TYNN31 nursery equipment - B

INCIDENT INVESTIGATION ASSIGNMENT INSTRUCTIONS
Nursery Equipment (HN)
DOCUMENT NUMBER:
DATE OF INCIDENT:

CATID: TYNN31 2020

FOLLOW-UP REQUESTED

HAZARD ANALYSIS

COMPLIANCE

PRIMARY CONTACT: Hope Nesteruk, ESME, 301-987-2579, [email protected]
BACK-UP CONTACT: Celestine Kish, ESHF, 301-987-2547, [email protected]
ASSIGNMENT MESSAGE:

Contact Hope Nesteruk prior to beginning this IDI to determine whether samples are
needed and to learn any other specific instructions before starting this IDI.
Information on serious incidents involving nursery equipment is important in evaluating the need
for revisions to voluntary or mandatory standards for these products. All deaths and serious injuries
and entrapment (or possible entrapment) incidents to children associated with these products should
be investigated.
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Provide product description, including dimensions, brand name, model; photograph product
if possible.
Determine age of product, manufacturer, place of purchase, and wording of any labels on
product/packaging.
Determine scenario/sequence of events, treatment administered, and patient disposition. If
more than one person was involved, explain how others were involved.
Collect all official documentation (paramedics, police, and coroner reports, medical records,
and death certificate).
Determine if product failure or faulty product design was a factor.
Determine if spacing of equipment or any protrusions played a role.
If entrapment was involved, take dimension measurements. Re-enact the entrapment using
a doll or a stuffed animal.
If there are broken components, collect the parts and/or product as a sample.

Please include all primary and all backup contacts in the distribution of the completed IDI.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Area below will be completed in Data Systems _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Person(s) to Contact:
Guidelines: Appendix 35 - Structural Entrapment
Appendix 46 - Nursery Products
Task Number:
Assigned to:

CPSC FORM 324A

Date:
Processed by: lew