Fort Wayne, IN ·
OSHA Injury Report: 021-00990
Injury · Days away from work
At a glance
On , an injury at 021-00990 in 5725 Coventry Ln, Fort Wayne, IN 46804 resulted in days away from work. Employee was store night clerk in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 021-00990
- Parent company
- Kroger Central KMA
- Street
- 5725 Coventry Ln
- City
- Fort Wayne
- State
- IN
- ZIP
- 46804
- On-site location
- PARKING LOT
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 31
- Days restricted or transferred
- 133
Before the incident
WALKING INTO STORE FROM LUNCH
What happened
EE was walking to re-enter the store after lunch when he slipped and fell on ice in the parking lot EE twisted his right leg and back
Injury or illness
Strained Posterior Low back Fall on ice snow ICEY SLIPPERY GROUND
Object or substance involved
ICEY SLIPPERY GROUND
Summary line
Strained Posterior Low back Fall on ice snow ICEY SLIPPERY GROUND
Employee and industry
- Job description
- STORE NIGHT CLERK
- SOC code
- 53-7065: Stockers and Order Fillers
- NAICS code
- 445110: Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2012
- Employees at this establishment (2024 average)
- 265
- Hours worked at this establishment (2024 total)
- 352,793
- EIN
- 311569568
- Establishment ID
- 963760
- Employer case #
- 867443
When (timing detail)
- Date of incident
- Shift started
- 23:00
- Time of incident
- 04:00
- Filing year
- 2024
- Submitted to OSHA
- 2025-02-25
More injuries at 021-00990
View 021-00990's full OSHA safety record →
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2024. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.
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