Abstract: On Tuesday morning, November 1, 1988, Employee #1, a printer, was removing foreign matter from a form roll on the rear of a Kase Offset Press, model #KSP-612. He reached 68 1/2 in. above the floor into the roller area and was wiping dust and debris off the form with a paper towel when his fingers became caught between an 8 in. by 19 1/2 in. form roll and the 1/2 in. metal shaft that drives the ink flow. He sustained bruises and contusions that required hospitalization. The employee had climbed over a conveyor to get to the restricted area while the machine was in operation, and he had not locked the machine out prior to cleaning, both of which are violations of employer policies and training. The employee had received three months training prior to being assigned to this machine. The accident was caused by employee misconduct. The machine is guarded by location.