FDA Adverse Event Malfunction Summary report: N

PUMP IN STYLE ADVANCED BREAST PUMP GO TOTE

MDR report key: 3955630 · Received June 13, 2014

Report

Report Number
1419937-2014-00490
Event Type
Malfunction
Date Received
June 13, 2014
Date of Event
January 29, 2014
Report Date
January 29, 2014
Manufacturer
MEDELA, INC.
Product Code
HGX
PMA / PMN Number
K031614
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

A REPLACEMENT WAS SENT TO THE CUSTOMER. THE PRODUCT INVOLVED IN THE COMPLAINT WAS RETURNED FOR EVALUATION AND THE BREACH WAS CONFIRMED. THIS ISSUE WITH THE 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 MANUFACTURER 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 MANUFACTURER 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. EVALUATION SUMMARY: A VISUAL EXAMINATION OF THE POWER SUPPLY REVEALED THE TRANSFORMER HOUSING WAS CRACKED OPEN. A VISUAL EXAMINATION OF THE CORD REVEALED NOTHING UNUSUAL. THE POWER SUPPLY WAS NOT ABLE TO BE PLUGGED IN SO THE VOLTAGE ACROSS THE DC PLUG WAS NOT MEASURED. RESISTANCE ACROSS THE DC PLUG WAS MEASURES .773M, WHICH INDICATES THAT THERE IS NOT A SHORT IN THE DC CORD. THE RESISTANCE ACROSS THE AC BLADES MEASURED AS 55.7, WHICH IS NORMAL AND INDICATES THAT THE THERMAL FUSE DID NOT BLOW.

Description of Event or Problem · 1

THE CUSTOMER REPORTED TO CUSTOMER SERVICE THAT HER TRANSFORMER WILL NOT POWER THE PUMP. WHEN THE TRANSFORMER WAS RECEIVED AT MEDELA, IT WAS DETERMINED TO BE BREACH, WHICH IS A SAFETY RISK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
350637 PUMP IN STYLE ADVANCED BREAST PUMP GO TOTE HGX MEDELA, INC. 57063/9207010 REV N-5112

Patients

Seq Age Sex Outcome Treatment
1