Inspection Detail

Inspection: 104542022 - Hyvee Food Stores, Inc.

Inspection Information - Office: Minnesota Department Of Labor And Industry

Inspection Nr: 104542022

Report ID: 0552700

Date Opened: 10/08/1986

Site Address:
Hyvee Food Stores, Inc.
1607 E. Hwy. 14
Rochester, MN 55904

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:5411

NAICS: 0

Inspection Type: Accident

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 10/08/1986

Emphasis:

Case Closed: 08/30/1988

Related Activity
Type	Activity Nr	Safety	Health
Accident	360761142

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	2			7		9
Current Violations	2			6		8
Initial Penalty	$434	$0	$0	$0	$0	$434
Current Penalty	$434	$0	$0	$0	$0	$434
FTA Penalty	$0	$0	$0	$0	$0	$0

Violation Items
#	Citation ID	Citaton Type	Standard Cited	Issuance Date	Abatement Due Date	Current Penalty	Initial Penalty	FTA Penalty	Latest Event	Note
1.	01001	Serious	52050040	10/29/1986	11/01/1986	$280	$280	$0	-
2.	01002	Serious	19100178 M12	10/29/1986	11/01/1986	$154	$154	$0	-
3.	02001	Other	19100303 G 1 II	10/29/1986	11/10/1986	$0	$0	$0	-
4.	02002	Other	19100303 G 2 I	10/29/1986	12/01/1986	$0	$0	$0	-
5.	02003	Other	19100305 G 2 III	10/29/1986	12/01/1986	$0	$0	$0	-
6.	02004	Other	19100037 Q 1	10/29/1986	12/01/1986	$0	$0	$0	-
7.	02005	Other	19100304 F 4	10/29/1986	12/01/1986	$0	$0	$0	-
8.	02006	Other	19100304 F 5 V	10/29/1986	12/01/1986	$0	$0	$221	I - Informal Settlement	Citation has been deleted.
9.	02007	Other	5210063001	10/29/1986	11/17/1986	$0	$0	$0	-

Investigation Summary

Investigation Nr: 689323

Event: 09/28/1986

FALL FROM ELEVATED FORKS OF FORK LIFT TRUCK

EMPLOYEE #1 WAS INSTRUCTED BY HIS SHIFT MANAGER TO CONSOLIDATE PRODUCTS ON THE PALLETS IN THE REAR STORE ROOM. THE SHIFT SUPERVISOR ELEVATED EMPLOYEE #1, THE ASSISTANT SHIFT SUPERVISOR, TEN FEET UP ON THE FORKS OF A CLARK FORK LIFT. EMPLOYEE #1 WAS MOVING PRODUCTS AROUND ON THESE PALLETS WHEN HE FELL TO THE CONCRETE FLOOR. HIS HEAD STRUCK EITHER THE FORK OF THE FORKLIFT OR THE CONCRETE FLOOR. HE WAS KNOCKED UNCONSCIOUS. THE SHIFT SUPERVISOR AND ANOTHER EMPLOYEE CAME TO HIS ASSISTANCE. HE REGAINED CONSCIOUSNESS AND WAS TRANSPORATED TO THE HOSPITAL. HE WAS OPERATED ON TO REMOVE A BLOOD CLOT FROM HIS BRAIN AND PLACED IN INTENSIVE CARE. NO LIFTING CAGE WAS USED ON THE FORKLIFT AND NO GUARDRAILS WERE PROVIDED ON THE METAL STORAGE BANKS. THE FORK LIFT LABEL CLEARLY INSTRUCTS THE OPERATOR TO "CARRY NO PASSENGERS, NEVER ELEVATE ANYONE WITHOUT A SECURED SAFETY PLATFORM". THE FORK LIFT WAS A CLARK, MODEL S30, TYPE E, SERIAL #S30-0052-4785FA. IT IS CALLED A CLARK POWERWORKER.

Keywords: HEAD, UNCONSCIOUSNESS, GUARDRAIL, UNSECURED, WORK RULES, INDUSTRIAL TRUCK, FALL, FALL PROTECTION, CONCUSSION

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	104542022			Hospitalized injury	Concussion	Management related occupations, n.e.c.

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