K Number
K012275
Device Name
PJ.S COMFORT PORTABLE ELECTRIC BREAST PUMP
Manufacturer
Date Cleared
2002-01-07

(172 days)

Product Code
Regulation Number
884.5160
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The intended use of the electrically powered (diaphragm-type) suction device is to express milk from the breast of lactating women.
Device Description
pj.s comfort® Portable Electric Breast Pump (suction device with a compressor unit) contains a diaphragm-type pump with a vacuum regulator (between 150mm unity oontaine a clapmelling a filter, soft silicone tube and plastic tubing. An accessory kit includes silicone breast cups and a collection cup. The device is battery and line-powered for 12V DC by an external transformer or utilizes a 12V-battery pack. The device is controlled by an electric sensor with intermittent suction at approximately 30-45 cycles. The bacterial filter contains an optical sensor, with an automatic shut off. The motor stops when liquid is sucked into the bacterial. The pump can be used with the Single Breast Pump Kit #6166-3 or the Double Breast Pump Kit #6166-0. Dimensions are 7 x 12 x 3 .5 inches and the weight is 4.5 lbs. Suction is controlled by the pump automatically. It will automatically be released when the adjusted vacuum is reached. An electronic sensor is built-in for automatic motor shut off: If milk flows into the bacterial filter, the motor stops automatically at once and the inside valves from the pump cannot be damaged through the milk. The bacterial filter should be changed regularly.
More Information

K#850705, K971543

K#850705, K971543

No
The description details a mechanical pump with electronic sensors for control and safety features, but there is no mention of AI or ML algorithms for learning, adaptation, or complex decision-making based on data.

No
A breast pump is generally considered a medical device, but not specifically a therapeutic device, as its primary function is to express milk rather than treat a disease or medical condition.

No

Explanation: The device's intended use is to express milk from the breast of lactating women, which is a therapeutic or assistive function, not a diagnostic one.

No

The device description clearly outlines multiple hardware components including a diaphragm-type pump, vacuum regulator, tubing, breast cups, collection cup, battery, external transformer, electric sensor, optical sensor, and motor.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is to "express milk from the breast of lactating women." This is a physical process performed on the body, not a test performed on a sample taken from the body to diagnose a condition.
  • Device Description: The description details a mechanical pump designed to create suction for milk expression. It does not describe any components or processes related to analyzing biological samples.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring specific substances (analytes)
    • Providing information for diagnosis, monitoring, or treatment decisions based on sample analysis.

Therefore, the pj.s comfort® Portable Electric Breast Pump is a medical device, but it falls under a different classification than an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The intended use of the electrically powered (diaphragm-type) suction device is to express milk from the breast.

The intended use of the electrically powered (diaphragm-type) suction device is to express milk from the breast of lactating women.

Product codes

85 HGX

Device Description

pirs comfort® Portable Electric Breast Pump (suction device with a compressor unit) contains a diaphragm-type pump with a vacuum regulator (between 150mm unity oontaine a clapmelling a filter, soft silicone tube and plastic tubing. An accessory kit includes silicone breast cups and a collection cup. The device is battery and line-powered for 12V DC by an external transformer or utilizes a 12V-battery pack. The device is controlled by an electric sensor with intermittent suction at approximately 30-45 cycles. The bacterial filter contains an optical sensor, with an automatic shut off. The motor stops when liquid is sucked into the bacterial. The pump can be used with the Single Breast Pump Kit #6166-3 or the Double Breast Pump Kit #6166-0. Dimensions are 7 x 12 x 3 .5 inches and the weight is 4.5 lbs.

Suction is controlled by the pump automatically. It will automatically be released when the adjusted vacuum is reached. An electronic sensor is built-in for automatic motor shut off: If milk flows into the bacterial filter, the motor stops automatically at once and the inside valves from the pump cannot be damaged through the milk. The bacterial filter should be changed regularly.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Breast

Indicated Patient Age Range

Lactating women

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Testing information demonstrating safety and effectiveness of the pj•s comfort® a) Portable Electric Breast Pump in the intended environment of use is supported by testing that was conducted in accordance with the FDA November 1993 Draft "Reviewer Guidance for Premarket Notification Submissions", DCRND, which outlined Electrical, Mechanical and Environmental Performance Requirements.
Patient-contacting material includes both skin contacted material (breast cups) b) and milk contacting materials. 21 CFR Parts 176, 177 and 178 were reviewed in order to ascertain materials approved for food contact. Materials are approved for food contact.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K#850705, White River Portable Electric Breast Pump, White Rive, Division of Natural Technologies, Inc., K971543, Luxmatic 12-15 ISC Portable electric Breast Pump, KaWeCo GmbH

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 884.5160 Powered breast pump.

(a)
Identification. A powered breast pump in an electrically powered suction device used to express milk from the breast.(b)
Classification. Class II (performance standards).

0

JAN 0 7 2002

Name of Company: Limerick Inc. Premarket Notification - 510(k) r remantel Notification - Scomfort® Portable Electric Breast Pump

EXHIBIT #1 Page 1 Of 3

510(K) SUMMARY

This summary of 510 (k) safety and effectiveness information is being submitted This summary of of of to (k) oursty and 21 CFR §807.92.

The assigned 510(k) number is: _150120 צו 201201

  • Submitter's Identification: 1.
    Limerick Inc. 903 North San Fernando Blvd., Suite 5 Burbank, California 91504

Date Summary Prepared: March 27, 2001

Name of the Device: 2.

pi·s comfort® Portable Electric Breast Pump

Predicate Devices Information: 3.

K#850705, White River Portable Electric Breast Pump, White Rive, Division of Natural Technologies, Inc.

