Urbandale, IA —
OSHA Injury Report: Urbandale - Main Store
Injury · Job transfer or restriction
At a glance
On , an injury at Urbandale - Main Store in Urbandale, IA 50322 resulted in job transfer or restriction. Employee was miaitln Dept Mgr H in supermarkets and Other Grocery (except Convenience) Stores.
Where did this happen?
- Establishment
- Urbandale - Main Store
- Parent company
- HY-VEE, INC.
- Street
- 8701 Douglas Ave
- City
- Urbandale
- State
- IA
- ZIP
- 50322
- On-site location
- Kitchen
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 44
Before the incident
Refilling the ice bucket
What happened
After she refilled the ice bucket she turned to leave and smacked her elbow on the sink. Almost dropped the bucket and heard a pop in her left shoulder as she tried to catch it. Left elbow arm is bruised sore and swollen.
Injury or illness
INJURY TYPE: Strain || BODY PART(S) AFFECTED: - Upper Arm (Clavicle and Scapula)
Object or substance involved
Ice bucket
Summary line
Left partial rotator cuff tear from catching falling bucket.
Employee and industry
- Job description
- Miaitln Dept Mgr H
- SOC code
- 41-1011 — First-Line Supervisors of Retail Sales Workers
- NAICS code
- 445110 — Supermarkets and Other Grocery (except Convenience) Stores
- NAICS vintage
- 2022
- Avg employees
- 370
- Total hours worked
- 425857
- EIN
- 420325638
- Establishment ID
- 1028507
- Employer case #
- 2023-14
When (timing detail)
- Date of incident
- Shift started
- 9:00:00.000
- Time of incident
- 13:00:00.000
- Submitted
- 29FEB24:15:47:00
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.