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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 72404233
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes Erosion (1750); Unspecified Infection (1930)
Date of Event 02/21/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Model number/catalog number 720185-01.Serial number n/a.Batch/lot number 919048003.Model/catalog description reservoir flat iz 100 ml.Unique identifier (udi) #: (b)(4).The device is not available for analysis; therefore, no physical or visual analysis of the product could be performed.There was no report of a device performance allegation.The reported patient symptoms of erosion and infection are acknowledged within the ifu and are not related to off-label use or failure to follow instructions.The reported patient symptoms of erosion and infection are known risks associated with this device type and indicated as such in the instructions for use.A risk review was completed; erosion and infection are defined in the risk documentation.This event type has been accounted for during product risk analysis to support acceptable risk benefit for the product.Based on a thorough review of the information, an investigation conclusion code of known inherent risk of device was assigned to this investigation.
 
Event or Problem Description
It was reported that the patient with an inflatable penile prosthesis (ipp) experienced penile erosion on the right side and infection in the penis.A surgical procedure was performed to remove the ipp and replaced it with a malleable device on the left side.The infection was treated with antibiotics.No further patient complications were reported.
 
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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
MDR Report Key24675061
Report Number2124215-2026-16042
Device Sequence Number21368559
Product Code JCW
UDI-Device Identifier00878953003467
UDI-Public(01)00878953003467(17)170129(10)918898001
Combination Product (Y/N)Y
Initial Reporter StateIL
Initial Reporter CountryUS
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2015
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) 03/24/2026
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 Date01/29/2017
Device Model Number72404233
Device Catalogue Number72404233
Device Lot Number918898001
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 02/25/2026
Initial Report FDA Received Date03/24/2026
Date Device Manufactured02/17/2015
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 Hospitalization; Required Intervention;
Patient Age53 YR
Patient SexMale
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