*401 OPINION
Plaintiffs Arlene and Richard Fiore (“Fiore”) appeal from the summary judgment granted to Collagen Corporation (“Collagen Corporation”) in Fiore’s products liability action. Fiore sued Collagen Corporation for Arlene’s injuries after she received injections of Zyderm Collagen Implant (“Zyderm”), an anti-wrinkle substance manufactured and sold by Collagen Corporation.
The trial court found that a section of the Medical Device Amendments of 1976 (“MDA”) preempted Fiore’s claims for negligence, strict liability in tort, breach of express and implied warranty, and fraud. It also denied leave to file an amended complaint alleging a violation of the Arizona Consumer Fraud Act after the court had granted summary judgment on the original complaint. We conclude that the MDA does not preempt state common law tort claims and thus reverse the judgment and remand for further proceedings consistent with this opinion. Therefore, we need not resolve whether the trial court erred in denying the motion to file an amended complaint.
I. FACTUAL AND PROCEDURAL BACKGROUND
Collagen Corporation manufactures and distributes products made from a purified form of bovine collagen. One of these products, Zyderm, is injected under the skin to correct or improve soft tissue deficiencies due to disease, trauma, or age. Zyderm is considered a Class III medical device.
Prior to 1976, the United States Food and Drug Administration (“FDA”) lacked authority to examine the safety and effectiveness of any medical device before the maker sold the device to the public unless the FDA could convince a court that the device was a drug. Robert S. Adler & Richard A Mann,
Preemption and Medical Devices: The Courts Run Amok,
59 Mo. L.Rev. 895, 910-11 (1994) (“Adler & Mann”). As a consequence of the Daikon Shield litigation, Congress amended the Federal Food, Drug, and Cosmetic Act, 21 U.S.C. §§ 301-93 (1972), to extend the FDA’s jurisdiction to medical devices. Adler & Mann,
supra,
at 911-12 n. 84;
Michael v. Shiley, Inc.,
Pursuant to these statutes, the FDA classifies all medical devices. The categories and the corresponding legal consequences of each can be briefly described as follows.
Class I devices, such as tongue depressors, are devices which generally pose little or no threat to public health and are subject only to general controls on manufacturing. See 21 U.S.C. § 360c(a)(l)(A). Class II devices, such as oxygen masks, pose a slightly greater risk of injury to patients, and accordingly, the MDA subjects them to performance standards, post market surveillance, guidelines for use and other appropriate controls. See id. § 360c(a)(l)(B). Class III devices ... include all devices which are to be implanted into people, which are used to sustain life, or which pose a potentially unreasonable risk of injury. See id. § 360c(a)(l)(C).
Michael,
Under the MDA,- no company may market or sell a Class III device until it obtains premarket approval from the FDA. 21 U.S.C. § 360e. The sponsoring company must submit “all information, published or known to or which should reasonably be known to the applicant, concerning investigations which have been made to show whether or not such device is safe and effective,” 21 U.S.C. § 360e(c)(l)(A), a description of the product’s ingredients, method of manufacture, and performance standards, as well as any other information requested by the FDA, 21 U.S.C. § 360e(c)(l)(B)-(G). Following review by a panel of medical experts and a favorable recommendation, the FDA may approve the application.
Additionally, the FDA’s regulations permit it to require warnings or instructions on the product’s labels and to regulate the manufacturing processes. 21 C.F.R. § 814.82, 820.100-101. The FDA may require the product’s sponsor to notify the public of a
*402
newly-discovered danger, to replace the device, or to refund its purchase price. 21 U.S.C. § 360h. The FDA’s continuing authority also requires manufacturers to report deaths or serious injuries from use of a Class III device.
See
21 C.F.R. § 803.24(a)(l)(i). The Act does not, however, authorize the FDA to require companies to compensate victims for either medical expenses or pain and suffering caused by a device failure.
See Mears v. Marshall,
On April 30, 1980, Collagen Corporation filed a premarket approval application for Zyderm. A panel of experts reviewed the application and imposed a number of conditions on Collagen Corporation. 1 In July 1981, the FDA issued an order permitting Collagen Corporation to market Zyderm. In 1991 and 1992, the FDA reviewed the premarket approval application and concluded that its initial approval of the application was appropriate.
