Accident Report Detail

Accident Summary Nr: 201120425 - EMPLOYEE INJURED IN FALL DUE TO CONCRETE FORM COLLAPSE

Accident Summary Nr: 201120425 -- Report ID: 0950613 -- Event Date: 07/02/1997
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
111829438	07/03/1997	1791	0	Casey-Fogli

Abstract: Employee #1 was pouring concrete into a second-level parking lot form when it unexpectedly collapsed under his feet and he fell down to the ground floor. Employee #1 sustained a back injury.

Keywords: CONCRETE FORM WORK, COLLAPSE, BACK, FALL, SPRAIN

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Other building		New project or new addition		$250,000 to $500,000	2

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	111829438			Hospitalized injury	Strain/Sprain	Concrete and terrazzo finishers	Distance of Fall: feet Worker Height Above Ground/Floor: 5 feet Cause: Pouring concrete floor at grade Fatality Cause: Fall, other

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