2. Suicide in an inpatient unit. 3. Retained instruments or other material after surgery requiring re-operation or further surgical procedure. 4. Intravascular gas embolism resulting in death or neurological damage. 5. Haemolytic transfusion reaction resulting from ABO blood group incompatibility. 6. Medication error resulting in death of a patient reasonably believed to be due to incorrect administration of drugs. 7. Maternal death associated with labour, birth and the puerperium. 8. Infant discharged to the family. 9. Other catastrophic event: incident severity rating 1 (ISR 1). Degree of impact: Harm death Harm permanent loss of functioning – – Harm permanent reduction in functioning Harm temporary loss of functioning – – Harm temporary reduction in functioning Harm but no loss/reduction in functioning – – Harm significantly inconvenienced No harm – Unknown Provide a de-identified summary of the event : [maximum 100 Did this event involve a transfer between agencies, campuses or health services? Yes No If this event will require a multi-agency review. ‘yes’, Describe any actions taken immediately following the event to eliminate the risk of recurrence:
2. Suicide in an inpatient unit. 3. Retained instruments or other material after surgery requiring re-operation or further surgical procedure. 4. Intravascular gas embolism resulting in death or neurological damage. 5. Haemolytic transfusion reaction resulting from ABO blood group incompatibility. 6. Medication error resulting in death of a patient reasonably believed to be due to incorrect administration of drugs. 7. Maternal death associated with labour, birth and the puerperium. 8. Infant discharged to the family. 9. Other catastrophic event: incident severity rating 1 (ISR 1). Degree of impact: Harm – death Harm – permanent loss of functioning Harm – permanent reduction in functioning Harm – temporary loss of functioning Harm – temporary reduction in functioning Harm – but no loss/reduction in functioning Harm – significantly inconvenienced No harm Unknown Provide a de-identified summary of the event : [maximum 100 Did this event involve a transfer between agencies, campuses or health services? Yes No If ‘yes’, this event will require a multi-agency review. Describe any actions taken immediately following the event to eliminate the risk of recurrence:
Sentinel%20event%20notification%20form%202018-19.docx