Abstract: On December 15, 2009, Employee #1 was working for a manufacturer of aerospace fasteners. She was assigned to work on a fillet roll machine, Number 19-10 (Powermatic, Serial Number: 072 ov218). The machine has a pneumatic hammer or punch that lowers to hold a bolt in place. Three small rollers work on the bolt (known as cold rolling) to produce a bolt with a head that is less susceptible to cracking. Employee #1 placed the bolt, by hand, into a small hole directly beneath the hammer and at the center of the three rollers. Once the piece was worked on, she removed the part, by hand, from the machine. Employee #1 indicated that the hammer lowered on its own while she was removing the bolt. However, the employer believed Employee #1 activated the machine and then placed her finger into the point of operation. Her right index finger tip was amputated and she was hospitalized for treatment. Activation of the machine would occur when a finger of the right and left hands were placed into two momentary action optical touch buttons at the same time. The buttons were not considered a safety device since, once the machine was activated, the timing of the hammer lowering did not prevent the employee's finger from being caught between the hammer and the bolt. The employer failed to guard the machine.