Accident Report Detail

Accident Summary Nr: 127645.015 - Employee sustains head contusion when struck by falling form

Accident Summary Nr: 127645.015 -- Report ID: 0111400 -- Event Date: 07/10/2020
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
1482713.015	07/10/2020		238110	Marguerite Concrete, Inc.

Abstract: At 8:00 a.m. on July 10, 2020, an employee working as a carpenter for a structural concrete contractor was on the ground tending to form climbers. The employee attached a Peri form tie pin to a rope so a coworker at the top of a form could hoist it up to put in place. The form pin got snagged on a metal object on the way up, turning over and sliding out of the knot, and striking the employee on his head. The employee received medical treatment without hospitalization for a contusion on his head.

Keywords: Carpenter, Commercial Building, Concrete Form Work, Construction, Contusion, Falling Object, Form work, Head, Hoist, Hoisting Mechanism, Hoistline, Misjudgment, Misjudgment of Hazardous Situation, Pin, Struck By

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Commercial building		New project or new addition			3	30

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	1482713.015	30	M	Non Hospitalized injury		Carpenters	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Pouring concrete foundations and walls Fatality Cause:

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