Employee NameAaron Wright
Job NameGosh conference
SupervisorSafety Steve
Place of IncidentTacoma
Time10:10 AM
Type of IncidentInjury
Nature of Injury
  • Puncture
Field #19 (No Label)

Medical Treatment

Medical TreatmentFirst Aid
Field #23 (No Label)

Incident Description

Describe what happened (Who, What, Where, When, Why & How). Be specific and detailed.

Hurt my hand shucking oysters

Field #29 (No Label)

Incident Review - To be Completed By SUPERVISOR

Was PPE Required?Yes
Was the correct PPE in use?No
If Yes: List the PPE - If No: ExplainUsed a paper towel instead of hand towel
Was the employee following safety procedures when the incident happened?No
If No: ExplainI really wanted oysters
How could this incident have been avoided?Impossible, oysters are delicious
List all witnesses:Casey Wright
EmployeeAaron Wright
SupervisorSafety Steve