Abstract: On January 15, 2009, Employee #1 was a die casting machine operator at a small die casting shop. He was conducting a production run of small parts in a die casting machine involving molten zinc casting. The 30-yr old machine was manufactured by Harvill Company. Employee #1 had completed four or five parts. At first the safety door opened and then the die opened. He was sprayed with molten metal, and his hands, neck and face were burned. He was wearing thermal safety gloves but the metal ignited the gloves. He was hospitalized at the Grossman Burn Center for treatment of second and third degree burns to his hands, neck and face. Upon investigation, no problems were observed with the safety interlock switches on the safety door or other safety switches on the machine.