What is a Severe Injury Fatality report?

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Confirm that the program(s) were implemented by reviewing the following, though not all inclusive, materials and information: - 1. Persons involved in the FAT/CAT, review safety and health training and the outlines or materials, used to conduct the training, for at least the past 5 years. In addition, request specific training related to the accident such as work processes, job tasks, equipment, machinery, etc. - 2. Employees trained in a language they understand and the translator(s) knowledgeable on the subject(s) being taught. Ensure the translators are not a fellow co-worker that does not understand the safety and health standards or the standard procedures being taught. - 3. Review all Safety and Health Programs related to the investigation being conducted. For example, a piece of machinery involved in the FAT/CAT investigation was not locked out; the company's LOTO program shall be evaluated as part of the investigation. - 4. Complete the Safety and Health Program Evaluation Checklist. Attach the completed checklist to the appropriate tab in the case file. - 5. During interviews, ask both the employees and the employer representatives about the company safety program. ## d. INITIAL REPORT - 1. Complete the Fatality/Catastrophe Report form for all fatalities or catastrophes. The purpose of this form is to provide NV OSHA with enough information to determine whether or not to investigate the event. It is also used as a research tool by NV OSHA and other agencies. - NOTE: The CSHO will finalize the Fatality/Catastrophe Report on the date it is completed or as soon as possible. - 2. If, after the initial report, the District Office becomes aware of information that affects the decision to investigate, update the Fatality/Catastrophe Report. If the additional information does not affect the decision to investigate, or the investigation has been initiated or completed, the Fatality/Catastrophe Report need not be updated. After updating the Fatality/Catastrophe Re…

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## 2. Fatality/Catastrophe (FAT/CAT) Report Form In addition to the Accident Report Intake Form, a FAT/CAT Report Form must be completed for all fatalities and catastrophes. Processing of the FAT/CAT Form shall be as follows: - a. The CSHO conducting the investigation will complete and enter into OIS a FAT/CAT Report Form for all fatalities and catastrophes as soon as possible after opening the investigation. Wherever possible, the age of the victim(s) should be provided, because this information may be used for research by UOSH, OSHA and other agencies. - b. UOSH will provide a copy of the completed FAT/CAT Report Form to the OSHA Region VIII Office within 48 hours of completion of the form. - c. If additional information relating to the event becomes available that affects the decision to investigate, the FAT/CAT Report Form is to be updated. ## 3. Investigation Summary Report - a. The Investigation Summary Report is used to summarize the results of investigations of all events that involve fatalities and catastrophes. An Inspection Summary Report must be opened in OIS at the beginning of the investigation, and saved as final as soon as UOSH becomes aware of a workplace fatality or catastrophe and determines it is within its jurisdiction, even if most of the data fields are left blank. The information on this form enables UOSH and OSHA to track fatalities and catastrophes and summarizes circumstances surrounding the event. - b. The Investigation Summary Report will be modified as needed during the investigation to account for updated information and accurately completed with all data fields at the conclusion of the investigation, including a thorough narrative description of the incident. - c. The Investigation Summary Report narrative should not be a copy of the summary provided on the Accident Intake or FAT/CAT Report Forms. The narrative must comprehensively describe the characteristics of the worksite; the employer and its relationship with other empl…

