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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 72404231
Medical Device Problem Code Inflation Problem (1310)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/06/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that this inflatable penile prosthesis (ipp) was not getting as full as it previously did.A surgical procedure was performed during which the device was explanted and replaced.Upon explant the physician did not find a leak, and it was suspected that the cause of the inflation issue was a stretch of the corpora.The patient fully recovered, and there were no patient complications reported.
 
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 is acknowledged within the instructions for use (ifu) and is 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.
 
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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 Key25305951
Report Number2124215-2026-28478
Device Sequence Number9362150
Product Code JCW
UDI-Device Identifier00878953003443
UDI-Public(01)00878953003443(17)200718(10)1000136794
Combination Product (Y/N)Y
Initial Reporter StateLA
Initial Reporter CountryUS
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2019
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) 05/27/2026
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? No
Operator of Device Lay User/Patient
Device Expiration Date07/18/2020
Device Model Number72404231
Device Catalogue Number72404231
Device Lot Number1000136794
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 05/07/2026
Initial Report FDA Received Date05/27/2026
Date Device Manufactured07/19/2018
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 Age79 YR
Patient SexMale
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