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Accident Report Detail

Accident Summary Nr: 122454.015 - Employee incurs multiple injuries in powered pallet jack col

Accident Summary Nr: 122454.015 -- Report ID: 0950633 -- Event Date: 06/23/2019
Inspection NrDate OpenedSICNAICSEstablishment Name
1416217.01507/15/2019424480Veg Fresh Farms

Abstract: At 10:45 a.m. on June 23, 2019, an employee was operating a Raymond powered pallet jack , model 8410, serial number 841-16-30347, coming out of a production area into the warehouse area. The employee made a left turn when a coworker operating a forklift was coming from the opposite direction at an unsafe speed and lost control, hitting the employee on the right side. The employee sustained contusions and crushing trauma to the right hip, thigh, knee, ear, and back. The employee was taken to Riverside Community Hospital and received treatment for two days. The employee worked as a temporary worker at a food manufacturing facility, Employer #2, through the primary employer, Employer #1. At 06:05 a.m. on June 24, 2019, the Employer #1's Safety Coordinator reported the incident in compliance with T8§342; however Employer #2 did not. At approximately 02:30 p.m. on July 15, 2019, a CSHO representative arrived on site and opened an investigation with Employer #1's safety officer and Employer #2's general manager. A general accident related violation, T8CCR 3650(t)(9), was cited due to lack of employer's knowledge.

Keywords: Abrasion, Back, Blunt force trauma, Collision, Contusion, Crushed, Crushing, Driving, Ear, Equipment Operator, Food processing, Forklift, Hip, Knee, Lost Control, Multiemployer, Operating, Operator, Pallet Jack, Powered Industrial Vehicle, Speeding, Struck By, Temporary Employment Agency, Temporary Worker, Thigh, Warehouse

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Occupation
1 1416217.015 43 M Hospitalized injury Machine operators, not specified

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