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- d. Inform witnesses in a tactful and nonthreatening manner that any person who knowingly makes a false statement, representation, or certification in any application, record, report, plan, or other document filed or required to be maintained under the Utah OSH Act is guilty of a class A misdemeanor in accordance with Utah Code Ann. § 34A-6-307(5)(c). ## F. Investigation Documentation Document all accident investigations thoroughly. - 1. Personal Data - Victim Potential items to be documented include: name; address; email address; telephone; age; sex; nationality; job title; date of employment; time in position; job being done at the time of the incident; training for job being performed at time of the incident; employee deceased/injured; nature of injury - fracture, amputation, etc.; and prognosis of injured employee. - 2. Incident Data Potential items to be documented include: how and why the incident occurred; the physical layout of the worksite; sketches/drawings; measurements; video/audio/photos to identify sources, and whether the accident was work-related. - 3. Equipment or Process Involved Potential items to be documented include: equipment type; manufacturer; model; serial number; manufacturer's instructions; kind of process; condition; misuse; maintenance program; equipment inspection (logs, reports); warning devices (detectors); tasks performed; how often equipment is used; energy sources and disconnecting means identified; and supervision or instruction provided to employees involved in the accident. - 4. Witness Statements Potential witnesses include: the public; fellow employees; management; emergency responders (e.g., police department, fire department); and medical personnel (e.g., medical examiner). - 5. Safety and Health Program Potential questions include: - a. Does the employer have a safety and/or health program? - b. Does the program address the type of hazard(s) that resulted in the serious injury/fatality/catastrophe? - c. How the element…

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- f. Only one Investigation Summary Report should be submitted for an event, regardless of how many inspections take place. If a subsequent event occurs during the course of an inspection, a new report for that event should be submitted. EXAMPLE 11-1: A fatality occurs in employer's facility in August. Both a safety and health inspection are initiated. One Investigation Summary Report should be filed to summarize the results of the inspections that resulted from the August fatality. However, in September, while the employer's facility is still undergoing the inspections, a second fatality occurs. In this case, a second Investigation Summary Report should be submitted for the second fatality and an additional inspection should be opened. ## 4. Related Event Code (REC) The Violation Worksheet provides specific supplemental information documenting hazards and violations. If any item cited is directly related to the occurrence of the fatality or catastrophe, select FAT/CAT/Accident. If multiple related event codes apply, the only code that has priority over relation to a fatality/catastrophe is imminent danger. ## K. Pre-Citation Review - 1. Because cases involving a fatality or catastrophe may result in civil or criminal enforcement actions, the Director or designee is responsible for reviewing all fatality and catastrophe investigation case files to ensure that the case has been properly developed and documented in accordance with the procedures outlined here. - 2. The Director or designee is responsible for ensuring that an Investigation Summary Report is entered into OIS for each incident. See Paragraph II.J.3. of this chapter, Investigation Summary Report . - 3. The Director or designee shall review all proposed violation-by-violation penalties. - 4. The Director or designee should establish a procedure to ensure each fatality or catastrophe is thoroughly investigated and processed in accordance with established policy. ## L. Post-Citation Procedures/…

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- 3. Preliminary Investigation . The Compliance Operations Manager or designee, upon notification of an accident involving a fatality, catastrophe or serious injury, shall gather as much information as is available prior to scheduling an inspection. If possible, this shall be done immediately through discussion with the person reporting the accident. If knowledge of the accident is received through the media or sources other than a representative of the employer, the employer shall be contacted as soon as possible to obtain additional information whenever the Compliance Operations Manager or designee believes that such contact will result in a more effective inspection. Such contact shall be considered advance notice and the procedures for advance notice shall be followed. - 4. Investigation Team. If an investigation team composed of experts in specific disciplines is required, the Compliance Operations Manager or designee shall so advise the Director. If resources beyond those available within the UOSH Office will be required to compose the team, the Director shall determine representation on the team and shall direct the investigation or delegate a CSHO to serve as an authorized representative who will maintain control of the inspection process. The team, as directed by the Compliance Operations Manager or designee, shall proceed promptly to the scene and shall function as a unit in all phases of the investigation until officially directed to return to normal operation. - 5. Selection of CSHO. If the Compliance Operations Manager or designee determines that an investigation team effort is not required, a CSHO with expertise in the particular industry or operation involved in the accident or illness shall be selected and sent to the establishment as soon as possible (where possible, 2 CSHOs shall be sent to investigations involving fatalities and catastrophes). - 6. Equipment . Prior to leaving for the accident scene, the team or CSHO, as applicable, shall s…