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Occupational Safety and Health Administration OSHA

Accident Report Detail

Accident Summary Nr: 121334.015 - Supervisor Is Injured By Falling Load From Forklift

Accident Summary Nr: 121334.015 -- Report ID: 0627500 -- Event Date: 05/11/2019
Inspection NrDate OpenedSICNAICSEstablishment Name
1402059.01505/13/2019238290New Millennium System Installations

Abstract: At 3:15 p.m. on May 11, 2019, Employee #1, a supervisor employed by a company p roviding rack and pallet installations, was working with crew members at a wareh ouse and installing a multi-level rack system. The supervisor was giving direc tions as rack frame components were lifted on the forks of a forklift. He was s tanding beneath the elevated load when one of the forks and load components fell from the lift, an estimated fall height of 15 feet, and struck the supervisor o n the head and shoulder. The supervisor was transported to the hospital and adm itted for treatment of head, shoulder, and upper back injuries. He remained hos pitalized for several weeks.

Keywords: back, blunt force trauma, construction, falling object, forklift, forks, head, installing, shoulder, spine, storage rack, struck by
Accident Details
End Use Project Type Project Cost Stories Non-building Height Fatality
Commercial building New project or new addition   1 15

Employee Details
Employee # Inspection Nr Age Sex Degree Nature of Injury Occupation Construction
1 1402059.015 35 M Hospitalized injury Supervisors; handlers,equip-cleaners,laborers nec Distance of Fall: feet
Worker Height Above Ground/Floor: feet
Cause: Temporary work (buildings, facilities)
Fatality Cause:

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