5.6 ACCIDENT AND INJURY REPORT Flashcards
Who submits accident and injury reports?
IDC
Hazard
work place condition that might result in injury, health impairment,
illness, disease, or death
hazard severity
assessment of the worst potential consequence is likely to occur
injury
condition of the body caused by external force
including stress or strain.
mishap
unplanned or unexpected event causing death, injury, occupational
illness, including days away from work, job
mishap probability
likelihood that a hazard will result in a mishap or loss
near mishap
event which injury or damage was avoided merely by chance
Web Enabled Safety System (WESS)
web-based safety mishap data collection and reporting system to Safety Center
DODI 6055.07
Mishap Notification, Investigation, Reporting and Record
Keeping.
OPNAVINST 5102.1E/MCO 5100.29C
Navy & Marine Corps Mishap and Safety
Investigation, Reporting and Record Keeping Manual
OPNAVINST 3750.6S
Naval Aviation Safety Management System
purpose of Mishap Investigation and Reporting
(1) To identify hazards with potential to cause frequent and severe mishaps.
(2) To identify hazards that could cause future mishaps.
(3) To identify unsafe acts and conditions and apply corrective measures.
(4) To identify mishap causal factors and develop appropriate corrective actions
Investigation and Reporting Required Conditions
(1) Class A, B and C government property damage mishaps.
(2) Class A, B, and C on-duty DoD civilian mishaps and military on/off-duty mishaps.
(3) Any other work-related illness or injury that involves medical treatment beyond first
aid.
Additional Investigation and Reporting Required Conditions pt 2
incidents of interest to the Navy and Marine Corps for mishap prevention
purposes.
-military fatalities within one hour of a command-sponsored Physical training (PT)
-result of a DoD activity, operation, or evolution that results in
the injury or death of a guest or military dependent.
Additional Investigation and Reporting Required Conditions pt 3
-on-duty military training-related fatalities, and any high or moderate risk training
mishaps that result in the: loss of 1 training day or roll back/disenrollment
-All explosive mishaps
-All on-duty diving cases
All afloat cases of grounding, collision, and flooding.
Additional Investigation and Reporting Required Conditions pt 4
-All fires occurring afloat
-All Government Motor Vehicle (GMV) or Government Vehicle Other (GVO) greater than $5K in damage or fatality
-medically diagnosed work-related illness and injury
-Significant Threshold Shift (STS) in hearing (10 db @ 2k,3k,4k hz)
Additional Investigation and Reporting Required Conditions pt 5
-work-related needle stick injury or cut from a sharp object
-Work-related tuberculosis infection
Class A mishap
-resulting total cost of damages 2 million or more
-aircraft is destroyed
-illness results in fatality
class b mishap
-total cost of damages is
$500,000 or more, but less than $2 million
-permanent partial disability
-three or more personnel are hospitalized single mishap
class c mishap
-property damages are $50,000 or more, but less than $500,000
-Nonfatal injury or illness results in 1 or more days away from work
class d mishap
-cost of property damages is $20,000 or more, but less than $50,000.
-injury or illness not otherwise classified as A B C
Accident and Injury Rep
Medical Department will submit an Accident/Injury Report as directed by
the Commanding Officer, on all injuries treated in sickbay. copy to safety officer
Safety Investigation Report (SIREP)
(a) Submitted to Commander, Naval Safety Center (COMNAVSAFECEN).
(b) Using Web-Enabled Safety System (WESS).
(c) Using WESS-DS via e-mail (if internet connectivity is a problem).
Hazard Report (HAZREP
Submitted for near-mishaps and situations where lessons learned should be
shared.
How is Safety Officer informed of mishap?
Through injury report, deck log entry or Department Head
Who is responsible for ensuring mishap investigation is conducted?
Safety Officer
Who appoints Mishap investigation board?
ISIC
Requirements for mishap investigation board?
(1) Minimum of 3 Member Team
(2) If fatality, a medical member may be appointed to the board.
(3) May be assisted by technical representatives or NAVSAFECEN.
(4) Encourage free and open disclosure during an investigation.
(5) Mishap Investigation Report (MIR) must be submitted within 30 days to the Safety Center.
Required Occupational Injury Recording Forms
(a) SF 600 (Chronological Record of Medical Care)
(b) ETR SF 558 (Emergency Treatment Record)
(c) SF 513 (Consultation)
(d) Accident Injury Report (SAMS Program or Local Form)
