Injury Line: Admiral Elevator Corp.
| Inspection Nr | 302133079 |
| Investigation Nr | 200021368 |
| Line Nr | 2 |
| Age | |
| Sex |   |
| Nature of Injury | Other |
| Part of Body | Multiple |
| Source of Injury | Machine |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Overhead Moving/Falling Obj Ac |
| Human Factor | Safety Devices Removed/Inoper. |
| Occupation | Specified mechanics and repairers |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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