TheMedical Centre

1. The Medical Centre The Medical Centre is situated in Burnaby Road, close to the Upper School main entrance and is open Monday to Saturday from 08.15 – 17.30 during term time only.

The Medical Centre is staffed by a team of fully qualified nurses:

Johanne Powell Senior School Nurse Manager RGN Full time Minor Illness / Minor Injury / Nurse Prescriber Practitioner

Ines Tanna School Nurse RGN Part time Zoe Garbould School Nurse RSCN Part time Rachel Smith School Nurse RGN / Part time Minor Illness Nurse Part time

The Medical Centre nurses can be contacted as follows:

Telephone: 01234 362261 Mobile: 07850 596803 Email: nurse@bedfordschool.org.uk

The Nurse Manager can be contacted directly by email: jpowell@bedfordschool.org.uk

The Line manager for all medical matters is the School Medical Officer and for all other matters, the Bursar. Support is provided as follows:

• Clerical Support - Bursary Administrator

• Transport to Hospital - Administration Office

The nurses are fully trained in advanced life saving skills, attend annual updates and are able to administer the following drugs within their professional competence level:

Glucagon Glucose Sachets Ventolin Entonox Oxygen

2. The role of The Medical CentreThe Medical Centre provides support and care for pupils, staff and visitors of Bedford School. This does not include outside contractors working on site.

It is a manned drop in facility and the nurses on duty are not expected to attend at other locations on the school estate to provide medical advice or treatment except if pre-arranged or in an emergency situation. Where this arises, the nurse will use her discretion after assessing the conflicting need to man the medical centre, especially if there are patients in her care, and the nature of the emergency.

Nurses role:

• Assessing pupils with minor illness and minor injuries, recognizing the appropriate treatments and referring pupils onto relevant pathways if required.

• Dispensing and ordering of OTC medications.

• Health Screening of all new pupils and pupils in year 8 before their transition into Upper School.

• Ongoing treatments for boys with chronic medical problems, but only under clear guidance from boys GP or consultant and with an up to date care plan in place.

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• Follow up treatments as required, this would include dressing / wound care.

• Advise boys and staff on health related problems when necessary.

• Referral of boys to the SMO (boarders only), counsellor or hospital as necessary.

• Maintain first aid facilities throughout the school and arrange first aid training for staff.

• Implement vaccinations in accordance with NHS Schools Vaccination Program, with consent from parents.

• Medicine control for boarding houses.

• Support boarding house staff in all medical matters and ongoing training.

• Flu vaccinations for boarders.

• House visits for boarders who are unwell.

• Providing ongoing Health Promotion advise to pupils and staff.

• Removal of clips / sutures following surgical procedure.

• Assist Vice Master in drug testing, carried out in the medical centre in accordance with Bedford School Drug Policy.

Parents are encouraged to contact the nurses if they have any concerns with regard to the medical / mental health of their son. We ask that parents update us on any recent changes to his medical questionnaire regarding medical history / allergies / medications and vaccination history. The nurses are always happy to answer any questions with regard to your son’s health and wellbeing or to offer support with ongoing issues.

The medical centre staff are able to treat a wide range of illnesses and the centre is fully equipped to care for day boys, in the short term, who are taken ill at school until parents / house staff are able to collect or arrangements can be made for collection.

Medical staff are able to offer advice on a number of issues which include:

• A variety of chronic illnesses.

• Travel vaccinations.

• Eating disorders.

• Sexual health.

• Minor injury.

• Minor illness.

• Smoking cessation.

All pupils are welcome to visit the medical centre where our friendly team of nurses are happy to offer a high standard of individual care, including counselling and health & wellbeing education. Wherever possible, pupils are encouraged to visit during break times for all routine health advice and non-urgent treatments.

We work closely with tutors and house staff to ensure that pupils are monitored closely and that issues of concern are dealt with efficiently. We encourage involvement with parents and advise all pupils to discuss any health issues / concerns at home, wherever possible.

We encourage boys with emotional issues to come and visit the nurses, where they will be offered support and time to rest and reflect, in a quiet and safe environment. The nursing staff work closely with the school counsellor.

