Injury Line: Champion Elevators Inc
| Inspection Nr | 123273237 | 
| Investigation Nr | 201921889 | 
| Line Nr | 1 | 
| Age | |
| Sex |   | 
| Nature of Injury | Other | 
| Part of Body | Chest | 
| Source of Injury | Materials Handlg Eq. | 
| Event Type | Caught In Or Between | 
| Environmental Factor | Materials Handlg Equip./Method | 
| Human Factor | Misjudgment, Haz. Situation | 
| Occupation | Supervisors; handlers,equip-cleaners,laborers nec | 
| Degree of Injury | Fatality | 
| Task Assigned | Task regularly assigned | 
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