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U.S. Department of Health and Human Services

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

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BOSTON SCIENTIFIC CORPORATION AMS 700 MS Pump; prosthesis, penis, inflatable Back to Search Results
Model Number 72404310
Medical Device Problem Code Mechanical Problem (1384)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/21/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
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.Based on the information available the cause that contributed to the reported event cannot be established.Therefore, a conclusion code of cause not established was assigned to this investigation.This record was identified during a retrospective review of complaint events; an electronic medical device report (emdr) was not previously submitted per applicable reporting criteria.Boston scientific has opened a nonconforming events and prevention investigation ((b)(4)) to determine the potential cause for why an emdr was not previously submitted to the food and drug administration (fda) in accordance with boston scientific's established medical device reporting process and fda adverse event reporting requirements.Information gained through these investigation efforts will be utilized to take action(s), as necessary.Model number/catalog number: 72404014.Serial number: n/a.Batch/lot number: 1100632728.Model/catalog description: cylinder.Unique identifier (udi) # (b)(4).
 
Event or Problem Description
It was reported that the pump of this inflatable penile prosthesis (ipp) was not working properly.As a result, the device was explanted and replaced.No additional information was provided.
 
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Brand Name
AMS 700 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 Key50871153
Report Number2124215-2026-50706
Device Sequence Number9425514
Product Code JCW
UDI-Device Identifier00878953003986
UDI-Public(01)00878953003986(17)290701(10)1100539889
Combination Product (Y/N)N
Initial Reporter CountryKS
PMA/510(K) Number
N970012
Number of Events Summarized1
Summary Report (Y/N)N
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Distributor
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 Number72404310
Device Catalogue Number72404310
Device Lot Number1100539889
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 01/21/2026
Initial Report FDA Received Date09/23/2026
Date Device Manufactured07/02/2024
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 Age68 YR
Patient SexMale
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