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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION AMS 700? CX TENACIO? Pump; prosthesis, penis, inflatable

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BOSTON SCIENTIFIC CORPORATION AMS 700? CX TENACIO? Pump; prosthesis, penis, inflatable Back to Search Results
Model Number 72404438
Medical Device Problem Code Inflation Problem (1310)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/15/2025
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the pump of this inflatable penile prosthesis (ipp) was not fully inflating.The cylinders and pump were explanted and replaced.There were no patient complications reported.
 
Additional Manufacturer Narrative
D4 unique identifier (udi) for reservoir: (b)(4).
 
Additional Manufacturer Narrative
D4 unique identifier (udi) for reservoir: (b)(4).The device is not available for analysis; therefore, no physical analysis of the product could be performed.The reported device performance allegation cannot be confirmed.Based on the information available the cause that contributed to the reported event cannot be established.Correction to field h7: if remedial act init, type.Correction to field h9: correction/removal reporting #.
 
Event or Problem Description
It was reported that the pump of this inflatable penile prosthesis (ipp) was not fully inflating.The cylinders and pump were explanted and replaced.There were no patient complications reported.
 
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Brand Name
AMS 700? CX 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
+1(508)652-1217
MDR Report Key23246398
Report Number2124215-2025-70663
Device Sequence Number21436105
Product Code JCW
Combination Product (Y/N)Y
Initial Reporter StateGA
Initial Reporter CountryUS
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Device Explanted Year2025
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Remedial Action Recall
Type of Report Initial,Followup,Followup
Report Date (Section B) 09/09/2026
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? No
Operator of Device Lay User/Patient
Device Model Number72404438
Device Catalogue Number72404438
Device Lot Number1100677577
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer10/03/2025
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/15/2025
Supplement Date Received by Manufacturer01/20/2026
08/25/2026
Initial Report FDA Received Date10/08/2025
Supplement Report FDA Received Date01/28/2026
09/09/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/17/2025
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
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
RESERVOIR: UPN 720185-01 / LOT 1100694492.; RESERVOIR: UPN 720185-01 / LOT 1100694492.
Outcome Attributed to Adverse Event Hospitalization; Required Intervention;
Patient Age66 YR
Patient SexMale
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