Electric Breast Pump (F5055)

K240218 · Fimilla (Shanghai) Maternity & Baby Articles Co., Ltd. · HGX · Oct 17, 2024 · Obstetrics/Gynecology

Device Facts

• Record ID: K240218
• Device Name: Electric Breast Pump (F5055)
• Applicant: Fimilla (Shanghai) Maternity & Baby Articles Co., Ltd.
• Product Code: HGX · Obstetrics/Gynecology
• Decision Date: Oct 17, 2024
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 884.5160
• Device Class: Class 2

Intended Use

The Electric Breast Pump (F5055) is intended to express milk from lactating women and collect milk from their breast. The device is intended for single user.

Device Story

Electric breast pump (F5055) for lactating women; single-user device. Microprocessor-driven air pump generates suction to extract milk into collection bottles. Components include breast shield assembly (silicone/polypropylene), pump unit, tubing, and adapter. Operated via key panel; offers massage, expression, and soothing modes. Powered by Li-ion battery or AC adapter. Used in home environment. Provides adjustable suction levels and cycle speeds to facilitate milk expression. Benefits patient by enabling milk collection for breastfeeding.

Clinical Evidence

Bench testing only. Includes biocompatibility (ISO 10993-1), electrical safety (IEC 60601-1), electromagnetic compatibility (IEC 60601-1-2), and home healthcare environment safety (IEC 60601-1-11). Performance testing verified suction strength, cycle speed, battery indicator, and backflow protection against design specifications.

Technological Characteristics

Powered breast pump; diaphragm pump mechanism. Materials: silicone (breast shield), polypropylene (breast shield body). Power: Li-ion battery or AC adapter. Connectivity: None. Software-controlled via microprocessor. Non-sterile. Standards: IEC 60601-1, IEC 60601-1-2, IEC 60601-1-11, ISO 10993-1.

Indications for Use

Indicated for lactating women to express and collect breast milk. Intended for single-user use.

Regulatory Classification

Identification

A powered breast pump in an electrically powered suction device used to express milk from the breast.

Predicate Devices

• Youha electric breast pump (K163136)

Submission Summary (Full Text)

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October 17, 2024

Fimilla (Shanghai) maternity & baby Articles Co., Ltd % Diana Hong General Manager Mid-Link Consulting Co., Ltd. P.O. Box 120-119 Shanghai. 200120 CHINA

Re: K240218

Trade/Device Name: Electric Breast Pump (F5055) Regulation Number: 21 CFR 884.5160 Regulation Name: Powered Breast Pump Regulatory Class: II Product Code: HGX Received: September 13, 2024

Dear Diana Hong:

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 (the 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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database available at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device"

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(https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30. Design controls; 21 CFR 820.90. Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review. the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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); medical device reporting of medical device-related adverse events) (21 CFR Part 803) for devices or postmarketing safety reporting (21 CFR Part 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rue"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See

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the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely,

# Monica D. Garcia -S

Monica D. Garcia, Ph.D. Assistant Director DHT3B: Division of Reproductive, Gynecology, and Urology Devices OHT3: Office of Gastrorenal, ObGyn, General Hospital, and Urology Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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# Indications for Use

Submission Number (if known)

K240218

Device Name

Electric Breast Pump (F5055)

Indications for Use (Describe)

The Electric Breast Pump (F5055) is intended to express milk from lactating women and collect milk from their breast. The device is intended for single user.

Type of Use (Select one or both, as applicable)

Prescription Use (Part 21 CFR 801 Subpart D)

|X | Over-The-Counter Use (21 CFR 801 Subpart C)

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# 510(k) Summary

This 510(k) Summary is being submitted in accordance with requirements of Title 21, CFR Section 807.92.

The assigned 510(k) Number: K240218

- 1. Date Prepared: 10/16/2024
- 2. Submitter Information

# Fimilla (Shanghai) maternity & baby Articles Co., Ltd. No. 65 Lane 3029 HuaXu Road HuaXin Town QingPu District Shanghai P.R. China

Contact Person: Jason Liu Position: Deputy General Manager Tel: [phone] Email: liumingchun(@fimilla.com

3. Correspondent Information Ms. Diana

Hong (Primary Contact Person) Ms. Xingqi Wang (Alternative Contact Person)

Tel: [phone] Fax: [phone]

#### 4. Device Information

Trade Name: Electric Breast Pump (F5055) Common Name: Electric Breast Pump Regulation Name: Powered Breast Pump Regulatory Class: II; Product Code: HGX (Pump, Breast, Powered); Regulation Number: 21 CFR 884.5160;

- 5. Identification of Predicate Device
Device510(K) Number: K163136 Product Name: Youha electric breast pump Models: YH-8004, YH-8016, YH-8006IV, YH-8015 The predicate device has not been subject to a design-related recall.

- 6. Indications for Use:

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The Electric Breast Pump (F5055) is intended to express milk from lactating women and collect milk from their breast. The device is intended for single user.

#### 7. Device Description

The Electric Breast Pump (F5055) is a powered breast pump to be used by lactating women to express and collect milk from their breast. The Electric Breast Pump (F5055) is intended for a single user. The proposed device is electrically powered and software-controlled. The device operates via a microprocessor-driven air pump, which generates suction on the breast to extract milk.

