), accompanied by SWD(2025) 1050 to 1052 final; explanatory memorandum, section 1 (51 notified bodies designated under the MDR and 19 under the IVDR at the date of the proposal; the repeated extension of the transitional periods 'was only a short-term solution to mitigate the risk of shortages' that 'could not solve the underlying structural problems') and section 5 (the amendments summarised by topic: simplification and proportionality, reduction of administrative burden, innovation and availability, predictability and cost-efficiency of certification, coordination, digitalisation, international cooperation, interplay with other Union legislation). Transmitted to the Council as doc 16919/25.
03
Council of the European Union, 'Regulation to simplify rules on medical and in vitro diagnostic devices: Progress report', Note from the General Secretariat to the Council, doc 9801/26 (5 June 2026), interinstitutional file 2025/0404(COD): para 5 (the Committee on Public Health (SANT) as responsible committee, Oliver Schenk as rapporteur, an IMCO opinion by Maria Guzenina, and 'The European Parliament is aiming to vote on its position early 2027'), para 6 (EESC opinion of 29 April 2026, doc 9402/26), para 8 (Commission presentations at the Working Party on Pharmaceuticals and Medical Devices on 14 January, 13 February and 12 March 2026; article-by-article examination from 23 March 2026, in four full-day meetings 'almost achieving a full read-through'), para 9 ('additional work with a view to refining and complementing the proposal will be necessary to reach a General Approach'), para 10 (delineation of tasks between the EMA and the MDCG), para 13 (well-established technology criteria; breakthrough and orphan pathway), para 14 (joint assessment teams; dispute mechanism 'challenging as currently envisaged'), para 15 (regulatory gaps and cumulative impact), para 16 (fee reductions and the financial sustainability of notified bodies), para 17 (delegated empowerments 'subject to legal scrutiny'), para 18 (international cooperation and reliance) and para 19 (AI and cybersecurity); presented to the EPSCO (Health) Council of 16 June 2026 under the Cyprus presidency. European Parliament, Committee on Public Health, Draft Report on the proposal for a regulation of the European Parliament and of the Council amending Regulations (EU) 2017/745 and (EU) 2017/746 as regards simplifying and reducing the burden of the rules on medical devices and in vitro diagnostic medical devices, rapporteur Oliver Schenk, PE787.987 (30 June 2026), procedure 2025/0404(COD). Deutsche Sozialversicherung Europavertretung (DSV), statement on the draft report by rapporteur Oliver Schenk on the targeted revision of the MDR and IVDR (14 July 2026), welcoming, in the statement's own description of the draft report, a clarification limiting the expanded equivalence provisions of Art. 61 MDR and a five-year limit on breakthrough and orphan device certificates with mandatory post-market clinical follow-up; the statement records the position of the German social-insurance institutions and is cited here for that position only.
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COM(2025) 1023 (n 2), Art. 5 of the proposed regulation: paragraph 1 (entry into force on the twentieth day following publication in the Official Journal), paragraph 2 (application six months after entry into force) and paragraph 3 (by derogation, Art. 1, points (47) and (95), Art. 2, points (33), (40) and (78), Art. 3 and Art. 4 apply from entry into force; Art. 1, points (27) to (40), and Art. 2, points (24) to (26), twelve months after entry into force; Art. 1, point (69), and Art. 2, point (55), three years after entry into force; Art. 1, point (15), five years after entry into force), read with Art. 1, point (47) (Art. 56 MDR, certificate validity), point (95) (Art. 120(14) and (15) MDR), points (27) to (40) (Art. 35 to 50 MDR, notified bodies), point (69) (new Art. 87a MDR, cybersecurity reporting) and point (15) (Art. 17 MDR, single-use devices and reprocessing).
