MIRF REPORT
Request:
Medical
Campus:
Vista
Location/Building:
[68]
Date of Incident:
March 28, 2026
Time of Incident:
5:20 PM
Number of Patients for this Incident:
[75]
List Patient(s) Name, Age, Parent/Guardian (if under 18),… :
Abijah Barajas 9. 1/8/17
Tawny Barajas. Mom
Describe Medical Event:
Mom states that pt was in a wrestling meet today where he got head butted around 2pm. No LOC. Per mom, pt has been more tired than normal today as well as having a headache in the occipital area. No vision/hearing problem. C/o nausea s vominting. Answers questions appropriately. Mom advised to have pt evaluated at an urgent care or ER. Mom states that she will take him to get evaluated. Mom refuses 911 to be activated for him. Pt left in moms care.
Actions Taken by Team Members:
[79]
Number of NCSM Team Members Involved:
[81]
List Name(s) of NCSM Team Members Involved:
Kevin Johnson
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