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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 72404256
Medical Device Problem Code Inadequacy of Device Shape and/or Size (1583)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/25/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that patient complained of floppy glands.Upon inspection, physician found that tips of the inflatable penile prosthesis (ipp) did not come to the top of the penile gland.As a result, the device was explanted and replaced.No further patient complications were reported.
 
Additional Manufacturer Narrative
Model number/catalog number: 720185-01.Serial number: n/a.Batch/lot number: 1100821531.Model/catalog description: reservoir flat iz 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 Key50840530
Report Number2124215-2026-50166
Device Sequence Number18629310
Product Code JCW
UDI-Device Identifier00878953003641
UDI-Public(01)00878953003641(17)270715(10)1100761192
Combination Product (Y/N)Y
Initial Reporter StateTN
Initial Reporter CountryUS
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 Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 09/21/2026
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 Number72404256
Device Catalogue Number72404256
Device Lot Number1100761192
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 08/25/2026
Initial Report FDA Received Date09/21/2026
Date Device Manufactured07/15/2025
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 Required Intervention; Hospitalization;
Patient Age69 YR
Patient SexUnknown
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