Risk Management Specialist
ISO 14971:2019 risk management implementation throughout the medical device lifecycle.
Table of Contents
Risk Management Planning Workflow
Establish risk management process per ISO 14971.
Workflow: Create Risk Management Plan
- Define scope of risk management activities:
- Medical device identification
- Lifecycle stages covered
- Applicable standards and regulations
- Establish risk acceptability criteria:
- Define probability categories (P1-P5)
- Define severity categories (S1-S5)
- Create risk matrix with acceptance thresholds
- Assign responsibilities:
- Risk management lead
- Subject matter experts
- Approval authorities
- Define verification activities:
- Methods for control verification
- Acceptance criteria
- Plan production and post-production activities:
- Information sources
- Review triggers
- Update procedures
- Obtain plan approval
- Establish risk management file
- Validation: Plan approved; acceptability criteria defined; responsibilities assigned; file established
Risk Management Plan Content
| Section |
Content |
Evidence |
| Scope |
Device and lifecycle coverage |
Scope statement |
| Criteria |
Risk acceptability matrix |
Risk matrix document |
| Responsibilities |
Roles and authorities |
RACI chart |
| Verification |
Methods and acceptance |
Verification plan |
| Production/Post-Production |
Monitoring activities |
Surveillance plan |
Risk Acceptability Matrix (5×5)
| Probability \ Severity |
Negligible |
Minor |
Serious |
Critical |
Catastrophic |
| Frequent (P5) |
Medium |
High |
High |
Unacceptable |
Unacceptable |
| Probable (P4) |
Medium |
Medium |
High |
High |
Unacceptable |
| Occasional (P3) |
Low |
Medium |
Medium |
High |
High |
| Remote (P2) |
Low |
Low |
Medium |
Medium |
High |
| Improbable (P1) |
Low |
Low |
Low |
Medium |
Medium |
Risk Level Actions
| Level |
Acceptable |
Action Required |
| Low |
Yes |
Document and accept |
| Medium |
ALARP |
Reduce if practicable; document rationale |
| High |
ALARP |
Reduction required; demonstrate ALARP |
| Unacceptable |
No |
Design change mandatory |
Risk Analysis Workflow
Identify hazards and estimate risks systematically.
Workflow: Conduct Risk Analysis
- Define intended use and reasonably foreseeable misuse:
- Medical indication
- Patient population
- User population
- Use environment
- Select analysis method(s):
- FMEA for component/function analysis
- FTA for system-level analysis
- HAZOP for process deviations
- Use Error Analysis for user interaction
- Identify hazards by category:
- Energy hazards (electrical, mechanical, thermal)
- Biological hazards (bioburden, biocompatibility)
- Chemical hazards (residues, leachables)
- Operational hazards (software, use errors)
- Determine hazardous situations:
- Sequence of events
- Foreseeable misuse scenarios
- Single fault conditions
- Estimate probability of harm (P1-P5)
- Estimate severity of harm (S1-S5)
- Document in hazard analysis worksheet
- Validation: All hazard categories addressed; all hazards documented; probability and severity assigned
Hazard Categories Checklist
| Category |
Examples |
Analyzed |
| Electrical |
Shock, burns, interference |
â |
| Mechanical |
Crushing, cutting, entrapment |
â |
| Thermal |
Burns, tissue damage |
â |
| Radiation |
Ionizing, non-ionizing |
â |
| Biological |
Infection, biocompatibility |
â |
| Chemical |
Toxicity, irritation |
â |
| Software |
Incorrect output, timing |
â |
| Use Error |
Misuse, perception, cognition |
â |
| Environment |
EMC, mechanical stress |
â |
Analysis Method Selection
| Situation |
Recommended Method |
| Component failures |
FMEA |
| System-level failure |
FTA |
| Process deviations |
HAZOP |
| User interaction |
Use Error Analysis |
| Software behavior |
Software FMEA |
| Early design phase |
PHA |
Probability Criteria
| Level |
Name |
Description |
Frequency |
| P5 |
Frequent |
Expected to occur |
>10â»Â³ |
| P4 |
Probable |
Likely to occur |
10â»Â³ to 10â»â´ |
| P3 |
Occasional |
May occur |
10â»â´ to 10â»âµ |
| P2 |
Remote |
Unlikely |
10â»âµ to 10â»â¶ |
| P1 |
Improbable |
Very unlikely |
<10â»â¶ |
Severity Criteria
| Level |
Name |
Description |
Harm |
| S5 |
Catastrophic |
Death |
Death |
| S4 |
Critical |
Permanent impairment |
Irreversible injury |
| S3 |
Serious |
Injury requiring intervention |
Reversible injury |
| S2 |
Minor |
Temporary discomfort |
No treatment needed |
| S1 |
Negligible |
Inconvenience |
No injury |
See: references/risk-analysis-methods.md
Risk Evaluation Workflow
Evaluate risks against acceptability criteria.
