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  "documentTitle": "Penumbra, Inc. (PEN)",
  "authorId": "54_Spruce_Point_Capital",
  "authorName": "Spruce Point Capital Management",
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  "presentationDate": "2019-07-31 00:00:00",
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  "notes": "The slide highlights a red-bordered row for Penumbra, Inc. to emphasize the anomaly.",
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      "text": "We find this concerning for a relatively young medical device company which has been funding studies for years in an attempt to gain clinical support for its core products.",
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      "text": "Payments to non-director doctors: $2.9M",
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      "text": "The Physician Payments Sunshine Act (Section 6002 of the Affordable Care Act of 2010) requires medical product manufacturers to disclose to the Centers for Medicare and Medicaid Services (CMS) any payments or other transfers of value made to physicians or teaching hospitals. Spruce Point analyzed over 28,000 transactions made by Penumbra to doctors from 2013-18. We found that Penumbra paid seven doctors $2.9M of consulting fees in the form of stock between Feb 9, 2016 and Dec 31, 2018, none of which has been disclosed in public filings. Stock payments to non-director and non-employee doctors of this magnitude are very rare in the CMS Open Payments Database. We also found that $4.4M of Penumbra stock was repurchased from 11 doctors in the year preceding the Company’s IPO. We find this concerning for a relatively young medical device company which has been funding studies for years in an attempt to gain clinical support for its core products.",
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      "text": "Public Companies Paying > $1M Of Stock In Consulting Fees",
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      "text": "Unusually High Payments To Non-Employee Doctors",
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