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Accident Report Detail

Accident Summary Nr: 201798675 - Employee Is Injured When Struck by Forklift

Accident Summary Nr: 201798675 -- Report ID: 0950644 -- Event Date: 09/30/2004
Inspection NrDate OpenedSICNAICSEstablishment Name
30133331610/04/20047513532120Carmenita Ford Truck Sales Dba Carmenita Truck Ctr

Abstract: At about 8:25 a.m. on September 30, 2004, Employee #1, with Carmenita Ford Truck Sales, was walking south on the east side of a service building when he was struck by an electric forklift (Toyota Model Number 5 FBE18, Serial Number 16513). The forklift operator had looked away momentarily, and was unable to stop when he saw Employee #1. The forklift mast struck Employee #1's right shoulder, and the left wheel ran over his right foot. He then fell to the ground. Employee #1 was hospitalized at La Palma Community Hospital for a pulled left hamstring, bruised right shoulder and arm, fractured big and little toes, and trauma and swelling to his right foot.

Keywords: FRACTURE, INDUSTRIAL TRUCK, STRUCK BY, TOW TRUCK, RUN OVER, CONTUSION, FOOT, INATTENTION

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Occupation
1 301333316 Hospitalized injury Fracture Supervisors; distrib., sched'g & adjusting clerks

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