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pdfOMB Control Number 3041-0029
Appendix 83
BACK
/
TRAY
SEAT
LEGS
Page 1 of 8
.
Appendix 83
.
HAZARD
HIGH CHAIRS
Escape:
Where child frees
selffrom
chair
by struggling,
standing
up, pushing
on tray,
and falls.
w
R
E
Where child
reac es for something
from
chair,
loses balance
and causes
chair to fall.
Restraint-Release:
Where child
playing
or "escaping"
breaks or
releases
restraint
system
and
falls.
In
Lift-Out:
Where child,
geti:ino
Out ot chair or being removed;
catches
body part in chair,
causing
injury.
Chair or Component
Where chair breaks
with child
in it.
lz
Page 2 of a
Fails:
or collapses
Appendix 83
Describe
supervisor/supervision,
attentive/distracted
during
number and ages of
accident;
children
being watched
Child
(more/normal/less)
active
than usual at time of accident
Child
was
Diaper
through
eating,
bored
clean/dirty
Child able to balance/walk/lift,
up from seated
position
and
how well
stand;
High chair was
length of use
child's
or
other;
Child's/adult's
past experience
with this seat restraint
and
ways lock/fastener
released/
misassembled
Victim's
clothing
(describe)
thigh dimensions
(PHOTOWaist,
GRAPH with scale or tape measure)
Page 3 of 8
Appendix
83
@UODELllMES
HIGH CHAIRS
Body
part
contacted/injured-q
Compared
with others
of same age/size and weight
were
sex, victim's
more/less
than normal/normal
Any instructions
read and
chair,
provided
understood
wi.th
TtiFTASK
PHOTOGRAPH or DIAGRAM 5he fottowing four part sequence. In each
part show the victim's and
auperaisor's body, Zimb and hand
positions; high chair tocation,.
tray POsitiOn;
seat restraint
detail. Describe ACTIONS:
INTENDED
BY VICTIM
IMMEDIATELY------_4
BEFORE THE ACCIDENT
(.what victim
and supervisor
were trying
to do)
AT THE MOMENT
THE TASK COULD
BE COMPLETED
AS INTENDED
.
Page 4 of
8
NOT--q
Appendix
83
/
AT THE MOMENT
VICTIM
OR SUPERVISOR TOOK A NEW, PERHAPS
CORRECTIVE
ACTION,
BUT BEFORE THE INJURY
I--
AT
b-
Was
THE
MOMENT
tray
or
OF INJURY
seat
messy
or
slippery
I--
Measure
(if possible)
and describe
hand manipulation
and
force,
direction
required
to release
tray/restraint
system
Lift-out
lifter
Why
child
previously
performed
-
by
-I-
being
-
lifted
DIAGRAM
injured
body part/product_
part relationship
in detail
3
I
Page 5 of
8
Appendix 83
aJMm!JlNE~
HIGH CHAIRS
‘L!
THE ENVIRONMENT
PHOTOGRAPH
or DIAGRAM
with dimenSims
or SCale:'room
size; nearby
objects/tables/counter
top/
furniture;
high chair location
Any interference
other children)
chair imbalance,
(dogs/cats/
possibly
causing
collapse
Any loud noises
(lawnmower/TV/-----Q
masking
sound of child's
music...)
playing/struggling/standing...
before accident
-4 )_
- -4
I-
If victim reaching for, something-_%
(toy,bottle)
possibly
causing
accident,
describe
object and
where placed
I--
Floor
-
material
l-~~-~~nglcan
Victim
at
and
supervisor
home
Page 6 of 8
condition
--i
=-[
see ,-d
-4 b--I-
Appendix
83
THE PRODUCT_
Seat restraint
type/fasteners*
material;
was it in use/secure; )+
any home-made
modifications/
known to user; ease of fastening/
adjustment/release;
which
part
broke (PHOTOGRAPH
or DIAGRAM)
-
Tray-release
mechanism;
ease of+
operation;
in place/secure;
anything
causing
sticking
(food...)
(PHOTOGRAPH
or DIAGRAM)
High
chair
-4
weight
Was chair collapsible/
noncollapsible
Product
part causing
failure;
seat restraint;
collapsed/
broken
joints.. .(PHOTOGRAPH
or
DIAGRAM)
I
Page
7 of
8
Appendix 83
Glun~ELoNE~
HIGH CHAIRS
Product
part causing
injury
(PHOTOGRAPH
or DIAGRAM)
Completely
describe
high chair:.-4
material/
age, new/used;
condition
of seat; tray; legs;
back; arms, center
of gravity
(PHOTOGRAPH
or DIAGRAM,
dimension)
Page 8 of 8
Y
File Type | application/pdf |
File Title | Appendix 83 - High Chairs |
Subject | Investigation Guidelines for mishaps involving high chairs |
Author | EXHR |
File Modified | 2010-03-10 |
File Created | 1997-04-01 |