Abstract: On August 6, 2009, Employee #1, a shop foreman with P P Manufacturing (a company engaged in sheet metal manufacturing) was operating a 20-ton, foot-controlled Press Rite punch press to flatten 1.5 in. by 1.5 in. steel plates. While removing a completed piece with his right hand, he inadvertently activated the foot control pedal. Employee #1 was hospitalized at Healthpointe Medical Group for an amputation of his right middle finger. There had been no point of operation guard in place, and Employee #1 was not using the hand-feeding device provided to remove the metal pieces. He had over 26 years of experience as a press operator.