Injury Line: Joe D & Tom L Elam Dba
| Inspection Nr | 15077019 |
| Investigation Nr | 14569230 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Concussion |
| Part of Body | Head |
| Source of Injury | Other |
| Event Type | Struck By |
| Environmental Factor | Flying Object Action |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Pharmacists |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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