In 1986 or 1987, Arlene Fiore received Zyderm injections. She filed this products liability action against Collagen Corporation and her doctor in February 1993, alleging that Collagen Corporation knew or should have known that the human immune system views Zyderm as a foreign protein, and thus Zyderm provokes significant immune and autoimmune reactions. The complaint stated that after the injections, Arlene suffered serious physical and emotional injury and was diagnosed with an autoimmune disease and other related conditions. The complaint alleged claims against Collagen Corporation (1) for negligence in developing, testing, manufacturing, inspecting, labeling, marketing, promoting, advertising, selling and distributing Zyderm; (2) for strict liability; (3) for breach of express and implied warranties that Zyderm was safe, fit, and proper for cosmetic use; and (4) for negligent or fraudulent representations of Zyderm’s safety and fitness to Fiore, her physicians, the FDA and the general public.
Collagen Corporation successfully moved for summary judgment on the theory that 21 U.S.C. §§ 360c through 360ss and the FDA regulations preempted all of Fiore’s claims. 2 Fiore then moved for leave to file an amended complaint alleging a claim against Collagen Corporation for violation of the Arizona Consumer Fraud Act, A.R.S. sections 44-1521 through -1534 (1994). The trial court denied the motion as untimely. We have appellate jurisdiction pursuant to A.R.S. section 12-2101(B) (1994).
II. DISCUSSION
A. Standard of Review
We review
de novo
the trial court’s interpretation of a statute.
Chaffin v. Commissioner of the Ariz. Dep’t of Real Estate,
B. Federal Preemption Doctrine in the Context of Cigarette Regulation
The preemption doctrine derives from the Supremacy Clause of the Constitution,
*403
which states: “This Constitution, and the Laws of the United States ... shall be the supreme Law of the Land; and the Judges in every State shall be bound thereby, any Thing in the Constitution or Laws of any State to the Contrary notwithstanding.” U.S. Const. Art. VI, Cl. 2. Thus, federal laws or regulations supersede conflicting state laws.
See Hillsborough County v. Automated Medical Lab., Inc.,
Numerous federal circuit and district courts have relied upon the preemption doctrine to eliminate or restrict state common law causes of action against manufacturers of medical devices. Many of these decisions adopted the reasoning of the United States Supreme Court in
Cipollone v. Liggett Group, Inc.,
Federal law does not supersede state regulation, however, “unless that [is] the clear and manifest purpose of Congress.”
Id.
at 516,
In
Cipollone,
the Court “narrowly” construed the language of the 1965 Act regulating cigarette labeling and advertising “in light of the presumption against the preemption of state police power regulation.”
Id.
The 1965 Act expressly provided for preemption and stated in part, “No statement relating to smoking and health, other than the statement required by section 4 of this Act, shall be required on any cigarette package.” It also provided, “No statement relating to smoking and health shall be required in the advertising of any cigarettes the packages of which are labelled in conformity with ... this Act.” § 5(a), (b). The Court noted that the federally required warning on cigarettes did not automatically “foreclose additional [state-imposed] obligations,” and it found no “inherent conflict between federal pre-emption of state warning requirements and the continued vitality of state common law damages actions.”
Id.
Thus, the statute superseded only positive state enactments “that mandate particular warning labels ... but not common law damages actions.”
Id.
at 518-19,
The Court reached a different conclusion in analyzing the 1969 Public Health Cigarette Smoking Act. The statute’s express preemption provision read: “(b) No
requirement or prohibition
based on smoking and health
shall be imposed under State law
with respect to the advertising or promotion of any cigarettes the packages of which are labeled in conformity with the provisions of this Act.”
