TranslateInspection Detail
Inspection: 104542022 - Hyvee Food Stores, Inc.
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Inspection Information - Office: Minnesota | ||||
| Nr: 104542022 | Report ID: 0552700 | Open Date: 10/08/1986 | ||
| Hyvee Food Stores, Inc. | ||||
| 1607 E. Hwy. 14 Rochester, MN 55904 | Union Status: NonUnion | |||
| SIC: 5411/Grocery Stores | ||||
| Inspection Type: | Accident | |||
| Scope: | Complete | Advanced Notice: | N | |
| Ownership: | Private | |||
| Safety/Health: | Safety | Close Conference: | 10/08/1986 | |
| Close Case: | 08/30/1988 | |||
| Related Activity: | Type | ID | Safety | Health |
| Accident | 360761142 | |||
| 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 Amount | $0 | $0 | $0 | $0 | $0 | $0 |
| # | ID | Type | Standard | Issuance | Abate | Curr$ | Init$ | Fta$ | Contest | LastEvent | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | - | ||
| Deleted | 8. | 02006 | Other | 19100304 F 5 V | 10/29/1986 | 12/01/1986 | $0 | $0 | $221 | I - Informal Settlement | |
| 9. | 02007 | Other | 5210063001 | 10/29/1986 | 11/17/1986 | $0 | $0 | $0 | - |
Accident Investigation Summary | ||||||
|---|---|---|---|---|---|---|
| Summary 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 | ||||||
| Inspection | Degree | Nature | Occupation | |||
| 1 | 104542022 | Hospitalized injury | Concussion | Management related occupations, n.e.c. | ||