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3. The role of the School Medical Officer (SMO)All boarders are registered with The De Parys Medical Centre. The role of the SMO is laid down in his contract with the school. In summary this covers the following areas:

• To provide general medical advice to the school when requested and on matters identified by the school. The SMO is responsible only for matters on which he has been asked to give his advice.

• To visit the school whenever reasonably requested to do so by the Head Master, The Bursar or the School Nurse on duty. Specifically, the SMO undertakes to make regular liaison visits to the school medical centre, in particular for an hour long session every Monday and Friday morning during term time. He arranges for himself, or one of the partners in the practice, to be on immediate call at all times when the school medical centre is open Monday to Saturday, 08.15 – 17.30.

• To arrange adequate on-call cover, with minimum delay, to deal with injured players whether from school or visiting schools, during Saturday afternoons of the Autumn and Spring terms.

• To conduct routine medical examinations of new boarders.

• To study medical questionnaires, identify problems and call up boys where there are problems.

• To see boarders at GP off site premises and school medical centre as required.

• To make available at his own expense a deputy from the partners in his practice to act for him in cases where he is prevented from acting in person by illness or unavoidable absence.

• To be and to remain throughout the tenure of this Contract of service a member of the Medical Defence Union Limited or other Medical Protection Society.

• Boarders can book appointments either off site at De Parys Surgery or in the Medical Centre, where a GP holds a one hour clinic, twice weekly. Appointments are booked through the nursing team or this service.

4. Medical questionnaires Parents are requested to complete and return a medical questionnaire for their son, which includes recent medical conditions and allergies and the date of your son’s last tetanus vaccination (full vaccination history is required for boarders). It is important for the safe care of your son that this document is completed and returned prior to your son starting at Bedford School.

The senior nurse will contact you prior to your son’s start date if more information is required and will discuss any medical issues with the SMO.

If your son has a relevant medical condition or allergy it is vital that the school medical centre are informed of any updates. This information will be recorded on your child’s electronic notes alerting staff to a known medical condition / allergy.

If the medical centre is not in possession of a medical questionnaire, this may delay the correct and safe treatment being given to your son.

The original completed medical questionnaires are kept securely in the medical centre. For boarders a copy is taken and kept securely in their boarding house.

In order to implement the above policy, the school will not normally admit any pupil unless a completed medical questionnaire is available, though the Head Master retains the right to waive the rule in certain circumstances.

It is the parent’s responsibility to inform the medical centre of any changes to these records.

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5. RecordsThe medical centre will keep an accurate written record of all consultations. These will be stored securely in accordance with the guidelines set down by the Nursing Midwifery Council. All visits are recorded in the desk diary.

All records of past pupils, including child visitors, will be stored securely and shredded following their 25th birthday.

Adult records are kept and discarded after 10 years.

6. ConfidentialityIn accordance with the SMO and nurse’s professional obligations, medical information about pupils, regardless of age, will remain confidential. However, in providing medical care for our pupils it is recognized that on occasions the medical staff may liaise with tutors and house staff, parents / guardians and the Head Master with the pupils consent. With all medical matters, the nurse and doctor will respect a pupils confidence except on the rare occasion when having failed to persuade the pupil to give consent to divulge, the doctor or nurse considers that it is in the pupil’s best interests or necessary for the protection of the wider school community, to breach confidentiality and pass information to a relevant person.

As far as is practicable within the rules of confidentiality, the SMO and the nurses will keep a boy’s house master or tutor informed of any medical factors which might be helpful to them when carrying out their pastoral role and in relation to a boys conduct and performance. When appropriate, they will inform the Head Master of any serious medical condition of which the school should be aware.

• Housemasters and tutors must keep the medical centre informed of a boy’s medical condition or personal situation to help ensure that treatment given is always the most effective in the circumstances. In serious cases, the housemaster, tutor and senior nurse should physically meet to discuss the case.

• Where a boy is to be admitted to the school who suffers from a chronic medical condition the medical centre should be informed in advance. When appropriate, the SMO or senior nurse will advise the Head Master of any implications for the school. This will enable the school to make any special arrangements thought necessary.

