Injury Line: City Of Ocean Shores Dba Ocean Shores Police Dept
| Inspection Nr | 115193823 |
| Investigation Nr | 170040356 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Other |
| Part of Body | Lung |
| Source of Injury | Water |
| Event Type | Ingestion |
| Environmental Factor | Weather, Earthquake, Etc. |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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