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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 72404232
Medical Device Problem Codes Inflation Problem (1310); Mechanical Problem (1384)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/06/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Model number/catalog number: 1720185-01.Serial number: n/a.Batch/lot number: 1000025422.Model/catalog description: reservoir, flat, iz, 100 ml.Unique identifier (udi) #: (b)(4).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.Mechanical issue and inflation issue 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 nonfunctioning device with inflation issues.A revision surgery was performed in which physician explanted the device and replaced it with a tactra device.There were no patient complications.
 
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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
+1(508)652-1217
MDR Report Key25368128
Report Number2124215-2026-29522
Device Sequence Number9994710
Product Code JCW
UDI-Device Identifier00878953003450
UDI-Public(01)00878953003450(17)191031(10)1000002474
Combination Product (Y/N)Y
Initial Reporter CountryBR
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2018
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 09/21/2026
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 Date10/31/2019
Device Model Number72404232
Device Catalogue Number72404232
Device Lot Number1000002474
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/05/2026
Supplement Date Received by Manufacturer09/10/2026
Initial Report FDA Received Date06/02/2026
Supplement Report FDA Received Date09/21/2026
Date Device Manufactured10/31/2017
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 Age68 YR
Patient SexMale
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