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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION AMS 700? CX TENACIO? Pump; prosthesis, penis, inflatable

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BOSTON SCIENTIFIC CORPORATION AMS 700? CX TENACIO? Pump; prosthesis, penis, inflatable Back to Search Results
Model Number 72404433
Medical Device Problem Codes Inflation Problem (1310); Nonstandard Device (1420); Failure to Deflate (4060)
Health Effect - Clinical Codes Pain (1994); Discomfort (2330)
Date of Event 05/15/2026
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.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.Model number/catalog number: 720185-01.Serial number: n/a.Batch/lot number: 1100650920.Model/catalog description: reservoir.Unique identifier (udi) # (b)(4).
 
Event or Problem Description
It was reported that the patient with this inflatable penile prosthesis (ipp) difficulty operating the pump, deflating and inflating, resulting in pain and discomfort in the scrotum.As a result, the cylinders and pump were explanted and replaced, while the reservoir was retained and reused.No further patient complications were reported.
 
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Brand Name
AMS 700? CX TENACIO? 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 Key25461053
Report Number2124215-2026-31040
Device Sequence Number12943156
Product Code JCW
UDI-Device Identifier00191506021344
UDI-Public(01)00191506021344(17)260328(10)1100480322
Combination Product (Y/N)Y
Initial Reporter StateCO
Initial Reporter CountryUS
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Remedial Action Recall
Type of Report Initial,Followup
Report Date (Section B) 09/30/2026
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 Date03/28/2026
Device Model Number72404433
Device Catalogue Number72404433
Device Lot Number1100480322
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer06/08/2026
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 05/15/2026
Supplement Date Received by Manufacturer09/02/2026
Initial Report FDA Received Date06/10/2026
Supplement Report FDA Received Date09/30/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/28/2024
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
If action reported to FDA under 21 USC 360i(g), list
FDA-assigned Recall Number or include a statement
Z-0142-2026
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention; Hospitalization;
Patient Age67 YR
Patient SexMale
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