FDA Adverse Event Malfunction Summary report: N

PUMP IN STYLE ADVANCED BREAST PUMP GO TOTE

MDR report key: 4121544 · Received July 29, 2014

Report

Report Number
1419937-2014-00570
Event Type
Malfunction
Date Received
July 29, 2014
Date of Event
July 17, 2014
Report Date
July 23, 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 POWER SUPPLY WAS SENT TO THE CUSTOMER. THE PRODUCT INVOLVED IN THE COMPLAINT WAS NOT RETURNED FOR EVALUATION/ INVESTIGATION AT THIS TIME. THEREFORE, NO CONCLUSIONS CAN BE MADE AD TO THE CAUSE OF THE EVENT. SHOULD ADDITIONAL INFO OR THE ORIGINAL PRODUCT BE RECEIVED, RESULTING IN NEW, CHANGED, OR CORRECTED INFO, A FOLLOW UP REPORT WILL BE FILED AT THAT TIME. 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 FORSEEABLE 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.

Description of Event or Problem · 1

THE CUSTOMER REPORTED TO CUSTOMER SERVICE THAT THE TRANSFORMER HOUSING FOR HER PUMP IN STYLE ADVANCED BREAST PUMP IS DAMAGED AND THERE IS A BREACH, WHICH IS A SAFETY RISK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
442688 PUMP IN STYLE ADVANCED BREAST PUMP GO TOTE HGX HGX MEDELA, INC. 57063/9207010 REV-L-1811

Patients

Seq Age Sex Outcome Treatment
1