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pdfINCIDENT INVESTIGATION ASSIGNMENT INSTRUCTIONS
Window Covering Incidents
DOCUMENT NUMBER:
DATE OF INCIDENT:
CATID: TYNN45 2020
FOLLOW-UP REQUESTED
HAZARD ANALYSIS
COMPLIANCE
PRIMARY CONTACT: Christopher Nguyen, 301-504-7871, [email protected]
BACK-UP CONTACT: Rana Balci-Sinha, ESHF, 301-987-2584, [email protected]
ASSIGNMENT MESSAGE:
Contact Christopher Nguyen prior to beginning the investigation to determine whether a sample needs to be
collected and whether the IDI can be done as a telephone investigation. Unless otherwise indicated, this IDI
should be conducted as an on-site investigation.
Please investigate the attached incident involving a window covering cord.
Document incident scenario. Using a doll or stuffed animal, photograph a re-enactment of how the child was found
entangled in the cord. Also, identify the type of window covering (e.g., mini-blind, Roman shade, roll-up, vertical).
Photograph window covering, any labels on the window covering including warning labels, and any safety features
including cord stops (donut shaped plastic devices found at the top of the pull cord) to prevent inner cord
strangulation or tie-down devices found on the looped cord or cord cleat type of devices that may be installed on the
wall. Please photograph all labeling inside the head rail. Determine if the cord was a pull cord, inner cord, tilt cord,
lift cord, or a continuous loop.
Obtain all official records including police, medical and coroner’s report where applicable.
If possible determine date of purchase, verified by receipt if available. Provide complete product identification,
including manufacturer, brand, date manufactured, place and date of purchase, model/serial numbers, cost,
etc. Manufacturer identification can sometimes be found in the head rail.
Please complete the following in response to this IDI Request:
1.
Complete all fields of the window covering cord investigation worksheet in App. 136.
2.
Photograph re-enactment of how the child was found entangled in the cord (if applicable)
3.
Please take and/or collect multiple photos of the window covering and the operating system(make sure thay
pictures are clear and shows in detail the operating system for each involved product).
4.
Obtain medical records
5.
Collect sample(if consumer retained legal counsel, try to obtain sample, or at a minimum, collect photos of
incident product from counsel)
6.
Collect the following within IDI:
a.
incident date
b.
consumer name
c.
city/state of incident
d.
product type (horizontal, vertical, blinds, shades, etc.)
e.
product name
CPSC FORM 324A
f.
brand name
g.
model name
h.
model number
i.
date of manufacture
j.
slat size(1 inch, 2 inch, etc.), if applicable
k.
material window covering is made of (faux wood, vinyl, etc.)
l.
cord configuration (standard operating cords, continuous loop/bead chains)
m. number of cords on product
n.
injury type
o.
narrative of events as occurred for each specific incident
p.
window covering measurements/dimensions
q.
window cord measurements (do not undo knotted/tangled cords)
7.
Police reports (if applicable)
8.
Death records (if applicable)
9.
Any other official records/relevant documents (including, but not limited to, legal proceedings,
correspondence with the relevant firm, and reports from other state agencies or emergency personnel)
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:
Task Number:
Assigned to:
CPSC FORM 324A
Appendix 136 – Window Covering Cords, revised August 2015
Date:
Processed by: lew
File Type | application/pdf |
File Title | ACCIDENT INVESTIGATION REQUEST FORM |
Author | John R. Murphy |
File Modified | 2019-09-13 |
File Created | 2019-09-13 |