MDCG 2023-7: Exemptions from clinical investigations, explained

When Article 61(4)–(6) lets you rely on existing data instead of a new clinical investigation.

Current Published August 12, 2026 Reviewed by Dr. Oliver Eidel

MDCG 2023-7 maps the four independent situations in which an implantable or class III device may avoid the MDR's default requirement for a clinical investigation. It also explains that sufficient access to equivalent-device data is always necessary, while a contract with the other manufacturer is mandatory only for the specific Article 61(5) route.

Who this applies to

This guidance applies when an implantable or class III device is being evaluated under MDR Article 61(4)–(6). Those devices start from a clear rule: a clinical investigation shall be performed unless one of four exemption cases is fully met.

For devices that are neither class III nor implantable, the need for a clinical investigation follows from the clinical-evaluation objectives and whether the existing evidence is sufficient. MDCG 2023-7 is not an exemption checklist for every device class.

The four exemption routes are separate

Do not combine the easiest condition from one case with another. The four routes are:

Route

Core conditions

Same manufacturer's modified device — Article 61(4)

Modification of the manufacturer's marketed device; Annex XIV equivalence endorsed by the notified body; sufficient marketed-device evaluation; appropriate PMCF with post-market studies

Legacy device — Article 61(6)(a)

Lawfully marketed under the AIMDD/MDD; sufficient clinical data; compliance with any applicable product-specific common specification

Listed well-established technology — Article 61(6)(b)

Device is one of the listed sutures, staples, dental fillings, braces, crowns, screws, wedges, plates, wires, pins, clips or connectors; sufficient data; applicable common specification followed

Another manufacturer's equivalent device — Article 61(5)

Article 61(4) conditions plus an ongoing full-access contract and evidence that the other device's clinical evaluation complies with the MDR

The contract requirement belongs to the Article 61(5) route. It does not automatically apply to the same-manufacturer, legacy-device or listed-technology routes.

Equivalence data and an exemption are different conclusions

Data from an equivalent device can contribute to a clinical evaluation even when it does not remove the obligation to run a clinical investigation. First establish equivalence across the technical, biological and clinical characteristics in Annex XIV; then separately test every condition of the chosen Article 61 exemption.

The device under evaluation still needs its own clinical evaluation. A marketed equivalent device's report does not replace it, and PMCF is expected to build evidence on the actual device rather than support equivalence forever.

What “sufficient access” means

The manufacturer must have enough access to the underlying data to evaluate every claimed technical, biological and clinical characteristic. Public summaries, labels and literature may be enough for some characteristics, but a similarity claim fails where decisive design, material, manufacturing or raw clinical information cannot be checked.

MDCG 2023-7 describes a hierarchy ranging from full technical-documentation access through detailed public or shared information to insufficient, assumption-based access. Record the source and access level characteristic by characteristic; do not write one blanket sentence saying that public data is sufficient.

What this means for you, practically

  1. Name the route. State which of the four Article 61 cases you rely on and why the other cases are irrelevant.
  2. Build a condition matrix. Map each legal condition to controlled evidence and a notified-body conclusion where required.
  3. Separate equivalence from exemption. Complete the Annex XIV equivalence assessment before deciding whether it removes the investigation requirement.
  4. Test data access characteristic by characteristic. Identify missing raw or proprietary data early; do not discover the gap during notified-body review.
  5. Plan device-specific PMCF. Define the post-market studies and milestones that will generate evidence on the device under evaluation.

This guidance works with the MDCG 2020-5 equivalence explainer and the MDCG 2020-7 PMCF plan explainer.

Read the official MDCG 2023-7 guidance.

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