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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 72404301
Medical Device Problem Codes Fluid/Blood Leak (1250); Inflation Problem (1310)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/07/2026
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 reported device performance allegation cannot be confirmed.Inflation issue and fluid leak are acknowledged within the instructions for use (ifu) and are not related to off-label use or failure to follow instructions.Based on the information available the cause that contributed to the reported event cannot be established; therefore, a conclusion code of cause not established was assigned to this investigation.
 
Event or Problem Description
It was reported that a patient with an inflatable penile prosthesis (ipp) presented with a device that stopped inflating.A revision surgery was performed, during which the physician confirmed fluid loss from the cylinders, with no holes or connection issues identified.The device was explanted and 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 Key25038297
Report Number2124215-2026-23352
Device Sequence Number10457642
Product Code JCW
UDI-Device Identifier00878953005720
UDI-Public(01)00878953005720
Combination Product (Y/N)N
Initial Reporter CountryGR
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2016
Device Explanted Year2026
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 04/29/2026
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 Number72404301
Device Catalogue Number72404301
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 04/07/2026
Initial Report FDA Received Date04/29/2026
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 SexUnknown
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