7. Procedure for boys taken ill at school or boys who are sent to school unwell Prep School Pupils sent to school unwell will be advised initially to report to Wells reception staff, who will call the medical centre staff to advise that the pupil is being sent to the medical centre or that parents / boarding staff are being contacted. If a pupil becomes unwell during the school day he will initially be sent to Wells reception to be assessed. If after a rest period he continues to feel unwell, reception staff will contact the medical centre. The Pupil will either be escorted to the medical centre by a staff member or another pupil or if able, collected by a member of the nursing team. If the nurse feels he is unable to return to school then parents / boarding staff will be contacted to arrange for collection within a reasonable time. All pupils seen and treated in the medical centre and returned to school will be given a note to give to parents at the end of school informing them of their son’s visit and any treatment administered and follow up advice. Boarding staff will be informed of any treatments / follow up advice given to a boarding pupil. On occasions, the nurses will contact parents if they need to discuss their son’s symptoms further before returning to school. For all minor illnesses / injuries and for injuries that have occurred outside school, staff will encourage them to come to reception during break times.

Day pupils not collected by 17.15 will be taken to Eagle House and their parents will be notified.

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Upper School Pupils are encouraged, wherever possible, to visit the medical centre during break times. If, however, they become unwell in class they are requested to inform the teaching staff who will give permission to leave the lesson. If the medical centre is unattended, a notice on the door will inform them to go to the Bell Room where staff will contact the nurse. No pupil will be allowed to go home without the nurse gaining consent from a parent or boarding staff if a boarder. On occasions the nurses will contact parents / boarding house staff if they need to discuss their symptoms further before returning to school. If a pupil needs to be collected by parents / boarding house staff, they will be contacted by medical centre staff and asked to collect in a reasonable time.

Pupils not collected by 17.15 will be taken to Burnaby House and their parents will be notified.

8. Procedures for day boys sustaining an injury during the school day in whole school Significant ‘knocks to the head’ must be seen and assessed in the medical centre and head injury advice and instructions to parents / boarding house staff must be given by the nurse along with advice for any follow up care. The nurse will advise if the boy can travel on the school bus if applicable. An off games slip will be issued to the boy if it is felt he should not participate in sport.

If diagnosed as concussion the pupil will be assessed as per the Concussion / Head Injury protocol.

All minor injuries which require treatment must be seen in the medical centre. The nurse will assess and treat accordingly. Appropriate information and advice will be given to pupil and parents / boarding staff if necessary. If a pupil needs to be seen in A&E, parents / boarding staff will be informed and if able, will collect and take them to A&E. If a parent is unavailable, a member of staff will take the boy to A&E and stay with them until the parent / boarding staff is able to attend. For boarders, house staff will be informed.

In the case of major injury staff are advised not to move the pupil and to contact a nurse. If deemed life threatening to contact 999 for the emergency ambulance and to send for nearest AED appliance which are located as follows:

• Main School - on the wall between the photocopy room and monitors’ room

• Rec Centre - on the wall in the front main entrance

• Prep School - on the wall beside the kitchen in the entrance of the EMH

• Theatre - on the wall in the foyer

9. Off games / rehabAny pupil requesting to be off games without prior written arrangement from the parent / boarding staff to the school must be seen by nursing staff and if deemed necessary, parents / boarding staff will be contacted. Rehab is for long term off games to encourage continued fitness levels or for shorter term injuries to encourage repair following the acute phase. Pupils are asked to see nursing staff who will assess their injury and parents may be contacted for more information if required. If a pupil is undergoing treatment with an outside physio, pupils are encouraged to bring written evidence of treatment to ensure that sessions are comparable with the treatment they are receiving. These sessions are very popular and often no spaces are available immediately. The pupil will be added to a waiting list and will be emailed when a space becomes available. Rehab staff are responsible for the treatment and discharge of the pupil and will notify the medical centre when a pupil has been discharged.

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10. Sport therapy sessionsSports therapists from Julie Dass The Stables Sport Injury Clinic offer ½ hour sessions on Bedford School site for all pupils. These sessions are booked directly online www.juliedass.com and payments are made directly.

