Injury Line: Roadway Express
| Inspection Nr | 112228846 |
| Investigation Nr | 170738272 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Dislocation |
| Part of Body | Shoulder |
| Source of Injury | Working Surface |
| Event Type | Fall(Same Level) |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Truck drivers, heavy |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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