05
Regulation (EU) 2017/745 of the European Parliament and of the Council of 5 April 2017 on medical devices [2017] OJ L117/1 (MDR), Art. 120(3a) (31 December 2027 for class III devices and class IIb implantable devices except sutures, staples, dental fillings, dental braces, tooth crowns, screws, wedges, plates, wires, pins, clips and connectors; 31 December 2028 for other class IIb devices, class IIa devices and class I devices placed on the market in sterile condition or having a measuring function), Art. 120(3b) (31 December 2028 for devices whose conformity assessment under Directive 93/42/EEC did not require a notified body, whose declaration of conformity was drawn up before 26 May 2021 and which require a notified body under the MDR) and Art. 120(3c) (conditions, including continued compliance with the directives, no significant changes in design and intended purpose, a quality management system in accordance with Art. 10(9) and a formal application lodged with a notified body no later than 26 May 2024, and a written agreement signed no later than 26 September 2024), all as inserted by Regulation (EU) 2023/607 of the European Parliament and of the Council of 15 March 2023 amending Regulations (EU) 2017/745 and (EU) 2017/746 as regards the transitional provisions for certain medical devices and in vitro diagnostic medical devices [2023] OJ L80/24; Art. 52(7) (class I devices: EU declaration of conformity after drawing up the technical documentation, with notified-body involvement limited to sterility, metrology and reuse aspects); Art. 56(2); Art. 58; Art. 61(4) and (5); Art. 86(1); Art. 87(3) to (5); Art. 109; Art. 123(3)(d). Regulation (EU) 2017/746 of the European Parliament and of the Council of 5 April 2017 on in vitro diagnostic medical devices [2017] OJ L117/176 (IVDR), Art. 110(3a) (31 December 2027 for devices holding a certificate issued under Directive 98/79/EC) and Art. 110(3b) (for devices that needed no notified body under the Directive, 31 December 2027 for class D devices, 31 December 2028 for class C devices, 31 December 2029 for class B devices and class A devices placed on the market in sterile condition) and Art. 110(3c) (conditions, including a quality management system by 26 May 2025 and formal applications lodged with a notified body no later than 26 May 2025, 26 May 2026 or 26 May 2027 depending on the class), as amended by Regulation (EU) 2024/1860 of the European Parliament and of the Council of 13 June 2024 amending Regulations (EU) 2017/745 and (EU) 2017/746 as regards a gradual roll-out of Eudamed, the obligation to inform in case of interruption or discontinuation of supply, and transitional provisions for certain in vitro diagnostic medical devices [2024] OJ L 2024/1860. Commission Decision (EU) 2025/2371 of 26 November 2025 on the notice regarding the functionality and the fulfilment of the functional specifications of certain electronic systems included in the European Database on Medical Devices [2025] OJ L 2025/2371, published 27 November 2025, from which the obligations relating to the first four EUDAMED electronic systems applied six months later under Art. 123(3)(d) MDR.
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Commission Implementing Regulation (EU) 2026/977 of 4 May 2026 laying down certain uniform quality management and procedural requirements for the conformity assessment activities carried out by a notified body designated under Regulations (EU) 2017/745 and (EU) 2017/746 of the European Parliament and of the Council [2026] OJ L 2026/977, adopted under Art. 36(3) MDR (n 5) and Art. 32(3) IVDR (n 5): Art. 2(2) (maximum timelines: 30 days for application review and signature of the contract, 120 days for the quality management system audit, 90 days for the product verification of each device or representative device, 20 days for the decision and certification), Art. 5 to 7 (re-certification reviews for product certificates and for quality management system certificates, and the decision on re-certification), Art. 8 (Art. 1 to 3 do not apply to procedures whose written agreement was signed before 25 February 2027; Art. 5 to 7 do not apply to re-certification reviews of certificates expiring before 25 November 2027) and Art. 9 (application from 25 February 2027, Art. 4(4) from 1 January 2028).
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COM(2025) 1023 (n 2), Art. 1, point (95) (new Art. 120(15) MDR: as regards devices for which a conformity assessment procedure is pending on the general application date, or for which a certificate is issued before that date, 'the manufacturer and the notified body may agree to continue applying the provisions of this Regulation in the form applicable before' that date 'until the conformity assessment procedure is finalised or until the certificate is renewed'); Art. 1, point (27) (new Art. 35(6a) MDR: without prejudice to other administrative or judicial remedies, a manufacturer or a notified body may raise with the authority responsible for notified bodies, in a duly substantiated manner, any unresolved dispute arising from the application of the requirements set out in Annex VII and the involvement of a notified body in the conformity assessment in accordance with Art. 52 and Annexes IX, X and XI, the authority to hear and decide within 90 days, with consultation of the manufacturer's Member State where it differs, annual reporting to the Commission and the MDCG, and the option for a Member State to assign the task to another authority or an out-of-court dispute resolution body). Council doc 9801/26 (n 3), para 14.
