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U.S. Department of Health and Human Services

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

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BOSTON SCIENTIFIC CORPORATION AMS 700 LGX MS PUMP; PROSTHESIS, PENIS, INFLATABLE Back to Search Results
Model Number 72404306
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 04/09/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Model number/catalog number: 72018201.Serial number: n/a.Batch/lot number: 1100348885.Model/catalog description: reservoir flat 100 ml.Unique identifier (udi) #: (b)(4).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 short 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.
 
Event or Problem Description
It was reported that the patient's inflatable penile prosthesis (ipp) length was reported to be too short.A surgical procedure was performed, during which the ipp was replaced.No patient complications were reported.
 
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Brand Name
AMS 700 LGX 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 Key25029685
Report Number2124215-2026-23024
Device Sequence Number18673629
Product Code JCW
UDI-Device Identifier00878953005768
UDI-Public(01)00878953005768(17)280830(10)1100348577
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2023
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) 04/28/2026
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 Model Number72404306
Device Catalogue Number72404306
Device Lot Number1100348577
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 04/09/2026
Initial Report FDA Received Date04/29/2026
Date Device Manufactured09/01/2023
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
Outcome Attributed to Adverse Event Hospitalization; Required Intervention;
Patient Age85 YR
Patient SexMale
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