Id.
at 515,
The Court then analyzed each common law claim to determine if it constituted a “requirement or prohibition based on smoking and health ... imposed under State law with respect to ... advertising or promotion____”
Id.
at 524,
*404 C. Preemption Under the MDA
As with the cigarette legislation, the MDA contains an express preemption provision. It states:
Except as provided in subsection (b) ..., no State ... may establish or continue in effect with respect to a device intended for human use any requirement—
(1) which is different from, or in addition to, any requirement applicable under this chapter to the device, and
(2) which relates to the safety or effectiveness of the device____
21 U.S.C. § 360k(a) (emphasis added).
A majority of
post-Cipollone
decisions interpreting § 360k(a) concludes that Congress intended “requirement” to include state common law tort claims of general application and thus find full or partial preemption of such claims against manufacturers of medical devices.
4
Mitchell v. Collagen Corp.,
In
Mitchell,
the Seventh Circuit Court of Appeals relied upon Cipollone’s holding that the 1969 Act’s phrase, “No requirement or prohibition ... shall be imposed under State law,” included state common law rules.
The Ninth Circuit Court of Appeals in November 1995 rejected this view in
Kennedy v. Collagen Corp.,
The Ninth Circuit reversed and held that generally applicable state common law, including tort law, is not preempted by § 360k(a).
Id.
at 1459-60. Under 21 U.S.C. § 360k(a)(l), a preempted state “requirement” is one that is either “in addition to” or “different from” an MDA requirement applicable to the device in question. Because Congress had not addressed the question of what constitutes a “State requirement” under § 360k(a), the court looked to the FDA’s own interpretation expressed in its regulation, 21 C.F.R. section 808.1(d).
Section 808.1(d) provides that state requirements are preempted
“only
when the Food and Drug Administration has established
specific
counterpart regulations or ... other
specific
requirements applfy] to a
particular device
under ... the act, thereby making any existing divergent State ... requirements applicable to the device different from or in addition to, the
specific
Food and Drug Administration requirements.” (Emphasis added.) The Ninth Circuit noted that the courts have not often found common law tort actions involving Class II devices preempted and questioned the failure to comparably construe the words “particular device” when dealing with Class III devices.
The court also noted that 21 U.S.C. § 360k(a) “does not preempt State ... requirements of general applicability where the purpose of the requirement relates either to other products in addition to devices ... or to unfair trade practices____”
Id.
at 1457-58 (quoting 21 C.F.R. § 808.1(d));
see, e.g.,
§ 808.1(d)(1) and (6)(ii). Because “state common law does not relate solely to or regulate any
particular
device or product to the exclusion of other devices or products,” it is not preempted.
Finally, the court could not accept the consequence of a finding of preemption. “[I]t is incredible to believe that Congress would, without comment, void all means of relief for those injured by illegal conduct.”
Id.
(citing
Silkwood v. Kerr-McGee Corp.,
Judge Reinhardt’s concurring opinion in
Kennedy
further explained the meaning of “State requirement.” He noted that decisions such as
Gile v. Optical Radiation Corp.,
We adopt
Kennedy
as the better reasoned view of preemption, despite its distinct minority status. In addition, “We customarily find Ninth Circuit authority persuasive on a federal question.”
State v. Burkett,
If a primary purpose of MDA were safety, it would be strange for Congress to eliminate the safety aspects inherent in tort litigation by destroying tort litigation ... with the same statute it passed to promote safety. It would be stranger still ... to take such a dramatic action without even mentioning it as a consequence of the passage of a bill that was debated for years. Yet the debate and Congressional record are barren of any indication that Congress intended to preempt court decisions by passing the 1976 Medical Device Amendments.
Haudrich v. Howmedica, Inc.,
The thoughtful analysis of Justice Chapman in
Haudrich
buttresses a narrow reading of 21 U.S.C. § 360k.
7
From a careful consideration of the entire statute, Justice Chapman found, for example, that Congress did not intend “State or political subdivision” to include state courts and thus that courts cannot be the source of “requirements” that
*407
are preempted.
Justice Chapman inferred, from repeated use of the word “requirement” to designate legislative or regulatory actions of both Congress and the FDA and also to refer to actions of “States or political subdivisions,” that “requirement” means legislative or regulatory acts rather than adjudicatory acts of the courts. See
id.
Also, in our opinion, the Committee Report on the MDA supports this inference. It expressed concern that differing requirements imposed by
jurisdictions
other than the Federal government would unduly burden interstate commerce. The new section 521 “contains special provisions ... governing regulation of devices by
States and localities.”
