Injury Line: Roosevelt Fire Dept.Engine Co. #1
| Inspection Nr | 313863094 | 
| Investigation Nr | 202033908 | 
| Line Nr | 1 | 
| Age | |
| Sex |   | 
| Nature of Injury | Other | 
| Part of Body | Chest | 
| Source of Injury | Bodily Motion | 
| Event Type | Card-Vasc/Resp Fail. | 
| Environmental Factor | Other | 
| Human Factor | Other | 
| Occupation | Occupation not reported | 
| Degree of Injury | Fatality | 
| Task Assigned | Task regularly assigned | 
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