I guess the correct answer the changes must be immediately implemented for the health and well being of the subject
Amendments involving changes to IRB approved protocols do NOT need prior IRB approval if the changes must be immediately implemented for the health and well being of the subject.
An amendment is a formal or official change madè to a law, contract, constitution, or other lègal document. It is based on the vèrb to amend, which means to change for bètter. Amendments can add, remοve, or update parts of thèse agreements.