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The Subtract to Ship: MDR Blog

642 in-depth guides on EU MDR certification for MedTech startups. By Tibor Zechmeister and Felix Lenhard.

19 topic clusters

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MDR Fundamentals & Regulatory Strategy

Start here — 70 guides

The MDR structure, actors, and core concepts every founder must understand before touching Annex I.

  • What MDR 2017/745 actually regulates
  • Notified Bodies, competent authorities, MDCG
  • Classification rules and conformity routes
  • Transition periods and 2023/607 amendment
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Device Classification & Conformity

Annex VIII Rules 1-22 — 46 guides

How to classify your device correctly the first time — and why getting it wrong costs months.

  • Class I, IIa, IIb, III decision logic
  • Rule 11 for software (SaMD)
  • Classification justification document
  • Borderline and qualification calls
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Clinical Evaluation & Investigations

Article 61 and Annex XIV — 51 guides

Clinical evidence that survives a Notified Body review, without burning your runway on unnecessary studies.

  • Clinical Evaluation Report (CER)
  • Equivalence and its three-dimensional proof
  • When you need a clinical investigation
  • PMCF planning and reporting
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Post-Market Surveillance & Vigilance

Articles 83-92 — 41 guides

Post-market surveillance and vigilance without turning it into paperwork theater.

  • PMS plan and Annex III content
  • Serious incident reporting timelines
  • PSUR for Class IIa/IIb/III
  • FSCA decisions and trend reporting
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Technical Documentation & Labeling

Annex II and labeling — 43 guides

Technical documentation that an auditor can navigate in minutes, not days.

  • Annex II structure and GSPR mapping
  • Device description and intended purpose
  • Labeling and IFU requirements
  • Cross-reference matrices
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EUDAMED, UDI & Registration

Identification and registration — 30 guides

Everything you need to know about EUDAMED, UDI, and what the Member States still want on top.

  • UDI-DI vs UDI-PI and Basic UDI-DI
  • EUDAMED modules and status
  • National registration (DMIDS, ANSM, BASG)
  • Multi-market UDI strategy
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Quality Management Under MDR

ISO 13485 + MDR Article 10(9) — 57 guides

A lean quality management system that passes audits without drowning the team.

  • Minimum viable QMS for startups
  • Design controls and design history
  • CAPA without bureaucracy
  • Supplier qualification
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Risk Management Under MDR

EN ISO 14971 + Annex I — 1 guides

Risk management that drives real design decisions, not a document produced for its own sake.

  • ISO 14971 risk management file
  • Hazards, hazardous situations, harm
  • Risk controls and residual risk
  • Benefit-risk and Annex Z trap
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Software as a Medical Device

IEC 62304 + Rule 11 — 55 guides

Software as a Medical Device from first commit through post-market, without pretending you're not agile.

  • Software safety classification (A/B/C)
  • Requirements, architecture, verification
  • SOUP and open source handling
  • Significant change under Article 120
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AI, ML & Algorithmic Devices

AI Act and Rule 11 — 40 guides

How MDR's static framework fits adaptive algorithms, and where the AI Act adds obligations.

  • AI Act and MDR dual classification
  • Training data and dataset hygiene
  • Drift, explainability, transparency
  • PCCP-style change control
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Electrical Safety & Systems Engineering

EN 60601-1 and friends — 36 guides

Electrical safety, EMC, and systems engineering for medical hardware — from PCB to test lab.

  • EN 60601-1 general requirements
  • EN 60601-1-2 EMC
  • Particular standards (60601-2-xx)
  • Home, emergency, closed-loop devices
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FDA & International Market Access

FDA + IMDRF + MDSAP — 45 guides

Market access beyond Europe, starting with the US and the major IMDRF jurisdictions.

  • FDA 510(k), De Novo, PMA
  • QMSR and ISO 13485 alignment
  • MDSAP and one-audit strategy
  • Country playbooks
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MedTech Startup Strategy & PMF

PMF and strategy — 49 guides

Product-market fit, business models, and startup strategy for regulated MedTech — not a SaaS playbook.

  • MedTech PMF reality check
  • Beachhead markets
  • Hospital procurement
  • Case studies and pivots
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Funding, Business Models & Reimbursement

Capital and reimbursement — 41 guides

How MedTech founders raise money, control burn, and plan for reimbursement from the first pitch.

  • Angels, VC, strategic investors
  • Non-dilutive funding (EIC, BMBF)
  • Reimbursement by country
  • HTA and value-based pricing
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Team Building, Operations & Scaling

Team and operations — 37 guides

Building the team, supply chain, and operations layer that MDR actually requires.

  • PRRC and RA hiring
  • CMO and supplier management
  • Scaling production under MDR
  • Acquisition readiness
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