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A worker at the Burnley factory was crushed to death in just three seconds when a machine slammed shut on him, an investigation has found.
Louis Michael Standen was killed on the evening of Tuesday, December 3, 2019 while working at food packaging manufacturer Doric FPD in Farrington Road, Burnley.
Louis was at the end of his shift using a Horauf cake board machine when he dropped an item inside the machine. When the 27-year-old went under the machine to retrieve the object, he got stuck as the machine lowered above his head and chest.
READ MORE: Colleagues ‘stifled’ screams from Burnley man trapped under machine
During the second day of the two-day investigation, the jury heard from Sharon Butler, an inspector with the Health and Safety Executive, who conducted an investigation into Louis’ death.
“On December 4, I got a call at 7 am to say that there had been a fatal accident and I was asked to attend as soon as possible,†Miss Butler said.
“I contacted a mechanical engineer to come with me and we arrived at 9am in the morning.”
When Miss Butler and the engineer visited the factory, Louis’s body was still stuck under the machine.
(Image: Houraf)
Miss Butler described the operation of the machine and referred to the two-minute and 21-second time window when the Horauf is turned off, after which the glue pan, which crushed Louis, lowers, leaving a gap of only 7.5 cm. The air supply had been cut off just before Louis went under the machine to retrieve the object he had dropped.
“When the power is off, and the air supply is turned off, it is powered by a compressor located in the woodworking shop. It took two minutes and 21 seconds for the air supply to get lost in the bin. glue which then lowers over a period of three second period, “she explained.
“It looks like the glue pot is lowered and that’s what caused the injuries to Louis,” added Miss Butler.
The investigation learned earlier that Louis, a former Burnley College student, told a colleague on the day of his death that he should not use the Horauf machine because he was not fully qualified.
(Photo: James Maloney)
However, Miss Butler reviewed Doric’s training records as part of her investigation, which showed Louis had signed documents confirming that he had completed Safe Work Systems training.
She also confirmed that there was nothing in the work safety systems documentation that referred to the time required for the air supply to the machine to be shut off or the three second period during which the glue is lowered.
“The hardest part was we had such a small window where the accident could have happened, it’s just one of those crashes where you look at it and think it’s an unfortunate event “, added Miss Butler.
“The risk of entrapment was only three seconds.”
Other witnesses, who testified on the first day of the investigation, also confirmed that Louis was properly trained. Angelina Grzechowiak, who suffered an accident when her wrist was trapped under the same machine seven weeks before Louis died, said she was among those who trained Louis and confirmed that it has been shown that he used a magnetic selector or a smaller selector to collect all the objects deposited in the operation of the machine.
A report from Sheldon Taylor, the mechanical engineer who visited Doric with Miss Butler, was read during the investigation.
“The glue pot posed an entrapment risk … The danger would not have been evident before the incident,” Taylor said in his report.
Returning to a conclusion of an accident, which relates to a deliberate act undertaken with unintended consequences, the president of the jury declared: “Louis Michael Standen died on December 3, 2019, asphyxiation caused by an external compression of the chest and neck .
“We believe Mr. Louis Standen went under the machine to retrieve a dropped item when the air pressure was cut off, it took 2 minutes 21 seconds due to the pressure drop, the glue pan dropped, moving the bin to a gap of 7.5 cm in three seconds.
Mr. Louis Standen had asked if the air pressure could be turned off and we conclude that he said yes. The loss of pressure caused the glue pan to fall, resulting in the entrapment of Louis Standen. We unanimously agree that the death of Louis Standen is the result of a mishap. “
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