Accident Report Detail

Accident Summary Nr: 200674950 - One is killed, three are injured in concrete form collapse

Accident Summary Nr: 200674950 -- Report ID: 0418800 -- Event Date: 08/25/2004
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
307301929	08/25/2004	1741	238140	Camas Construction Corp.

Abstract: At 9:00 a.m. on August 25, 2004, three employees were working from the top of wood forms, pouring concrete for a tie beam. The forms suddenly collapsed, sending the employees to the ground among the wreckage. Employee #1 was struck in the head by a section of the wood form and was killed. Employee #2 was trapped in the debris and wet concrete. He was rescued by the local Fire and Rescue Service in about 1 hour. He was taken to a local trauma center and was hospitalized in serious condition. Two other employees were treated at the scene.

Keywords: CONCRETE FORM WORK, FRACTURE, HEAD, COLLAPSE, FALL, STRUCK BY

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Single family or duplex dwelling		New project or new addition		$50,000 to $250,000	1		X

Employee Details
Employee #	Inspection Nr	Degree of Injury	Nature of Injury	Occupation	Construction
1	307301929	Hospitalized injury	Other	Occupation not reported	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Pouring concrete foundations and walls Fatality Cause: Collapse of structure
2	307301929	Non Hospitalized injury	Other	Occupation not reported	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Pouring concrete foundations and walls Fatality Cause: Collapse of structure
3	307301929	Fatality	Other	Occupation not reported	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Pouring concrete foundations and walls Fatality Cause: Collapse of structure

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