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Inspection Detail
Inspection: 1531496.015 - Kvh Hayward Inc.
Inspection Information - Office: Eau Claire Area Office
Site Address:
Kvh Hayward Inc.
15574 Wisconsin 77
Hayward, WI 54843
Mailing Address:
Po Box 1386, Hayward, WI 54843
Union Status: NonUnion
SIC:
NAICS: 442110/Furniture Stores
Inspection Type: Fat/Cat
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 05/25/2021
Emphasis: P:Fall, L:Fall, L:Piv
Case Closed: 07/12/2023
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 1768502 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 6 | 1 | 7 | |||
| Current Violations | 6 | 1 | 7 | |||
| Initial Penalty | $21,065 | $0 | $0 | $3,901 | $0 | $24,966 |
| Current Penalty | $14,746 | $0 | $0 | $2,731 | $0 | $17,476 |
| FTA Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| # | Citation ID | Citaton Type | Standard Cited | Issuance Date | Abatement Due Date | Current Penalty | Initial Penalty | FTA Penalty | Contest | Latest Event | Note |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. | 01001 | Serious | 19100023 B13 | 08/20/2021 | 09/03/2021 | $2,731 | $3,901 | $0 | I - Informal Settlement | ||
| 2. | 01002 | Serious | 19100028 B01 I | 08/20/2021 | 09/03/2021 | $2,731 | $3,901 | $0 | I - Informal Settlement | ||
| 3. | 01003 | Serious | 19100030 A03 | 08/20/2021 | 09/13/2021 | $2,731 | $3,901 | $0 | I - Informal Settlement | ||
| 4. | 01004 | Serious | 19100140 D02 II | 08/20/2021 | 09/13/2021 | $1,638 | $2,340 | $0 | I - Informal Settlement | ||
| 5. | 01005A | Serious | 19100178 A04 | 08/20/2021 | 10/15/2021 | $2,731 | $3,901 | $0 | I - Informal Settlement | ||
| 6. | 01005B | Serious | 19100178 A05 | 08/20/2021 | 10/15/2021 | $0 | $0 | $0 | I - Informal Settlement | ||
| 7. | 01006 | Serious | 19100178 L01 II | 08/20/2021 | 09/13/2021 | $2,185 | $3,121 | $0 | I - Informal Settlement | ||
| 8. | 02001 | Other | 19040039 A02 | 08/20/2021 | $2,731 | $3,901 | $0 | I - Informal Settlement |
Investigation Summary
At approximately 3:58 a.m. on May 17, 2021, an employee was working from an extension ladder to install light fixture mounting brackets to interior roof trusses approximately 16 feet above the showroom floor. The employee utilized a Werner brand 24-foot aluminum extension ladder. The employee fell, presumably from the extension ladder to the tile floor. The employee was transported to a local hospital to receive treatment for multiple blunt force injuries to the head and body. The employee later died from these injuries.
Keywords: Blunt force, Extension Ladder, Fall, Head, Ladder, Lighting, Truss
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 1531496.015 | 66 | M | Fatality | Painters, construction and maintenance |