4th State MedicalRegenerative · Technology
Regulatory Roadmap

A disciplined path from innovation to medical adoption.

4th State Medical intends to pursue the regulatory pathways appropriate to each product, intended use, and market — including 510(k), De Novo, or other pathways as regulatory analysis supports.

Stages

Fourteen milestones on the regulatory pathway.

  1. 01Scientific and Market Assessment

    Landscape review, unmet need analysis, and scientific rationale.

  2. 02Product Definition and Intended Use

    Precise articulation of intended use and target user needs.

  3. 03Regulatory Classification Strategy

    Analysis of applicable classification and pathway options.

  4. 04Quality-System Development

    Establishing procedures aligned with applicable QMS expectations.

  5. 05Design Controls and Risk Management

    Structured design inputs, outputs, verification, and risk analysis.

  6. 06Engineering Verification

    Verification of design outputs against defined requirements.

  7. 07Performance and Safety Testing

    Bench testing across representative use conditions.

  8. 08Biocompatibility Where Applicable

    Evaluation aligned with applicable standards for patient-contacting elements.

  9. 09Electrical and Software Testing Where Applicable

    Assessment aligned with recognized standards for connected systems.

  10. 10Human-Factors and Usability

    Formative and summative evaluation of user interaction.

  11. 11Preclinical and Clinical Evidence Where Required

    Study design and execution as needed for the intended pathway.

  12. 12FDA Submission

    Preparation and submission of appropriate regulatory dossier.

  13. 13Clearance or Authorization

    Response to agency review and issuance of applicable authorization.

  14. 14Post-Market Quality and Evidence

    Surveillance, quality monitoring, and continued evidence generation.

NoticeThe specific pathway, submission type, testing scope, and permitted claims for any product will be determined by regulatory analysis based on the final intended use and technological characteristics. Clearance, authorization, or substantial equivalence is not assumed.
510(k) & CPT Code Pathway
02

The submission and coding path for market-facing products.

Products advanced to submission follow a coordinated regulatory-and-coding sequence intended to enable clinical adoption alongside clearance.

01
Preclinical Package

Characterization, biocompatibility, and process controls assembled to support submission.

02
Pre-Submission (Q-Sub)

Structured engagement with FDA to align on classification, testing, and evidence expectations.

03
510(k) Submission

Traditional or Special 510(k) demonstrating substantial equivalence to a predicate device.

04
CPT Code Pathway

Coordinated coding-and-coverage work to enable clinical adoption and reimbursement.

05
PMA (if required)

Full pre-market approval pursued for products where classification and evidence require it.

06
FDA Clearance / Approval

Response to agency review and issuance of applicable authorization prior to market entry.

Anticipated Impact

A safe, advanced treatment with potential for accelerated wound and burn healing — especially in complex cases such as diabetic ulcers and trauma recovery — pending clearance and appropriate labeling.

Areas of Future Research and Evaluation

Fields being explored — not statements of cleared indications.

Wound care
Dermatology
Podiatry
Plastic and reconstructive medicine
Surgical recovery
Sports medicine
Orthopedics
Women's health
Tissue-response research
Regenerative delivery
NoticeThese areas represent potential fields of research and future evaluation only. They are not statements of cleared indications, approved uses, or established clinical efficacy.