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Accident Report Detail

Accident Summary Nr: 200033108 - Employee killed in fall down elevator shaft

Accident Summary Nr: 200033108 -- Report ID: 0521700 -- Event Date: 11/21/2007
Inspection NrDate OpenedSICNAICSEstablishment Name
31136982111/21/20071771238110Adjustable Forms, Inc.

Abstract: At approximately 10:00 a.m. on November 21, 2007, Employee #1, a carpenter with Adjustable Forms, Inc., was part of a three-man crew raising an elevator shaft cover from the 10th floor to the 12th floor. A coworker on the 10th floor tied a rope to the shaft cover and pried the cover loose, preparing it to be raised. The coworker on the 13th floor told Employee #1 to wait until he came down to help pull the cover up. Apparently Employee #1 started to pull the cover up by himself because the coworker on the 10th floor later stated that the cover began to rise. Once the full weight of the cover came off the 10th floor, it began to fall. Employee #1 was pulled through the guardrail system and briefly held onto the rope, but eventually fell through the shaft opening. He crashed through the permanent cover on the first floor and landed in the elevator pit, approximately four stories below ground level. Employee #1 was killed.

Keywords: COVER, GUARDRAIL, CARPENTER, WORK RULES, CONSTRUCTION, FALL, FALL PROTECTION, FLOOR OPENING, ELEVATOR SHAFT
Accident Details
End Use Project Type Project Cost Stories Non-building Height Fatality
Single family or duplex dwelling New project or new addition $20,000,000 and over 15 X

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Occupation Construction
1 311369821 Fatality Other Occupation not reported Distance of Fall: feet
Worker Height Above Ground/Floor: 160 feet
Cause: Installation Of Decking-Initial Laying Deck (Incl
Fatality Cause: Fall through opening (other than roof)

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