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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 Code Mechanical Problem (1384)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/17/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that an inflatable penile prosthesis (ipp) could not be used as intended because the pump could not be pressurized, resulting in the inability to achieve an erection.A surgical procedure was performed to remove the ipp.No patient complications were reported.
 
Additional Manufacturer Narrative
Model number/catalog number: 72018201, batch/lot number: 1100732528, model/catalog description: reservoir flat 100 ml, unique identifier (udi) #: (b)(4).
 
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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 Key50213565
Report Number2124215-2026-42965
Device Sequence Number6098545
Product Code JCW
UDI-Device Identifier00878953005720
UDI-Public(01)00878953005720(17)300420(10)1100713576
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2026
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 08/11/2026
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 Model Number72404301
Device Catalogue Number72404301
Device Lot Number1100713576
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 07/17/2026
Initial Report FDA Received Date08/11/2026
Date Device Manufactured04/21/2025
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 Age36 YR
Patient SexMale
Patient Weight209 LB
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