Irish Standard I.S. EN ISO :2009

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Irish Standard I.S. EN ISO 10993-5:2009 NSAI 2009 No copying without NSAI permission except as permitted by copyright law.

I.S. EN ISO 10993-5:2009 Incorporating amendments/corrigenda issued since publication: This document is based on: This document replaces: EN ISO 10993-5:2009 I.S. EN ISO 10993-5:1999 EN ISO 10993-5:1999 This document was published under the authority of the NSAI and comes into effect on: 19 August, 2009 Published: 1 June, 2009 1 October, 1999 ICS number: 11.100.20 NSAI 1 Swift Square, Northwood, Santry Dublin 9 T +353 1 807 3800 F +353 1 807 3838 E standards@nsai.ie W NSAI.ie Sales: T +353 1 857 6730 F +353 1 857 6729 W standards.ie Price Code: M Údarás um Chaighdeáin Náisiúnta na héireann

EUROPEAN STANDARD NORME EUROPÉENNE EUROPÄISCHE NORM I.S. EN ISO 10993-5:2009 EN ISO 10993-5 June 2009 ICS 11.100.20 Supersedes EN ISO 10993-5:1999 English Version Biological evaluation of medical devices - Part 5: Tests for in vitro cytotoxicity (ISO 10993-5:2009) Évaluation biologique des dispositifs médicaux - Partie 5: Essais concernant la cytotoxicité in vitro (ISO 10993-5:2009) This European Standard was approved by CEN on 17 April 2009. Biologische Beurteilung von Medizinprodukten - Teil 5: Prüfungen auf In-vitro-Zytotoxizität (ISO 10993-5:2009) CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this European Standard the status of a national standard without any alteration. Up-to-date lists and bibliographical references concerning such national standards may be obtained on application to the CEN Management Centre or to any CEN member. This European Standard exists in three official versions (English, French, German). A version in any other language made by translation under the responsibility of a CEN member into its own language and notified to the CEN Management Centre has the same status as the official versions. CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and United Kingdom. EUROPEAN COMMITTEE FOR STANDARDIZATION COMITÉ EUROPÉEN DE NORMALISATION EUROPÄISCHES KOMITEE FÜR NORMUNG Management Centre: Avenue Marnix 17, B-1000 Brussels 2009 CEN All rights of exploitation in any form and by any means reserved worldwide for CEN national Members. Ref. No. EN ISO 10993-5:2009: E

EN ISO 10993-5:2009 (E) I.S. EN ISO 10993-5:2009 Contents Page Foreword...3 Annex ZA (informative) Relationship between this International Standard and the Essential Requirements of EU Directive 93/42/EEC...4 Annex ZB (informative) Relationship between this International Standard and the Essential Requirements of EU Directive 90/385/EEC...5 2

I.S. EN ISO 10993-5:2009 EN ISO 10993-5:2009 (E) Foreword This document (EN ISO 10993-5:2009) has been prepared by Technical Committee ISO/TC 194 "Biological evaluation of medical devices" in collaboration with Technical Committee CEN/TC 206 Biological evaluation of medical devices the secretariat of which is held by NEN. This European Standard shall be given the status of a national standard, either by publication of an identical text or by endorsement, at the latest by December 2009, and conflicting national standards shall be withdrawn at the latest by December 2009. Attention is drawn to the possibility that some of the elements of this document may be the subject of patent rights. CEN [and/or CENELEC] shall not be held responsible for identifying any or all such patent rights. This document supersedes EN ISO 10993-5:1999. This document has been prepared under a mandate given to CEN by the European Commission and the European Free Trade Association, and supports essential requirements of EC Directives. For relationship with EC Directives, see informative Annex ZA and ZB, which are integral parts of this document. According to the CEN/CENELEC Internal Regulations, the national standards organizations of the following countries are bound to implement this European Standard: Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and the United Kingdom. Endorsement notice The text of ISO 10993-5:2009 has been approved by CEN as EN ISO 10993-5:2009 without any modifications. 3

EN ISO 10993-5:2009 (E) I.S. EN ISO 10993-5:2009 Annex ZA (informative) Relationship between this International Standard and the Essential Requirements of EU Directive 93/42/EEC This International Standard has been prepared under a mandate given to CEN by the European Commission and the European Free Trade Association to provide a means of conforming to Essential Requirements of the New Approach Directive 93/42/EEC on medical devices. Once this standard is cited in the Official Journal of the European Communities under that Directive and has been implemented as a national standard in at least one Member State, compliance with the clauses of this standard given in Table ZA.1 confers, within the limits of the scope of this standard, a presumption of conformity with the corresponding Essential Requirements of that Directive and associated EFTA regulations. Table ZA.1 Correspondence between this International Standard and Directive 93/42/EEC Clause(s)/sub-clause(s) of this International Standard Essential Requirements (ERs) of Directive 93/42/EEC 4, 5, 6, 7, 8, 9, 10 Annex I: 7.1, 7.2, 7.5 Qualifying remarks/notes WARNING: Other requirements and other EU Directives may be applicable to the product(s) falling within the scope of this International standard. 4

