Oregon, WI ·
OSHA Injury Report: Oregon - Main Store
Injury · Other recordable case
At a glance
On , an injury at Oregon - Main Store in 787 N Main Street Ste 1, Oregon, WI 53575 resulted in other recordable case. Employee was produce Clerk in supermarkets and Other Grocery (except Convenience) Stores.
Where did this happen?
- Establishment
- Oregon - Main Store
- Parent company
- HY-VEE, INC.
- Street
- 787 N Main Street Ste 1
- City
- Oregon
- State
- WI
- ZIP
- 53575
- On-site location
- Produce Department
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
reaching up for peppers
What happened
in the cooler reaching up for fresh peppers to stock and he slipped. He stated there was some white powder on the floor. White powder was possibly banana bread mix that had broken open earlier and not been cleaned up. He stated he does not remember what happened next except for seeing Store Manager asking him if he was ok (he was laying on the floor)
Injury or illness
INJURY TYPE: Multiple Physical Injuries Only || BODY PART(S) AFFECTED: Multiple Head Injury
Object or substance involved
none
Summary line
Facial laceration and blunt trauma from slip and fall on substance.
Employee and industry
- Job description
- Produce Clerk
- SOC code
- 53-7062: Laborers and Freight, Stock, and Material Movers, Hand
- NAICS code
- 445110: Supermarkets and Other Grocery (except Convenience) Stores
- NAICS vintage
- 2022
- Employees at this establishment (2023 average)
- 101
- Hours worked at this establishment (2023 total)
- 110,302
- EIN
- 420325638
- Establishment ID
- 1189339
- Employer case #
- 2023-4
When (timing detail)
- Date of incident
- Shift started
- 15:00
- Time of incident
- 16:45
- Filing year
- 2023
- Submitted to OSHA
- 2024-02-29
More injuries at Oregon - Main Store
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2023. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.
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