Mask yourself!

The debate about whether wearing face masks can really help in preventing the spread of COVID-19 or not is ongoing and hot. Fact is that in many of the affected areas - such as Austria, just to name one - masks have been made mandatory. The problem is: often masks are simply not available and pharmacies do not get enough supplies.

Do it yourself

For this reason, many people have enganged in often rather pittoresque attempts at fabricating their own masks using diverse materials, ranging from scarves to female absorbents. Also companies in some of the COVID-19 hotspots, such as Italy’s Calzedonia group or Spain’s Zara, have partly reconverted production to face masks. But are there any requirements when distributing face masks to public?

Face masks are medical devices

As per art. 1 par. 2 of the European Directive on medical devices no. 93/42/EEC any instrument that helps in preventing a disease is considered a “medical device”. The EU member states have passed national legislation to implement the directive. In the case of Germany, most provisions are to be found in the Medizinproduktegesetz (MPG). All in all, however, the legal framework is broadly comparable in all EU states.

In brief, considering face masks as medical devices means that before being put on the market (regardless of whether this happens for free or at a cost) they must be clinically tested and approved by the competent authorities. In addition, they must comply with a long list of safety and compatibility requirements and bare the well-known “CE” seal.

Under German law, producers of medical devices are also obliged to declare their activity to the competent authorities.

Finding a workaround

Quite obviously, companies whose main business is not the production of medical devices will hardly be capable of meeting all those requirements in such a short time as to be still useful to face the current emergency. In some cases (e.g. in Italy), governments have temporarily easened the requirements to put masks on the market in order to allow for a quicker response.

But wherever governmental action has not been taken, the only option is a workaround: face masks may be produced and sold (or given out for free) as by making sure that they are not advertised as “medical face masks”.

Details matter

It’s however not sufficient to simply declare that a mask is no “medical device”, if the way it’s advertised, including wording, pictures, context, descriptions etc. etc. clearly suggest that it helps in preventing contagion - because that would be exactly what a medical device is defined by.

Therefore, the utmost care must be used when describing the masks: no element may mislead customers into thinking that they are buying a disease-preventing instrument. Definitions such as “protective face mask” or “protective device”, let alone “medical mask”, may very well be regarded as misleading, while simply defining the product as “mask” or “face mask” should prove legally safe.

The same reasoning must be obviously applied to descriptions, pictures and any additional documentation: masks must basically be treated as standard clothing accessories, without any medical purpose or function.

Risks

Given the circumstances, offering masks to public may easily land in the limelight of public health, competition and consumer protection authorities and result in audits, sanctions or, as the case may be, even criminal investigations.

In addition, in Germany (and in any other country with a similar legal framework), competitors are entitled to exercise unfair competition claims: medical devices producers may therefore sue such newcomer masks producers for misleading the market, if the above-mentioned conditions are not met.

Feeling sick? Grab your smartphone!

Normally we’re used to hear and read about potential health risks connected to the excessive use of smarphones and mobile devices. But this time it’s the other way around: Germany recently passed a digital health act (“Digitale Versorgungsgesetz”) allowing doctors to prescribe to patients the use of certain health applications, whose costs will be covered by public health insurances.

apps medical devices

The explicit recognition of “software” as medical device directly derives from art. 2 of the European Regulation on medical devices (2017/745/EU), that - inter alia - divides medical devices in general in several classes based on their function and on their inherent risks. The German law allows for the recognition of software applications as medical devices (“health apps”) only if included in the two lowest risk-classes (i.e. I and IIa).

Practical examples of how an app could be implemented as a medical device are apps allowing for the tracking of certain health data (e.g. daily glucose values for diabetes patients, or general health data of pregnant women), apps providing psycological assistance, apps helping to measure reactions, such as sight or hearing etc. etc.

Also, the government’s goal is to improve the access to medical aid by allowing for online consultations via apps.

how to get an app approved

There are two aspects in the planned approval process for medical apps:

  • just as any other traditional medical device, medical apps must in future be approved by the Federal Agency for Pharmaceuticals and Medical Devices (BfArM) in order to be marketed as such (i.e. as “medical”)

  • once a health app has been approved, doctors may prescribe its use and the costs connected thereto are covered by the public (and private) health insurances

The approval process will consist in checking that the health app complies with a list of requirements of both medical, technological and legal nature.

From a legal perspective, the most important issue deinitely is protection and security of data , which has to be ensured in numerous ways. Also, consumer protection and liability (in particular in connection with the health claims the app is presented under) will play a major role. Currently, a draft regulation concerning the application process in being circulated: although this version is not final yet, it gives already a pretty specific insight into what the approval process will most likely look like, and already allows interested app owners to move into the outlined direction.

new opportunities

The development and approval of health apps represents a major opportunity both for established pharmaceutical enterprises and for smaller companies, that are often faster and more flexible in adopting new technology also in this branch. The approval process in Germany will be open app owners from all over the world, if the current regulation is not amended in that respect. In any case, due to the principle of non-discrimination, owners based elsewhere within the EU could hardly be excluded.