Injury Line: Aaa Of No Calif,Nevada & Utah
| Inspection Nr | 316610534 |
| Investigation Nr | 202653770 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Other |
| Part of Body | Bodysystem |
| Source of Injury | Drugs/Alcohol |
| Event Type | Ingestion |
| Environmental Factor | Chemical Action/Reaction Expos |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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