№ lp_2_1_22596
Official incident reporting form outlining required documentation, notification procedures, investigative findings, and regulatory compliance obligations for Emergency Medical Services Operational Programs under Maryland state regulations.
Organization: Maryland Institute for Emergency Medical Services Systems
Acronym: MIEMSS
Regulatory Framework: Title 30, Subtitle 03, Chapter 03 – Medical Direction
Legal Authority: Education Article §§ 13-509, 13-510, 13-516, Annotated Code of Maryland
Jurisdiction: Maryland
Document Type: Incident Report Form
Subject: Patient Care Quality Assurance and EMS Incident Reporting
Related Program: Emergency Medical Services Operational Programs (EMSOP)
Reporting Deadlines: Within 5 days and within 35 days of awareness of an incident
Recipients: MIEMSS Compliance Office; State EMS Medical Director
Applicable Roles: QA Officer; EMS Operational Program Medical Director; EMS Clinician
Includes: Incident classification; clinician identification; hospital involvement; disciplinary action notification; remediation plan
Communication Methods: Written submission; email; telephone notification
Regulatory Reference: COMAR Title 30.03.03.06D
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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