Accident Report Detail

Accident Summary Nr: 141723.015 - Employee falls from scaffold form and receives multiple inju

Accident Summary Nr: 141723.015 -- Report ID: 0830500 -- Event Date: 12/07/2021
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
1567418.015	12/08/2021		238910	Native Sun Materials Inc.

Abstract: At 12:30 p.m. on December 7, 2021, an employee worked to reposition scaffolding form system to the next higher bracket on an elevator and stairway core. As the system was hoisted by crane, the system shifted and turned ninety degrees and the employee fell approximately sixty-five feet. The employee landed on their feet, but lost consciousness. Shortly after, the employee regained consciousness and was hospitalized to treat a possible brain bleed, injury to pelvis, back injuries, leg fracture and wrist injuries.

Keywords: Back, Brain Bleed, Crane, Elevator, Fall, Fall From Elevation, Fall Protection, Fracture, Hoist, Leg, Load Shift, Loss of consciousness, Pelvis, Scaffold, Stair, Unconsciousness, Wrist

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Multi-family dwelling		New project or new addition			6

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Construction
1	1567418.015	21	M	Hospitalized injury		Distance of Fall: 65 feet Worker Height Above Ground/Floor: 65 feet Cause: Elevator, escalator installation Fatality Cause:

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