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Safety Incidents OSHA Severe Injury Reports · 2015–2025

Fort Atkinson, WI —

OSHA Injury Report: 534-00396

Respiratory condition · Days away from work

At a glance

On , a respiratory condition at 534-00396 in 1505 Madison Ave, Fort Atkinson, WI 53538 resulted in days away from work. Employee was fRONT END LEAD CLERK in supermarkets and Other Grocery Except Convenience Stores.

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Where did this happen?

Establishment
534-00396
Parent company
Roundy's
Street
1505 Madison Ave
City
Fort Atkinson
State
WI
ZIP
53538
On-site location
Front End

What was the outcome?

Outcome
Days away from work (code 2)
Type
Respiratory condition (code 3)
Days away from work
5

Before the incident

Performing job duties

What happened

EE is alleging contracing COVID 19 while at work

Injury or illness

COVID 19 Lungs Pandemic COVID 19

Object or substance involved

Covid-19

Summary line

COVID 19 Lungs Pandemic COVID 19

Employee and industry

Job description
FRONT END LEAD CLERK
SOC code
41-2011 — Cashiers
NAICS code
445110 — Supermarkets and Other Grocery Except Convenience Stores
NAICS vintage
2022
Avg employees
128
Total hours worked
116524
EIN
390854535
Establishment ID
966306
Employer case #
24_210498

When (timing detail)

Date of incident
Filing year
2023
Submitted
28FEB24:20:55:00

More injuries at 534-00396

View 534-00396's full OSHA safety record →

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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 — no per-record IMIS deep link exists.