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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 72404451
Medical Device Problem Code Inadequacy of Device Shape and/or Size (1583)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/05/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the inflatable penile prosthesis (ipp) was undersized.The ipp was explanted.There were no patient complications reported.
 
Additional Manufacturer Narrative
There was no device available for analysis; therefore, no physical or visual analysis of the product could be performed.The reported issues with length too long may have been due to a potential measurement error.Based on the information available, a conclusion code of unintended use error caused or contributed to event was assigned to this investigation.D4 unique identifier (udi) for reservoir: (b)(4).
 
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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 Key24472334
Report Number2124215-2026-11106
Device Sequence Number9615404
Product Code JCW
UDI-Device Identifier00191506021429
UDI-Public(01)00191506021429(17)260625(10)1100537430
Combination Product (Y/N)Y
Initial Reporter StateNY
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) 02/27/2026
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 Date06/25/2026
Device Model Number72404451
Device Catalogue Number72404451
Device Lot Number1100537430
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 02/05/2026
Initial Report FDA Received Date02/27/2026
Date Device Manufactured06/25/2024
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
Concomitant Medical Products
and Therapy/Usage Dates
RESERVOIR: UPN 720185-01 / LOT 1100785204
Outcome Attributed to Adverse Event Hospitalization; Required Intervention;
Patient Age69 YR
Patient SexUnknown
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