UNITED STATES
DEPARTMENT OF LABOR

At approximately 1:00 p.m. on February 14, 2013, Employee #1 was working for the Costco Wholesale Corporation at a warehouse in La Mesa, CA. At the time of the incident, a coworker was working as a trained and authorized forklift operator. Employee #1 and the coworker related the details of the incident in an interview with an inspector. During the interview, the coworker stated to that, just before the incident, he had driven a Crown Model Number RC 55-35-30 standup forklift, with Serial Number 1A353301, out the receiving door with a pallet of TV's and loaded them onto a Federal Express (FedEx) truck for shipment. Employee #1 stood at the door and verified that the pallets went out. Employee #1 loaded the final pallet on the truck. The coworker looked back and saw Employee #1 at the rollup door. The coworker then looked forward, put the forklift in reverse, and lowered the forks to just above the ground as he continued to back up. After backing up for about five seconds, the coworker turned around and saw that Employee #1 was right there. The coworker ran over Employee #1's right foot. Employee #1 sustained fractures and trauma to the left ankle and foot. Paramedics from the La Mesa fire department transported Employee #1 to Sharp Memorial Hospital, where he was treated and hospitalized for more than 24 hours. Video of the incident shows that the coworker walked out the roll-up door onto the receiving dock a few seconds after the forklift drove out. Employee #1 walked to the end of a row pallets containing recycled cardboard located next to a block wall on the receiving ramp. He went to the end of the pallets and was going to count the number of pallets of cardboard. He was looking at the pallets and the building when he was struck. Employee #1 was standing at the end of the cardboard pallets with his back to the forklift and its operation when the backing forklift struck him. The video does not show the forklift loading the FedEx truck or the forklift operations before the contact occurs between the forklift and Employee #1. When representatives of Crown Lift Trucks inspected the forklift, they found no mechanical problems with it. The forklift had a working audible travel alarm and a working strobe light. The coworker stated that he had been operating a forklift for approximately 15 years. The coworker was last certified on a forklift on September 30, 2010. Employee #1 was last trained on pedestrian safety on September 14, 2012. The accident was reported to the Division by Employee #1 at approximately 1:45 p.m. on February 14, 2013. The accident was reported to the Division in Compliance with T8 CCR 342(a). The Division opened an inspection on March 5, 2013.