Abstract 1. 1. This thirty-eight year old adult white male was caught in machinery while at work in a cement plant. The right humerus, scapula and all attached musculature were completely avulsed. He was brought to the hospital in a state of deep shock and it appeared as though he would not survive. No similar case is reported in the literature where the entire shoulder girdle was ripped away with avulsion of the amount of tissue loss in this case, with survival. 2. 2. Had it not been for immediate first aid at the plant and the rapid attendance by a physician this would have been another industrial accident death. 3. 3. The patient complained of no pain until he was completely out of shock reaction. The existence of pain is often taken for granted, especially when the patient has suffered a severe trauma. The only pain he complained of was at a late date and this was a “phantom pain” in the amputated hand and fingers which subsided in time. 4. 4. Horner's syndrome appears to have remained constant without any appreciable recession, due to injury to the cervical sympathetic nerves. 5. 5. The patient is now back at work at his usual job as a foreman at a cement plant and is well adjusted.