Which countries have officially adopted ICH-GCP E6(R2) as a standard, in addition to U.S., EU, Japan, Canada, and Australia?
India has aligned national regulations with ICH-GCP.
DCGI/ICMR Guidelines (India): Explicitly adopt ICH E6(R2) as part of its Good Clinical Practice standards.
China and Brazil are harmonizing, but full official adoption is noted in India.
A revised protocol added genomic testing to banked tissue samples. Before shipping samples, what must the site do?
21 CFR 56.109(a): IRB must review and approve any protocol amendments before implementation.
ICH E6(R2) 4.5.2: Changes affecting subjects (e.g., genomic testing) require IRB/IEC approval and updated consent.
Thus, site must first obtain IRB approval for revised protocol and ICF.
An approved investigational device exemption (IDE) permits a device to be:
An Investigational Device Exemption (IDE) allows an unapproved medical device to be used in a clinical investigation.
21 CFR 812.1(a): ''An approved IDE permits a device to be shipped lawfully for the purpose of conducting investigations of the device without complying with other requirements of the Food, Drug, and Cosmetic Act that would otherwise apply.''
It does not allow commercial sale (B), non-study clinical use (C), or marketing as a humanitarian device (D).
Thus, the correct answer is A (Shipped lawfully for clinical study).
21 CFR 812.1(a) (IDE exemption provisions).
After completion of a Phase III trial, which document should IRB/IEC retain?
21 CFR 56.115(a)(5): IRBs must retain records of IRB membership (names, qualifications, affiliations, occupations).
Other documents (contracts, enrollment logs, product labels) are site or sponsor responsibilities, not IRB's.
The FDA may propose to terminate an IND during a Phase I study if the FDA finds that which of the following conditions exists?
The FDA has authority to impose clinical holds and terminations on IND studies when subject safety is at risk.
21 CFR 312.44(b)(1): ''The FDA may propose to terminate an IND if it finds that human subjects would be exposed to an unreasonable and significant risk of illness or injury.''
21 CFR 312.42(e): ''If an IND is placed on clinical hold and the deficiencies have not been adequately addressed within 30 days, FDA may terminate the IND.''
Annual reports (A) are required but noncompliance usually results in clinical hold, not immediate termination. IRB approval delays (B) do not trigger termination; the site simply cannot begin. Investigators report safety data to sponsors, not directly to FDA (C).
Thus, the correct answer is D (The FDA issued a clinical hold, and 30 days have elapsed).
21 CFR 312.44(b)(1) (Termination of an IND).
21 CFR 312.42(e) (Clinical hold procedures).
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