Abstract: On February 11, 1997, Employee #1, a printing press operator, became aware that the blanket on the blanket cylinder of printing press #3200CD had low spots which prevented the proper transfer of ink to the paper. He began to change the blanket. Employee #1 had inserted his right thumb into the recess that ran the length of the blanket cylinder when he accidentally hit the toggle switch that activated the machine. His thumb struck against a roll guard and was amputated. Employee #1 was transported by Sacramento City Fire Department to U.C. Davis Medical Center in Sacramento; his thumb was not reattached.