Title 21Food and DrugsRelease 119-73

§360h Notification and other remedies

Title 21 › Chapter CHAPTER 9— - FEDERAL FOOD, DRUG, AND COSMETIC ACT › Subchapter SUBCHAPTER V— - DRUGS AND DEVICES › Part Part A— - Drugs and Devices › § 360h

Last updated Apr 6, 2026|Official source

Summary

The Secretary must act when a medical device sold across state lines creates an unreasonable risk to public health and no other practical law-based fix will work. If the Secretary finds this, they can order public notice. After giving a chance for a short, informal hearing, the Secretary can require companies to submit a plan to fix the problem if the danger seems caused by bad design or manufacture (not by someone else’s poor use) and notice alone won’t stop the risk. Plans can require repairing the device, replacing it with a safe equivalent, or refunding the purchase price (minus a fair allowance for use if the device has been owned one year or more at the time of notice or actual notice). People other than manufacturers, importers, distributors, or retailers must not be charged for these remedies, and they must be paid back for reasonable expenses to get the remedy. If there is a reasonable chance a device could cause serious harm or death, the Secretary must order an immediate stop to distribution and tell health professionals and facilities to stop using it. After a hearing, the Secretary can change that order to require a recall, set a timetable, and demand progress reports. A recall will not force devices back from individuals, and it will not be required from facilities if taking them back would be more dangerous than leaving them in use; individuals must be warned about the risks. The Secretary can also order manufacturers, importers, distributors, or retailers to reimburse each other’s costs when needed to protect public health. Following these orders does not remove any other legal liability, and courts must consider any remedies already provided when awarding economic damages.

Full Legal Text

Title 21, §360h

Food and Drugs — Source: USLM XML via OLRC

(a)If the Secretary determines that—
(1)a device intended for human use which is introduced or delivered for introduction into interstate commerce for commercial distribution presents an unreasonable risk of substantial harm to the public health, and
(2)notification under this subsection is necessary to eliminate the unreasonable risk of such harm and no more practicable means is available under the provisions of this chapter (other than this section) to eliminate such risk,
(b)(1)(A)If, after affording opportunity for an informal hearing, the Secretary determines that—
(i)a device intended for human use which is introduced or delivered for introduction into interstate commerce for commercial distribution presents an unreasonable risk of substantial harm to the public health,
(ii)there are reasonable grounds to believe that the device was not properly designed or manufactured with reference to the state of the art as it existed at the time of its design or manufacture,
(iii)there are reasonable grounds to believe that the unreasonable risk was not caused by failure of a person other than a manufacturer, importer, distributor, or retailer of the device to exercise due care in the installation, maintenance, repair, or use of the device, and
(iv)the notification authorized by subsection (a) would not by itself be sufficient to eliminate the unreasonable risk and action described in paragraph (2) of this subsection is necessary to eliminate such risk,
(B)The Secretary shall approve a plan submitted pursuant to an order issued under subparagraph (A) unless he determines (after affording opportunity for an informal hearing) that the action or actions to be taken under the plan or the manner in which such action or actions are to be taken under the plan will not assure that the unreasonable risk with respect to which such order was issued will be eliminated. If the Secretary disapproves a plan, he shall order a revised plan to be submitted to him within a reasonable time. If the Secretary determines (after affording opportunity for an informal hearing) that the revised plan is unsatisfactory or if no revised plan or no initial plan has been submitted to the Secretary within the prescribed time, the Secretary shall (i) prescribe a plan to be carried out by the person or persons to whom the order issued under subparagraph (A) was directed, or (ii) after affording an opportunity for an informal hearing, by order prescribe a plan to be carried out by a person who is a manufacturer, importer, distributor, or retailer of the device with respect to which the order was issued but to whom the order under subparagraph (A) was not directed.
(2)The actions which may be taken under a plan submitted under an order issued under paragraph (1) are as follows:
(A)To repair the device so that it does not present the unreasonable risk of substantial harm with respect to which the order under paragraph (1) was issued.
(B)To replace the device with a like or equivalent device which is in conformity with all applicable requirements of this chapter.
(C)To refund the purchase price of the device (less a reasonable allowance for use if such device has been in the possession of the device user for one year or more—
(i)at the time of notification ordered under subsection (a), or
(ii)at the time the device user receives actual notice of the unreasonable risk with respect to which the order was issued under paragraph (1),
(3)No charge shall be made to any person (other than a manufacturer, importer, distributor or retailer) for availing himself of any remedy, described in paragraph (2) and provided under an order issued under paragraph (1), and the person subject to the order shall reimburse each person (other than a manufacturer, importer, distributor, or retailer) who is entitled to such a remedy for any reasonable and foreseeable expenses actually incurred by such person in availing himself of such remedy.
(c)An order issued under subsection (b) with respect to a device may require any person who is a manufacturer, importer, distributor, or retailer of the device to reimburse any other person who is a manufacturer, importer, distributor, or retailer of such device for such other person’s expenses actually incurred in connection with carrying out the order if the Secretary determines such reimbursement is required for the protection of the public health. Any such requirement shall not affect any rights or obligations under any contract to which the person receiving reimbursement or the person making such reimbursement is a party.
(d)Compliance with an order issued under this section shall not relieve any person from liability under Federal or State law. In awarding damages for economic loss in an action brought for the enforcement of any such liability, the value to the plaintiff in such action of any remedy provided him under such order shall be taken into account.
(e)(1)If the Secretary finds that there is a reasonable probability that a device intended for human use would cause serious, adverse health consequences or death, the Secretary shall issue an order requiring the appropriate person (including the manufacturers, importers, distributors, or retailers of the device)—
(A)to immediately cease distribution of such device, and
(B)to immediately notify health professionals and device user facilities of the order and to instruct such professionals and facilities to cease use of such device.
(2)(A)If, after providing an opportunity for an informal hearing under paragraph (1), the Secretary determines that the order should be amended to include a recall of the device with respect to which the order was issued, the Secretary shall, except as provided in subparagraphs (B) and (C), amend the order to require a recall. The Secretary shall specify a timetable in which the device recall will occur and shall require periodic reports to the Secretary describing the progress of the recall.
(B)An amended order under subparagraph (A)—
(i)shall—
(I)not include recall of a device from individuals, and
(II)not include recall of a device from device user facilities if the Secretary determines that the risk of recalling such device from the facilities presents a greater health risk than the health risk of not recalling the device from use, and
(ii)shall provide for notice to individuals subject to the risks associated with the use of such device.
(3)The remedy provided by this subsection shall be in addition to remedies provided by subsections (a), (b), and (c).

Legislative History

Notes & Related Subsidiaries

Editorial Notes

Amendments

1992—Subsec. (b)(1)(A)(ii). Pub. L. 102–300 substituted “or” for “and” after “properly designed” and “time of its design”. 1990—Subsec. (e). Pub. L. 101–629 added subsec. (e).

Reference

Citations & Metadata

Citation

21 U.S.C. § 360h

Title 21Food and Drugs

Last Updated

Apr 6, 2026

Release point: 119-73