MIRF REPORT
Request:
Bumped head
Campus:
San Marcos/Escondido
Location/Building:
[68]
Date of Incident:
October 16, 2022
Time of Incident:
9:05 AM
Number of Patients for this Incident:
[75]
List Patient(s) Name, Age, Parent/Guardian (if under 18),… :
Avery Matzner
2 years old
Katie Matzner (mom)
661-644-4290
Describe Medical Event:
Avery slipped off chair and bumped her head on the table.
Actions Taken by Team Members:
[79]
Number of NCSM Team Members Involved:
[81]
List Name(s) of NCSM Team Members Involved:
Aaron Via (medical)
Steve Harvey (safety)
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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