ADVOCATE FDA PROGRAM

Dual-Track
FDA Strategy

Two parallel regulatory pathways. One unified mission.

De Novo Authorization — SaMD MDDT Qualification — NAM

“The Doctor” — Patient-Facing Clinical Reasoning Engine

De Novo Authorization

Software as a Medical Device (SaMD)

Deutsch is our autonomous clinical agent that interacts directly with patients to manage cardiovascular disease. As a novel SaMD for autonomous prescription management — no predicate device exists — we pursue De Novo classification with a regulatory-first architecture.

Our strategy combines early FDA engagement (TEMPO pilot, Breakthrough Device Designation) with rigorous real-world evidence generation at safety-net hospitals, culminating in an 800-patient pivotal RCT and De Novo submission by Month 39.

UI Health, Chicago

Urban safety-net hospital, 70% minority patient population, Epic EHR integration

Second US Site

Under negotiation — expanded multi-site validation for geographic diversity

“The Regulator” — Independent Safety Supervisor

MDDT Qualification

Medical Device Development Tool — Non-Clinical Assessment Model (NAM)

Popper is our deterministic safety supervisor that validates every clinical decision before it reaches a patient. Seven safety gates run in 47ms median — no model drift, no hallucination in safety paths. We're qualifying it as an FDA MDDT to become the industry standard for clinical AI safety.

Once qualified, Popper becomes a reusable standard: other companies building clinical AI can use Popper to accelerate their own FDA clearance. Its deterministic, non-ML architecture ensures complete reproducibility and auditability.

Regulatory Timeline

39-month pathway from pre-program through authorization

NOW
1
Pre-Program

Now — Month 0

500-patient deployment at two medical centers (May 2026). TEMPO SOI filed.

2
Phase 1A

Months 0 – 12

513(g) Meeting (Month 6). BDD Application (Month 9). 50+ patients at UI Health.

3
Phase 1B

Months 12 – 24

Expanded validation (200+ patients). FDA IDE prep. Spanish language support.

4
Phase 2

Months 24 – 39

Pivotal RCT (N=800). De Novo Submission.

NOW
1
Pre-Program

Now — Month 0

Popper 100% complete. Hermes open-sourced. 500-patient deployment with Deutsch.

2
Phase 1A

Months 0 – 12

IV&V framework validated. MDDT pre-submission meeting. Drift detection operational.

3
Phase 1B

Months 12 – 24

MDDT proposal submission. Expanded disease policy packs. Cross-TA1 validation.

4
Phase 2

Months 24 – 39

Full MDDT Qualification. Industry adoption.

Key Regulatory Levers

Six strategic mechanisms accelerating the De Novo pathway

FDA PILOT

TEMPO Pilot (Filed)

Statement of Interest to FDA's TEMPO pilot (Cardio-Kidney-Metabolic track), seeking early clinician-supervised deployment at UI Health — accelerating evidence by up to 12 months.

DESIGNATION

Breakthrough Device Designation

Application at Month 9, citing urgent health equity need (46% of US counties lack a cardiologist). Priority review + interactive FDA feedback.

INSIDER ACCESS

FDA Panel Authority

Dr. Mladen Vidovich sits on FDA Circulatory System Devices Panel (2025–2028). Ensures evidence generation meets highest regulatory standards.

FUTURE-PROOFING

PCCP

Pre-authorizes future AI/ML model updates without re-submission, preventing "regulatory lock-in." Consistent with FDA GMLP Principle 10.

INTELLIGENCE

DHAC Tracking

Tracking FDA's Digital Health Advisory Committee — advises on AI/ML SaMD oversight.

EVIDENCE

Pivotal RCT Design

800-patient, multi-site, pragmatic non-inferiority RCT with FDA IDE structure. 500-patient pre-program evidence at two medical centers.

Key Strategic Levers

Why Popper becomes the industry standard for clinical AI safety

MARKET POSITION

Industry Standard

Once qualified, Popper becomes the recognized FDA standard for clinical AI safety supervision.

SCALABILITY

Disease-Agnostic Design

Same architecture supports HF, post-MI, diabetes, COPD, future conditions.

ECOSYSTEM

Open-Source Commitment

Hermes protocol (Apache 2.0, open-source since Feb 5, 2026) is the open standard for TA1–TA2 communication.

RELIABILITY

Deterministic, Not ML

Seven safety gates, 47ms median. No model drift, no hallucination. Complete reproducibility.