MIRF REPORT
Request:
Fall
Campus:
Vista
Location/Building:
[68]
Date of Incident:
November 16, 2025
Time of Incident:
10:40 AM
Number of Patients for this Incident:
[75]
List Patient(s) Name, Age, Parent/Guardian (if under 18),… :
Patient:Vivian Kueker , 6 years old
Mother: Nicole Kueker
Father: Jonny Kueker
Describe Medical Event:
Slipped and fell on her lower back after using the bathroom, outside the bathroom.
Ambulating normal, no complaint of pain or discomfort, no bruising noted on lower back.
BP 100/72, heart rate 70 bpm, oxygen saturation 94% room air, respiratory rate 19/ min.
Actions Taken by Team Members:
[79]
Number of NCSM Team Members Involved:
[81]
List Name(s) of NCSM Team Members Involved:
Don
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]
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