Accident Report Detail
Accident Summary Nr: 201126521 - Employee injured in same-level fall on work platform
| Inspection Nr | Date Opened | SIC | NAICS | Establishment Name |
|---|---|---|---|---|
| 310093257 | 01/11/2008 | 1622 | 237310 | Disney Construction Inc. |
Abstract: At approximately 4:00 p.m. on December 17, 2007, Employee #1 and a coworker were engaged in concrete form work at a shopping center in Pacifica, CA. They were on a Form Traveler, standing on a concrete form and holding the spreader bar, a round metal pipe approximately 30 ft long and 5 in. in diameter. Employee #1 was cutting the pipe braces to set them on the forms for the Form Traveler. When he cut the wire and held the full weight of the heavy pipe, he lost his balance and fell on the same level, landing on his left side on the wooden beam. He sustained fractured ribs and injured his shoulder. Employee #1 later stated that he was well-trained and that it was an accidental fall.
| End Use | Project Type | Project Cost | Stories | Non-building Height | Fatality | ||
|---|---|---|---|---|---|---|---|
| Bridge | New project or new addition | $20,000,000 and over | 1 | 100 | |||
| Employee # | Inspection Nr | Age | Sex | Degree of Injury | Nature of Injury | Occupation | Construction |
|---|---|---|---|---|---|---|---|
| 1 | 310093257 | Hospitalized injury | Fracture | Carpenter apprentices | Distance of Fall: feet Worker Height Above Ground/Floor: 1 feet Cause: Forming Fatality Cause: Fall, other |
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