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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION AMS 700? CX TENACIO? Pump; prosthesis, penis, inflatable

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BOSTON SCIENTIFIC CORPORATION AMS 700? CX TENACIO? Pump; prosthesis, penis, inflatable Back to Search Results
Model Number 72404432
Medical Device Problem Codes Inflation Problem (1310); Migration (4003)
Health Effect - Clinical Code Unspecified Tissue Injury (4559)
Date of Event 07/17/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that a patient with an inflatable penile prosthesis (ipp) presented with a device that would not provide sufficient rigidity on one side and would not fully inflate on both sides.A revision surgery was performed, during which the physician confirmed that the right cylinder had migrated proximally within the corpora.The device was explanted and replaced.There were no further patient complications.
 
Additional Manufacturer Narrative
Model number/catalog number: 720185-01 serial number: n/a batch/lot number: 1100941734 model/catalog description: reservoir, flat, iz, 100 ml unique identifier (udi) #:(b)(4).The device is not available for analysis; therefore, no physical analysis of the product could be performed.The reported device performance allegation cannot be confirmed.Migration, tissue damage and inflation issue are acknowledged within the instructions for use (ifu) and are not related to off-label use or failure to follow instructions.
 
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Brand Name
AMS 700? CX TENACIO? 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 Key50869613
Report Number2124215-2026-50665
Device Sequence Number9314125
Product Code JCW
UDI-Device Identifier00191506021337
UDI-Public(01)00191506021337(17)280422(10)1100963851
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 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) 09/23/2026
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 Number72404432
Device Catalogue Number72404432
Device Lot Number1100963851
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 09/14/2026
Initial Report FDA Received Date09/23/2026
Date Device Manufactured04/23/2026
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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