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| Inspection Nr | 101183150 |
| Investigation Nr | 14278352 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Burn/Scald(Heat) |
| Part of Body | Back |
| Source of Injury | Fire/Smoke |
| Event Type | Card-Vasc/Resp Fail. |
| Environmental Factor | Gas/Vapor/Mist/Fume/Smoke/Dust |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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