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What is a Major Unusual Incident (MUI)?


An MUI is an incident that has a negative impact on the health and welfare of a consumer. It does not matter if the incident is actually seen, or only suspected or alleged. By law, if an employee hears about or suspects that an MUI has occurred it must be reported. Failure to report an MUI may result in criminal or civil liability.

THE FOLLOWING MUIs MUST BE REPORTED WHEREVER OR WHENEVER THEY OCCUR. A REPORT MUST BE FILED WHEN THE INCIDENT IS ALLEGED, SUSPECTED OR WITNESSED:

  • ABUSE:
    • Physical abuse: The use of force that could (but doesn’t have to) result in physical harm to the consumer
    • Sexual abuse: Unlawful sexual conduct or contact with a consumer, and unlawful acts such as public indecency or voyeurism directed toward a consumer, or soliciting sexual activity with a consumer who is a minor
    • Verbal abuse: The purposeful use of words , gestures , or other communicative means to threaten, force, intimidate, harass or humiliate consumer 
  • PROHIBITED SEXUAL RELATIONS: A DD employee or employee’s supervisor engaging in consensual sexual conduct or contact with a consumer who is not the employee’s spouse 
  • ATTEMPTED SUICIDE: A physical attempt by a consumer that results in emergency room treatment, in-patient observation, or hospital admission 
  • EXPLOITATION: The unlawful or improper act of using a consumer or a consumer’s resources for monetary or personal benefit, profit, or gain 
  • FAILURE TO REPORT: Failure of a person who is required to report an incident of abuse, neglect or misappropriation involving a consumer whose health and welfare can reasonably be expected to be substantially at risk 
  • LAW ENFORCEMENT: Any incident that results in a consumer being arrested, charged with a crime, or incarcerated 
  • MISAPPROPRIATION: Taking something of value from a consumer without his or her permission or knowledge, or against his or her will 
  • MISSING INDIVIDUAL: An incident in which a consumer’s whereabouts, after immediate measures are taken, are unknown and the consumer is believed to be at imminent risk or to pose a risk to others 
  • NEGLECT: Failing, when there is a duty to do so, to provide a consumer with treatment, care, goods, supervision o r services and the failure results in a reasonable risk of harm 
  • PEER-TO-PEER ACTS: Acts committed by one consumer against another including a physical act that is targeted at another consumer, is not random, and that results in injuries that require treatment by a physician, physician assistant, or nurse practitioner or even if not targeted, any head/neck injuries or attempted choking; sexual act as described above without consent; intentional misappropriation of money or property of at least $2 0 in value or significant sentimental value, and verbal acts, and exploitation as described above 
  • ACCIDENTAL OR SUSPICIOUS DEATH

THE FOLLOWING MUIs MUST BE REPORTED WHEN 1) THE INCIDENT OCCURS WHILE THE CONSUMER IS UNDER THE CARE OF OR RECEIVING SERVICES FROM A DD PROVIDER OR 2) I F THE CONSUMER LIVES IN AN ICF/IID OR RECEIVES 24 HOUR WAIVER SERVICES:
  • DEATH OTHER THAN ACCIDENTAL OR SUSPICIOUS
  • MEDICAL EMERGENCY: An incident requiring the use of emergency medical intervention to save the individual’s life such as choking relief techniques, CPR, etc. 
  • UNSCHEDULED HOSPITAL ADMISSION: Any unscheduled admission unless it is due to a condition specified in an ISP or nursing care plan which indicates the specific symptoms and criteria that require hospitalization 
  • SIGNIFICANT INJURY: An injury from a known or unknown cause , not considered abuse, that results in concussion, broken bone, dislocation, 2nd or 3rd degree burns, or that requires immobilization, casting, or 5 or more sutures 
  • UNAPPROVED BEHAVIOR SUPPORT: The use of any aversive strategy or intervention without approval by the human rights committee or behavior support committee or without informed consent that results in a likely risk to the consumer’s health and welfare
  • RIGHTS CODE VIOLATION: Any violation of the rights of a consumer which are enumerated in the Ohio Revised Code. The violation must create a reasonable risk of harm to the consumer’s health and welfare.


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Cuyahoga County Board of Developmental Disabilities
1275 Lakeside Avenue East
Cleveland, Ohio 44114-1129
PHONE: (216)241-8230 - FAX: (216)861-0253