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Safety Incidents OSHA Severe Injury Reports · 2015–2025

Portland, OR —

OSHA Injury Report: Foodservice Pacific NW - 1017

Injury · Days away from work

At a glance

On , an injury at Foodservice Pacific NW - 1017 in 19606 NE San Rafael St, Portland, OR 97230 resulted in days away from work. Employee was driver Shuttle.

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Where did this happen?

Establishment
Foodservice Pacific NW - 1017
Street
19606 NE San Rafael St
City
Portland
State
OR
ZIP
97230
On-site location
Foodservice Pacific NW 1017 Front lot

What was the outcome?

Outcome
Days away from work (code 2)
Type
Injury (code 1)
Days away from work
180

Before the incident

Strain Injury by Push Pulling

What happened

EE states he was hooking up his rear trailer The dolly was seized against the leading edge of the trailer and would not move He says he went over to the left side of the dolly tire to push it away from trailer he felt a pop in his left shoulder

Injury or illness

Cause Strain or Injury By Body Part Shoulder s Body Part Position Right Detail Cause Strain Injury by Push Pulling

Object or substance involved

Converter Dolly

Summary line

Cause Strain or Injury By Body Part Shoulder s Body Part Position Right Detail Cause Strain Injury by Push Pulling

Employee and industry

Job description
Driver Shuttle
SOC code
53-3053 — Shuttle Drivers and Chauffeurs
NAICS code
424410
NAICS vintage
2022
Avg employees
153
Total hours worked
323768
EIN
840629503
Establishment ID
205907
Employer case #
1201WC2303

When (timing detail)

Date of incident
Shift started
15:03:00.000
Time of incident
18:35:00.000
Filing year
2023
Submitted
06MAR24:18:30:00

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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.