Accident Report Detail

Accident Summary Nr: 118030.015 - Employee fractures leg in fall from scaffold, form detaches

Accident Summary Nr: 118030.015 -- Report ID: 0751910 -- Event Date: 07/11/2019
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
1416000.015	07/17/2019		238110	Foundations Unlimited Inc.

Abstract: At 8:45 a.m. on July 11, 2019, an employee working as a construction laborer for a concrete contractor was in the process of removing forms from the top of a foundation for a commercial building. The employee was working approximately 6 feet off the ground from a scaffold that was attached to 3-foot wide by 9-foot tall Tuf-N-Lite concrete forms. As the employee was working, a form came detached from the concrete anchors causing the employee to fall to the concrete slab below. The employee fractured his right leg and was hospitalized.

Keywords: Blunt force, Blunt force trauma, Commercial Building, Concrete, Concrete Form Work, Concrete Slab, Construction, Forming, Fracture, Insufficient Supervision, Laborer, Leg, Misjudgment, Misjudgment of Hazardous Situation, Scaffold, Struck Against, Work Surface

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Commercial building		New project or new addition				6

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	1416000.015	51	M	Hospitalized injury		Construction laborers	Distance of Fall: feet Worker Height Above Ground/Floor: 6 feet Cause: Forming Fatality Cause:

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