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Share your case histories with us!
Information to create a case history is obtained from a complete incident investigation report and/or injury report. Sharing case histories helps everyone learn from the event. Not communicating the facts and sharing the scenarios to learn from them can make the incident even more tragic. Sharing this type of information contributes to preventing injuries and can save lives.

ELECTRICAL INCIDENT CASE HISTORY FORM
 
INCIDENT: (this section describes the scenario and includes who, what, where without revealing personal identification)

 

RESULTING OR POTENTIAL INJURY: (this section describes the extent of injury or what the potential injury could have been)

 

BACKGROUND INFORMATION: (this section includes information to help clarify any element of the incident such as environment, procedure compliance, contributing factors, other circumstances, repeat problem, etc.)

 

LESSONS LEARNED: (this section summarizes conclusions about the incident and corrective actions taken to prevent similar incidents in the future)

 


 
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