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| Inspection Nr | 15118649 |
| Investigation Nr | 14460794 |
| Line Nr | 4 |
| Age | |
| Sex | |
| Nature of Injury | Other |
| Part of Body | Othbodysys |
| Source of Injury | Gases |
| Event Type | Inhalation |
| Environmental Factor | Gas/Vapor/Mist/Fume/Smoke/Dust |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Food counter, fountain and related occupations |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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