Injury Line: Ccmr Of Maryland , Inc.
| Inspection Nr | 104461488 |
| Investigation Nr | 170070601 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Electric Shock |
| Part of Body | Multiple |
| Source of Injury | Elec Apparat/Wiring |
| Event Type | Shock |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Supervisors, food preparation & service occupation |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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