Accident Report Detail

Accident Summary Nr: 136206.015 - Employee incurs contusion in lower back while attempting to

Accident Summary Nr: 136206.015 -- Report ID: 0336000 -- Event Date: 05/28/2021
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
1535621.015	06/09/2021		321992	Champion Modular, Inc.

Abstract: At 10:00 a.m. on May 28, 2021, Employee #1 was attempting to right an engineered scaffold that had tipped over. As the employee and others tried to reposition it, the scaffold fell farther to the ground instead of resting on the catwalk. Employee #1 sustained a contusion to the lower back and was hospitalized for treatment.

Keywords: Back, Catwalk, Contusion, Scaffold, Scaffold Collapse, Scaffolding, Tips Over

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury
1	1535621.015	47	M	Hospitalized injury

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