BUNN12 mattress bedding fire incidents

BUNN12 mattress bedding fire incidents.pdf

National Electronic Injury Surveillance System (NEISS) and Follow-up Activities for Product Related Injuries

BUNN12 mattress bedding fire incidents

OMB: 3041-0029

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INCIDENT INVESTIGATION ASSIGNMENT INSTRUCTIONS
Mattresses and Bedding Fire Incidents
DOCUMENT NUMBER:
DATE OF INCIDENT:

CATID: BUNN12 2020

FOLLOW-UP REQUESTED

HAZARD ANALYSIS

COMPLIANCE

PRIMARY CONTACT: David Miller, EPHA, 301-504-7323, dmiller@cpsc.gov
BACK-UP CONTACT: Justin Jirgl, CRE, 301-504-7814, jjirgl@cpsc.gov
ASSIGNMENT MESSAGE:

Conduct an investigation of the attached mattress/bedding fire incident using Appendix 15,
revised December 2014.
If possible, determine whether the mattress was a pre- or post-open flame standard mattress. No
separate narrative report is necessary, per Appendix 15.
Also complete the data record sheet found in Appendix 129 on the presence and operation of
smoke alarms, sprinklers, and fire extinguishers, or indicate that none of these products were
present.
Please include all primary and all backup contacts in the distribution of the completed IDI.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Area below will be completed in Data Systems _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Person(s) to Contact:
Guidelines: Appendix 15
Appendix 129
Task Number:
Assigned to:

CPSC FORM 324A

Date:
Processed by: lew


File Typeapplication/pdf
File TitleACCIDENT INVESTIGATION REQUEST FORM
AuthorPreferred Customer
File Modified2019-09-06
File Created2019-09-06

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