Photo: 123RF
A baker lost half his arm after he became stuck in a blocked crumbing machine without an operational shut-off sensor.
He was working night shift at Christchurch family business Baker Boys and went to assist two colleagues before matters took a horrible turn.
The victim was in another room, weighing up ingredients while his colleagues were mixing and packing the machine.
As the machine became blocked and required clearing, one of them tried to free the blockage by kicking it numerous times.
When that failed, the victim and another person stepped in to assist.
They separated a screw conveyor and crumbing machine, and the victim then removed a guard and began clearing the blocked infeed with his hand.
The ingredients blocking the crumbing machine obscured the screw, which was still rotating.
As he was clearing the blockage, his right hand was caught by the rotating screw.
An ambulance was called, and he was admitted to hospital, where he underwent surgery.
Unfortunately, his hand could not be reattached and half of his forearm had to also be amputated.
Baker Boys and electrical contractors Pye Electrical were found responsible following a WorkSafe investigation and were sentenced in Christchurch District Court on Thursday.
A summary of facts showed Pye Electrical carried out weekly electrical maintenance at the Baker Boys facility and had completed 2800 jobs for them since 2007.
At the time of the incident, the sensor showed signs of wear and damage, and was not operational.
The safety relay had been bridged out, allowing the machine to run, while the guard was found not to be compliant as it would not prevent someone reaching through into the screw conveyor.
The sensor on the machine was bypassed more than two years before the August 2023 incident.
A Pye Electrical director carried out the work in March 2021, assuming Baker Boys was made aware of the sensor bypass after communicating with one of their engineers.
A two-page invoice issued to Baker Boys by Pye a few days after stated the work had been done and the invoice was paid.
Baker Boys Christchurch. Photo: Supplied/Google Maps Street View
Experts find faults
Baker Boys contacted WorkSafe on the day of the incident, and inspectors attended the scene and issued a non-disturbance notice.
WorkSafe issued a shutdown notice after a scene examination the next day and a month later, attended the scene with an engineering expert.
The expert concluded it was likely the bridging of the relay contributed to the incident, stating the lack of well-tried safety principles such as having no electrical protection for the circuit, as well as the number of parts by which failure could lead to a dangerous state, resulted in a performance level that did not meet minimum requirements.
The expert found other issues with the machine, including a non-compliant guard, its emergency stop design and its location.
Baker Boys also engaged an expert who concluded the design of the safety architecture of the control system did not follow basic safety principles and as such, the machine did not achieve even the most basic level of safety architecture.
Pye said it had taken several remedial steps and made improvements since the incident, accepting that the work carried out in March 2021 was not in accordance with its standards.
Companies failed to identify risks
The summary of facts said the risk was an inadequately guarded machine, including a sensor that had been bypassed, which exposed the victim to the moving parts of the machine when clearing a blockage.
Pye Electrical had failed to ensure the bypass on the machine was only temporary and to ensure the bypass was communicated effectively to Baker Boys.
Baker Boys failed to undertake an adequate risk assessment to identify risks associated with the machine and to adequately monitor the effectiveness of the machine controls.
It also failed to ensure the machine was adequately guarded, monitor its compliance and review the effectiveness of the system of work for clearing blockages.
As a result, Baker Boys was found to have failed to comply with its duty to ensure reasonable health and safety and exposed workers to a risk of death or serious injury.
The business was fined $35,000 and told to pay $9290 in reparations at the sentencing.
Pye Electrical was fined $30,000 and told to pay $26,937 in reparations for putting Baker Boys employees at risk from work carried out as part of the conduct of its business.
WorkSafe acting regional manager Darren Handforth said bypassing a safety sensor and not reinstating it "is bad enough, but for a worker to then lose half their arm as a result is horrific".
"For its part, Baker Boys' risk assessment was inadequate, and its machine guarding did not meet standards.
"Workers should not be suffering harm like this in 2025, and businesses must manage their risks."
This story originally appeared in the New Zealand Herald.