Accident Report Detail

Accident Summary Nr: 120304.015 - Employee is struck by falling formwork panel and receives mu

Accident Summary Nr: 120304.015 -- Report ID: 0950611 -- Event Date: 04/03/2019
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
1390532.015	04/03/2019		236116	Pacific Structures, Inc.

Abstract: At 9:50 a.m. on April 3, 2019, an employee rigged form panels in preparation for them to be lifted by crane to the work area. The employee stood back approximately forty feet and the load was raised. At approximately one-hundred and thirty feet, a form panel broke and fell. A section of panel struck a struck and bounced off a post and struck the employee. The employee fell backwards and received lacerations to the skull and back, right leg, and right hip fractures. The employee was taken to the hospital and admitted for treatment.

Keywords: Back, Crane, Crane Load, Fall, Falling Object, Form work, Fracture, Hip, Laceration, Leg, Panel, Rigging, Skull, Struck By

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

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	1390532.015	29	M	Hospitalized injury		Construction laborers	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Forming Fatality Cause:

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