I.S. EN ISO 10993-5:2009 EN ISO 10993-5:2009 (E) Annex ZB (informative) Relationship between this International Standard and the Essential Requirements of EU Directive 90/385/EEC This International Standard has been prepared under a mandate given to CEN by the European Commission and the European Free Trade Association to provide a means of conforming to Essential Requirements of the New Approach Directive 90/385/EEC on active implantable medical devices. Once this standard is cited in the Official Journal of the European Communities under that Directive and has been implemented as a national standard in at least one Member State, compliance with the clauses of this standard given in Table ZB.1 confers, within the limits of the scope of this standard, a presumption of conformity with the corresponding Essential Requirements of that Directive and associated EFTA regulations. Table ZB.1 Correspondence between this International Standard and Directive 90/385/EEC Clause(s)/sub-clause(s) of this International Standard Essential Requirements (ERs) of Directive 90/385/EEC 4, 5, 6, 7, 8, 9, 10 Annex I: 9 Qualifying remarks/notes WARNING Other requirements and other EU Directives may be applicable to the product(s) falling within the scope of this standard. 5

I.S. EN ISO 10993-5:2009 This page is intentionally left BLANK.

I.S. EN ISO 10993-5:2009 INTERNATIONAL STANDARD ISO 10993-5 Third edition 2009-06-01 Biological evaluation of medical devices Part 5: Tests for in vitro cytotoxicity Évaluation biologique des dispositifs médicaux Partie 5: Essais concernant la cytotoxicité in vitro Reference number ISO 10993-5:2009(E) ISO 2009

ISO 10993-5:2009(E) I.S. EN ISO 10993-5:2009 PDF disclaimer This PDF file may contain embedded typefaces. In accordance with Adobe's licensing policy, this file may be printed or viewed but shall not be edited unless the typefaces which are embedded are licensed to and installed on the computer performing the editing. In downloading this file, parties accept therein the responsibility of not infringing Adobe's licensing policy. The ISO Central Secretariat accepts no liability in this area. Adobe is a trademark of Adobe Systems Incorporated. Details of the software products used to create this PDF file can be found in the General Info relative to the file; the PDF-creation parameters were optimized for printing. Every care has been taken to ensure that the file is suitable for use by ISO member bodies. In the unlikely event that a problem relating to it is found, please inform the Central Secretariat at the address given below. COPYRIGHT PROTECTED DOCUMENT ISO 2009 All rights reserved. Unless otherwise specified, no part of this publication may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying and microfilm, without permission in writing from either ISO at the address below or ISO's member body in the country of the requester. ISO copyright office Case postale 56 CH-1211 Geneva 20 Tel. + 41 22 749 01 11 Fax + 41 22 749 09 47 E-mail copyright@iso.org Web www.iso.org Published in Switzerland ii ISO 2009 All rights reserved

I.S. EN ISO 10993-5:2009 ISO 10993-5:2009(E) Contents Page Foreword... iv Introduction... vi 1 Scope... 1 2 Normative references... 1 3 Terms and definitions... 1 4 Sample and control preparation... 2 4.1 General... 2 4.2 Preparation of liquid extracts of material... 3 4.3 Preparation of material for direct-contact tests... 4 4.4 Preparation of controls... 5 5 Cell lines... 5 6 Culture medium... 5 7 Preparation of cell stock culture... 6 8 Test procedures... 6 8.1 Number of replicates... 6 8.2 Test on extracts... 6 8.3 Test by direct contact... 7 8.4 Test by indirect contact... 7 8.5 Determination of cytotoxicity... 9 9 Test report... 10 10 Assessment of results... 11 Annex A (informative) Neutral red uptake (NRU) cytotoxicity test... 12 Annex B (informative) Colony formation cytotoxicity test... 19 Annex C (informative) MTT cytotoxicity test... 24 Annex D (informative) XTT cytotoxicity test... 29 Bibliography... 34 ISO 2009 All rights reserved iii

