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Accident Report Detail

Accident Summary Nr: 200271641 - Employee Is Struck by Falling Form and Is Killed

Accident Summary Nr: 200271641 -- Report ID: 0524500 -- Event Date: 12/19/2006
Inspection NrDate OpenedSICNAICSEstablishment Name
30857508312/19/20063272327390Prestress Engineering Corporation

Abstract: On Tuesday, December 19, 2006, three employees were working as the set-up crew, breaking down a concrete form from 102 feet high to 90 feet high, taking the bottom rollers off, and servicing and maintaining the rollers at the south end of the 350 East Bed. The three employees were in the process of taking off the rollers. The beds, made of concrete and concrete forms, were located outside on the west side of the property. The beds were approximately 400 feet long and 10 feet deep with approximately 340 feet of form located in the beds. The employees were on day 2 of a 5-day process of tearing down the bed. The employees had taken one set of rollers off a 30-foot section of form and proceeded to the next form. At approximately 10:30 a.m., Employee #1 started to jack up the form with the form jack when he realized they had forgotten a metal shim that was needed at the other section of the form. Employee #1 went to the previous section of the form to look for the metal shim but could not find it. A coworker started walking toward Employee #1 to help find the metal shim. While the coworker was walking toward Employee #1, the 30-foot section of form fell on Employee #1 crushing him, and he was declared dead at the scene. Employee #1, age 40, had been employed as a laborer for Prestress Engineering Corporation, a manufacturing facility of concrete products, for 7.5 weeks. This work was a normal routine, and Employee #1 had performed it daily since he was hired.

Keywords: CONCRETE FORM WORK, CRUSHED, FALLING OBJECT, JACK

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Occupation
1 308575083 Fatality Other Occupation not reported

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