K971543, Luxmatic 12-15 ISC Portable electric Breast Pump, KaWeCo GmbH

Device Description: র্ব .

pirs comfort® Portable Electric Breast Pump (suction device with a compressor unit) contains a diaphragm-type pump with a vacuum regulator (between 150mm unity oontaine a clapmelling a filter, soft silicone tube and plastic tubing. An accessory kit includes silicone breast cups and a collection cup. The device is battery and line-powered for 12V DC by an external transformer or utilizes a 12V-battery pack. The device is controlled by an electric sensor with intermittent suction at approximately 30-45 cycles. The bacterial filter contains an optical sensor, with an automatic shut off. The motor stops when liquid is sucked into the bacterial. The pump can be used with the Single Breast Pump Kit #6166-3 or the Double Breast Pump Kit #6166-0. Dimensions are 7 x 12 x 3 .5 inches and the weight is 4.5 lbs.

1

K012275

Name of Company: Limerick Inc. Premarket Notification - 510(k) Name of Devise: The pj•scomfort® Portable Electric Breast Pump

EXHIBIT #1 Page 2 of 3

Suction is controlled by the pump automatically. It will automatically be released when the adjusted vacuum is reached. An electronic sensor is built-in for automatic motor shut off: If milk flows into the bacterial filter, the motor stops automatically at once and the inside valves from the pump cannot be damaged through the milk. The bacterial filter should be changed regularly.

5. Intended Use:

The intended use of the electrically powered (diaphragm-type) suction device is to express milk from the breast.

Comparison to Predicate Devices: 6.

Table of Comparison to Legally Marketed Device:

The following is a comparison chart outlining differences and similarities between pj.s comfort® Portable Electric Breast Pump, White River Portable Electric Breast Pump and Luxmatic 12-15 ISC Portable Electric Breast Pump:

PARAMETERpj's comfortWHITE RIVER (K#850705)LUXMATIC (K#971543)
Pump TypeDiaphragmSameSame
Vacuum Control CycleYesSameSame
Adjustable Suction Range150-220 mm HgNot availableSame
Vacuum GaugeYesSameSame
Bacteria FilterYesNot availableSame
Collection BottlesYesSameSame
Single Patient UseYesSameSame
Indications For UseSameSameSame
TimerYesNot availableNot available
Weight4.5 lbs.10 lbs.4.5 lbs.

2

KO12275

Name of Company: Limerick Inc. Premarket Notification - 510(k) Name of Devise: The pj•scomfort® Portable Electric Breast Pump

EXHIBIT #1 Page 3 of 3

Discussion of Non-Clinical Tests Performed for Determination of 7. Substantial Equivalence is as follows:

  • Testing information demonstrating safety and effectiveness of the pj•s comfort® a) Portable Electric Breast Pump in the intended environment of use is supported by testing that was conducted in accordance with the FDA November 1993 Draft "Reviewer Guidance for Premarket Notification Submissions", DCRND, which outlined Electrical, Mechanical and Environmental Performance Requirements.
  • Patient-contacting material includes both skin contacted material (breast cups) b) and milk contacting materials. 21 CFR Parts 176, 177 and 178 were reviewed in order to ascertain materials approved for food contact. Materials are approved for food contact.

Discussion of Clinical Tests Performed: 8.

Non-Applicable

9. Conclusions:

The pirs comfort® Portable Electric Breast Pump has the same intended use, similar design and technology as the White River Portable Electric Breast Pump and the Luxmatic 12-15 ISC Portable Electric Breast Pump. As our comparison chart indicates, as well as our testing data, the pjrs comfort® Portable Electric Breast Pump raises no new questions of safety or effectiveness. Thus, when compared to the predicated device, the pj.s comfort® Portable Electric Breast Pump does not incorporate any significant changes in intended use, method or operation, material or design that could affect safety or effectiveness.

3

Image /page/3/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo is a circular emblem with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the top half of the circle. Inside the circle is a stylized image of three wavy lines that resemble a caduceus, a symbol often associated with healthcare.

ood and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 0 7 2002

Ms. Patricia A. Kelly President Limerick, Inc. 903 N. San Fernando Boulevard Suite 5 BURBANK CA 91504-4327

Re: K012275 Trade/Device Name: pj.s comfort® Portable Electric Breast Pump Regulation Number: 21 CFR 884.5160 Regulation Name: Powered breast pump Regulatory Class: II Product Code: 85 HGX Dated: November 9, 2001 Received: November 13, 2001

Dear Ms. Kelly:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (sections 531-542 of the Act); 21 CFR 1000-1050.

4

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at one of the following numbers, based on the regulation number at the top of this letter:

8xx.1xxx(301) 594-4591
876.2xxx, 3xxx, 4xxx, 5xxx(301) 594-4616
884.2xxx, 3xxx, 4xxx, 5xxx, 6xxx(301) 594-4616
892.2xxx, 3xxx, 4xxx, 5xxx(301) 594-4654
Other(301) 594-4692

Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.

Sincerely yours,

Nancy C. Brogdon

Nancy C. Brogdon Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

Name of Company: Limerick Inc. Namo of Golmpacation - 510(k) 0 122 25 Name of Devise: The pj.scomfort® Portable Electric Breast Pump

EXHIBIT B

INDICATIONS FOR USE

510(K) Number:

1012275

The pj•scomfort® Portable Electric Breast Pump Device Name:

The intended use of the electrically powered (diaphragm-Indication for Use: type) suction device is to express milk from the breast of lactating women.

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription UseorOver-the-Counter Usex
(Per 21 CFR 801.109)

Nancy Brogdon

(Division Sign-Off)

Division of Reproductive, Abdominal,

and Radiological Devices

510(k) NumberK012275
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