Osler
Forms
Simulation Program Damage Report
Required fields are marked with asterisks (
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Full Name
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Phone Number
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I confirm I am Toronto Metropolitan University faculty:
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Yes
TMU Email Address:
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Name of damaged or malfunctioned equipment:
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Select malfunctioned equipment
Adult Difficult Airway Trainer
Adult CPR Task Trainer
Adult Intubation Trainer
Adult Tracheostomy Trainer
Adult Virtual Stethoscope
Advanced Patient Catheterization
AED
Arterial Arm Stick
Ascope
ASL 5000 Lung Simulator
Bed
Bladder Scanner
Braeden CPR training manikin with light
Clinical Chloe
Code Blue Cart
Defib Training Cables
Defibrillator
Difficult Airway Cart
Glidescope
Isolette
IV Pump
Mechanical Lift
Neonatal Intubation Trainer
NG Tube and Trach Care Trainer
Ostomy Care
Paediatric Airway Trainer
PB840 Ventilator
PB980 Ventilator
Radiant Warmer
Rapid Infuser
ResusciAnne Manikin
Sim Baby
Sim Junior
SimMan Classic
SimMan Essential with Bleeding
Sim NewB
Stretcher
Vein Finder
Video Bronchoscope and Tower
Vital Sign Machine
Other
Description of the damage or malfunction:
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Description of events at the time that the damage or malfunction occurred:
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Description of immediate action taken when the damage or malfunction occurred:
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Please provide any recommendations related to how this may have been prevented or how to rectify the issue:
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Submit