The proposed device is available in one model, F5055. The provided non-sterile and is not to be sterilized by the user prior to use. The device includes a breast shield assembly, bottles, pump unit, tubing, an adapter, and pump unit. The breast shield assembly includes a silicone breast shield and polypropylene breast shield body that contacts the user's breast. The main specifications of the subject device are shown in Table 1.

| Model | F5055 |
|-----------------|----------------------------------|
| Pumping option | Single or Double |
| Operating type | Key panel |
| Basic functions | Massage mode |
| Basic functions | Expression mode |
| Basic functions | Soothing mode |
| Power Supply | Li-ion battery and power adapter |

Table 1 Main specifications of subject device

#### 8. Comparison of Intended Use and Technological Characteristics with the Predicate Device

The table below compares the intended use and technological characteristics of the subject and predicate device.

| ITEM | Subject Device | Predicate Device (K163136) | Remark |
|--------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------|--------|
| Product | Electric Breast Pump (F5055) | Youha Electric Breast Pump | / |
| Product Code | HGX | HGX | Same |
| Regulation Number | 21 CFR 884.5160 | 21 CFR 884.5160 | Same |
| Class | II | II | Same |
| Indication for Use | The Electric Breast Pump (F5055) is intended to express milk from lactating women and collect milk from their breast.<br>The device is intended for single user. | The Youha electric breast pump is intended to be used by lactating women to express and collect milk from their breasts. It is intended for a single user. | Same |

General Comparison of the Subject and Predicate Device Table 1.

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| Patient<br>Population | Breastfeeding women | Breastfeeding women | Same |
|------------------------|------------------------------|------------------------------------------|-----------|
| Anatomical<br>Sites | Breast | Breast | Same |
| Direct user<br>contact | Yes | Yes | Same |
| Sterile | Provided Non-sterile | Provided Non-sterile | Same |
| Single User | Single Use | Single Use | Same |
| Re-useable | Yes | Yes | Same |
| Power Source | AC Adapter or Li-Ion Battery | AC/DC wall converter and<br>Rechargeable | Different |

| Table 2. Performance Comparison of the Subject and Predicate Device | | |
|---------------------------------------------------------------------|--|--|
| | | |

| ITEM | Subject Device | (Predicate Device K163136) | Remark |
|-----------------|-------------------------------------|--------------------------------------------------------------------------------------------|--------|
| Product | Electric Breast Pump (F5055) | Youha Electric Breast Pump | / |
| Pump Type | Diaphragm | Diaphragm | Same |
| Pumping Options | Single and Double Pumping:<br>F5055 | Single and Double Pumping:<br>YH-8004/YH-8016<br>Single Pumping Only:<br>YH-8006IV/YH-8015 | Same |

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| Cycling/Suction<br>Mechanism | Control | Microprocessor | Microprocessor | Same |
|------------------------------|-----------------|-------------------|-------------------------------------------------|-----------|
| Adjustable Suction levels | | Yes | Yes | Same |
| Suction<br>Levels | Massage mode | F5055: 9 | YH8004:6<br>YH8016:6<br>YH8015:9<br>YH8006IV:10 | Different |
| | Expression mode | F5055: 9 | YH8004:6<br>YH8016:6<br>YH8015:9<br>YH8006IV:10 | |
| | Soothing mode | F5055: 9 | N/A | |
| Suction Strength | | 70-280mmHg | 34-280mmHg | Different |
| Cycle speed | | 20-135 cycles/min | 16-122cycles/min | Different |
| Backflow Protection | | Yes | Yes | Same |

The subject and predicate device have similar indications for use statements and the same intended use - the expression and collection of breast milk. The technological differences between the subject and predicate devices are the power source, suction levels, suction strength, and cycle speed. These differences do not raise different questions of safety and effectiveness.

- 9. Summary of Non-Clinical Performance Testing
## Biocompatibility

- > Meets Attachment G recommendations (FDA Guidance document "Use of International Standard ISO 10993-1, "Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process" (issued September 2023))
Electrical Safety and Electromagnetic Compatibility

- > Testing per IEC 60601-1:2010 + AMD2:2020 Medical equipment - Part 1: General requirements for basic safety and essential performance
- > Testing per IEC 60601-1-2:2014/AMD1: 2020 Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral Standard: Electromagnetic disturbances - Requirements and tests
- > Testing per IEC 60601-1-11:2015/AMD1:2020 Medical electrical equipment – Part 1-11: General requirements for basic safety and essential performance - Collateral Standard: Requirements for medical electrical equipment and medical electrical equipment and medical electrical systems used in the home healthcare environment

## Software

- > Software documentation and verification in accordance with the FDA Guidance document "Content of Premarket Submissions for Device Software Functions" (June 2023)
### Performance Testing

- > Suction strength, cycle speed, battery indicator, and backflow testing to demonstrate that the device

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met design specifications throughout its stated use life.

- 10. Conclusion
The results of the performance testing described above demonstrate that the Electric Breast Pump (F5055) is as safe and effective as the predicate device and supports a determination of substantial equivalence.