Accident Report Detail

Accident Summary Nr: 105647.015 - Employee falls from concrete form, incurs multiple fractures

Accident Summary Nr: 105647.015 -- Report ID: 0522500 -- Event Date: 05/09/2018
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
1316677.015	05/17/2018		236210	Shook Construction Co.

Abstract: At 4:30 p.m. on May 9, 2018, Employee #1 and a coworker, employed by a construction company, were engaged in concrete form work for a sewer/water treatment plant. They were working from a scaffold platform attached to a form wall and setting and pinning concrete form panels. Needing to place a pin at the top of the form wall, Employee #1 climbed around a corner of the wall and up to the top. After setting the pin, as he attempted to return to the scaffold platform, Employee #1 fell backwards, a fall height of 24 feet. Emergency services were called, and Employee #1 was transported to the hospital. He was admitted and treated for injuries that included a fractured pelvis, multiple fractured ribs, and a fractured vertebra.

Keywords: Concrete Form Work, Construction, Fall, Fall Protection, Fracture, Pelvis, Rib, Scaffold, Vertebra, Wall

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Sewer/water treatment plant		New project or new addition			1	30

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	1316677.015	38	M	Hospitalized injury		Carpenter apprentices	Distance of Fall: 24 feet Worker Height Above Ground/Floor: 24 feet Cause: Pouring concrete foundations and walls Fatality Cause:

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