Accident Report Detail

Accident Summary Nr: 200356152 - Employee Falls from Form Work, Fractures Wrist

Accident Summary Nr: 200356152 -- Report ID: 0453710 -- Event Date: 04/24/2007
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
310925334	04/24/2007	1771	238110	Rebaroco Inc

Abstract: Employee #1 was working within the concrete form work of the elevator penthouse on a six-story condominium building. Employee #1 was creating holes in the form panels in order to tie reenforcement bar support chairs. When Employee #1 finished his task he unhooked his positioning device and began to climb out when he lost his grasp on a whaler board and fell approximately 12-ft to 14-ft onto a temporary plywood platform. Employee #1 broke his left wrist. Employee #1 was treated but was not hospitalized.

Keywords: CONCRETE FORM WORK, FRACTURE, REBAR, FALL, LOST BALANCE, WRIST

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Multi-family dwelling		New project or new addition		$5,000,000 to $20,000,000	6

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	310925334			Non Hospitalized injury	Fracture	Occupation not reported	Distance of Fall: feet Worker Height Above Ground/Floor: 70 feet Cause: Forming Fatality Cause: Fall from/with structure (other than roof)

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