PMA
Premarket Approval: The FDA's most demanding review pathway, used for the highest-risk devices.
Premarket approval covers what a 510(k) cannot, typically Class III devices: those that support or sustain life, or carry a serious risk of injury. The Manufacturer has to show the device is safe and effective on its own evidence, usually clinical data. Nothing is established by comparison to another product. Reviews take far longer than a 510(k) and often go to an advisory panel. Devices on this route are approved, not cleared.