Here is a MUCH MUCH abbreviated example of the concepts addressed by the primary questioner relating to design controls. In practice, for such a complex product below, there may be many branches and levels of design inputs and specifications from one set of user requirements.
Sample Product: Steerable ablation catheter
User requirement: (testable during product validation/clinical trials)
Physician must be able use the catheter to deliver an ablation to the medial wall of the left atrium via venous access and transeptal puncture.
(One of many potential user requirements for this product.)
Design Input: (testable during verification/animal studies)
Catheter must be long enough to reach heart from femoral venous entry and have length and flexibility sufficient to move freely within all chambers of the heart.
Distal segment curvature must be controlled by operator.
Distal catheter segment much be able to enter right atrium via IVC and cross septum via septal puncture into left atrium (steerable distal segment must have length no less than x).
Curvature of distal segment must permit catheter to be able to bend catheter tip back onto catheter body with a radius no greater than x, while remaining in the same plane.
Etc.
Design Specifications: (testable during verification/bench studies)
Reliability = x operations without failure
Catheter body material, diameter, thickness, length = w, x, y, z
Catheter distal segment material, diameter, thickness, length = w, x, y, z
Pull wire material, size, length = x, y, z
Pull wire attachment = x
Material bonding = x
Handle = x
Etc.