ISO 10993-5:2009(E) I.S. EN ISO 10993-5:2009 Foreword ISO (the International Organization for Standardization) is a worldwide federation of national standards bodies (ISO member bodies). The work of preparing International Standards is normally carried out through ISO technical committees. Each member body interested in a subject for which a technical committee has been established has the right to be represented on that committee. International organizations, governmental and non-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of electrotechnical standardization. International Standards are drafted in accordance with the rules given in the ISO/IEC Directives, Part 2. The main task of technical committees is to prepare International Standards. Draft International Standards adopted by the technical committees are circulated to the member bodies for voting. Publication as an International Standard requires approval by at least 75 % of the member bodies casting a vote. Attention is drawn to the possibility that some of the elements of this document may be the subject of patent rights. ISO shall not be held responsible for identifying any or all such patent rights. ISO 10993-5 was prepared by Technical Committee ISO/TC 194, Biological evaluation of medical devices. This third edition cancels and replaces the second edition (ISO 10993-5:1999) which has been technically revised. ISO 10993 consists of the following parts, under the general title Biological evaluation of medical devices: Part 1: Evaluation and testing within a risk management process Part 2: Animal welfare requirements Part 3: Tests for genotoxicity, carcinogenicity and reproductive toxicity Part 4: Selection of tests for interactions with blood Part 5: Tests for in vitro cytotoxicity Part 6: Tests for local effects after implantation Part 7: Ethylene oxide sterilization residuals Part 9: Framework for identification and quantification of potential degradation products Part 10: Tests for irritation and skin sensitization Part 11: Tests for systemic toxicity Part 12: Sample preparation and reference materials Part 13: Identification and quantification of degradation products from polymeric medical devices Part 14: Identification and quantification of degradation products from ceramics Part 15: Identification and quantification of degradation products from metals and alloys iv ISO 2009 All rights reserved

I.S. EN ISO 10993-5:2009 ISO 10993-5:2009(E) Part 16: Toxicokinetic study design for degradation products and leachables Part 17: Establishment of allowable limits for leachable substances Part 18: Chemical characterization of materials Part 19: Physico-chemical, morphological and topographical characterization of materials [Technical Specification] Part 20: Principles and methods for immunotoxicology testing of medical devices [Technical Specification] ISO 2009 All rights reserved v

ISO 10993-5:2009(E) I.S. EN ISO 10993-5:2009 Introduction Due to the general applicability of in vitro cytotoxicity tests and their widespread use in evaluating a large range of devices and materials, it is the purpose of this part of ISO 10993, rather than to specify a single test, to define a scheme for testing which requires decisions to be made in a series of steps. This should lead to the selection of the most appropriate test. Three categories of test are listed: extract test, direct contact test, indirect contact test. The choice of one or more of these categories depends upon the nature of the sample to be evaluated, the potential site of use and the nature of the use. This choice then determines the details of the preparation of the samples to be tested, the preparation of the cultured cells, and the way in which the cells are exposed to the samples or their extracts. At the end of the exposure time, the evaluation of the presence and extent of the cytotoxic effect is undertaken. It is the intention of this part of ISO 10993 to leave open the choice of type of evaluation. Such a strategy makes available a battery of tests, which reflects the approach of many groups that advocate in vitro biological tests. The numerous methods used and endpoints measured in cytotoxicity determination can be grouped into the following categories of evaluation: assessments of cell damage by morphological means; measurements of cell damage; measurements of cell growth; measurements of specific aspects of cellular metabolism. There are several means of producing results in each of these four categories. The investigator should be aware of the test categories and into which category a particular technique fits, in order that comparisons be able to be made with other results on similar devices or materials both at the intra- and interlaboratory level. Examples of quantitative test protocols are given in annexes. Guidance for the interpretation of the results is given in this part of ISO 10993. vi ISO 2009 All rights reserved

INTERNATIONAL STANDARD I.S. EN ISO 10993-5:2009 ISO 10993-5:2009(E) Biological evaluation of medical devices Part 5: Tests for in vitro cytotoxicity 1 Scope This part of ISO 10993 describes test methods to assess the in vitro cytotoxicity of medical devices. These methods specify the incubation of cultured cells in contact with a device and/or extracts of a device either directly or through diffusion. These methods are designed to determine the biological response of mammalian cells in vitro using appropriate biological parameters. 2 Normative references The following referenced documents are indispensable for the application of this document. For dated references, only the edition cited applies. For undated references, the latest edition of the referenced document (including any amendments) applies. ISO 10993-1, Biological evaluation of medical devices Part 1: Evaluation and testing within a risk management system ISO 10993-12, Biological evaluation of medical devices Part 12: Sample preparation and reference materials 3 Terms and definitions For the purposes of this document, the terms and definitions given in ISO 10993-1 and the following apply. 3.1 culture vessels vessels appropriate for cell culture including glass petri dishes, plastic culture flasks or plastic multiwells and microtitre plates NOTE These can be used interchangeably in these methods provided that they meet the requirements of tissue culture grade and are suitable for use with mammalian cells. 3.2 positive control material material which, when tested in accordance with this part of ISO 10993, provides a reproducible cytotoxic response ISO 2009 All rights reserved 1

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