At approximately 7:00 p.m. on November 15, 2006, Employee #1 was a process operator at the Chlorine Liquefaction Unit, Block A-19. He was preparing to bleed off chlorine on a process line, to clear the line for maintenance work. The valve handle indicated that it was in a CLOSED position. Employee #1 opened the cap to the bleed valve to insert a tube to clear the chlorine. However, the bleed valve was NOT completely closed, and the pressure on the chlorine line caused the cap to blow off, releasing chlorine.
Employee #1 was exposed to the inhalation hazard of chlorine gas when his airline became caught on a nearby pipe and his mask was pulled away. He continued to work until his shift was over. He went to a coworker’s home after leaving the plant because he was too tired to go home. Employee #1 was hospitalized approximately one hour later. He was pronounced dead at 10:00 a.m. on November 16, 2006.
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Violation Summary
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|---|---|---|---|---|---|
| Serious | Willful | Repeat | Other | Total | |
| Initial Violations | 2 | 2 | |||
| Current Violations | 2 | 2 | |||
| Initial Penalty | $10,000 | $0 | $0 | $0 | $10,000 |
| Current Penalty | $10,000 | $0 | $0 | $0 | $10,000 |
| FTA Amount | $0 | $0 | $0 | $0 | $0 |
| Violation Items | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| # | ID | Type | Standard | Issuance | Abate | Curr$ | Init$ | Contest | LastEvent | |
| Deleted | 1. | 01001A | Serious | 19100119 F01 IB – Normal operations; | 04/30/2007 | 05/24/2007 | $0 | $5,000 | 05/17/2007 | R – Review Commission |
| 2. | 01001B | Serious |
19100119 F04 – The employer shall develop and implement safe work practices to provide for the control of hazards during operations such as lockout/tagout; confined space entry; opening process equipment or piping; and control over entrance into a facility by maintenance, contractor, laboratory, or other support personnel. These safe work practices shall apply to employees and contractor employees. |
04/30/2007 | 05/24/2007 | $5,000 | $0 | 05/17/2007 | R – Review Commission | |
| Deleted | 3. | 01002A | Serious |
19100119 D03 II – The employer shall document that equipment complies with recognized and generally accepted good engineering practices. |
04/30/2007 | 05/24/2007 | $0 | $5,000 | 05/17/2007 | R – Review Commission |
| 4. | 01002B | Serious |
19100119 J06 II – Appropriate checks and inspections shall be performed to assure that equipment is installed properly and consistent with design specifications and the manufacturer’s instructions. |
04/30/2007 | 05/24/2007 | $5,000 | $0 | 05/17/2007 | R – Review Commission | |
Source: https://www.osha.gov/pls/imis/establishment.inspection_detail?id=310259437
I was unable to find the OSHRC Case File