Accident Report Detail

Accident Summary Nr: 170110068 - Employees bruised in fall when support forms fail

Accident Summary Nr: 170110068 -- Report ID: 0111400 -- Event Date: 08/20/1991
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
107317943	08/20/1991	1542	0	Brisk Waterproofing Company

Abstract: Employees #1 through #4 were edging a 10 ft by 18 ft section of a poured concrete floor when forms supporting the concrete failed, causing the section to collapse. The employees fell 9 feet to the next floor below and suffered bruises. The project consisted of rehabilitating concrete decking of an existing garage. Joists were supported by 2 by 4s and 2 by 8s bolted to the existing concrete beam. Eccentric loads on expansion-type anchor bolts and washers, spaced 3 ft o.c. along the 2 by 8s, created shear and additional tension. Forces may have exceeded the structural capacity of the bolts, washers, and wood members. The forms were not designed by a structural engineer and no design, drawing, or plans of the forms were found at the job site.

Keywords: CONCRETE FORM WORK, JOIST, COLLAPSE, OVERLOADED, CONSTRUCTION, FALL, CONTUSION

Employee Details
Employee #	Inspection Nr	Degree of Injury	Nature of Injury	Occupation
1	107317943	Non Hospitalized injury	Bruise/Contus/Abras	Occupation not reported
2	107317943	Non Hospitalized injury	Bruise/Contus/Abras	Occupation not reported
3	107317943	Non Hospitalized injury	Bruise/Contus/Abras	Occupation not reported
4	107317943	Non Hospitalized injury	Bruise/Contus/Abras	Occupation not reported

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