Abstract: At approximately 3:00 p.m. on March 15, 1991, Employee #1, of Theodon Books, Inc., was operating a book hydropress, which presses a groove on the edges of book spines. The machine was operated by placing a book between its horizontal jaws and using a foot pedal to bring a positioning bar into contact with the book. Two hand switches then initiated the press action. Employee #1 was operating the press with only one hand switch. His fingers were injured when he put them in the danger zone and they became caught by the press. The two hand switches were not self-canceling, and the danger zone was not guarded.