Inspection Detail

Case Status: CLOSED

Inspection: 1412818.015 - Mercyone Waterloo

Inspection Information - Office: Iowa 0751910

Inspection Nr: 1412818.015

Report ID: 0751910

Date Opened: 07/01/2019

Site Address:
Mercyone Waterloo
3421 W 9th St
Waterloo, IA 50702

Mailing Address:
3421 W 9th St, Waterloo, IA 50702

Union Status: NonUnion

SIC:

NAICS: 622110/General Medical and Surgical Hospitals

Inspection Type: Referral

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 07/01/2019

Emphasis:

Case Closed: 11/25/2019

Related Activity
Type	Activity Nr	Safety	Health
Referral	1468536	Yes

Case Status: CLOSED

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1					1
Current Violations				1		1
Initial Penalty	$8,524	$0	$0	$0	$0	$8,524
Current Penalty	$0	$0	$0	$10,000	$0	$10,000
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	Contest	Latest Event	Note
1.	01001A	Serious	19100332 B01	09/05/2019	10/22/2019	$0	$8,524	$0		I - Informal Settlement	Citation has been deleted.
2.	01001B	Other	19100333 A01	09/05/2019	10/22/2019	$10,000	$0	$0		I - Informal Settlement

Investigation Summary

Investigation Nr: 117632.015

Event: 06/24/2019

Employee incurs concussion in fall off ladder after being sh

At 8:00 a.m. on June 24, 2019, an employee was standing on an 8 foot self supporting ladder removing existing 2 foot by 2 foot florescent lights and replacing them with Columbia LCAT22 LED contemporary lights. The employee received an electric shock caused him to fall from an 8 foot self supporting ladder. The employee struck his head on a table during the fall incurring a concussion and requiring hospitalization.

Keywords: Abrasion, Back, Concussion, Contusion, Electric Shock, Electric current, Electrical, Energized, Fall, Fracture, Head, Installing, Ladder, Lighting Fixture, Lockout, Lockout/Tagout

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	1412818.015	30	M	Hospitalized injury		Electricians

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