Incident analysis reporting responsibility

After Action Report A post-incident analysis report gathered by a responsible party or responding agency after termination of a hazardous materials incident, describing actions taken, materials involved, impacts and similar information. 

Several randomized trials have demonstrated that leuprolide and goserelin are effective agents when used alone in patients with advanced prostate cancer.19 Response rates around 80% have been reported, with a lower incidence of adverse effects compared with estrogens.19 There are no direct comparative trials of the currently available LHRH agonists or the dosage formulations, but a recent meta-analysis reported that there is no difference in efficacy or toxicity between leuprolide and goserelin. Therefore, the choice between the two usually is made based on cost and patient and physician preference for a dosing schedule. 

The reporting and analysis of all types of incidents is a responsibility of employees and management. The Health and Safety Department can assist in managing safety in several ways. These professionals have special training and expertise in the area of root cause analysis. Their services are very valuable in identifying potential hazards and contributing causes, which you may not recognize. 

In a retrospective cost analysis, the records of 527 patients with acute leukemia were studied (11). They had been treated in a multicenter, randomized trial for febrile neutropenia with ceftazidime and amikacin plus either teicoplanin (6 mg/kg in a single dose n — 275) or vancomycin (30 mg/kg/day in 2 doses n — 252). Qinical responses were equivalent. Again the higher acquisition costs for teicoplanin were counterbalanced by the lower incidence of adverse events and easier administration, resulting in overall similar costs for both regimens. A total of 8% of patients treated with vancomycin reported adverse events compared with 3.2% of patients treated with teicoplanin. Rashes occurred in 6.0 versus 1.4% respectively. Nephrotoxicity, ototoxicity, fever, and hypotension occurred in very few patients. 

The Navy should also take responsibility for transmitting information to larger national and, if developed, international data collection and analysis centers. In the United States, the Centers for Disease Control and Prevention is taking the lead for homeland security in this area, and it would be a logical referral site for analysis and further consultative help. As noted above, commercial cruise lines are mandated to report to the CDC when an incidence rate reaches 2 percent of the presumed at-risk population. Thus, the CDC would become the ultimate national registry of suspicious medical data for both the civilian and military communities. 

Immediate outcome—the adverse state the system reached immediately after the active failure. Examples are release of agent, plant damage, or personal injury. Reporting and investigation flow charts supplied by the Army indicate that the severity of outcome often determines the incident s prominence for managers, the workforce, or the community, which in turn drives subsequent responses. Incidents with more salient outcomes naturally receive more scrutiny, which may bias the data set used for analysis. 

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