11. Medications, non-prescription medication The medical centre holds a stock of non-prescription medicines and at the discretion of the school nurse, medication will only be administered if the following criteria have been met:

1. Written consent from parents has been given to administer medication.

2. A medical questionnaire, completed and signed by a parent, is in her possession.

3. She is aware of existing medical conditions and allergies.

4. She has treated the boy before and therefore has discussed medication with a parent.

5. She checks whether the boy is taking, or has taken, any other medication.

MEDICATION KEPT AND DISPENSED IN THE MEDICAL CENTRE

Paracetamol 500mg

Soluble Paracetamol 500 mg

Calpol 6+ For under 12s

Ibuprofen 200 mg

Ibuprofen suspension 100 mg/5 ml

Ibuprofen Gel

Gaviscon Liquid / Tablets

Imodium (Loperamide 2 mg)

Dioralyte

Bongela

Strepsils / Strepsils Extra

Lemsip Cold Relief

Simple Linctus

Sudafed Tablets

Loritadine 10mg

Cetirizine 10mg

Piriton Tablets / Syrup

Hydrocortisone 1% cream

Optrex Eyewash

Parents are asked to inform the medical centre if they have administered any medications prior to the start of the school day by email, nurse@bedfordschool.org.uk.

Pupils must NOT bring medication or drugs into school for their personal use unless prescribed by a doctor. Parents are strongly advised that all OTC medications are administered from the medical centre.

12. Short term prescribed medication, i.e. antibiotics The nursing staff will not accept medicines that have been taken out of the original container as dispensed or make changes to dose on parental instructions. The nurses are happy to administer medicines prescribed to boys by their GP which require a school time dose. The prescribed medication must be brought to the medical centre at the start of the school day for safe keeping and administration. The medicine must be in the original container displaying clear instructions, including name of the pupil and the dose required. The school does not allow pupils to carry these medicines. Please inform nursing staff by email, nurse@bedfordschool.org.uk, with regard to the reason for the short term use of prescription medication and consent to administer the required dose.

The medical centre is the appropriate place to administer such medications, however, it is recognized in the case of Prep School pupils that it is more convenient for medicines to be held in a secure place and refrigerated, if required, by the school secretary. All medication must be in the appropriate box, with the pupil’s name clearly visible, accompanied by a note from the parent and will

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be recorded as given specifying;

1. Name of Boy 2. Date and time given 3. Medication and dose given

The Medical centre will be informed of medication given in the Prep School. Boarders requiring a lunch time will return to their house and Matron will administer.

13. Medicines prescribed to boys with chronic medical conditions These can only be given under the guidance of the boy’s GP or hospital consultant. A letter from parents or the medical advisor should be sent to the school nurse giving clear instructions as to the method of administration and to the dosage. Parents / boarding house staff will inform the medical centre in writing by email, nurse@bedfordschool.org.uk. If the medical staff have not received required documentation this may delay the administration of such medication in school. Your son may require a health care plan, if this is required a nurse will contact you.

Inhalers for Asthma These are safe and easy to use. They should be clearly labelled with the pupil’s name and kept with him at all times. Parents / boarding house staff are responsible for ensuring and reminding their son / pupil to carry his inhaler with him at all times and that it is in date. The school now holds an emergency stock of salbutamol reliever inhalers which will be administered in an emergency for boys who are registered as asthmatic and for whatever reason have not got their own inhaler with them. The school ask that all pupils diagnosed with asthma complete an asthma action plan, this will be sent out electronically to all parents. On return this action plan will be stored electronically in your sons ISAM account. This information will be used by teachers and staff to ensure the most appropriate action will be delivered in an emergency.

Epipens The school should have access to two Epipens on school site, as recommended by anaphylaxis campaign and Addenbrooks Hospital Allergy Department.

Upper School pupils must carry their own Epipen with them at all times and a spare Epipen must be kept in the medical centre. They must ensure that they take Epipens with them off site at all times. Periodically, the nurses will check with Epipen users in the Upper School that they are carrying their Epipen with them and will email when expiry dates are close. It is boys and parents responsibility to ensure that epipens are replaced promptly. If staff do not have access to 2 in date epipens, the Head Master will be informed and this may restrict off site activity as boys safety cannot be assured.

