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| Inspection Nr | 120303557 |
| Investigation Nr | 201031911 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Other |
| Part of Body | Chest |
| Source of Injury | Machine |
| Event Type | Struck By |
| Environmental Factor | Catch Point/Puncture Action |
| Human Factor | Safety Devices Removed/Inoper. |
| Occupation | Machine operators, not specified |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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