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COM(2025) 1023 (n 2), Art. 1, point (47) (Art. 56(1) and (2) MDR replaced, paragraph 2 providing that 'The validity of certificates shall not be limited in time, unless in exceptional cases where the notified body considers it necessary to limit the period of validity based on duly justified grounds', with extension on application following an assessment under Annex VII, Section 4.11; new Art. 56(2a) MDR, appropriate surveillance activities during the validity of the certificate, including periodic reviews taking into consideration developments of the state of the art and proportionate to the risk class; Art. 56(3) MDR, conditions on the validity of the certificate such as limiting the intended purpose to certain groups of patients or requiring specific PMCF studies; Art. 56(4) MDR, suspension, withdrawal or conditions where the requirements are no longer met); Annex, point (5) (Annex VII, Section 4.11 replaced: periodic reviews of approved quality management systems and certificates, and the extension of a certificate's period of validity where it has exceptionally been limited) and point (7) (Annex IX, Section 3.3: surveillance audits and assessments once every 12 months, but only once every 24 months 'where justified in light of the results of previous surveillance audits and assessments, and in the absence of any concerns resulting from data from post-market surveillance or vigilance'; remote audits on justified grounds; Section 3.4: short-notice or unannounced audits when justified by concerns related to post-market surveillance or vigilance data or at the request of a competent authority). MDR (n 5), Art. 56(2) (validity not exceeding five years, extendable for further periods each not exceeding five years on a re-assessment) and Art. 58 (voluntary change of notified body, which the proposal does not amend).
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COM(2025) 1023 (n 2), Annex, point (6)(g) (Annex VIII, Section 6.3, Rule 11 replaced: software intended to generate an output that confers a clinical benefit and is used for diagnosis, treatment, prevention, monitoring, prediction, prognosis, compensation or alleviation of a disease or condition is class I, unless the output is intended for a disease or condition in a critical situation with a risk of causing death or an irreversible deterioration of a person's state of health, class III; in a serious situation with a risk of causing a serious deterioration of a person's state of health or a surgical intervention, or to drive clinical management in a critical situation, class IIb; or in a non-serious situation, or to drive clinical management in a serious situation, or to inform clinical management in a critical or serious situation, class IIa), point (6)(c) and (d) (reusable surgical instruments class I regardless of the body part with which they come into contact) and point (6)(e) (total or partial joint replacements and spinal implants class III, with the exception of components such as screws, wedges, plates and instruments and other devices that are well-established technology devices); Art. 1, point (2) (new Art. 2, point 72 MDR, definition of well-established technology device, replacing the lists in Art. 18(3), 52(4) and 61(6)(b) MDR) and point (42) (new Art. 51a MDR: a dispute arising from the application of Annex VIII referred to the competent authority of the Member State of the manufacturer's registered place of business or, where the manufacturer has no registered place of business in the Union and has not yet designated an authorised representative, of the authorised representative named under Annex IX; consultation of the other Member States within 30 days; expert-panel opinion on a substantiated disagreement). MDR (n 5), Annex VIII, Section 6.3, Rule 11 (software intended to provide information used to take decisions with diagnosis or therapeutic purposes: class IIa, class III where those decisions may cause death or an irreversible deterioration, class IIb where they may cause a serious deterioration or a surgical intervention; software intended to monitor physiological processes class IIa, or class IIb for vital physiological parameters; all other software class I) and Art. 52(7). Council doc 9801/26 (n 3), para 13 (the well-established technology criteria need 'further refinement and clarification'). Federal Food, Drug, and Cosmetic Act § 520(o)(1)(E), 21 U.S.C. § 360j(o)(1)(E) (a software function excluded from the device definition where it is not intended to acquire, process or analyze a medical image or a signal and is intended for displaying, analyzing or printing medical information, for supporting or providing recommendations to a health care professional about prevention, diagnosis or treatment, and for enabling that professional to independently review the basis for the recommendations), as added by section 3060 of the 21st Century Cures Act, Pub. L. No. 114-255 (13 December 2016).
