ANTIGO, WI —
OSHA Injury Report: 4223-M1900
Injury · Days away from work
At a glance
On , an injury at 4223-M1900 in ANTIGO, WI 54409 resulted in days away from work. Employee was store Facilities Team Member in all Other General Merchandise Stores.
Where did this happen?
- Establishment
- 4223-M1900
- Street
- 2511 NEVA RD
- City
- ANTIGO
- State
- WI
- ZIP
- 54409
- On-site location
- Sales floor
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 1
Before the incident
Turning back in the maintenance key and he was stepping around someone else to get in that area.
What happened
As he stepped around he caught the side of his shoe and went down. He protected his head with his left arm and then his right arm went out and he heard a snap in his right shoulder resulting in sharp pain to his right shoulder.
Injury or illness
Right shoulder injury
Object or substance involved
concrete floor
Summary line
Stepping around and he caught the side of his shoe and fell down causing a right shoulder injury
Employee and industry
- Job description
- Store Facilities Team Member
- SOC code
- 9999 — Uncoded
- NAICS code
- 452319 — All Other General Merchandise Stores
- NAICS vintage
- 2017
- Avg employees
- 121
- Total hours worked
- 149960
- EIN
- 410806238
- Establishment ID
- 446230
- Employer case #
- 265922
When (timing detail)
- Date of incident
- Shift started
- 8:55:00.000
- Time of incident
- 13:50:00.000
- Submitted
- 06FEB24:21:04:00
Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year unspecified. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.