AI SaMD Playbook
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    EU
    European Union · AI Act + MDR

    The double-classification trap.

    An AI-enabled SaMD that is Class IIa or above under the MDR is, in almost every case, a high-risk AI system under the EU AI Act. That means two parallel conformity assessments, two technical files, and two sets of post-market obligations · all stitched onto one product.

    Posture · Statutory · two regulations, one deviceLast reviewed · April 2026
    Key facts
    AI Act high-risk obligations apply
    Aug 2026
    GPAI obligations apply
    Aug 2025
    Maximum penalty
    €35M / 7% turnover
    Aligned with
    MDR · IVDR · NIS2
    §01

    How the AI Act classifies medical AI

    Article 6 designates AI systems as high-risk where they are safety components of products covered by EU harmonisation legislation listed in Annex I · which includes the MDR and IVDR. In practice, almost any AI-enabled medical device with a notified-body route under MDR is high-risk under the AI Act.

    • Risk management system covering AI-specific harms across the lifecycle.
    • Data and data governance with documented quality, bias, and representativeness measures.
    • Technical documentation per Annex IV · additive to the MDR technical file.
    • Logging, transparency, human oversight, accuracy, robustness, and cybersecurity by design.
    §02

    Conformity assessment, twice

    For high-risk medical AI, the AI Act conformity assessment is integrated into the MDR notified-body route · but it is not absorbed by it. Manufacturers still need an AI-specific quality management system, an AI-specific risk management process, and AI-specific post-market monitoring.

    §03

    General-purpose AI and foundation models

    If your SaMD is built on top of a general-purpose AI model (GPAI) · including most LLMs and large vision models · you inherit obligations that flow from the GPAI provider, plus your own as a downstream deployer or provider. Contractually pinning the model and its documentation is no longer optional.

    • Provider documentation, training data summaries, and copyright disclosures must flow to you.
    • GPAI models with systemic risk trigger additional model-evaluation and incident-reporting duties.
    • Substantial modification of a GPAI for medical use can make you the provider in the eyes of the Act.
    §04

    Cybersecurity & the CRA overlap

    Cybersecurity expectations come from MDR Annex I (security by design), the AI Act (robustness against adversarial inputs, model integrity), and · for products with digital elements · the Cyber Resilience Act from 2027. Build the control set once and map it across all three.

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