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Accident Report Detail

Accident Summary Nr: 128954.015 - Foreman, tied off to falling concrete form, is killed when c

Accident Summary Nr: 128954.015 -- Report ID: 0418100 -- Event Date: 08/24/2020
Inspection NrDate OpenedSICNAICSEstablishment Name
1489809.01508/24/2020238190Cornerstone Forming, Llc

Abstract: At 10:50 a.m. on August 24, 2020, Employee #1 and a coworker, employed by a concrete construction company, were working at a multi-employer project, the construction of a hospital building. They were in the process of lifting and repositioning a pre-cast concrete column form, designated north side panel, using a tower crane operated by the coworker. Employee #1, the crew foreman, was tied off to another concrete form, designated west side panel. The two forms had been connected by pins, and all the pins but one had been removed. The one pin inadvertently remaining continued to connect the two panels. As the crane lifted the north panel approximately 3 inches to adjust its position, the remaining connecting pin broke free, which caused the west panel to twist and fall with Employee #1 still tied to it. The panel fell on top of Employee #1, and Employee #1 was crushed between the panel and a generator. Employee #1 initially tried to talk and get up, but later that day he died from the crushing injuries.

Keywords: Bolt, Caught Between, Concrete Panel, Construction, Crane, Crushed, Crushing, Electric Generator, Fall, Fall Protection, Form work, Pin, Tie-Off, Tower Crane
Accident Details
End Use Project Type Project Cost Stories Non-building Height Fatality
Other building New project or new addition   0 18 X

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Construction
1 1489809.015 33 M Fatality Distance of Fall: feet
Worker Height Above Ground/Floor: feet
Cause: Forming
Fatality Cause:

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