More examples in Healthcare/Medical Examination Reports
Lightning Strike Medical Examination Example
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LIGHTNING NAME OF DECEDENT: This form is to be completed in addition to the ROD form in these guidelines THE DECEDENT WHEN STRUCK, WAS THE DECEDENT UNDERNEATH A SHELTER, IN A MOTOR VEHICLE OR BOAT,
IN THE WATER OR OUT OF WATER - DESCRIBE: WAS THE DECEDENT WEARING, HOLDING, OR STANDING NEAR METAL OBJECTS? WAS ANYONE ELSE INJURED IN THIS INCIDENT? ARE THERE ANY INDICATIONS ON THE CLOTHING (BURNS, ETC.) OF A LIGHTNING STRIKE? ARE THERE ANY MAGNETIZED METALLIC OBJECTS IN THE CLOTHING OR ON THE DECEDENT? IF
YES, DESCRIBE: ARE THERE ANY PATTERN BURNS FROM METALLIC OBJECTS?, SURFACE BURNS, LINEAR BURNS,
ARBORESCENT MARKINGS -- FEATHERING, OR ANY NOTICEABLE FRACTURES? IF YES, DESCRIBE: DOES THE DECEDENT EXHIBIT ANY WOUNDS OF ENTRY AND/OR EXIT (IF SO, DESCRIBE)? THE SCENE - DESCRIBE THE SCENE IN GENERAL: BE SURE TO SEND IN ALL CLOTHING WITH THE DECEDENT AT WHAT TIME OF DAY DID THE LIGHTNING STRIKE TAKE PLACE: WEATHER CONDITIONS: CLOUDY CLEAR RAIN WINDY OTHER: WAS IT RAINING AT THE TIME OF THE INCIDENT, AND IF SO, WAS IT RAINING? HARD MODERATE LIGHT SPRINKLING DRIZZLING FOGGY DESCRIBE THE ENVIRONMENT WHERE THE LIGHTNING STRUCK (EVIDENCE OF BURNING, SOIL
DAMPNESS, MAN -MADE ELECTRICAL STRUCTURES, ETC.) IS THERE ANY EVIDENCE OF DEAD ANIMALS IN THE AREA? NAME OF INVESTIGATOR DMI#
IN THE WATER OR OUT OF WATER - DESCRIBE: WAS THE DECEDENT WEARING, HOLDING, OR STANDING NEAR METAL OBJECTS? WAS ANYONE ELSE INJURED IN THIS INCIDENT? ARE THERE ANY INDICATIONS ON THE CLOTHING (BURNS, ETC.) OF A LIGHTNING STRIKE? ARE THERE ANY MAGNETIZED METALLIC OBJECTS IN THE CLOTHING OR ON THE DECEDENT? IF
YES, DESCRIBE: ARE THERE ANY PATTERN BURNS FROM METALLIC OBJECTS?, SURFACE BURNS, LINEAR BURNS,
ARBORESCENT MARKINGS -- FEATHERING, OR ANY NOTICEABLE FRACTURES? IF YES, DESCRIBE: DOES THE DECEDENT EXHIBIT ANY WOUNDS OF ENTRY AND/OR EXIT (IF SO, DESCRIBE)? THE SCENE - DESCRIBE THE SCENE IN GENERAL: BE SURE TO SEND IN ALL CLOTHING WITH THE DECEDENT AT WHAT TIME OF DAY DID THE LIGHTNING STRIKE TAKE PLACE: WEATHER CONDITIONS: CLOUDY CLEAR RAIN WINDY OTHER: WAS IT RAINING AT THE TIME OF THE INCIDENT, AND IF SO, WAS IT RAINING? HARD MODERATE LIGHT SPRINKLING DRIZZLING FOGGY DESCRIBE THE ENVIRONMENT WHERE THE LIGHTNING STRUCK (EVIDENCE OF BURNING, SOIL
DAMPNESS, MAN -MADE ELECTRICAL STRUCTURES, ETC.) IS THERE ANY EVIDENCE OF DEAD ANIMALS IN THE AREA? NAME OF INVESTIGATOR DMI#