Prep School pupils will be allocated a yellow carry bag which will store two Epipens and antihistamine medication and any other medication as included on their health care plan. These bags are kept in the PA to Headmaster Prep School office. All staff are aware that these bags should be signed out if a pupil is going off site and signed in when he returns.

Please ensure Epipens are brought to the medical centre at the beginning of term to be distributed to the designated area. The nurse will contact parents prior to expiry dates for replacements – we ask parents to please ensure these are replaced promptly for the safety of your child.

The school nurse will meet with all boys with Epipens during their first week of starting school and there after annually.

A photo board of pupils with life threatening allergies / medical conditions is distributed electronically to all staff. School staff are encouraged to attend Epipen training annually; this is delivered by the school nurse.

It is important that all pupils take their emergency medications (Epipens, inhalers, diabetic emergency medication) with them for all off site activities. This is a shared responsibility between pupil, parent and teacher. Parents are advised to stress to their child the importance of taking responsibility for their medical needs.

Boys who carry epipens must ensure they take 2 epipens off site with them at all times. Prep school – if your son has been allocated a specific medical bag this will be collected by staff in charge of trip / off site activity and will ensure they are returned at the end of trip / activity.

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Medical centre will include relevant medications for trips as requested by staff. The staff member will be responsible for these items throughout the trip and for their safe return.

The school give clear instructions on the administration of emergency medication and any staff not willing to administer such medications are asked to discuss and alert the Headmaster, to ensure that such medication is able to be administered efficiently and correctly especially during off site events, by a trained member of staff.

Parents will be informed if some child missuses their medication, and appropriate disciplinary procedures will be followed.

The school have clear guidance to staff on the storage of medication during school and on offsite events as outlined in school medicine policy.

Sharps boxes are kept in school medical centre.

14. Controlled drugs These are drugs which are included in the schedule of the Misuse of Drugs Regulations and therefore have to be stored and administered in a certain way. They will be administered by the nursing team or boarding house staff who have completed medicine administration training.

Any boy who has been prescribed a controlled drug will be under the supervision of a specialist medical doctor. The parents must contact the medical centre by email, nurse@bedfordschool.org.uk, giving clear written instructions as to why the drug has been prescribed and the dose and time the medication is to be given.

• These drugs must be securely locked within a locked cabinet. The key is to be kept in a safe place known only by nursing staff or appropriately trained boarding staff.

• Each tablet has to be accounted for and signed for by two members of staff.

• The drug must be kept in the original prescribed container.

• Starting quantity of drugs must be recorded in a controlled drug book within the cabinet.

• Pupils are not allowed to carry such medication on them.

For Parents of Boarders a copy of the School Boarding Medicine Policy is available from Housemaster.

15. Immunisations Bedford School support the National Child Health School Vaccination Programme and pupils are offered boosters of Diphtheria Tetanus and Polio and Meningitis ACWY in remove year. All such vaccinations are given following a returned consent form signed by the parent / guardian. BCG is not given routinely throughout Bedfordshire. Testing and vaccination is offered only to boarders who have arrived from an endemic country. Parents will be notified by Bedford TB Nursing Services for consent where a pupil is identified as fulfilling the policy criteria. Boarders are offered an annual vaccination against seasonal influenza. Advice for Travel Vaccinations can be given by medical centre staff, but vaccinations are not administered on site.

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16. Out of hours Dr on call (boarding staff only) Bedford On Call is a group of Bedfordshire GP’s and Nurse Practitioners, who provide urgent care to patients outside of normal surgery hours. This service can be contacted by boarding staff by ringing 111 or De Parys Avenue Surgery. The service operates Monday to Thursday from 18.30 – 08.00 and Friday 18.30 – Monday 08.00hrs. If the problem is deemed urgent or life threatening they will summon an emergency ambulance. For all other enquiries a GP / NP will return the call and will conduct a telephone triage, with 4 available pathways.

