Accident Report Detail

Accident Summary Nr: 115470.015 - Employee falls from form, fractures ribs and wrist

Accident Summary Nr: 115470.015 -- Report ID: 0317900 -- Event Date: 03/26/2019
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
1394077.015	04/18/2019		238110	Hamm Brothers Concrete Contractors, Inc.

Abstract: At 9:45 a.m. on March 26, 2019, Employee #1, employed by a concrete construction contractor, was engaged in form work at a residential site. He was standing on top of a form 9 feet above grade and pouring concrete into the form when air got into the concrete hose. The hose jerked and the employee was knocked off the form. The employee fell 9 feet. The employee was transported to the hospital, where he was admitted for treatment of multiple fractured ribs and a fractured wrist.

Keywords: Blunt force trauma, Concrete Form Work, Fall, Fall Protection, Fracture, Installing, Residential Construction, Rib, Struck By, Work Surface, Wrist

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
		New project or new addition				9

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	1394077.015	52	M	Hospitalized injury		Concrete and terrazzo finishers	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Forming Fatality Cause:

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