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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDELA LLC BREASTPUMP PNSA STARTER; PUMP, BREAST, POWERED

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MEDELA LLC BREASTPUMP PNSA STARTER; PUMP, BREAST, POWERED Back to Search Results
Model Number 9207010/57081
Device Problems Failure to Pump (1502); Device Inoperable (1663)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 09/08/2016
Event Type  malfunction  
Manufacturer Narrative
Troubleshooting was conducted with the customer, though a cause of the issue could not be determined.The customer was sent a replacement pump.The original pump was requested for evaluation.During evaluation of the product, a breach in the power supply housing was observed.This issue with a damaged rev l power supply for the pump in style device was addressed in investigation (b)(4).The investigation found that they were being damaged during shipment from the manufacturer to medela.This damage was causing the plastic housing to fail prematurely when subjected to normal use and foreseeable misuse.The packaging used by the manufacturer to ship the power supply to medela was 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 was modified to reduce the handling and potential for double stacking of the skids.The shipping packaging strength was also increased to further protect the power supply during shipping.Since then, as a part of routine continuous improvement activities, a rev p power supply has been distributed to market, manufactured under a revised design and by a different manufacturer.
 
Event Description
On (b)(6) 2016, the customer alleged to medela llc that her pump in style advanced breast pump was no longer working.She stated that when she turned the pump on, it would just hum and does not pump.
 
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Brand Name
BREASTPUMP PNSA STARTER
Type of Device
PUMP, BREAST, POWERED
Manufacturer (Section D)
MEDELA LLC
mchenry IL
Manufacturer (Section G)
MEDELA LLC
1101 corporate drive
mchenry IL 60050
Manufacturer Contact
robert sokolowski
1101 corporate drive
mchenry, IL 60050
MDR Report Key6997448
MDR Text Key92049577
Report Number1419937-2017-00292
Device Sequence Number1
Product Code HGX
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K031614
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type consumer
Reporter Occupation Other
Type of Report Initial
Report Date 11/02/2017
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received11/02/2017
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Model Number9207010/57081
Device Catalogue Number9207010/57081
Device Lot NumberREV L / 2011
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/20/2016
Distributor Facility Aware Date09/22/2017
Date Manufacturer Received09/22/2016
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage N
Patient Sequence Number1
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