OSHA Accident Investigation · Summary #14252423
MALLINCKRODT INC RALEIGH PARENTERAL PLANT DIAS NOS
RALEIGH, NC·
Event description
EMPLOYEE KILLED WHEN HE ENTERED A CONFINED SPACE
Investigation abstract
EMPLOYEE #1 WAS WORKING AS SET-UP OPERATOR IN A STERILE CORE WHERE CONRAY 30 WAS IEVE THE GASKET AND AN ANGLE IRON PIECE THAT HAD PROBABLY BEEN DROPPED. OTHER EM PLOYEES LATER FOUND EMPLOYEE #1, DEAD, IN THE BOTTOM OF THE TANK. BEING PROCESSED. ON THE EVENING OF OCTOBER 7, 1986, EMPLOYEE #1 WAS CLEANING HO LD TANK #4 WHICH WAS A 6000 LITER CAPACITY STAINLESS STEEL TANK. CLEANING WAS TO BE PERFORMED ONLY FROM OUTSIDE THE TANK. EMPLOYEE #1 HAD BEEN INSTRUCTED NEVER TO ENTER A TANK. IF TANK ENTRY WAS NECESSARY, IT WAS TO BE DONE BY MAINTENANCE P ERSONNEL IN ACCORDANCE WITH THE PROCEDURE FOR ENTERING TANKS AND ENCLOSED SPACES . APPARENTLY WHILE EMPLOYEE #1 WAS CLEANING THE TANK, A GASKET FELL INTO THE TAN K. EMPLOYEE #1 ATTEMPTED TO RETRIEVE THE GASKET WITH A 4 FOOT LONG PIECE OF ANGL E IRON. WHEN THE ATTEMPT FAILED, EMPLOYEE #1 APPARENTLY ENTERED THE TANK TO RETR
Victim
-
#1 Fatality Age 32 M
- Nature of injury
- 2
- Part of body
- 31
- Event type
- 14
- Source
- 43
- Occupation code
- 754
- Human factor
- 1
- Environmental factor
- 18
- Hazardous substance
- 1900
- Task assigned
- 1
Codes shown verbatim from OSHA's accident-investigation database. A human-readable decoder is coming in a future release once the accident_lookup2 dictionary is loaded.