Accident Report Detail

Accident Summary Nr: 201164472 - Employee injured when struck by falling form

Accident Summary Nr: 201164472 -- Report ID: 0950641 -- Event Date: 02/26/2003
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
126108091	03/06/2003	1751	238130	Bomel Construction Co Inc

Abstract: At approximately 1:30 p.m. on February 26, 2003, Employee #1 was attempting to remove rigging from a 12-foot form. The rigging became entangled on the form braces as the rigging was being raised with a crane, causing the form to tip over and fell on the employee. He suffered a crushed sternum and broken ribs and was transported to Harbor UCLA Medical Center where he stayed for 9 days.

Keywords: CONCRETE FORM WORK, FRACTURE, RIGGING, CONSTRUCTION, RIB, STRUCK BY

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Commercial building		New project or new addition		$20,000,000 and over	5

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	126108091			Hospitalized injury	Fracture	Occupation not reported	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Forming Fatality Cause: Crushed/run-over by construction equipment during

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