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COM(2025) 1023 (n 2), Art. 1, point (52) (Art. 61(4) MDR, first subparagraph: 'In the case of implantable class IIb devices and class III devices, other than custom-made devices, clinical investigations shall be performed, except if'; Art. 61(5) MDR replaced: a manufacturer of a device demonstrated to be equivalent to an already marketed device not manufactured by it may rely on paragraph 4 'provided that the original clinical evaluation has been performed in compliance with the requirements of this Regulation and the manufacturer provides clear evidence thereof to the notified body'; Art. 61(10) MDR replaced, permitting a demonstration of conformity based on non-clinical testing methods alone, 'including performance evaluation, bench testing, in vitro, ex vivo, in silico testing, computational modeling or simulation and pre-clinical evaluation', where adequately justified) and Art. 1, point (2) (Art. 2, point 48 MDR, clinical data extended to studies published in scientific literature that are not necessarily peer-reviewed; recital 9). MDR (n 5), Art. 61(4) ('In the case of implantable devices and class III devices, clinical investigations shall be performed, except if') and Art. 61(5) (equivalence to another manufacturer's device conditional on 'a contract in place that explicitly allows the manufacturer of the second device full access to the technical documentation on an ongoing basis' and on an original clinical evaluation compliant with the regulation, with clear evidence thereof provided to the notified body), Annex XIV, Part A, Section 3 (equivalence in technical, biological and clinical characteristics) and Art. 109 (confidentiality). Council doc 9801/26 (n 3), para 15 (several delegations 'identify certain regulatory gaps and remain cautious regarding the cumulative impact of some of the simplifications proposed by the Commission').
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COM(2025) 1023 (n 2), Art. 1, point (44) (new Art. 52a MDR: paragraph 2, a breakthrough device is one expected to introduce in the Union a high degree of novelty with respect to the device technology, the related clinical procedure or the application of the device in clinical practice, and expected to provide a significant positive clinical impact on patients or public health for a life-threatening or irreversibly debilitating disease or condition, either against available alternatives and the state of the art or by fulfilling an unmet medical need; paragraph 3, an orphan device is one intended for the treatment, diagnosis or prevention of a disease or condition that presents in not more than 12 000 individuals in the Union per year, where there are insufficient available alternatives or the device is expected to provide a clinical benefit compared to them; paragraph 4, an expert-panel opinion on a duly substantiated request by a manufacturer or a notified body, published on a dedicated website; paragraph 6, prioritised conformity assessment and, where appropriate, a rolling review; paragraph 7, a certificate where pre-market clinical evidence, even if based on limited clinical data, is deemed adequate and either the benefit of immediate availability outweighs the risk associated with the additional data still required or the benefit-risk ratio is favorable and the manufacturer commits to post-market clinical follow-up, the notified body limiting the certificate's validity and specifying conditions where appropriate) and Art. 1, point (95) (new Art. 120(14) MDR: a legacy device under paragraph 3a or 3b that meets the orphan criteria may be placed on the market after the paragraph 3a and 3b dates if an expert panel has confirmed the criteria, there are no significant changes in design and intended purpose and the device presents no unacceptable risk; the PSUR to be updated at least annually and submitted annually to the competent authority; devices without a valid certificate under paragraph 2 not to bear the CE marking; the declaration of conformity to state that the device is an orphan device placed on the market under that provision; an expert-panel opinion to be requested at least every 10 years). Council doc 9801/26 (n 3), para 13 (general support for the adapted pathway; some delegations would extend it to other categories 'such as paediatric devices'). Federal Food, Drug, and Cosmetic Act § 515B, 21 U.S.C. § 360e-3 (breakthrough devices: a program to expedite the development of, and provide priority review for, devices that provide for more effective treatment or diagnosis of life-threatening or irreversibly debilitating human disease or conditions and that represent breakthrough technologies, for which no approved or cleared alternatives exist, that offer significant advantages over existing alternatives, or the availability of which is in the best interest of patients; determination within 60 calendar days of a request), as added by section 3051 of the 21st Century Cures Act, Pub. L. No. 114-255; 21 CFR 814.3(n) (a humanitarian use device is a medical device intended to benefit patients in the treatment or diagnosis of a disease or condition that affects or is manifested in not more than 8,000 individuals in the United States per year). DSV statement (n 3).
