MIRF REPORT
Request:
Child tripped and hit head causing large bump on forehead
Campus:
Vista
Location/Building:
[68]
Date of Incident:
October 3, 2024
Time of Incident:
11:10 AM
Number of Patients for this Incident:
[75]
List Patient(s) Name, Age, Parent/Guardian (if under 18),… :
Brenna Ender (4 yrs) Heather Ender (Mother) telephone number 760-989-1935
Describe Medical Event:
Child was playing and tripped over toy train tracks set up on floor. She fell into the edge of an open drawer hitting the middle of her forehead causing a large bump and slight open wound across the bump.
Actions Taken by Team Members:
[79]
Number of NCSM Team Members Involved:
[81]
List Name(s) of NCSM Team Members Involved:
Jon Fecteau
Mike Kaiser
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?:
NCS team lead:
[249]
If any revisions or updates are needed to be made to this incident, complete the form below.
Please select a valid form