MIRF REPORT
Request:
Head injury
Campus:
Vista
Location/Building:
[68]
Date of Incident:
July 20, 2025
Time of Incident:
12:38 PM
Number of Patients for this Incident:
[75]
List Patient(s) Name, Age, Parent/Guardian (if under 18),… :
2 sisters:
Ellie (older sister) – head injury – small bump
Bridgett (younger sister) – lip injury – small abrasion
Dad: Doug 619-564-1650
Describe Medical Event:
Two sisters were in the sanctuary with Dad when they both turned towards each other suddenly by accident and Ellie’s head bumped Bridget’s lip.
Actions Taken by Team Members:
[79]
Number of NCSM Team Members Involved:
[81]
List Name(s) of NCSM Team Members Involved:
Alice Besong
Pete Hahn
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