Fort Wayne, IN —
OSHA Injury Report: 021-00990
Injury · Other recordable case
At a glance
On , an injury at 021-00990 in 5725 Coventry Ln, Fort Wayne, IN 46804 resulted in other recordable case. Employee was cHEESE SHOP MUR 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
- DELI DEPT BACK ROOM
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
REACHING FOR HANDLE ON [REDACTED]
What happened
EE WAS LOAD CARDBOARD INTO A FULL BAILER EE WENT TO CLOSE BAILER GATE AND START THE BAILER EE OVEREXTENDED TO REACH HANDLE AND LOST THEIR BALANCE EE FELL TO THE GROUND AND STRUCK INTO THE BAILER MUSCLE SPRAIN TO LOWER BACK CONTUSION ON LEFT THIG
Injury or illness
Strained Posterior Low back Fall self
Object or substance involved
self
Summary line
Strained Posterior Low back Fall self
Employee and industry
- Job description
- CHEESE SHOP MUR
- SOC code
- 9999 — Uncoded
- NAICS code
- 445110 — Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2012
- Avg employees
- 265
- Total hours worked
- 352793
- EIN
- 311569568
- Establishment ID
- 963760
- Employer case #
- 878342
When (timing detail)
- Date of incident
- Shift started
- 11:30
- Time of incident
- 16:00
- Filing year
- 2024
- Submitted
- 25FEB2025:19:46:00
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Fort Wayne, IN—
021-00990
Fort Wayne, IN—
021-00990
View 021-00990's full OSHA safety record →
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2024. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.