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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 Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Deformity/ Disfigurement (2360)
Date of Event 06/24/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient with this inflatable penile prosthesis (ipp) presented with curvature, resulting in patient dissatisfaction.A surgical procedure was performed during which the ipp was removed and replaced with a tactra device.It was noted that no device related issues were present, the device cycled properly.No additional information was provided.
 
Additional Manufacturer Narrative
Model number/catalog number: 720185-01.Serial number: n/a.Batch/lot number: 0179070018.Model/catalog description: reservoir flat iz 100 ml.Unique identifier (udi) #: (b)(4).
 
Event or Problem Description
It was reported that the patient with this inflatable penile prosthesis (ipp) presented with curvature, resulting in patient dissatisfaction.A surgical procedure was performed during which the ipp was removed and replaced with a tactra device.It was noted that no device related issues were present, the device cycled properly.No additional information was provided.
 
Event or Problem Description
It was reported that the patient with this inflatable penile prosthesis (ipp) presented with curvature, resulting in patient dissatisfaction.A surgical procedure was performed during which the ipp was removed and replaced with a tactra device.It was noted that no device related issues were present, the device cycled properly.No additional information was provided.
 
Additional Manufacturer Narrative
Model number/catalog number: 720185-01 serial number: n/a batch/lot number: 0179070018 model/catalog description: reservoir flat iz 100 ml unique identifier (udi) #: (b)(4) the device is not available for analysis; therefore, no physical or visual analysis of the product could be performed.There was no report of a device performance allegation.The device history record (dhr) review confirmed that the device met all material, assembly and performance specifications.A review of the device instructions for use (ifu) was completed and did not reveal any evidence of device misuse, off label use, or failure to follow instructions.A risk review was completed and confirmed that the event of disfigurement was defined in the product risk documentation.This event type has been accounted for during analysis to support acceptable risk benefit for the product.Based on the information available, a conclusion code of adverse event related to patient condition was assigned to this investigation, as the patient's condition, disease, or anatomy is demonstrably responsible for the adverse event and use of the device has neither caused nor otherwise influenced the adverse event.
 
Additional Manufacturer Narrative
Model number/catalog number: 720185-01.Serial number: n/a.Batch/lot number: 0179070018.Model/catalog description: reservoir flat iz 100 ml.Unique identifier (udi) #: (b)(4).The device is not available for analysis; therefore, no physical or visual analysis of the product could be performed.There was no report of a device performance allegation.The device history record (dhr) review confirmed that the device met all material, assembly and performance specifications.A review of the device instructions for use (ifu) was completed and did not reveal any evidence of device misuse, off label use, or failure to follow instructions.A risk review was completed and confirmed that the event of disfigurement was defined in the product risk documentation.This event type has been accounted for during analysis to support acceptable risk benefit for the product.Based on the information available, a conclusion code of adverse event related to patient condition was assigned to this investigation, as the patient's condition, disease, or anatomy is demonstrably responsible for the adverse event and use of the device has neither caused nor otherwise influenced the adverse event.
 
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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
MDR Report Key25883611
Report Number2124215-2026-38927
Device Sequence Number15926139
Product Code JCW
UDI-Device Identifier00878953003443
UDI-Public(01)00878953003443(17)190508(10)174964005
Combination Product (Y/N)Y
Initial Reporter StateSC
Initial Reporter CountryUS
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2017
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date (Section B) 08/27/2026
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 Date05/08/2019
Device Model Number72404231
Device Catalogue Number72404231
Device Lot Number0174964005
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 06/24/2026
Supplement Date Received by Manufacturer07/28/2026
07/28/2026
Initial Report FDA Received Date07/20/2026
Supplement Report FDA Received Date08/27/2026
08/27/2026
Date Device Manufactured05/08/2017
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 Age76 YR
Patient SexMale
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