| Brand Name | NEX-D2 POSTERIOR FIXATION SYSTEM |
| Common Device Name | BONE TAP, MIS, 4.5MM |
| Manufacturer (Section D) |
| NEXT ORTHOSURGICAL |
| 3270 corporate view suite a |
| vista CA 92081 |
|
| Manufacturer (Section G) |
| NEXT ORTHOSURGICAL |
| 3270 corporate view, suite a |
|
| vista CA 92081 |
|
| Manufacturer Contact |
|
alicia
hernandez
|
| 3270 corporate view, suite a |
| vista, CA 92081
|
|
7602953600
|
|
| MDR Report Key | 22997742 |
| Report Number | 3010020754-2025-00003 |
| Device Sequence Number | 12963399 |
| Product Code |
LXH
|
| UDI-Device Identifier | 00840314121103 |
| UDI-Public | 00840314121103 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | JA |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2024 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
User Facility,Distributor |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Remedial Action |
Replace |
| Type of Report
| Initial |
| Report Date (Section B) |
08/29/2025 |
| 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
|
| Device Model Number | CBZB005-45 |
| Device Catalogue Number | CBZB005-45 |
| Device Lot Number | 0001217C1 |
| Was Device Available for Evaluation? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 08/08/2024 |
| Initial Report FDA Received Date | 09/08/2025 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Is the Device Labeled for Single Use? (Y/N) |
No
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Reuse
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Age | 81 YR |
| Patient Sex | Female |
| Patient Ethnicity | Non Hispanic |
| Patient Race | Asian |
|
|