Fond du Lac, WI ·
OSHA Injury Report: Agnesian St. Francis Home
Injury · Other recordable case
At a glance
On , an injury at Agnesian St. Francis Home in 33 Everett Street, Fond du Lac, WI 54935 resulted in other recordable case. Employee was resident Care Assistant LTC in nursing Care Facilities (Skilled Nursing Facilities).
Where did this happen?
- Establishment
- Agnesian St. Francis Home
- Parent company
- SSM Health
- Street
- 33 Everett Street
- City
- Fond du Lac
- State
- WI
- ZIP
- 54935
- On-site location
- patient room
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Regular job duties
What happened
placing cap back onto insulin pen the needle got caught and poked thru the side
Injury or illness
Puncture
Object or substance involved
Contaminated
Summary line
writer was performing insulin administration when placing cap back onto insulin pen the needle got caught and poked thru the side when writer grabbed the cap the needle pierced skin of the writer and drew blood writer immediately notified supervisor
Employee and industry
- Job description
- Resident Care Assistant LTC
- SOC code
- 31-1131: Nursing Assistants
- NAICS code
- 623110: Nursing Care Facilities (Skilled Nursing Facilities)
- NAICS vintage
- 2022
- Employees at this establishment (2023 average)
- 188
- Hours worked at this establishment (2023 total)
- 264,568
- EIN
- 391029998
- Establishment ID
- 662786
- Employer case #
- WC171316
When (timing detail)
- Date of incident
- Shift started
- 14:00
- Time of incident
- 20:30
- Filing year
- 2023
- Submitted to OSHA
- 2024-02-29
More injuries at Agnesian St. Francis Home
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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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