Fort Wayne, IN —
OSHA Injury Report: 021-00990
Injury · Job transfer or restriction
At a glance
On , an injury at 021-00990 in Fort Wayne, IN 46804 resulted in job transfer or restriction. Employee was gROCERY 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
- DAIRY SECTION
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 67
Before the incident
ABOUT TO PUT AWAY PALLET OF MILK
What happened
The EE fell and landed on his back as he was moving away from some cases of falling milk EE did not request for first aid or EMS and he will not be seeking medical treatment EE sustained some soreness to his back and the inside of his left knee
Injury or illness
Fracture Left Knee Fall on same level FLOOR
Object or substance involved
FLOOR
Summary line
Fracture Left Knee Fall on same level FLOOR
Employee and industry
- Job description
- GROCERY CLERK
- SOC code
- 53-7065 — Stockers and Order Fillers
- NAICS code
- 445110 — Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2022
- Avg employees
- 272
- Total hours worked
- 328611
- EIN
- 311569568
- Establishment ID
- 963760
- Employer case #
- 863624
When (timing detail)
- Date of incident
- Shift started
- 14:00:00.000
- Time of incident
- 17:00:00.000
- Submitted
- 28FEB24:15:14:00
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.