Accident Report Detail

Accident Summary Nr: 121094.015 - Employee incurs multiple injuries in fall from roof or roof

Accident Summary Nr: 121094.015 -- Report ID: 0524200 -- Event Date: 10/17/2019
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
1440549.015	10/25/2019		238160	Robert Kulesza Dba Super Remodeling, Inc.

Abstract: At 7:45 p.m. on October 17, 2019, an employee was working as a roofer. At an unspecified point, the employee either fell approximately twenty feet from the roof or an access ladder (no witnesses were present.) The employee received severe head and body blunt force trauma. The employee was taken to a local hospital, where he later died of his injuries.

Keywords: Blunt force trauma, Fall, Fall Protection, Head, Ladder, Roof, Roofer, Torso

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Commercial building		Alteration or rehabilitation			1	20	X

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Construction
1	1440549.015	61	M	Fatality		Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Roofing Fatality Cause:

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