Accident Report Detail

Accident Summary Nr: 111222.015 - Employee falls when form work panel collapses and receives f

Accident Summary Nr: 111222.015 -- Report ID: 0626000 -- Event Date: 11/17/2018
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
1361882.015	11/19/2018		237310	Flatiron/Dragados, Llc

Abstract: At 7:30 a.m. on November 17, 2018, an employee was attaching rebar to the top of a concrete column. At some point, during the work, a form work panel adjacent to the employee collapsed causing the employee to fall approximately twelve feet. The employee was taken to a hospital for treatment of fractures to both legs.

Keywords: Collapse, Concrete Form Work, Fall, Fall Protection, Fracture, Leg, Rebar

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Highway, road, street		Other			0	12

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	1361882.015	34	M	Hospitalized injury		Construction trades, n.e.c.	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Forming Fatality Cause:

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