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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION AMS 700 CX MS PUMP; PROSTHESIS, PENIS, INFLATABLE

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BOSTON SCIENTIFIC CORPORATION AMS 700 CX MS PUMP; PROSTHESIS, PENIS, INFLATABLE Back to Search Results
Model Number 72404238
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Erosion (1750)
Date of Event 01/13/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that a patient with an inflatable penile prosthesis (ipp) implant device experienced distal erosion of the right cylinder.The physician removed the ipp system and implanted the left side with a tactra prosthesis.No further patient complications were reported.
 
Additional Manufacturer Narrative
C2/d10: concomitant product udi for reservoir is (b)(4).The device is not available for analysis; therefore, no physical or visual analysis of the product could be performed.Erosion is acknowledged within the ifu and are not related to off label use or failure to follow instructions.The ifu provides guidance and instruction to achieve successful ams 700 implantation and to prevent erosion related symptoms.The reported patient symptom(s) are known risk associated with this device type and indicated as such in the instructions for use.
 
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Brand Name
AMS 700 CX MS 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
5086521217
MDR Report Key24299924
Report Number2124215-2026-07295
Device Sequence Number13110759
Product Code JCW
UDI-Device Identifier00878953003511
UDI-Public(01)00878953003511(17)250928(10)1100368772
Combination Product (Y/N)Y
Initial Reporter StateAL
Initial Reporter CountryUS
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Device Explanted Year2026
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) 02/09/2026
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 Expiration Date09/28/2025
Device Model Number72404238
Device Catalogue Number72404238
Device Lot Number1100368772
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 01/13/2026
Initial Report FDA Received Date02/09/2026
Date Device Manufactured09/29/2023
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
Concomitant Medical Products
and Therapy/Usage Dates
720185-01 RESERVOIR FLAT IZ 100 ML LOT 1100370588
Outcome Attributed to Adverse Event Hospitalization; Required Intervention;
Patient Age68 YR
Patient SexMale
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