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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 72404232
Medical Device Problem Codes Inflation Problem (1310); Material Puncture/Hole (1504)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/04/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that this inflatable penile prothesis (ipp)'s pump wasn't working properly, it stayed flat and would not inflate.Upon revision, a hole in right cylinder was noticed.As a result, the device was explanted and replaced.No further patient complications were reported.
 
Additional Manufacturer Narrative
Model number/catalog number: 72404155.Serial number: n/a.Batch/lot number: 481364009.Model/catalog description: reservoir 65 ml pc/iz.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 Key50855055
Report Number2124215-2026-50418
Device Sequence Number10053657
Product Code JCW
UDI-Device Identifier00878953003450
UDI-Public(01)00878953003450(17)090316(10)486268009
Combination Product (Y/N)Y
Initial Reporter StateMI
Initial Reporter CountryUS
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2007
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 09/22/2026
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 Date03/16/2009
Device Model Number72404232
Device Catalogue Number72404232
Device Lot Number486268009
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 08/27/2026
Initial Report FDA Received Date09/22/2026
Date Device Manufactured03/27/2007
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 Age74 YR
Patient SexMale
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