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Accident Report Detail

Accident Summary Nr: 201166972 - Employee Sustains Concussion When Struck by Lumber

Accident Summary Nr: 201166972 -- Report ID: 0950641 -- Event Date: 06/03/2005
Inspection NrDate OpenedSICNAICSEstablishment Name
12615016806/07/20051771238990Structural Shotcrete Systems Inc

Abstract: At 2:20 p.m. on June 3, 2005, Employee #1, with Structural Shotcrete Systems, was standing on the planks of a short scaffold applying Shotcrete to a wall. A load of metal clamps used for form works was being transported overhead on a job-made wooden pallet. This pallet was constructed using 4-ft by 8-ft by 1-in.-thick plywood with four pieces of 4-in by 4-in. lumber nailed underneath. As the load passed over Employee #1, the plywood bent in the middle and a piece of lumber fell on him. Employee #1 was transported to California Medical Hospital, where he was treated for a concussion.

Keywords: HEAD, SUSPENDED LOAD, LUMBER, STRUCK BY, CONCUSSION, FALLING OBJECT, SCAFFOLD
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 65

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Occupation Construction
1 126150168 Non Hospitalized injury Concussion Brickmasons and stonemasons Distance of Fall: feet
Worker Height Above Ground/Floor: feet
Cause: Waterproofing
Fatality Cause: Struck by falling object/projectile

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