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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PENUMBRA, INC. RUBY COIL LP; HCG, KRD

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PENUMBRA, INC. RUBY COIL LP; HCG, KRD Back to Search Results
Catalog Number RBYLP0105
Medical Device Problem Code Premature Separation (4045)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/10/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The product was not returned for evaluation.Without the return of the device, the root cause of the problem cannot be determined.The manufacturing records for this lot were reviewed and did not reveal any outstanding discrepancies, design, or quality concerns.
 
Event or Problem Description
The patient was undergoing a coil embolization procedure in the gastroduodenal artery (gda) using ruby coil lps and a non-penumbra microcatheter.While advancing a ruby coil lp through the microcatheter, the ruby coil lp had unintentionally detached within the microcatheter.Therefore, the physician removed the microcatheter containing the detached ruby coil lp and the embolization coil was flushed out from the microcatheter using saline.The microcatheter was advanced back into the vessel.The physician then advanced a new ruby coil lp and the same issue occurred.The microcatheter containing the detached ruby coil lp was removed and the embolization coil was flushed out.It was reported that the physician decided to switch to a new microcatheter.The procedure was completed using new ruby coil lps and the new microcatheter.There was no report of an adverse effect to the patient.
 
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Brand Name
RUBY COIL LP
Common Device Name
HCG, KRD
Manufacturer (Section D)
PENUMBRA, INC.
one penumbra place
alameda CA 94502
Manufacturer (Section G)
PENUMBRA, INC.
one penumbra place
alameda CA 94502
Manufacturer Contact
veronica menezes
one penumbra place
alameda, CA 94502
5107483200
MDR Report Key24769562
Report Number3005168196-2026-00106
Device Sequence Number9153229
Product Code HCG
UDI-Device Identifier00815948025967
UDI-Public00815948025967
Combination Product (Y/N)N
Initial Reporter StateOR
Initial Reporter CountryUS
PMA/510(K) Number
K230284
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 04/02/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Catalogue NumberRBYLP0105
Device Lot NumberF00020212
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/11/2026
Initial Report FDA Received Date04/02/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured12/08/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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