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Accident Report Detail

Accident Summary Nr: 201057783 - Employee Falls Into Trench And Is Injured

Accident Summary Nr: 201057783 -- Report ID: 0950642 -- Event Date: 08/11/2003
Inspection NrDate OpenedSICNAICSEstablishment Name
30078282808/19/20031794238910Bock Company

Abstract: At approximately 10:15 a.m. on August 11, 2003, Employee #1, the company foreman, and a coworker were finishing building concrete forms to build a cast-in-place underground vault. The excavation was approximately 18 ft deep by 10 ft wide and 18 ft long. At the time of the accident the victim was standing on a 12-in. by 12-in. wooden whaler using a 2-in. by 4-in. by 8-ft board as a lever to push the end of a form flush with another form so that Employee #1 could nail both forms together. Employee #1 was not using fall protection. While pulling the wooden member, the lower end suddenly came out of place causing Employee #1 to loose his balance and fall into the excavation. Employee #1 tried to grab existing PVC conduit located a few feet below the top of the excavation in an attempt to break the fall. The attempt was unsuccessful and Employee #1 fell to the bottom of the excavation. Employee #1 sustained a lower back injury requiring surgery. Employee #1 was hospitalized.

Keywords: CONCRETE FORM WORK, EXCAVATION, FRACTURE, TRENCH, BACK, UNDRGRD INSTALLATION, FALL, FALL PROTECTION, BRACING, LOST BALANCE
Accident Details
End Use Project Type Project Cost Stories Non-building Height Fatality
Powerline, transmission line New project or new addition Under $50,000 18

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Occupation Construction
1 300782828 Hospitalized injury Fracture Construction laborers Distance of Fall: feet
Worker Height Above Ground/Floor: 18 feet
Cause: Forming
Fatality Cause: Fall from/with structure (other than roof)

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