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REPORTING REQUIREMENTS TABLE

Reportable Injury/Condition / Required By / Who is required to report / What is reported / Report to whom / Time Frame for Reporting / Reference /
1. Occupational Injuries and Illnesses / Labor Code section 6409
Title 8 / Physician / See Doctor’s First Report of Occupational Injury or Illness form – Must be signed by MD / Employer’s Insurer / Within 5 days of the initial examination / Doctors First Report of Occupational Injury or Illness form
2. Pesticide Injuries and Illnesses
Pesticide poisoning or chemical exposure / Health & Safety Code 105200 / Physician / See Doctor’s First Report of Occupational Injury or Illness form / Local Health Officer / Phone within 24 hours and
Doctors First Report of Injury / Doctors First Report of Occupational Injury or Illness form
3. Incidents involving medical devices which are reasonably believed to have caused or contributed to the serious injury or death of a patient. / Safe Medical Devices Act of 1990
(21 U.S.C. section 360i(b) / Providers, facilities / See Medwatch Form / SHCS Safety Officer, who reports to FDA / Within 10 working days / See SHCS P&P 140-11 Medical Device, Biologics, and Vaccine Reporting for instructions
4. Adverse reactions to vaccines:
See Health Resources and Services Administration Vaccine Injury Table for list of reportable vaccines / Natl Childhood Vaccine Injury Act of 1986 (42 U.S.C. sections 300aa-1 to 300aa-34) / All providers / See Vaccine Adverse Event Reporting System form / FDA / See VAERS Website
5. Reportable Diseases
See Yolo County Health Department Website for list of reportable diseases. / Title 17, Calif Code of Regs section 2500
Health & Safety Code
Section 120250 / Person in Charge of Clinical Lab,
provider / Confidential Morbidity Report / Yolo County Health Dept. / Within one working day from the time the laboratory notifies the provider / Yolo County Health Dept Web Page:
6. Disorders characterized by Lapses of Consciousness
Age 14 or older who is diagnosed with disorder characterized by lapses of consciousness / Health & Safety Code section 103900
Title 17, Ca Code of Regs Section 2800 / Physician / Name of patient
Date of birth
Address
Diagnosis / Local Health Officer who reports to Dept. Motor Vehicles / Within 7 calendar days / See CDPH 110C Form
7. Reye Syndrome / Health & Safety Code 103925 / Physician / See CDC Reye Syndrome Case Investigation Report form / California Department of Public Health / Within 7 days of establishing diagnosis / CDPH Communicable Disease Control Forms
8. Animal Bites / California Department of Health Care Services / Provider / See Animal Bite or Scratch Reporting form / Local Health Officer & UCD Environmental Health & Safety / See SHCS P&P 140-09
Animal Bite or Scratch Reporting

Questions, reference CHA Consent Manual 12/2014