From:
WorkSafe online notifiable event submission
To:
Subject:
You have submitted a notifiable event
Date:
Friday, 22 February 2019 8:34:41 pm
injury
22/02/2019
ON-c00865bd-dc3b-4697-a0cd-f92e8941dbe1
1982
22/02/2019 8:34:20 PM
Act
Notification Details
notificationType
injury
Triage Details
Are you authorised to report this event?
Information
Yes
Was the event work-related or in a place of work?
Yes
Did the event involve any of the following?
None of these
Official
HSWA Injury Test
What treatment did the injured person receive?
the
Admitted to hospital
Injury Details
How many people were injured?
under
1
Injury Report 1
Injuries
Right upper limb
Hand - Wounds, serious cuts or lacerations, Other injury not listed
Released
here
Harm Info
What were they injured by?
Machinery or fixed plant
How were they hurt?
Hitting object(s) with part of the body
Victim Details
What is the person’s relationship to your business or organisation?
Your employee
What is their name?
What is their gender?
1982
Male
What is their phone number?
Act
How long has the person worked at the business or organisation?
Unknown
How many hours had they worked before the event happened?
3
What is their job?
Other
Illness Details
Event Details
Information
What date did the event happen?
22/02/2019
What time did the event happen?
10:00 a.m.
Official
What is the address where the event happened?
, Wellington, 6011, New Zealand
Describe where at the address the event happened.
the
, Wellington, 6011, New Zealand
How did the event happen?
Firefighter was entering building for a 2nd alarm event. He removed his glove
to get a firm hold of his tool to open the door, and when using it his hand
when straight glass cutting his right hand
Has the scene been preserved?
under
No
Has your business or organisation begun investigating the event?
Yes
Has another government organisation been notified?
Fire and Emergency New Zealand
PCBU Details
Released Legal name
Fire and Emergeny NZ
NZBN
9429041909904
Physical address
2 Oriental Parade, wellington 6149
Postal address
2 Oriental Parade, wellington 6149
Industry
Professional, Scientific, Technical, Administrative and Support Services
Are there Health & Safety representatives at the workplace?
Yes
Have any of them received the NZQA training?
Yes
Who should we contact about this notification?
Email address for the contact person
1982
Direct dial phone number for the contact person
Act
Reporter Details
Your name
Your email address
Confirm your email address
Your phone number
Information
Your job title or role
Region 3 Safety, Health and Wellbeing Coordinator
Declaration statement – I declare that to the best of my knowledge, the
information provided in this notification is true and correct.
1
Official
Authorisation statement: I am an authorised officer or a delegate reporting on
behalf of the business or organisation (PCBU).
1
the
Reference Details
Notification Reference ID
ON-c00865bd-dc3b-4697-a0cd-f92e8941dbe1
under
Submission date
22/02/2019
Submission time
8:34:20 PM
Have you (or anyone else) called us already about this event?
No
Notification method
web form
Released
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