MIRF REPORT
Request:
Head bump
Campus:
Vista
Location/Building:
[68]
Date of Incident:
October 3, 2019
Time of Incident:
11:15 AM
Number of Patients for this Incident:
[75]
List Patient(s) Name, Age, Parent/Guardian (if under 18),… :
Noelle Clapp 9mo
Jill Clapp (mom)
Describe Medical Event:
Baby tried to pull herself up using the corner of the wall in room 3 and slipped and bumped her forehead (left side). There was a large notable bump with bruising and a minor laceration. Ice applied immediately and mom was called. Mom will take child to the doctor if needed.
Actions Taken by Team Members:
[79]
Number of NCSM Team Members Involved:
[81]
List Name(s) of NCSM Team Members Involved:
Naomi Roth
Was medical attention accepted?”:
Yes
Medical attention was refused by (name and relationship to… :
Naomi Roth
Was 911 emergency service called?:
No
Was patient transported via 911 emergency services?:
No
What hospital was victim transported to?:
None
NCS team lead:
[249]
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