Accident Report Detail

Accident Summary Nr: 200640829 - One employee killed, one injured by falling concrete form

Accident Summary Nr: 200640829 -- Report ID: 0627700 -- Event Date: 01/16/1998
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
301873568	01/23/1998	1629	0	Wells Enterprises

Abstract: Employees #1 and #2 were attaching a crane sling to a concrete form to remove it from the concrete sound barrier wall that was being built. The two men stepped onto the whaler at the bottom of the form, whereupon it let go and fell on top of them. Employee #1 was killed and Employee #2 sustained a severely fractured ankle. At the time of the accident, there were no taper pins in the forms to hold them together, nor was the form braced on the side that fell.

Keywords: CONCRETE FORM WORK, UNSECURED, WORK RULES, MECH MAT HANDLING, STRUCK BY, BRACING, FALLING OBJECT

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Highway, road, street		New project or new addition		$20,000,000 and over	1		X

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	301873568			Fatality	Other	Occupation not reported	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Pouring concrete foundations and walls Fatality Cause: Lifting operations
2	301873568			Hospitalized injury	Other	Occupation not reported	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Pouring concrete foundations and walls Fatality Cause: Lifting operations

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