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| Inspection Nr | 123490765 |
| Investigation Nr | 202126066 |
| Line Nr | 2 |
| Age | |
| Sex | |
| Nature of Injury | Electric Shock |
| Part of Body | Hand(S) |
| Source of Injury | Elec Apparat/Wiring |
| Event Type | Shock |
| Environmental Factor | Other |
| Human Factor | Lockout/Tagout Proced Malfunc |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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