MIRF REPORT
Request:
Child was bit
Campus:
Vista
Location/Building:
[68]
Date of Incident:
November 7, 2019
Time of Incident:
9:45 AM
Number of Patients for this Incident:
[75]
List Patient(s) Name, Age, Parent/Guardian (if under 18),… :
Kiley Harnishfeger 3 years old
Kimberly Harnishfeger (Mom).
Describe Medical Event:
Ice pack applied for 15 minutes to the left forearm. Mom notified.
*Jolene Bentley- ChildCare worker notified Coordinator.
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… :
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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