“…improve the product quality by reducing the number of errors that are made, while at the same time, supporting the achievement of delivery dates, budget constraints, and in the case of MD software development, the achievement of the primary goals of creating safe and effective MDs. Medical device software developers typically develop software in accordance with a plan-driven sequential SDLC, such as the V-model or waterfall,29 as it is a tried and trusted life cycle approach within the industry for producing the deliverables demanded by the regulatory authorities 30,31. However, participants agreed that this is a timeconsuming, resource-intensive, and rigid plan-driven approach that is not well suited for developing MMAs in a timely manner.The group discussion identified several concerns with adopting either a waterfall or V-model SDLC adoption, such as: there is no focus upon iterations, consequently, making it difficult to deliver frequent releases and to change incorrect decisions in a timely manner; they do not embrace change easily, thus, any changes introduced once the project has started can create financial overruns; they do not include a prototyping practice, therefore making it more difficult to engage users in the development process; a large amount of time is spent producing and verifying documentation, therefore leaving less time for the development and testing; there is a sign-off process after every software development phase, hence, bringing an inflexibility in terms of incorporating changes post sign-off.In traditional MD development, there is a heavy emphasis on documentation and sign-off before proceeding to the next stage.…”