What is the first option for a company if a device is declared NSE by the FDA?

When a device is declared Not Substantially Equivalent (NSE) by the FDA following a 510(k) submission, the primary course of action for the company typically involves addressing the concerns that led to the NSE determination. Resubmitting a 510(k) with new data is a strategic option that allows the company to provide additional evidence or improvements in the device’s design, performance, or intended use. This resubmission can specifically target the issues raised by the FDA during the NSE review.

In contrast, the other options do not align with the immediate steps that are generally recommended after receiving an NSE decision. Filing a premarket approval (PMA) application is a much more extensive process and would not be the first necessity following an NSE declaration. It is meant for devices that are significantly different in terms of risk and regulatory scrutiny. Petitioning for a downclassification might be possible but typically involves a lengthy process that may not resolve the information gaps identified by the FDA during the original review. Lastly, pursuing approval in Europe does not directly address the FDA's findings and may not be feasible if the device is still under U.S. regulatory considerations.

Thus, resubmitting a 510(k) with new data is the most logical and immediate