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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 72404238
Medical Device Problem Codes Collapse (1099); Fluid/Blood Leak (1250); Inflation Problem (1310)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/15/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient's inflatable penile prosthesis (ipp) exhibited inflation issues that were suspected to be related to fluid loss.During the revision procedure, the pump was found to be collapsed.No air was observed within the system, and no apparent leak was identified upon device removal or during evaluation.The source of the fluid loss could not be determined intraoperatively.The ipp was replaced, and no patient complications were reported.
 
Additional Manufacturer Narrative
Concomitantly implanted product at time of the event: model number/catalog number: 720185-01, serial number: n/a, batch/lot number: 1000339010, model/catalog description: reservoir flat iz 100 ml, unique identifier (udi) #: (b)(4).
 
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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 Key50240196
Report Number2124215-2026-43521
Device Sequence Number10261968
Product Code JCW
UDI-Device Identifier00878953003511
UDI-Public(01)00878953003511(17)210811(10)1000315854
Combination Product (Y/N)Y
Initial Reporter StateAL
Initial Reporter CountryUS
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2019
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 08/13/2026
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 Date08/11/2021
Device Model Number72404238
Device Catalogue Number72404238
Device Lot Number1000315854
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 07/15/2026
Initial Report FDA Received Date08/13/2026
Date Device Manufactured08/12/2019
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 Age57 YR
Patient SexMale
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