Inspection Detail

Inspection: 309033405 - Napa Distribution Center

Inspection Information - Office: Indiana Department Of Labor

Inspection Nr: 309033405

Report ID: 0551800

Date Opened: 10/05/2005

Site Address:
Napa Distribution Center
200 W Coliseum Blvd
Fort Wayne, IN 46801

Mailing Address:
Attn Don Oldham Po Box 1210, Fort Wayne, IN 46801

Union Status: NonUnion

SIC:4225

NAICS: 493110/General Warehousing and Storage

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 10/06/2005

Planning Guide: Safety-Manufacturing

Emphasis:

Case Closed: 11/16/2005

Related Activity
Type	Activity Nr	Safety	Health
Accident	100990431

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				2		2
Current Violations				2		2
Initial Penalty	$0	$0	$0	$4,500	$0	$4,500
Current Penalty	$0	$0	$0	$0	$0	$0
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.	01001	Other	4000623	10/26/2005	10/31/2005	$0	$4,500	$0		I - Informal Settlement
2.	01002	Other	19100026 A03 VII	10/26/2005	11/07/2005	$0	$0	$0		-

Investigation Summary

Investigation Nr: 200993368

Event: 09/22/2005

Employee Falls and Dies Latter of Pulmonary Embolus

At approximately 10:30 a.m. on September 16, 2005, an employee was standing on a three step movable ladder pulling materials for an order. The material was located on the third shelf in a storage rack about 83-in. above the floor. He turned around to step down and misjudged the step and fell. He was conscious and sitting on the step ladder when a coworker heard him call for help. He had his right pant leg pulled up and told the coworkers that he thought he had broken his leg. The fall distance from the top step was about 28.5-in. and the fall surface was concrete. The employee was taken to the hospital for treatment and released the same day. The employee went home and was visited by the warehouse manager the next day. The employee told the manager that he was in great deal of pain. He was on crutches at that time. On September 22, he suffered from pulmonary embolus and died.

Keywords: EMBOLISM, FRACTURE, LADDER, FALL, PULMONARY EMBOLISM, LEG

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	309033405			Fatality	Other	Stock handlers and baggers

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