MIRF REPORT
Request:
Hurt forearm
Campus:
Vista
Location/Building:
[68]
Date of Incident:
October 1, 2024
Time of Incident:
8:00 PM
Number of Patients for this Incident:
[75]
List Patient(s) Name, Age, Parent/Guardian (if under 18),… :
Carter Banes (13) (Mother) Brenna
Describe Medical Event:
Carter was playing a tug of war game with his friends inside of the Edge during tournament series. This game was outside of the actual TNL game being played so leaders were not around to see this incident occur. According to Carter, the tug of war rope broke causing him to fall backwards bracing his fall with his right arm. After falling, Carter claimed he could not feel his arm just below his elbow.
Actions Taken by Team Members:
[79]
Number of NCSM Team Members Involved:
[81]
List Name(s) of NCSM Team Members Involved:
Jon Fecteau
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