Fort Wayne, IN —
OSHA Injury Report: 130 Fort Wayne North
Injury · Other recordable case
At a glance
On , an injury at 130 Fort Wayne North in Fort Wayne, IN 46805 resulted in other recordable case. Employee was store Manager in department Store.
Where did this happen?
- Establishment
- 130 Fort Wayne North
- Parent company
- Kohls Inc
- Street
- 835 E Coliseum Blvd
- City
- Fort Wayne
- State
- IN
- ZIP
- 46805
- On-site location
- Fitting Room
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Maintenance Activities
What happened
While uninstalling a mirror it fell off wall and landed on my left foot.
Injury or illness
Laceration Lower Extremities Foot
Object or substance involved
Tools Equipment
Summary line
While uninstalling a mirror it fell off wall and landed on my left foot.
Employee and industry
- Job description
- Store Manager
- SOC code
- 41-1011 — First-Line Supervisors of Retail Sales Workers
- NAICS code
- 452210 — Department Store
- NAICS vintage
- 2017
- Avg employees
- 77
- Total hours worked
- 77859
- EIN
- 133357362
- Establishment ID
- 1306482
- Employer case #
- K-24-08873
When (timing detail)
- Date of incident
- Time of incident
- 16:00
- Filing year
- 2024
- Submitted
- 21FEB2025:20:20:00
Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2024. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.