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COM(2025) 1023 (n 2), Art. 1, point (67) (Art. 86(1) MDR: manufacturers of class IIb and class III devices update the PSUR in the first year after the certificate is issued and every two years thereafter, or when there is a significant change in the benefit-risk determination or in the acceptability of undesirable side-effects; manufacturers of class IIa devices update it when necessary; Art. 86(2) MDR: for class III devices or class IIb implantable devices, other than well-established technology devices, the notified body reviews the PSUR during the surveillance assessment), point (68) (Art. 87(3) MDR: a serious incident reported immediately after the manufacturer has established a causal relationship, or that such a relationship is reasonably possible, 'and not later than 30 days after they become aware of the incident'; Art. 87(4) and (5) MDR not amended) and point (69) (new Art. 87a MDR: report to the CSIRTs designated as coordinators of the Member States where the device has been made available and to ENISA of any actively exploited vulnerability as defined in Art. 3, point (42), of Regulation (EU) 2024/2847 contained in the device, or any severe incident under Art. 14(5) of that Regulation having an impact on the security of the device, through the Art. 92 electronic system not later than 30 days after awareness; applicable three years after entry into force under Art. 5(3)(c) of the proposal); Annex, point (5) (Annex VII, Section 4.9 as amended: 'The procedures and contractual arrangements referred to in the first paragraph shall clearly distinguish between changes that do not need to be reported, that need to be reported without requiring prior approval and that require prior approval', and 'Where appropriate, the notified body and the manufacturer shall agree on a predetermined change control plan enabling the manufacturer to implement changes in accordance with such a plan without prior information'). MDR (n 5), Art. 86(1) (PSUR updated at least annually for class IIb and class III devices and at least every two years for class IIa devices), Art. 87(3) (not later than 15 days), Art. 87(4) (serious public health threat: immediately and not later than 2 days) and Art. 87(5) (death or unanticipated serious deterioration: not later than 10 days). Regulation (EU) 2024/2847 of the European Parliament and of the Council of 23 October 2024 on horizontal cybersecurity requirements for products with digital elements (Cyber Resilience Act) [2024] OJ L 2024/2847, Art. 3, point (42) and Art. 14(5). 21 CFR 803.50(a) (a manufacturer reports no later than 30 calendar days after becoming aware of information reasonably suggesting that a marketed device may have caused or contributed to a death or serious injury, or has malfunctioned in a way likely to do so if the malfunction recurred) and 21 CFR 803.53 (5-day report where an MDR reportable event necessitates remedial action to prevent an unreasonable risk of substantial harm to the public health). Federal Food, Drug, and Cosmetic Act § 515C, 21 U.S.C. § 360e-4 (predetermined change control plans for devices), as added by section 3308 of the Food and Drug Omnibus Reform Act of 2022, Pub. L. No. 117-328, div. FF.
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COM(2025) 1023 (n 2), Art. 1, point (90) (new Section 2, 'International cooperation', inserted after Art. 108 MDR: Art. 108a, international regulatory and administrative cooperation, the Commission to participate in relevant international fora 'including the International Medical Device Regulators Forum (IMDRF), the Medical Device Single Audit Programme (MDSAP) and International Standardisation Organisations' and empowered to sign administrative arrangements with authorities of third countries on the exchange of information, joint or coordinated inspections and coordinated safety actions; Art. 108b, reliance mechanisms, under which the Commission 'may participate in bilateral or multilateral reliance mechanisms or reliance programmes' that 'shall enable the use of assessments, inspections, and other regulatory decisions carried out or taken by regulatory authorities of third countries or international organisations or international bodies', provided that the mechanism 'ensures a level of health and safety protection equivalent to that required under this Regulation' and that 'effective arrangements for mutual exchange of information, transparency, and oversight are in place', such mechanisms to be 'taken into consideration by competent authorities, economic operators or notified bodies', with implementing acts to establish detailed rules for their recognition, conditions for the participation of notified bodies and procedural safeguards for manufacturers; Art. 108c, capacity building and technical assistance). Council doc 9801/26 (n 3), para 18 (most delegations support increased international cooperation while recalling 'the need to respect the procedures set out in the Treaties as well as the prerogatives of the Council').
