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| Inspection Nr | 111608980 |
| Investigation Nr | 812016 |
| Line Nr | 3 |
| Age | |
| Sex | |
| Nature of Injury | Other |
| Part of Body | Bodysystem |
| Source of Injury | Motor Vehicle (Hwy) |
| Event Type | Struck By |
| Environmental Factor | Other |
| Human Factor | Perception Malfunc,Task-Envir. |
| Occupation | Supervisors, n.e.c. |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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