1 Scope

1.1 Inclusions

This International Standard specifies requirements for the development, validation, and routine control of an ethylene
oxide sterilization process for medical devices in both the industrial and health care facility settings, and it
acknowledges the similarities and differences between the two applications.

NOTE 1 Among the similarities are the common need for quality systems, staff training, and proper safety measures. The major
differences relate to the unique physical and organizational conditions in health care facilities, and to the initial condition of reusable
medical devices being presented for sterilization.

NOTE 2 Health care facilities differ from medical device manufacturers in the physical design of processing areas, in the
equipment used, and in the availability of personnel with adequate levels of training and experience. The primary function of the
health care facility is to provide patient care, medical device reprocessing is just one of a myriad of activities that are performed to
support that function.

NOTE 3 In terms of the initial condition of medical devices, medical device manufacturers generally sterilize large numbers of
similar medical devices that have been produced from virgin material. Health care facilities, on the other hand, must handle and
process both new medical devices and reusable medical devices of different descriptions and with varying levels of bioburden. They
are therefore faced with the additional challenges of cleaning, evaluating, preparing, and packaging a medical device prior to
sterilization. In this International Standard, alternative approaches and guidance specific to health care facilities are identified as
such.

NOTE 4 EO gas and its mixtures are effective sterilants that are primarily used for heat- and/or moisture-sensitive medical
devices that cannot be moist heat sterilized.

NOTE 5 Although the scope of this International Standard is limited to medical devices, it specifies requirements and provides
guidance that can be applicable to other health care products.

1.2 Exclusions


1.2.1 This International Standard does not specify requirements for the development, validation, and routine
control of a process for inactivating the causative agents of spongiform encephalopathies, such as scrapie, bovine
spongiform encephalopathy, and Creutzfeldt-Jakob disease. Specific recommendations have been produced in
particular countries for the processing of materials potentially contaminated with these agents.

NOTE See ISO 22442-1, ISO 22442-2 and ISO 22442-3.

1.2.2 This International Standard does not detail a specified requirement for designating a medical device as
sterile.

NOTE Attention is drawn to national or regional requirements for designating medical devices as ?sterile?. See for example
EN 556?1 or ANSI/AAMI ST67.

1.2.3 This International Standard does not specify a quality management system for the control of all stages of
production of medical devices.

NOTE The effective implementation of defined and documented procedures is necessary for the development, validation, and
routine control of a sterilization process for medical devices. Such procedures are commonly considered to be elements of a quality
management system. It is not a requirement of this International Standard to have a full quality management system during
manufacture or reprocessing. The necessary elements are normatively referenced at appropriate places in the text (see, in
particular, Clause 4). Attention is drawn to the standards for quality management systems (see ISO 13485) that control all stages of
production or reprocessing of medical devices. National and/or regional regulations for the provision of medical devices might
require the implementation of a full quality management system and the assessment of that system by a third party.

1.2.4 This International Standard does not specify requirements for occupational safety associated with the design
and operation of EO sterilization facilities.

NOTE 1 For further information on safety, see examples in the Bibliography. National or regional regulations may also exist.

NOTE 2 EO is toxic, flammable, and explosive. Attention is drawn to the possible existence in some countries of regulations
giving safety requirements for handling EO and for premises in which it is used.

1.2.5 This International Standard does not cover sterilization by injecting EO or mixtures containing EO directly
into packages or a flexible chamber.

NOTE See ISO 14937 for these types of EO processes.

1.2.6 This International Standard does not cover analytical methods for determining levels of residual EO and/or
its reaction products.

NOTE 1 For further information see ISO 10993-7.

NOTE 2 Attention is drawn to the possible existence of national or regional regulations specifying limits for the level of EO
residues present on or in medical devices.