Accident Report Detail

Accident Summary Nr: 200211522 - Employee killed when struck by falling mass of concrete

Accident Summary Nr: 200211522 -- Report ID: 0626000 -- Event Date: 10/12/2004
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
308080712	10/12/2004	1771	238110	Keystone Structural Concrete Ltd.

Abstract: On October 12, 2004, Employee #1 was removing plywood sheeting from an overhead, hollow, inverted concrete pan. The pan form had accidentally became filled with concrete. Employee #1 was taking off the sheeting when the concrete mass that was in the form and supported by the plywood fell out and struck him. Employee #1 was killed.

Keywords: CONCRETE FORM WORK, WORK RULES, CONSTRUCTION, STRUCK BY, FALLING OBJECT, ACCIDENTAL DISCHARGE

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Other building		New project or new addition		$1,000,000 to $5,000,000	2	6	X

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	308080712			Fatality	Other	Laborers, except construction	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Pouring or installing floor decks Fatality Cause: Struck by falling object/projectile

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