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| Inspection Nr | 311217129 |
| Investigation Nr | 201863008 |
| Line Nr | 10 |
| Age | |
| Sex | |
| Nature of Injury | Other |
| Part of Body | Chest |
| Source of Injury | Motor Vehicle (Hwy) |
| Event Type | Caught In Or Between |
| Environmental Factor | Overhead Moving/Falling Obj Ac |
| Human Factor | Position Inapropriate For Task |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |