Adverse Event Report — Employee Safety

Branch where the event occurred *
BayrampaşaİdealtepeBursa

Type of event *
Near-miss eventActual event

Unit / location where the event occurred *

Role of the employee involved *

Outcome of the event *
Event occurred and resulted in temporary disability/illnessEvent occurred and resulted in permanent disability/illnessEvent occurred and resulted in deathEvent occurred but caused no harmEvent did not occur, but a hazardous condition/behaviour exists (preventive-action error report)

Duration of exposure *
Acute (instantaneous) exposureOngoing chronic exposure — less than one monthOngoing chronic exposure — between one month and one yearOngoing chronic exposure — longer than one yearDiscontinued chronic exposure — less than one monthDiscontinued chronic exposure — between one month and one yearDiscontinued chronic exposure — longer than one year

Time the event occurred / began *
00:00-04:0004:01-08:0008:01-12:0012:01-16:0016:01-20:0020:01-23:59

Date of the event *

Have you reported this to the Ministry of Health notification system? *
ReportedNot reported

Work Accident Report *
InitiatedNot initiated

White Code Process *
InitiatedNot initiated

Describe the adverse event *

Any comments or suggestions (optional)