Accident Report Detail

Accident Summary Nr: 201113982 - Employee injured in fall from formwork

Accident Summary Nr: 201113982 -- Report ID: 0950643 -- Event Date: 06/24/2002
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
126188663	07/11/2002	1771	0	J F Shea Const. Inc.

Abstract: At 12:00 p.m. on June 24, 2002, Employee #1 with J.F. Shea Construction, was building formwork for a concrete wall during the renovation of a County of Los Angeles Sewer Treatment Plant in Valencia, CA. He was climbing the formwork wearing a full body harness and lanyard for fall protection with a positioning hook attached to the body harness for a positioning device. At an elevation of 12 to 15 ft, Employee 1 attached his positioning hook to a vertical 2-in. by 4-in. wood stiff-back used to support and brace the horizontal wood form boards. The stiff-back boards were wedged in place with metal tie-backs and wedges. The metal wedges were held in place with eight-penny nails. As Employee 1 leaned back, the stiff-back to which he was attached twisted away from structure, causing him to fall backwards to the ground. He was hospitalized at Henry Mayo Hospital in Newhall, CA for a fractured right wrist, dislocated fifth lumbar vertebrae, and bruised right heel.

Keywords: CONCRETE FORM WORK, FRACTURE, LANYARD, RIB, FALL, FALL PROTECTION, TIE-OFF, VERTEBRA, CONCRETE, WRIST

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Sewer/water treatment plant		New project or new addition		$5,000,000 to $20,000,000		20

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	126188663			Hospitalized injury	Fracture	Occupation not reported	Distance of Fall: feet Worker Height Above Ground/Floor: 15 feet Cause: Forming Fatality Cause: Fall from/with structure (other than roof)

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