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    Real-Time PMA Supplement Review

    Expedited PMA supplement review pathway where FDA and the manufacturer meet to review minor device or labeling changes in real time.

    Reviewed by Christian Espinosa, Founder, Blue Goat CyberLast reviewed June 20, 2026

    Definition

    Real-Time Review is an FDA option for minor PMA supplements where the agency and the manufacturer schedule a face-to-face or virtual meeting to review the proposed change together, with the goal of issuing a decision at or shortly after the meeting. It is appropriate for minor changes to design, software, manufacturing, sterilization, or labeling that do not affect safety or effectiveness. Sponsors must submit eligible-determination requests in advance, and FDA must agree that the change qualifies before scheduling.
    What the regulation says
    FDA's 'Real-Time Premarket Approval Application Supplements' guidance defines eligibility and procedural expectations. Real-Time Review is one of several supplement pathways alongside Special PMA Supplement (changes to manufacturing), 30-Day Notice (manufacturing changes meeting specific criteria), and traditional PMA Supplement.

    What this means in practice

    Real-Time Review can dramatically shorten the supplement timeline (often weeks instead of months) when used for genuinely minor changes. It is widely used for low-risk software changes, minor label updates, and incremental manufacturing process changes. For software-containing devices, RTR is a common path for changes that fall outside a Predetermined Change Control Plan but are still narrow in scope.
    Common pitfalls
    • Requesting Real-Time Review for changes that aren't truly minor, FDA will reject the request and the sponsor loses time.
    • Failing to prepare materials at PMA-supplement quality for the meeting, Real-Time Review compresses calendar time, not depth of evidence.
    • Conflating Real-Time Review with the Special PMA Supplement (manufacturing-change-in-effect) pathway, they apply to different change types.
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    Primary references

    3 sources
    Link health: 3 verified· last checked 2026-06-20
    FDA·1IMDRF·1RAPS·1
    1. 1
      Real-Time PMA Supplements Guidance
      Verified
      FDAfda.gov
    2. 2
      IMDRF Documents
      Verified
      IMDRFimdrf.org
    3. 3
      RAPS Regulatory Focus
      Verified
      RAPSraps.org

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