There are 4 routes of care:

1. Advice will be given over the phone with self-care instructions.

2. A centre appointment will be issued, Bedoc Centre South Wing Bedford Hospital.

3. A Dr will visit.

4. An emergency ambulance will be called if deemed to be life threatening.

17. Medical conditions and care protocols Bedford School recognizes the importance of all children with medical conditions to be able to fully participate in school life. This includes off site events and residential school trips within a safe environment where staff are aware and equipped to recognize, support and deal with routine and emergency needs of the child, ensuring they are able to achieve their full potential. All staff have access to medical information, care protocols and are encouraged to check this information regularly.

All staff are encouraged to attend regular first aid updates and have access to medical condition protocols document to enable staff to feel confident in knowing what is expected of them in the event of a lifesaving emergency

The school understands that not all children with the same medical condition will have the same needs and each child will be treated individually to their requirements as written into their individual Health Care Plan.

The school give clear instructions on the administration of emergency medication and any staff not willing to administer such medications are asked to discuss and alert the Head Master to ensure that such medication is able to be administered efficiently and correctly, especially during off site events, by a trained member of staff.

Boarders with Medical conditions will be assessed individually of their needs and requirements to ensure safety of themselves and boarding staff.

Parents are asked to immediately inform the school medical centre or boarding staff if the needs of their child changes.

18. Health Care Plan (HCP) protocol

An individual Health Care Plan (HCP) is developed for pupils attending Bedford School who have specific medical needs. The HCP will enable the school to have further access to the pupil’s individual medical requirements, as routine and in the event of a medical emergency. A HCP gives clear instructions regarding potential health problems that can occur in a school environment. The nursing staff at Bedford School develop plans to aid staff in the delivery of care and administration of medicines in emergency medical situations, ensuring a safe environment for the pupils of Bedford School to learn. The medical staff work closely with the individual and parents to recognize their health needs and to deliver safe care.

The main purpose of an HCP is to identify the level of support that is needed. An HCP clarifies for staff, parents and the pupil the help that can be provided and is necessary. Medical staff and parents review the care plan at least once a year, depending on the nature of the child’s needs. The nursing staff ask parents to update the medical centre of any changes in their son’s medical needs and treatments and the importance of such information being passed on.

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Not all children with medical needs will require an HCP. Current HCP in place:

• Boys who carry an Epipen.

• Boys with a common medical condition ie Diabetes.

• Boys with a less common medical condition.

• Boys requiring on going medical treatment i.e. Growth Hormone Medication, ADHD medication.

The HCP is stored electronically on the pupils ISAMS account; Parents are emailed a copy with a covering letter. We ask Parents of Day Pupils to read through with their child and to contact the medical centre staff if they have any questions.

Individual Boarding houses will have a copy of the emergency care plan of their boarders

The care plan for Epipen Prep School pupils is also kept in their individual epipen yellow bag

Upper school pupils Epipen care plans are within their medical boxes, kept in Medical Centre

Zoe Garbould ensures that HCP’s are in place and are up dated and will liaise with both staff, parents and pupils

Parents who feel their child should have a HCP and would like to discuss this are advised to contact Zoe Garbould on zgarbould@bedfordschool.org.uk.

FORWARD PLANNING

The School is a member of The Anaphylaxis Campaign, Asthma UK and Diabetes UK and receive regular updates and information.

This policy is reviewed on an annual basis.

REFERENCES

• Anaphylaxis and schools - How we can make it work The Anaphylaxis Campaign

• “Supporting Pupils with Medical Needs” (DfEE circular 14/96)

• Food Allergies - Tanya Wright

USEFUL LINKS

• www.patient.co.uk

• www.nhs.uk/Conditions/vaccinations/Pages/vaccination-schedule-age-checklist.aspx

• www.anaphylaxis.org.uk

• www.asthma.org.uk

• www.diabetes.org.uk

• www.studentsagainstdepression.org

TO BE REVIEWED January 2017

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Bedford School, De Parys Avenue, Bedford MK40 2TU

Tel:+44 (0)1234 362216

Email: admissions@bedfordschool.org.uk

www.bedfordschool.org.uk

Bedford School is part of The Harpur Trust: a company limited by guarantee. Registered in England: Company No. 3475202.

Registered Office: Pilgrim Centre, Brickhill Drive, Bedford, MK41 7PZ. Registered Charity No. 1066861.