Shawnee, KS ·
OSHA Injury Report: Shawnee - Main Store
Injury · Other recordable case
At a glance
On , an injury at Shawnee - Main Store in 13550 W 63rd St, Shawnee, KS 66216 resulted in other recordable case. Employee was deliveryDriver in supermarkets and Other Grocery except Convenience Stores.
Where did this happen?
- Establishment
- Shawnee - Main Store
- Parent company
- HY-VEE, INC.
- Street
- 13550 W 63rd St
- City
- Shawnee
- State
- KS
- ZIP
- 66216
- On-site location
- Fast Fresh
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Employee was refueling a van and tripped on the fuel pump hose. He fell- flat on the concrete surface without being able to catch himself.
What happened
Employee was refueling a van and tripped on the fuel pump hose. He fell- flat on the concrete surface without being able to catch himself.
Injury or illness
INJURY TYPE: Multiple Physical Injuries Only || BODY PARTS AFFECTED: Skull
Object or substance involved
Concrete parking lot
Summary line
Laceration forehead; rt knee abrasion form fall to ground from losing balance
Employee and industry
- Job description
- DeliveryDriver
- SOC code
- 00-9900: Insufficient Information - NIOSH
- NAICS code
- 445110: Supermarkets and Other Grocery except Convenience Stores
- NAICS vintage
- 2012
- Employees at this establishment (2025 average)
- 200
- Hours worked at this establishment (2025 total)
- 257,089
- EIN
- 420325638
- Establishment ID
- 1028469
- Employer case #
- 2025-7
When (timing detail)
- Date of incident
- Shift started
- 09:05
- Time of incident
- 11:22
- Filing year
- 2025
- Submitted to OSHA
- 2026-02-27
More injuries at Shawnee - Main Store
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2025. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.
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