Inspection Detail

Inspection: 308414291 - Wal Mart Stores Inc

Inspection Information - Office: Medford

Inspection Nr: 308414291

Report ID: 1054116

Date Opened: 12/06/2004

Site Address:
Wal Mart Stores Inc
2051 Newmark
Coos Bay, OR 97420

Mailing Address:
Po Box 82, Bentonville, AR 72712

Union Status: NonUnion

SIC:5311

NAICS: 452112/Discount Department Stores

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 01/06/2005

Planning Guide: Safety-Manufacturing

Emphasis:

Case Closed: 04/21/2005

Related Activity
Type	Activity Nr	Safety	Health
Accident	101620565

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				1		1
Current Violations				1		1
Initial Penalty	$0	$0	$0	$500	$0	$500
Current Penalty	$0	$0	$0	$500	$0	$500
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	701070021 A	01/18/2005	12/06/2005	$500	$500	$0		-

Investigation Summary

Investigation Nr: 201621786

Event: 12/03/2004

Employee Dies from Head Injury Due to Fall

At approximately 4:00 p.m. on December 3, 2005, Employee #1 was standing on a step ladder that was about 3 feet above the floor to arrange store items on a shelf. Employee #1 fell and struck his head on the floor. A witness came to his aid and emergency services were called. Employee #1 was transported to Bay Area Hospital and treated for a head injury. He was later transferred to Emanual Hospital in Portland Oregon where he died from severe head trauma. It was not determined whether Employee #1 fell from a loss of balance or if a medical condition could have been the cause. However, a witness reported that Employee #1 appeared disoriented and struggled while receiving assistance after the fall.

Keywords: HEAD, LADDER, STRUCK AGAINST, FALL, STORAGE RACK, WORK SURFACE

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	308414291			Fatality	Other	Buyers, wholesale & retail trade except farm prod.

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