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<td><a href="https://misportal.jlab.org/ll/index.jsf?function=view&lessonId=969">ENG-16-0817- Minor Electric Shock from Milwaukee Heat Tool ¿ Model 1400- No Injuries</a></td>
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<h2 style="white-space:nowrap">Statement of Lessons Learned</h2>
<pre>1. Electric shock events, of any magnitude, occurring at Jefferson Lab must be reported followed by an immediate visit with Occupational Medicine.
2. When a tool is known or suspected to be defective, it must be tagged and taken out of service immediately.
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<h2 style="white-space:nowrap">Discussion of Activities</h2>
<pre>A worker experienced an electrical shock when they were using a Milwaukee brand heat tool on heat shrink tubing for a new wire connection. At that time, the worker¿s finger was touching the metallic end of the heat tool before it was hot, while their elbow on the same arm was in contact with an electrically grounded cabinet. The worker discontinued the use of this tool, and obtained another type of heat tool to complete the work.
There was some delay in reporting and investigating this event, partially attributed to the worker¿s scheduled vacation. When the individual returned to the Laboratory on Tuesday August 23rd, they were evaluated by occupational medicine and released without restriction.
The tool was subsequently tagged out of service. There are no visual indications that this equipment had been damaged. A review of the Consumer Products Safety Commission website did not indicate any recalls for this product condition. Additional investigation revealed that while the tool is labeled Milwaukee, it was manufactured by Wagner Spray Tech. Procurement records were reviewed and the purchases for this model heat tool were made approximately 2 years prior. An all-staff email has been distributed to administratively tag all similar heat tools for proper inspection and disposition.
Upon review of the equipment rack in which the worker was using the heat tool, the 120 volt outlet being used was not Ground Fault Circuit Interrupter (GFCI) protected. If the power source for this tool were GFCI protected by a Class A GFCI, a shock may still have occurred, but it would have been limited to the specifications of the GFCI trip circuit (4-6 mA trip current level).
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<h2 style="white-space:nowrap">Analysis</h2>
<pre>Equipment Difficulty:
¿ Initial thought is that the tool is defective. The tool was being sent back to the manufacturer for further analysis, and post-inspection report.
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<h2 style="white-space:nowrap">Recommended Actions</h2>
<pre>Extent of condition:
1.Survey the lab for the same exact brand/model heat gun (Milwaukee Model 1400 Heat Tool) and deliver all to ESH at trailer 35.
2. Send the defective Heat Tool to the Wagner Quality Control Department for further investigation. Depending on the outcome of the analysis done by the Wagner corporation, initiate further corrective action(s) as deemed necessary.
3. Discuss the policy on GFCI usage with the Electrical Safety Committee (ESC) meeting.
4. The policy of reporting electrical shocks to Occupational Medicine and following up with an immediate visit does not appear in the appropriate section (OCC. Med.) of the ESH manual. This policy should also be reviewed to be populated in other lab media venues (e.g. SAF100).
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<h2 style="white-space:nowrap">JLab Preventive Measures</h2>
<pre>See corrective actions</pre>
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<h2>Comments</h2>
<h5 style="white-space:nowrap">9/28/2016 8:51:50 AM by Johnson, Tina</h5>
<pre>SME reviewed and approved. PLEASE share these lessons learned within your work groups. This may also be helpful if you use similar tools at home. </pre>
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<legend>Summary</legend>
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<tr class="row">
<td class="label" nowrap>Lesson ID:</td>
<td class="dataval">969</td>
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<tr class="row">
<td class="label" nowrap>Status:</td>
<td class="dataval">OK</td>
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<tr class="row">
<td class="label" nowrap>Doc ID:</td>
<td class="dataval">2016-JLAB-969</td>
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<tr class="row">
<td class="label" nowrap>Priority:</td>
<td class="dataval">Info</td>
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<tr class="row">
<td class="label" nowrap>Safety Related:</td>
<td class="dataval">NO</td>
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<tr class="row">
<td class="label" nowrap>Originator:</td>
<td class="dataval">Johnson, Tina</td>
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<tr class="row">
<td class="label" nowrap>Issued:</td>
<td class="dataval">9/20/2016 11:32:47 AM</td>
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<tr class="row">
<td class="label" nowrap>Approved By:</td>
<td class="dataval">Johnson, Tina</td>
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<tr class="row">
<td class="label" nowrap>Approved On:</td>
<td class="dataval">9/28/2016 8:51:50 AM</td>
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<td class="label">Source:</td>
<td class="dataval">
<a href="https://www.jlab.org/div_dept/dir_off/oa/notable/secure/final%20eng-16-0817.pdf" target="_blank">TJNAF NE</a>
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<td class="label" nowrap>Location:</td>
<td class="dataval">TJNAF</td>
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<td class="label" nowrap>Cost Savings:</td>
<td class="dataval"></td>
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<tr class="row">
<td class="label" nowrap>Contact:</td>
<td class="dataval">Todd Kujawa</td>
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<tr class="row">
<td class="label" nowrap>Queued Emails:</td>
<td class="dataval">0</td>
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<tr class="row">
<td class="label" nowrap>Sent Emails:</td>
<td class="dataval">0</td>
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<tr class="row">
<td class="label" nowrap>Viewings:</td>
<td class="dataval">16 times</td>
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<legend>Attachments</legend>
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<legend>Hazard Issues</legend>
<ul class="lesson_attribute_listing">
<li>Electricity</li>
<li>Portable Hand Tools</li>
<li>50V or Greater: De-energized Work</li>
<li>50V or Greater: Diagnostic Type Operations</li>
</ul>
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<legend>Skills</legend>
<ul class="lesson_attribute_listing">
<li>SAF603: SAF603A FPA-70E BASIC ELECTRICAL TRAINING</li>
<li>SAF607: HAND TOOLS & LADDER SAFETY</li>
<li>SAF603A: ELECTRICAL SAFETY AWARENESS</li>
<li>SAF603N: NFPA-70E BASIC ELECTRICAL SAFETY</li>
<li>SAF604: HIGH VOLTAGE IN R&D</li>
<li>SAF603S: Switching of Electrical Equipment</li>
<li>SAF603M: NFPA-70E for Managers</li>
<li>SAF603N1: ARC FLASH:LIVE to TELL! (ELE016EFV)</li>
<li>SAF603N2: Electrical Safety:Beware of the Bite (ELE5EFV)</li>
<li>SAF603N3: Electrical Safety for the Qualified Worker (ELECEFV)</li>
</ul>
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<legend>Distribution/Notification</legend>
<ul class="lesson_attribute_listing">
<li>*Division Safety Officers (DSOs)</li>
<li>*Safety Wardens</li>
<li>*DOE Notification</li>
<li>*ESH&Q Liaisons</li>
</ul>
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Do you have a lesson learned you would like to contribute? Contact the <a href="mailto:mbailey@jlab.org,sjsmith@jlab.org,cjohnson@jlab.org">Lesson Learned Coordinator</a>.