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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PENUMBRA, INC. POD PACKING COIL; HCG, KRD

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PENUMBRA, INC. POD PACKING COIL; HCG, KRD Back to Search Results
Catalog Number RBYPODJ60
Medical Device Problem Code Premature Separation (4045)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/17/2026
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 collaterals using a pod packing coil (packing coil) and a lantern delivery microcatheter (lantern).While advancing a packing coil into the target location using the lantern, the lantern kicked out of the vessel.The physician was unable to advance the lantern back into the vessel.The physician still attempted to advance the packing coil into the vessel but noticed under fluoroscopy that the distal end of the coil was stuck on an existing vascular plug.The physician decided to remove the lantern and packing coil.While retracting the packing coil into the lantern, the physician was experiencing resistance, and the coil unintentionally detached.Therefore, the physician used a snare device and forceps to remove the detached packing coil.The procedure was completed using a new pushable coils and a new microcatheter.There was no report of an adverse effect to the patient.
 
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Brand Name
POD PACKING COIL
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 Key25606522
Report Number3005168196-2026-00211
Device Sequence Number12123651
Product Code HCG
UDI-Device Identifier00814548017679
UDI-Public00814548017679
Combination Product (Y/N)N
Initial Reporter StateHI
Initial Reporter CountryUS
PMA/510(K) Number
K170852
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 Other Health Care Professional
Type of Report Initial
Report Date (Section B) 06/24/2026
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 NumberRBYPODJ60
Device Lot NumberF00007541
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 04/17/2026
Initial Report FDA Received Date06/24/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured07/14/2023
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 Age16 YR
Patient SexMale
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