Workflow: Evaluate Identified Risks
- Calculate initial risk level from probability à severity
- Compare to risk acceptability criteria
- For each risk, determine:
- Acceptable: Document and accept
- ALARP: Proceed to risk control
- Unacceptable: Mandatory risk control
- Document evaluation rationale
- Identify risks requiring benefit-risk analysis
- Complete benefit-risk analysis if applicable
- Compile risk evaluation summary
- Validation: All risks evaluated; acceptability determined; rationale documented
Risk Evaluation Decision Tree
Risk Estimated
â
â¼
Apply Acceptability Criteria
â
âââ Low Risk ââââââââââ⺠Accept and document
â
âââ Medium Risk âââââââ⺠Consider risk reduction
â â Document ALARP if not reduced
â â¼
â Practicable to reduce?
â â
â Yesââ⺠Implement control
â Noâââ⺠Document ALARP rationale
â
âââ High Risk âââââââââ⺠Risk reduction required
â â Must demonstrate ALARP
â â¼
â Implement control
â Verify residual risk
â
âââ Unacceptable ââââââ⺠Design change mandatory
Cannot proceed without control
ALARP Demonstration Requirements
| Criterion |
Evidence Required |
| Technical feasibility |
Analysis of alternative controls |
| Proportionality |
Cost-benefit of further reduction |
| State of the art |
Comparison to similar devices |
| Stakeholder input |
Clinical/user perspectives |
Benefit-Risk Analysis Triggers
| Situation |
Benefit-Risk Required |
| Residual risk remains high |
Yes |
| No feasible risk reduction |
Yes |
| Novel device |
Yes |
| Unacceptable risk with clinical benefit |
Yes |
| All risks low |
No |
Risk Control Workflow
Implement and verify risk control measures.
Workflow: Implement Risk Controls
- Identify risk control options:
- Inherent safety by design (Priority 1)
- Protective measures in device (Priority 2)
- Information for safety (Priority 3)
- Select optimal control following hierarchy
- Analyze control for new hazards introduced
- Document control in design requirements
- Implement control in design
- Develop verification protocol
- Execute verification and document results
- Evaluate residual risk with control in place
- Validation: Control implemented; verification passed; residual risk acceptable; no unaddressed new hazards
Risk Control Hierarchy
| Priority |
Control Type |
Examples |
Effectiveness |
| 1 |
Inherent Safety |
Eliminate hazard, fail-safe design |
Highest |
| 2 |
Protective Measures |
Guards, alarms, automatic shutdown |
High |
| 3 |
Information |
Warnings, training, IFU |
Lower |
Risk Control Option Analysis Template
RISK CONTROL OPTION ANALYSIS
Hazard ID: H-[XXX]
Hazard: [Description]
Initial Risk: P[X] Ã S[X] = [Level]
OPTIONS CONSIDERED:
| Option | Control Type | New Hazards | Feasibility | Selected |
|--------|--------------|-------------|-------------|----------|
| 1 | [Type] | [Yes/No] | [H/M/L] | [Yes/No] |
| 2 | [Type] | [Yes/No] | [H/M/L] | [Yes/No] |
SELECTED CONTROL: Option [X]
Rationale: [Justification for selection]
IMPLEMENTATION:
- Requirement: [REQ-XXX]
- Design Document: [Reference]
VERIFICATION:
- Method: [Test/Analysis/Review]
- Protocol: [Reference]
- Acceptance Criteria: [Criteria]
Risk Control Verification Methods
| Method |
When to Use |
Evidence |
| Test |
Quantifiable performance |
Test report |
| Inspection |
Physical presence |
Inspection record |
| Analysis |
Design calculation |
Analysis report |
| Review |
Documentation check |
Review record |
Residual Risk Evaluation
| After Control |
Action |
| Acceptable |
Document, proceed |
| ALARP achieved |
Document rationale, proceed |
| Still unacceptable |
Additional control or design change |
| New hazard introduced |
Analyze and control new hazard |
Post-Production Risk Management
Monitor and update risk management throughout product lifecycle.
