Accident Report Detail

Accident Summary Nr: 104931.015 - Employee slips and falls from an elevated work surface and s

Accident Summary Nr: 104931.015 -- Report ID: 0950643 -- Event Date: 10/26/2017
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
1290314.015	01/26/2018		327390	Jensen Enterprises, Inc.

Abstract: At 10:51 a.m. on October 26, 2017, an employee was installing a concrete utility vault into an existing excavation. The employee completed the task and was packing up his equipment to leave the site. While strapping down several outrigger pads on top of an elevated work platform for the QMC Boom Crane Truck, the employee slipped and fell, bounced off the ground, and fell into the space between the concrete vault wall and the excavation wall. The employee suffered contusions to the head and right knee. The employee was hospitalized 24 hours after the accident.

Keywords: Boom Truck, Contusion, Elevated Work Plat, Fall, Head, Knee, Slip

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
		New project or new addition			0	5

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	1290314.015	54	M	Non Hospitalized injury		Crane Operator	Distance of Fall: 5 feet Worker Height Above Ground/Floor: 5 feet Cause: Installing equipment (HVAC and other) Fatality Cause:

Thank You for Visiting Our Website

You are exiting the Department of Labor's Web server.

The Department of Labor does not endorse, takes no responsibility for, and exercises no control over the linked organization or its views, or contents, nor does it vouch for the accuracy or accessibility of the information contained on the destination server. The Department of Labor also cannot authorize the use of copyrighted materials contained in linked Web sites. Users must request such authorization from the sponsor of the linked Web site. Thank you for visiting our site. Please click the button below to continue.