MDR – Article 68 – Clinical investigations in emergency situations

Article 68

Clinical investigations in emergency situations

1. By way of derogation from point (f) of Article 62(4), from points (a) and (b) of Article 64(1) and from points (a) and (b) of Article 65, informed consent to participate in a clinical investigation may be obtained, and information on the clinical investigation may be given, after the decision to include the subject in the clinical investigation, provided that that decision is taken at the time of the first intervention on the subject, in accordance with the clinical investigation plan for that clinical investigation and that all of the following conditions are fulfilled:

(a)due to the urgency of the situation, caused by a sudden
life-threatening or other sudden serious medical condition, the
subject is unable to provide prior informed consent and to receive
prior information on the clinical investigation;
(b)there are scientific grounds to expect that participation of the
subject in the clinical investigation will have the potential to
produce a direct clinically relevant benefit for the subject resulting
in a measurable health-related improvement alleviating the
suffering and/or improving the health of the subject, or in the
diagnosis of its condition;
(c)
it is not possible within the therapeutic window to supply all prior information to and obtain prior informed consent from his or her
legally designated representative;
(d)the investigator certifies that he or she is not aware of any
objections to participate in the clinical investigation previously
expressed by the subject;
(e)the clinical investigation relates directly to the subject’s medical
condition because of which it is not possible within the therapeutic window to obtain prior informed consent from the subject or from
his or her legally designated representative and to supply prior
information, and the clinical investigation is of such a nature that itmay be conducted exclusively in emergency situations;
(f)the clinical investigation poses a minimal risk to, and imposes a
minimal burden on, the subject in comparison with the standard
treatment of the subject’s condition.

2. Following an intervention pursuant to paragraph 1 of this Article, informed consent in accordance with Article 63 shall be sought to continue the participation of the subject in the clinical investigation, and information on the clinical investigation shall be given, in accordance with the following requirements:

(a)regarding incapacitated subjects and minors, the informed consent
shall be sought by the investigator from his or her legally designated representative without undue delay and the information referred toin Article 63(2) shall be given as soon as possible to the subject and
to his or her legally designated representative;
(b)regarding other subjects, the informed consent shall be sought by
the investigator without undue delay from the subject or his or her
legally designated representative, whichever can be done sooner,
and the information referred to in Article 63(2) shall be given as
soon as possible to the subject or his or her legally designated
representative, as applicable.

For the purposes of point (b) where informed consent has been obtained from the legally designated representative, informed consent to continue the participation in the clinical investigation shall be obtained from the subject as soon as he or she is capable of giving informed consent.

3. If the subject or, where applicable, his or her legally designated representative does not give consent, he or she shall be informed of the right to object to the use of data obtained from the clinical investigation.