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Regulation (EU) 2024/1689 of the European Parliament and of the Council of 13 June 2024 laying down harmonised rules on artificial intelligence (AI Act) [2024] OJ L 2024/1689, Art. 2(2) ('For AI systems classified as high-risk AI systems in accordance with Article 6(1) related to products covered by the Union harmonisation legislation listed in Section B of Annex I, only Article 6(1), Articles 102 to 109 and Article 112 apply. Article 57 applies only in so far as the requirements for high-risk AI systems under this Regulation have been integrated in that Union harmonisation legislation'), Art. 6(1) (an AI system is high-risk where it is intended to be used as a safety component of a product, or is itself a product, covered by the Annex I legislation and that product is required to undergo a third-party conformity assessment under that legislation), Art. 43(3) (for high-risk AI systems covered by the Section A legislation, the provider follows the conformity assessment procedure required under those acts, and the requirements of Chapter III, Section 2 apply and are part of that assessment), Annex I, Section A, points 11 and 12 (Regulations (EU) 2017/745 and (EU) 2017/746) and Section B, points 13 to 20 (civil aviation security, two- and three-wheel vehicles, agricultural and forestry vehicles, marine equipment, rail interoperability, motor vehicles and civil aviation), and Annex III, point 5(d) (AI systems intended to evaluate and classify emergency calls or to establish priority in the dispatching of emergency first response services, 'as well as of emergency healthcare patient triage systems'). COM(2025) 1023 (n 2), Art. 4 (Annex I AI Act amended: in Section A, points 11 and 12 deleted; in Section B, Regulations (EU) 2017/745 and (EU) 2017/746 added as points 21 and 22) and recital 23 (the parallel application of the two regimes 'could lead to overlaps of requirements and stifle innovation'; the application of the AI Act to those devices 'should be limited to those provisions referred to in Article 2(2) of that Regulation'; where needed the Commission may use its implementing and delegated powers to lay down specific requirements regarding artificial intelligence, taking into account Chapter III, Section 2 AI Act; notified bodies designated to assess high-risk AI systems under the MDR or the IVDR should also meet the AI-related requirements of Art. 31 AI Act). Council doc 9801/26 (n 3), para 19 (several delegations supportive of preventing overlaps and creating one regulatory framework for AI-enabled medical devices by limiting the application of the AI Act; some delegations wish to complement the implementing and delegated powers 'to lay down specific sectoral requirements regarding AI'; the extent to which cybersecurity legislation should be reflected in the sectoral legislation 'a matter for further discussions').
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European Commission, Proposal for a Regulation of the European Parliament and of the Council amending Regulations (EU) 2024/1689 and (EU) 2018/1139 as regards the simplification of the implementation of harmonised rules on artificial intelligence (Digital Omnibus on AI), COM(2025) 836 final (19 November 2025), procedure 2025/0359(COD). A provisional interinstitutional agreement was reached on 7 May 2026; the European Parliament adopted its first-reading position on 16 June 2026; the Council adopted the act on 29 June 2026; the final act, whose title as signed also covers Regulation (EU) 2023/1230, was signed on 8 July 2026 and, as of publication, awaited publication in the Official Journal, entering into force on the third day following it. As adopted, the amending regulation replaces Art. 113, third paragraph, point (c) AI Act (n 14) so that Chapter III, Sections 1 to 3 apply from 2 December 2027 to Annex III high-risk systems and from 2 August 2028 to systems classified as high-risk under Art. 6(1) and Annex I; inserts Art. 2(13) AI Act, under which the application of specific requirements or obligations in Art. 9 to 15 and Art. 17 to 25 may be limited for Art. 6(1) systems where and to the extent that the Annex I, Section A legislation provides an equivalent or higher level of protection of health, safety or fundamental rights and the limitation does not reduce the overall level of protection, the Commission to adopt the specifying delegated acts by 2 August 2027; amends Art. 111(2) AI Act so that the regulation applies to high-risk systems placed on the market or put into service before the date of application of Chapter III only if they are subject to significant changes in their designs from that date, providers and deployers of high-risk systems intended to be used by public authorities having in any case to comply by 2 August 2030; replaces Art. 2(2) AI Act so that, for Section B products, only Art. 6(1), Art. 60a and Art. 102 to 112 AI Act apply; in Annex I deletes point 1 of Section A and adds Regulation (EU) 2023/1230 on machinery to Section B as point 21; and inserts Art. 6(1a) to (1c) AI Act on systems that do not qualify as safety components.
