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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION AMS 700 LGX? TENACIO? PUMP; PROSTHESIS, PENIS, INFLATABLE

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BOSTON SCIENTIFIC CORPORATION AMS 700 LGX? TENACIO? PUMP; PROSTHESIS, PENIS, INFLATABLE Back to Search Results
Model Number 72404452
Medical Device Problem Code Malposition of Device (2616)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/27/2025
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Concomitant product udi for reservoir is (b)(4).
 
Event or Problem Description
It was reported that the patient with this inflatable penile prosthesis (ipp) was dissatisfied with the placement of the cylinders, as the previous implant had not been fully dilated.A surgical procedure was performed in which the device was removed and replaced.There were no patient complications reported.
 
Additional Manufacturer Narrative
Concomitant product udi for reservoir is (b)(4).Correction to field h7: if remedial act init, type.Correction to field h9: correction/removal reporting #.There was no device available for analysis; therefore, no physical or visual analysis of the product could be performed.The reported issue with malposition may have been due to a potential error in the location of the placement.The device history record (dhr) review confirmed that the device met all material, assembly and performance specifications.Based on the information available, a conclusion code of unintended use error caused or contributed to event was assigned to this investigation.
 
Event or Problem Description
It was reported that the patient with this inflatable penile prosthesis (ipp) was dissatisfied with the placement of the cylinders, as the previous implant had not been fully dilated.A surgical procedure was performed in which the device was removed and replaced.There were no patient complications reported.
 
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Brand Name
AMS 700 LGX? TENACIO? PUMP
Common Device Name
PROSTHESIS, PENIS, INFLATABLE
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer Contact
farshad fahimi
4100 hamline avenue north
building c
saint paul, MN 55112
MDR Report Key23143486
Report Number2124215-2025-66300
Device Sequence Number21043391
Product Code JCW
UDI-Device Identifier00191506021436
UDI-Public(01)00191506021436(17)260329(10)1100480677
Combination Product (Y/N)Y
Initial Reporter StateTN
Initial Reporter CountryUS
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2024
Device Explanted Year2025
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Remedial Action Recall
Type of Report Initial,Followup
Report Date (Section B) 02/11/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Operator of Device Lay User/Patient
Device Expiration Date03/29/2026
Device Model Number72404452
Device Catalogue Number72404452
Device Lot Number1100480677
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 08/27/2025
Supplement Date Received by Manufacturer01/20/2026
Initial Report FDA Received Date09/25/2025
Supplement Report FDA Received Date02/11/2026
Date Device Manufactured03/29/2024
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
If action reported to FDA under 21 USC 360i(g), list
FDA-assigned Recall Number or include a statement
Z-0143-2026
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
UPN: 720185-01 LOT: 1100583501. RESERVOIR.; UPN: 720185-01 LOT: 1100583501. RESERVOIR.
Outcome Attributed to Adverse Event Hospitalization; Required Intervention;
Patient Age50 YR
Patient SexUnknown
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