Helpdesk

Incidents

Incident Date & Time	Place of Incident	Person Effected
11-Sep-2025 11:12am	Kolkata, West bengal	Mohan Das
13-Sep-2025 10:09am	Kolkata, West bengal	Rahul Dutta

Incident Details

Date

19-09-2025

Time

11:40am

Place Of Incident

Kolkata, West Bengal

Person Effected

Staff

Employee ID

215487

Name of Person Effected

Mohan Das

Age

Gender

Male

Incident Contributing Factors

Patient Issue

Staff Issue

Communication Issue

Medication Issue

Event Description (Attach supporting documents)

Complete description of Incident (Include any objects, tools, chemicals, potential source of infection involved etc.)

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Witnessed By

Pritam Dutta

Reported By

Pritam Dutta

Department

Sales

Department

Sales

Time & Date

18-09-2025 10:12am

Time & Date

19-09-2025 11:40am

Root Cause Analysis By HOD/Incharge of The Department

Findings: (Incident summary, Sequence of events, Information reviewed, (EMR, SOP, Legal act, etc.), Specific findings, Casual statements)

Recommendations

Casual Statement	Recommendation	Accountability	Timeline	Remarks
-	-	-	-	-

Action Taken

Immidiate Corrective Action Preventive Action

Bedside Teaching

Attendance Sheet With Date

Regular Rounds By Supervisor

Supervisor Name

Use Of Checklist

Checklist Name

Others (In Details)

Name & Signature of Concern Dept. Head

Name & Signature of Quality Head