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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 72404456
Medical Device Problem Codes Inflation Problem (1310); Inadequacy of Device Shape and/or Size (1583); Migration (4003)
Health Effect - Clinical Code Discomfort (2330)
Date of Event 11/01/2025
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
The device is not available for analysis; therefore, no physical analysis of the product could be performed.The patient symptom is a known risk associated with this device type/procedure, and it is noted as such as in the instructions for use.
 
Event or Problem Description
It was reported that the pump of this inflatable penile prosthesis (ipp) was hard to squeeze and had flipped upside down in the scrotum, causing discomfort.The patient stated he was unable to fully inflate the cylinders.The physician confirmed that the pump was difficult to operate, had flipped upside down in the scrotum, and suspected that the tubing was too long.As a result, the pump was explanted and replaced.No additional information has been provided.
 
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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 Key23946092
Report Number2124215-2026-00126
Device Sequence Number7946080
Product Code JCW
UDI-Device Identifier00191506021467
UDI-Public(01)00191506021467(17)260715(10)1100547750
Combination Product (Y/N)Y
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Device Explanted Year2025
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 01/02/2026
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 Date07/15/2026
Device Model Number72404456
Device Catalogue Number72404456
Device Lot Number1100547750
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer12/26/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/10/2025
Initial Report FDA Received Date01/02/2026
Date Device Manufactured07/15/2024
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
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention; Hospitalization;
Patient Age59 YR
Patient SexMale
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