Justice Chapman additionally pointed out that the FDA’s regulations contain numerous provisions wholly inconsistent with the notion that “requirement” includes state court decisions. 21 C.F.R. § 808.3(d) defines “political subdivision” as “any lawfully established local governmental unit” that has “the authority to establish or continue in effect any
requirement .
...” (Emphasis added.) This definition suggests that courts are not within the class of entities that establish requirements and thus that their decisions are not preempted by § 360k.
Further, 21 C.F.R. section 808.20(c)(1) provides that a state or political subdivision’s application for an FDA exemption from preemption must include:
Identification and a current copy of any statute, rule, regulation, or ordinance of the State or political subdivision considered by the State or political subdivision to be a requirement which is preempted, with a reference to the date of enactment, promulgation, or issuance in final form. . .[and][i]f the requirement has been subject to any judicial or administrative interpretations, the State or political subdivision shall furnish copies of such judicial or administrative interpretations.
(Emphasis added.) Nothing in this regulation suggests court decisions are regarded as a source of requirements.
In urging the courts to reconsider and to stop barring claims of persons injured by medical devices, Adler and Mann conclude: “[Pjreemption of product liability claims ... is misplaced — at least without ... a precise plan for offsetting approaches to protect consumers. Innovation without protection hardly improves the lives of our citizens and, ... the FDA by itself simply cannot provide an *408 adequate source of safety to the public from dangerous medical devices.” Adler & Mann, supra, at 945.
In Kennedy, the Ninth Circuit has taken a well-grounded step to assure injured persons an avenue of redress for injures resulting from medical devices, and we join it. We reverse the judgment below and remand this matter for further proceedings consistent with this opinion.
Notes
. The FDA required Collagen Corporation to obtain its approval of any change that might adversely affect Zyderm’s safety or effectiveness; to submit copies of all labeling in final printed form; to conduct studies of treated patients; to promptly report adverse reactions or incidents of mislabeling or failure to meet the PMA specifications; and to submit all written promotional materials, annual reports, including reports of in vitro, animal, and clinical studies, and descriptions of any changes in Zyderm not previously submitted in a supplemental premarket approval application.
. The trial court cited two recent federal cases finding preemption under the MDA and relevant regulations,
Stamps v. Collagen Corp.,
. The Court later stated that while
Cipollone
did not establish a rule that an express preemption clause entirely forecloses implied preemption, an express clause nevertheless implies such an effeet.
Freightliner Corp. v. Myrick,
.
Talbott v. C.R. Bard, Inc.,
. Section 808.1(b) provides:
Section 521(a) of the act [21 U.S.C. § 360k(a)] contains special provisions governing the regulation of devices by States and localities. That section prescribes a general rule that after May 28, 1976, no State or political subdivision of a State may establish or continue in effect any requirement with respect to a medical device intended for human use having the force and effect of law (whether established by statute, ordinance, regulation, or court decision), which is different from, or in addition to, any requirement applicable to such device under any provision of the act and which relates to the safety or effectiveness of the device or to any other matter included in a requirement applicable to the device under the act. (Emphasis added).
. The Illinois Supreme Court determined that the defendant in Haudrich had waived the preemption issue in the trial court, and therefore declined to reach it.
. 21 U.S.C. § 360k states:
(a) General rule
Except as provided in subsection (b) of this section, no State or political subdivision of a State may establish or continue in effect with respect to a device intended for human use any requirement-
(1) which is different from, or in addition to, any requirement applicable under this chapter to the device, and
(2) which relates to the safety or effectiveness of the device or to any other matter included in a requirement applicable to the device under this chapter.
(b) Exempt requirements
Upon application of a State or a political subdivision thereof, the Secretary may, by regulation ..., exempt from subsection (a) ..., under [prescribed] conditions ..., a requirement of such State or political subdivision applicable to a device intended for human use if—
(1) the requirement is more stringent than a requirement under this chapter which would be applicable to the device if an exemption were not in effect under this subsection; or
(2) the requirement—
(A) is required by compelling local conditions, and
(B) compliance with the requirement would not cause the device to be in violation of any applicable requirement under this chapter.
