TYNN32 playground equipment

INCIDENT INVESTIGATION ASSIGNMENT INSTRUCTIONS
Playground Equipment
DOCUMENT NUMBER:
DATE OF INCIDENT:

CATID: TYNN32 2020

FOLLOW-UP REQUESTED

HAZARD ANALYSIS

COMPLIANCE

PRIMARY CONTACT: Khalisa Phillips, ESHF, 301-987-2592, [email protected]
BACK-UP CONTACTS: James Tark, EPHA, 301-504-7707, [email protected]
Stephen Hopkins, CDI, 301-504-6883, [email protected]
ASSIGNMENT MESSAGE:

Information on deaths and severe injuries associated with home and public playground equipment should be
investigated. This information will be used in support of voluntary standards activities to address playground
hazards. In addition, deaths or serious injuries that occur in indoor "pay-for-play" settings, fast-food
restaurants, and plastic toy-like indoor/outdoor units for young children are of interest. Incidents involving
newer or unusual types of equipment, burns, entrapment, or strangulation are of particular concern.
Provide product description, including materials of construction, brand name, model; photograph product if
possible. Determine age of product, manufacturer, and place of purchase. Sketch the layout of equipment
indicating horizontal distances between structures and extent of surfacing in all directions.
Determine sequence/scenario 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, death certificate).
Determine if product characteristics, design features, or failures were a factor. Determine if spacing of
equipment or any protrusions played a role. If victim fell, determine fall distance and surface (type and
depth) landed on. If entrapment was involved, obtain dimensions of area of entrapment. If a burn was
involved, determine weather conditions at time of incident, shading (if applicable), and identify approximate
north direction on layout sketch. For head injuries, document point of impact, material contacted, and for
non-fall incidents, any external forces that may be a factor.
If a swing, determine composition (e.g., wood, metal, plastic, etc.) of swing seat, and whether victim was
alone or with others. If a fall from a slide, determine size of horizontal section at top of slide and height of
side walls. If an object that spins, determine speed (rotations/second).
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 39 - Playground Equipment
Task Number:
Assigned to:

CPSC FORM 324A

Date:
Processed by: lew