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Medizinprodukteverordnung (MepV) vom 1. Juli 2020 (SR 812.213), in the version in force on 1 July 2026: Art. 4(1)(f) and its footnote (the EU-MDR defined as Verordnung (EU) 2017/745, 'zuletzt geändert durch Verordnung (EU) 2024/1860'), Art. 5(2) (references to the EU-MDR are to the version fixed in the footnote to Art. 4(1)(f), and references to other EU acts to the versions fixed in Anhang 3), Art. 15 (classification into classes I, IIa, IIb and III according to Anhang VIII EU-MDR, taking into account the Commission implementing acts listed in Anhang 5a), Art. 23 (conformity assessment according to Art. 52 and 54 and Anhänge IX to XI EU-MDR), Art. 25(4) (certificates issued by bodies designated under EU law with a seat in an EU or EEA state, and not recognised under an international agreement, are treated as equivalent to certificates of Swiss bodies where it can credibly be shown that the conformity assessment procedures applied satisfy the Swiss requirements and that the issuing body has a qualification equivalent to that required in Switzerland; inserted with effect from 26 May 2021, AS 2021 281), Art. 26(1) and (2) (certificates valid for a maximum of five years, the period to be stated in the certificate; extension on the manufacturer's application, following a re-assessment, by at most five years at a time, repeatable), Art. 51 (a manufacturer without a seat in Switzerland may place devices on the market only through a person with a seat in Switzerland mandated in writing, whose rights, duties and mandate follow Art. 11 EU-MDR), Art. 94 and Anhang 4 (the Commission acts adopted under the EU-MDR provisions listed there apply directly in Switzerland in the version binding on the EU Member States), Art. 95(1) (Swissmedic takes the Commission's implementing acts under the EU-MDR into account in enforcement) and Art. 101(1) (legacy devices until 31 December 2027 for class III and implantable class IIb devices other than the listed exceptions, and until 31 December 2028 for other class IIb, class IIa and sterile or measuring class I devices, and for up-classified class I devices; in the version of the ordinance of 29 September 2023, in force since 1 November 2023, AS 2023 576); the product-registration duty introduced by the ordinance of 20 November 2024 (Produkteregistrierungspflicht), in force since 1 July 2026, AS 2024 742: Art. 17(5) MepV (UDI information to be registered with Swissmedic), Art. 55(1) MepV (manufacturers or their authorised representatives and importers register with Swissmedic before first placing a device on the market) and Art. 108(2) and (3) MepV (registration of products, systems and procedure packs placed on the market since 1 July 2026 to be completed by 31 December 2026, and without delay where a serious incident, a field safety corrective action or a trend has to be reported under Art. 66 MepV). Swissmedic, 'swissdamed: As of 1 July 2026, mandatory registration applies to medical devices and in vitro diagnostic medical devices' (notice of 1 July 2026).
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Agreement between the European Community and the Swiss Confederation on mutual recognition in relation to conformity assessment (signed 21 June 1999, entered into force 1 June 2002) [2002] OJ L114/369 (SR 0.946.526.81), Annex 1, ch 4 (medical devices), whose trade-facilitating effects for devices under the MDR (n 5) ceased on 26 May 2021. Schweizerischer Bundesrat, Botschaft über das Paket «Stabilisierung und Weiterentwicklung der Beziehungen Schweiz-EU (Bilaterale III)» (13. März 2026), Geschäft 26.023, BBl 2026 615, recording the signature of the bulk of the package in Brussels on 2 March 2026, including the amending protocol (BBl 2026 619) and the institutional protocol (BBl 2026 620) to the agreement; the realignment of the medical-devices chapter with the MDR is left to a later decision of the Committee established under the agreement, and no published instrument dated the protocols' entry into force as of publication.

Where a proposal reshapes the certificate, the class and the evidence of a device while the deadlines of the unamended text keep running in the EU and in Switzerland, the sequencing of a European market strategy is a matter for tailored analysis.

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