Accident Report Detail

Accident Summary Nr: 200771269 - Two employees injured when concrete form fell onto scaffold

Accident Summary Nr: 200771269 -- Report ID: 0134000 -- Event Date: 03/28/2001
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
303805220	03/28/2001	1622	0	Shea/Traylor/Healy, Joint Venture

Abstract: Two employees were working in a tunnel at the base of an associated shaft, removing concrete forms while standing on tubular welding scaffolding. When an employee applied pressure to a section of concrete form it separated from the shaft wall and tunnel roof interface and fell onto the scaffold, causing the two employees to fall sixteen feet to the tunnel floor. Employee #1 fractured his wrist, had a head laceration, and fractured a vertebra. Employee #2 received back contusions.

Keywords: CONCRETE FORM WORK, FRACTURE, HEAD, CONSTRUCTION, LACERATION, FALL, VERTEBRA, CONTUSION, WRIST

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Pipeline		Other		$20,000,000 and over	1	16

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	303805220			Hospitalized injury	Fracture	Construction laborers	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Forming Fatality Cause: Struck by falling object/projectile
2	303805220			Non Hospitalized injury	Bruise/Contus/Abras	Construction laborers	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Forming Fatality Cause: Struck by falling object/projectile

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