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Safety Incidents OSHA Severe Injury Reports · 2015–2025

South Bend, IN —

OSHA Injury Report: 021-00901

Injury · Job transfer or restriction

At a glance

On , an injury at 021-00901 in 4526 W Western Ave, South Bend, IN 46619 resulted in job transfer or restriction. Employee was gROCERY CLERK in supermarkets and Other Grocery Except Convenience Stores.

Where did this happen?

Establishment
021-00901
Parent company
Kroger Central KMA
Street
4526 W Western Ave
City
South Bend
State
IN
ZIP
46619
On-site location
FRONT END WATER DISPLAY NEAR RESTROOMS

What was the outcome?

Outcome
Job transfer or restriction (code 3)
Type
Injury (code 1)
Days restricted or transferred
8

Before the incident

LIFTING CASE OF WATER

What happened

EE WAS LIFTING 40 CT OF WATER AND FELT SOMETHING POP IN LOWER BACK AS HE WAS TWISTING

Injury or illness

Strained Posterior Low back Lifting 40 COUNT CASE OF WATER

Object or substance involved

40 COUNT CASE OF WATER

Summary line

Strained Posterior Low back Lifting 40 COUNT CASE OF WATER

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
64
Total hours worked
99457
EIN
311569568
Establishment ID
963706
Employer case #
851998

When (timing detail)

Date of incident
Shift started
13:30:00.000
Time of incident
20:00:00.000
Submitted
28FEB24:15:14:00

More injuries at 021-00901

View 021-00901's full OSHA safety record →

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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.