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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 72404302
Medical Device Problem Codes Collapse (1099); Inflation Problem (1310); Mechanical Problem (1384); Difficult or Delayed Activation (2577)
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 this inflatable penile prosthesis (ipp) was not working properly and the pump could not be pressured, and the body of the penis could not erect.As a result, the device was explanted.No patient complications were reported.
 
Additional Manufacturer Narrative
Model number/catalog number: 72018201.Serial number: n/a.Batch/lot number: 1100744899.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 Key50256062
Report Number2124215-2026-43759
Device Sequence Number18675760
Product Code JCW
UDI-Device Identifier00878953005737
UDI-Public(01)00878953005737(17)301008(10)1100808666
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
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Distributor
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 09/02/2026
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 Number72404302
Device Catalogue Number72404302
Device Lot Number1100808666
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
Supplement Date Received by Manufacturer08/09/2026
Initial Report FDA Received Date08/14/2026
Supplement Report FDA Received Date09/03/2026
Date Device Manufactured10/09/2025
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 Age43 YR
Patient SexMale
Patient Weight176 LB
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