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Occupational Safety and Health Administration OSHA

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 NrDate OpenedSICNAICSEstablishment Name
12618866307/11/200217710J 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 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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