Testing in a Medical Device Context Limitations are few



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Testing in a Medical Device Context Limitations are few Ruud Cox, Improve Quality Services www.eurostarconferences.com @esconfs #esconfs

From Research to Manufacturing Law Regulations Big Organisation Market Segment Healthcare, Deep Brain Stimulation Divisions Manufacturer Research New organisation Manufacturer Hospital Hospital Hospital Products Probe Tools to support Surgical Procedures Hospital Product Prototypes

Deep Brain Stimulation A pacemaker for the brain

Almost no testing Incomplete, overdue documentation

Organise Testing Approach: Exploratory Testing (Verification & Validation) Learning, investigation, discovery followed by Scripted Testing to demonstrate that the product conforms to specified requirements and to provide objective evidence for submission. Conformance, Compliance

Exploratory Testing In the given situation, this was the best way to Learn more about the product Add value by providing feedback Charters, Debriefs, Screen Recordings, Managed A big success

Regulations and Testing Verification only 820.3(aa) Verification means confirmation by examination and provision of objective evidence that specified requirements have been fulfilled. Testing is one of many possible verification activities DESIGN CONTROL GUIDANCE FOR MEDICAL DEVICE MANUFACTURERS This Guidance relates to FDA 21 CFR 820.30 and Sub-clause 4.4 of ISO 9001

Objective Evidence Check pressure. Check that the pressure is OK. Record the pressure here. Check that the pressure is between 50 and 75 psi. A check requires a decision rule i.e. specific, measurable requirements Example from Medical Device Software Verification, Validation and Compliance by David A. Vogel ISBN 1596934220

Specified Requirements User Stories Sometimes with acceptance criteria Traditional requirements The product shall... User Stories and traditional requirements were not linked A real challenge!

Global Design System Graphical User Interface Business Logic Component Component Component Component

Component Testing Software Interface Testability Exploratory Testing Coverage/risk outline Scripted Testing [Test] [RequirementTags("Req1", "Req7")] void FooBar() { Assert.That( ); } Unit tests annotated with requirement tags for traceability Specify test cases for high risk specified requirements only

Structure Bugs Issues Risks Functions Time Operations Platform Data Coverage

Structure Bugs Issues Risks Functions Time Operations Data Platform Coverage/Risk outline

Why PASS and FAIL is not enough PASS only means that no problem was found, which doesn t mean that there s no problem Comparable Products Lots of remarks during evaluation at hospital Our product side-by-side to competitors product

Independent Testing Testers were reponsible for ALL test documentation Providing Objective Evidence Developers did some unit testing but Their tests were undocumented Could not be used as Objective Evidence Why does testing take so long?

JIGGLE! Time-out Testing Incomplete, overdue specified requirements. Independent testing. I don t know nothing about testing. What does the team know about or does have experience with working in a Medical Device Context? Agile/Scrum Almost no Agile practices. The team didn t live Scrum. What does the team know about or does have experience with Agile/Scrum?

Regulations and Agile/Scrum CONCURRENT ENGINEERING. Although the waterfall model is a useful tool for introducing design controls, its usefulness in practice is limited. DESIGN CONTROL GUIDANCE FOR MEDICAL DEVICE MANUFACTURERS This Guidance relates to FDA 21 CFR 820.30 and Sub-clause 4.4 of ISO 9001 Agile TIR SW Committee Draft 1.0 Guidance on the use of AGILE practices in the development of medical device software

Improvements after Time-out Testing IEC 62304 training, Less independent testing. Agile/Scrum Product Backlog, Sprint Planning, Definition of Done, Scrum Board, Sprint Review, Retrospectives, Smaller Teams each with their own Scrum Master Scrum Master, Product Owner training Agile/Scrum Coach Overdue specified requirements

Other Identified Risks Component not traceable to global design and risk analysis 3D mathematical model was not specified Claim these results

Clarify mission System Architect Product Owner Program Director Test Architect Director Quality & Regulations Status reporting

Observe the work of testing A diary might help

Lessons Learned, Conclusions A feedback loop is mandatory Mission Status Reporting Medical Device Context is not limiting Exploratory testing is possible Agile/Scrum is possible No matter what the problem is, it s always a people problem. Gerald M. Weinberg

Questions Ruud Cox email rco@improveqs.nl Twitter Blog @ruudcox http://ruudcox.wordpress.com/