Abstract: On or about 4:00 p.m. on September 15, 1994, Employee #1 was operating a punch press with a foot control and possum pull backs. She was putting steel parts into the die area with her right hand and removing the finished parts with her left hand. The pullbacks had been adjusted for her when she started the job at 6:10 a.m. The right side was then re-adjusted by the supervisor because the pull back was too tight for Employee #1 to get a part into the die area. Employee #1 stated that her reach was not checked after the last adjustment and that she ran the press the rest of the day with no problems. At 2:50 p.m., Employee #1 went on break. She unhooked herself from the pull backs and removed the wrist band. At 3:00 p.m. she returned and hooked her right hand first, then her left hand, and then started to operate the press with her left hand. Around 4:00 p.m. she put a part in the die with her right hand and felt pain. The press had come down and caught her hand. Employee #1 yelled for help and, wanting to free her hand, pushed down on the foot control. The press went up and she removed her hand. Two fingers were amputated.