The GAO has issued a report entitled “Medical Devices: FDA Should Take Steps to Ensure That High-Risk Device Types Are Approved through the Most Stringent Premarket Review Process.” The GAO found that in fiscal years (FY) 2003 through 2007, as part of its premarket review, the FDA: (1) reviewed 13,199 submissions for class I and II devices via the 510(k) process, clearing 11,935 (90%) of these submissions; (2) reviewed 342 submissions for class III devices through the 510(k) process, clearing 228 (67%) of these submissions; and (3) reviewed 217 original and 784 supplemental PMA submissions for class III devices and approved 78% and 85%, respectively, of these submissions. Although Congress envisioned that class III devices would be approved through the more stringent PMA process, and the Safe Medical Devices Act of 1990 required that FDA either reclassify or establish a schedule for requiring PMAs for class III device types, the GAO concluded that this process remains incomplete. GAO found that in FYs 2003 through 2007, FDA cleared submissions for 24 types of class III devices through the 510(k) process. As of October 2008, four of these device types had been reclassified to class II, but 20 device types could still be cleared through the 510(k) process. FDA said it is committed to issuing regulations either reclassifying or requiring PMAs for the class III devices currently allowed to receive clearance for marketing via the 510(k) process, but it did not provide a time frame for doing so. The GAO recommends that FDA expeditiously take steps to issue regulations for class III device types currently allowed to enter the market via the 510(k) process by requiring PMAs or reclassifying them to a lower class. HHS agreed with the GAO’s recommendation.