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| Inspection Nr | 312922149 |
| Investigation Nr | 201925112 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Chest |
| Source of Injury | Machine |
| Event Type | Struck By |
| Environmental Factor | Flying Object Action |
| Human Factor | Lockout/Tagout Proced Malfunc |
| Occupation | Heavy equipment mechanics |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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