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| Inspection Nr | 302716295 |
| Investigation Nr | 201771102 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Amputation |
| Part of Body | Legs |
| Source of Injury | Machine |
| Event Type | Caught In Or Between |
| Environmental Factor | Shear Point Action |
| Human Factor | Safety Devices Removed/Inoper. |
| Occupation | Attendants, amusement and recreation facilities |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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