FDA Adverse Event Malfunction Summary report: N

PUMP IN STYLE ADVANCED BREAST PUMP METRO BAG

MDR report key: 3070333 · Received April 17, 2013

Report

Report Number
1419937-2013-00223
Event Type
Malfunction
Date Received
April 17, 2013
Date of Event
February 1, 2013
Report Date
February 1, 2013
Manufacturer
MEDELA, INC.
Product Code
HGX
PMA / PMN Number
K031614
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

A REPLACEMENT POWER SUPPLY WAS SENT TO THE CUSTOMER. ATTEMPTS TO FOLLOW-UP WITH THE CUSTOMER TO GET ADDITIONAL INFORMATION, INCLUDING A FINAL ATTEMPT LETTER, WERE UNSUCCESSFUL. THE PRODUCT INVOLVED IN THE COMPLAINT WAS RETURNED AND EVALUATED. A VISUAL EXAM OF THE POWER SUPPLY REVEALED THE TRANSFORMER HOUSING WAS CRACKED OPEN, EXPOSING INNER ELECTRICAL CIRCUITRY. A VISUAL EXAM OF THE CORD REVEALED NOTHING UNUSUAL. THE POWER SUPPLY WAS PLUGGED IN AND THE VOLTAGE ACROSS THE DC PLUG WAS MEASURED AT 12.89 VDC, WHICH IS NORMAL AND INDICATES THAT THE POWER SUPPLY IS PRODUCING THE CORRECT VOLTAGE. RESISTANCE ACROSS THE DC PLUG WAS MEASURED OPEN, WHICH INDICATES THAT THERE IS NOT A SHORT IN THE DC CORD. SMOKE, FIRE AND SPARKING WERE NOT OBSERVED WHILE THE POWER SUPPLY WAS PLUGGED IN. THE RESISTANCE ACROSS THE AC BLADES MEASURED AS 55.70 OHMS, WHICH IS NORMAL AND INDICATES THAT THE THERMAL FUSE DID NOT BLOW. THIS ISSUE WITH A DAMAGED TRANSFORMER HOUSING FOR THE PUMP IN STYLE DEVICE WAS ADDRESSED IN INVESTIGATION (B)(4). THE INVESTIGATION FOUND THAT THE TRANSFORMERS ARE BEING DAMAGED DURING SHIPMENT FROM THE MFR TO MEDELA. THIS DAMAGE IS CAUSING THE PLASTIC HOUSING TO FAIL PREMATURELY WHEN SUBJECTED TO NORMAL USE AND FORESEEABLE MISUSE. THE PACKAGING USED BY THE MFR TO SHIP THE TRANSFORMERS TO MEDELA IS NOT ROBUST ENOUGH TO HANDLE ALL OF THE POTENTIAL SHIPPING, HANDLING, AND ABUSE CONDITIONS THAT COULD ARISE FROM LOGISTICS OF THE CONSOLIDATION PROCESS. AS A RESULT OF THE INVESTIGATION, THE SHIPPING AND CONSOLIDATION PROCESS HAS BEEN MODIFIED TO REDUCE THE HANDLING AND POTENTIAL FOR DOUBLE STACKING OF THE SKIDS. THE SHIPPING PACKAGING STRENGTH HAS ALSO BEEN INCREASED TO FURTHER PROTECT THE TRANSFORMERS DURING SHIPPING. SHOULD ADDITIONAL INFORMATION BE RECEIVED RESULTING IN NEW, CHANGED, OR CORRECTED INFORMATION, A FOLLOW-UP REPORT WILL BE FILED.

Description of Event or Problem · 1

CUSTOMER CALLED IN TO CUSTOMER SERVICE STATING THE ADAPTER WILL NOT POWER PUMP. (B)(6) 2013 UPDATE: UPON RECEIPT OF THE PRODUCT, A BREACH IN THE TRANSFORMER HOUSING WAS NOTICED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
164656 PUMP IN STYLE ADVANCED BREAST PUMP METRO BAG HGX MEDELA, INC. 57036-9207010 REV L

Patients

Seq Age Sex Outcome Treatment
1