Workflow: Post-Production Risk Monitoring
- Identify information sources:
- Customer complaints
- Service reports
- Vigilance/adverse events
- Literature monitoring
- Clinical studies
- Establish collection procedures
- Define review triggers:
- New hazard identified
- Increased frequency of known hazard
- Serious incident
- Regulatory feedback
- Analyze incoming information for risk relevance
- Update risk management file as needed
- Communicate significant findings
- Conduct periodic risk management review
- Validation: Information sources monitored; file current; reviews completed per schedule
Information Sources
| Source |
Information Type |
Review Frequency |
| Complaints |
Use issues, failures |
Continuous |
| Service |
Field failures, repairs |
Monthly |
| Vigilance |
Serious incidents |
Immediate |
| Literature |
Similar device issues |
Quarterly |
| Regulatory |
Authority feedback |
As received |
| Clinical |
PMCF data |
Per plan |
Risk Management File Update Triggers
| Trigger |
Response Time |
Action |
| Serious incident |
Immediate |
Full risk review |
| New hazard identified |
30 days |
Risk analysis update |
| Trend increase |
60 days |
Trend analysis |
| Design change |
Before implementation |
Impact assessment |
| Standards update |
Per transition period |
Gap analysis |
Periodic Review Requirements
| Review Element |
Frequency |
| Risk management file completeness |
Annual |
| Risk control effectiveness |
Annual |
| Post-market information analysis |
Quarterly |
| Risk-benefit conclusions |
Annual or on new data |
Risk Assessment Templates
Hazard Analysis Worksheet
HAZARD ANALYSIS WORKSHEET
Product: [Device Name]
Document: HA-[Product]-[Rev]
Analyst: [Name]
Date: [Date]
| ID | Hazard | Hazardous Situation | Harm | P | S | Initial Risk | Control | Residual P | Residual S | Final Risk |
|----|--------|---------------------|------|---|---|--------------|---------|------------|------------|------------|
| H-001 | [Hazard] | [Situation] | [Harm] | [1-5] | [1-5] | [Level] | [Control ref] | [1-5] | [1-5] | [Level] |
FMEA Worksheet
FMEA WORKSHEET
Product: [Device Name]
Subsystem: [Subsystem]
Analyst: [Name]
Date: [Date]
| ID | Item | Function | Failure Mode | Effect | S | Cause | O | Control | D | RPN | Action |
|----|------|----------|--------------|--------|---|-------|---|---------|---|-----|--------|
| FM-001 | [Item] | [Function] | [Mode] | [Effect] | [1-10] | [Cause] | [1-10] | [Detection] | [1-10] | [SÃOÃD] | [Action] |
RPN Action Thresholds:
>200: Critical - Immediate action
100-200: High - Action plan required
50-100: Medium - Consider action
<50: Low - Monitor
Risk Management Report Summary
RISK MANAGEMENT REPORT
Product: [Device Name]
Date: [Date]
Revision: [X.X]
SUMMARY:
- Total hazards identified: [N]
- Risk controls implemented: [N]
- Residual risks: [N] Low, [N] Medium, [N] High
- Overall conclusion: [Acceptable / Not Acceptable]
RISK DISTRIBUTION:
| Risk Level | Before Control | After Control |
|------------|----------------|---------------|
| Unacceptable | [N] | 0 |
| High | [N] | [N] |
| Medium | [N] | [N] |
| Low | [N] | [N] |
CONTROLS IMPLEMENTED:
- Inherent safety: [N]
- Protective measures: [N]
- Information for safety: [N]
OVERALL RESIDUAL RISK: [Acceptable / ALARP Demonstrated]
BENEFIT-RISK CONCLUSION: [If applicable]
APPROVAL:
Risk Management Lead: _____________ Date: _______
Quality Assurance: _____________ Date: _______
Decision Frameworks
Risk Control Selection
What is the risk level?
â
âââ Unacceptable ââ⺠Can hazard be eliminated?
â â
â Yesââ´âNo
â â â
â â¼ â¼
â Eliminate Can protective
â hazard measure reduce?
â â
â Yesââ´âNo
â â â
â â¼ â¼
â Add Add warning
â protection + training
â
âââ High/Medium ââ⺠Apply hierarchy
starting at Level 1
New Hazard Analysis
| Question |
If Yes |
If No |
| Does control introduce new hazard? |
Analyze new hazard |
Proceed |
| Is new risk higher than original? |
Reject control option |
Acceptable trade-off |
| Can new hazard be controlled? |
Add control |
Reject control option |
Risk Acceptability Decision
| Condition |
Decision |
| All risks Low |
Acceptable |
| Medium risks with ALARP |
Acceptable |
| High risks with ALARP documented |
Acceptable if benefits outweigh |
| Any Unacceptable residual |
Not acceptable – redesign |
Tools and References
Scripts
Risk Matrix Calculator Features:
- ISO 14971 5×5 risk matrix calculation
- FMEA RPN (Risk Priority Number) calculation
- Interactive mode for guided assessment
- Display risk criteria definitions
- JSON output for integration
References
Quick Reference: ISO 14971 Process
| Stage |
Key Activities |
Output |
| Planning |
Define scope, criteria, responsibilities |
Risk Management Plan |
| Analysis |
Identify hazards, estimate risk |
Hazard Analysis |
| Evaluation |
Compare to criteria, ALARP assessment |
Risk Evaluation |
| Control |
Implement hierarchy, verify |
Risk Control Records |
| Residual |
Overall assessment, benefit-risk |
Risk Management Report |
| Production |
Monitor, review, update |
Updated RM File |
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