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Safety Incidents OSHA Severe Injury Reports · 2015–2025

Urbandale, IA —

OSHA Injury Report: Urbandale - Main Store

Injury · Job transfer or restriction

At a glance

On , an injury at Urbandale - Main Store in 8701 Douglas Ave, 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
Filing year
2023
Submitted
29FEB24:15:47:00

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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.