Abstract: At 9:45 a.m. on October 9, 1998, Employee #1 was helping a coworker during the change out of the upper die of a Roto-die hydraulic press brake. The die was held up in place by two wooden blocks. Eight of Employee #1's fingers were resting on the lower die when his foot migrated over onto the guarded foot pedal and depressed it as he changed the die. The upper die continued moving down, breaking the wooden support blocks and crushing the bones on all eight fingers. Employee #1's index, middle, and ring fingers on both hands were amputated above the first joint, while his little fingers were amputated at mid-joint. Paramedics responded and Employee #1 was transported by ambulance to the hospital.