Inspection Detail

Inspection: 312553589 - Appleton Medical Center

Inspection Information - Office: Appleton Area Office

Inspection Nr: 312553589

Report ID: 0521100

Date Opened: 10/02/2009

Site Address:
Appleton Medical Center
1818 N. Meade Street
Appleton, WI 54911

Mailing Address:
, , 00000

Union Status: Union

SIC:8062

NAICS: 622110/General Medical and Surgical Hospitals

Inspection Type: Referral

Scope: Partial

Advanced Notice: Y

Ownership: Private

Safety/Health: Safety

Close Conference: 03/04/2010

Emphasis: S:Struck-By

Case Closed: 04/15/2010

Related Activity
Type	Activity Nr	Safety	Health
Referral	200651701	Yes
Referral	200652592	Yes

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1					1
Current Violations	1					1
Initial Penalty	$1,875	$0	$0	$0	$0	$1,875
Current Penalty	$1,313	$0	$0	$0	$0	$1,313
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	19100147 C06 I	03/09/2010	03/27/2010	$1,313	$1,875	$0		I - Informal Settlement
2.	01001B	Serious	19100147 C06 II	03/09/2010	03/27/2010	$0	$0	$0		-

Investigation Summary

Investigation Nr: 200651701

Event: 10/02/2009

Employee Is Injured When Struck by Flying Object

At approximately 2:45 p.m. on October 2, 2009, Employee #1, a machine operator, was working with a boiler technician to replace a gas valve actuator on the boiler, a Hurst Boiler and Welding Co. Inc. Mfg., Serial Number S2500 15037, and Model Number B66549. The repair was completed and the boiler technician was on the control end while Employee #1 was on the other end of the boiler, looking through the sight glass. There was an internal boiler gas explosion and Employee #1 was hit by a manhole. He was hospitalized for treatment.

Keywords: HEAD, PRESSURE VESSEL, BOILER, MACHINE OPERATOR, EXPLOSION, STRUCK BY, CONCUSSION, FLYING OBJECT

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	312553589			Hospitalized injury	Concussion	Machine operators, not specified

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