REPORT OF CONTACT

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VA OFFICE
Buffal0, Neu York
lDEl{TlFlCATlOtt Nos. (CJC, SS, xss, V, K .rc.)
LAST NAI\IIE-FIRST NAME-I,|DDLE NAIIE OF YETERAII OW or piilt DATE Of CONTAGT
03/ os /2oL4
ADORESS OF VETEMN
IELEPHOiE NO.
(.|F
VElEtaF:l't (hE dc ir@ L'ode)
PERSON CONTACTED
Michele Brayley
TYPE OF COI{TACT (ctw*ow)
fleensoml f]
isumorue
ADORESS OF PERSOiI CONTACIED TELEPIIOT'E NO. OF PERSOI.I CONTACTED
(htchd. Ar.q L'odc)
PERSON WHO CONTACTEO YOU I YFt OF CO?{TAG I (clwk w)
flrrnsour- [
reuenoar
AODflESS OF PERSON WHO COI.ITACTED YOU TELEP}IOIIIE IVO. OF PERSON W.IO
CONIACTEO YOt (btclude ua de)
BRIEF STATEi{EM OF INFORMATION REQUESTED AtlD GltlEN (Cqtbw u
14e
2
ttwdal)
As f uaa settlng up my scopea for the day f nollced one of t,he Buction butE,ons had
dried fecal matter t/redged inside the neek of the button. The packaglng waa sealed, iE
came up from sterile proceseing that way. Michele Brayley rras ln t.he'endoscopy depb.
aE Ehe time, so I gave bhe button to her, aE Ehe is in Ehe infection control dept.
DMSION OA SECTION EXECUIEO BY
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