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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDELA LLC PUMP IN STYLE ADVANCED - ON-THE-GO TOTE; PUMP, BREAST, POWERED

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MEDELA LLC PUMP IN STYLE ADVANCED - ON-THE-GO TOTE; PUMP, BREAST, POWERED Back to Search Results
Model Number 57063
Device Problems Fire (1245); Melted (1385); Overheating of Device (1437); Smoking (1585)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 05/31/2018
Event Type  malfunction  
Manufacturer Narrative
The customer was sent a replacement power supply and return of the original power supply was requested for testing/evaluation.In follow up with a complaint handler on (b)(6) 2018, the customer indicated via email that the power supply was always hot and for that reason, she would always unplug it after using; that the plastic on the housing was warped and soft, but hardened back up once it cooled down; and that though it was hot on her fingers, it did not burn her, as she dropped it quickly.She also indicated that there was a break in the housing near the prongs and that the replacement power supply was working without issue.On (b)(6) 2018, a complaint handler followed up again with the customer after receiving her response for additional information on (b)(6) 2018 and to clarify whether the customer witnessed fire.The customer responded with "i recall a spark and smell and pop sound" and did not confirm her original report of fire.This issue with a damaged rev m power supply for the pump in style device was addressed in investigation ir12-0037.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) 2018, the customer alleged to medela llc that the power supply for her pump in style breast pump was hot and when she pulled it out, it started on fire.The customer alleged that she noticed smoke as well and the power supply melted and snapped by the housing.
 
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Brand Name
PUMP IN STYLE ADVANCED - ON-THE-GO TOTE
Type of Device
PUMP, BREAST, POWERED
Manufacturer (Section D)
MEDELA LLC
1101 corporate dr
mchenry IL 60050
Manufacturer (Section G)
MEDELA LLC
1101 corporate drive
mchenry IL 60050
Manufacturer Contact
jan kloiber
1101 corporate drive
mchenry, IL 60050
MDR Report Key7581652
MDR Text Key110769038
Report Number1419937-2018-00142
Device Sequence Number1
Product Code HGX
Combination Product (y/n)N
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 06/07/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received06/08/2018
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Model Number57063
Device Catalogue Number57063
Device Lot Number9207010 REV M
Was Device Available for Evaluation? No
Date Manufacturer Received05/31/2018
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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