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Accident Summary Nr: 201177854 - Employee Falls Off Scaffolding

Accident Summary Nr: 201177854 -- Report ID: 0950621 -- Event Date: 06/01/2005
Inspection NrDate OpenedSICNAICSEstablishment Name
30088377406/08/20051742238310Central Valley Drywall, Inc

Abstract: On June 1, 2005, Employee #1 was unscrewing sheetrock while standing on a 4 ft high by 2 in. wide by 5ft long Terry Scaffold. Employee #1 stepped off the scaffolding and fell to the ground. Employee #1 broke his collarbone, separated his shoulder, and suffered head trauma. Employee #1 was hospitalized and treated for his injuries. Employee was seriously injured due to the forces generated from the fall.

Keywords: HEAD, SHOULDER, COLLARBONE, FALL, SCAFFOLD
Accident Details
End Use Project Type Project Cost Stories Non-building Height Fatality
Commercial building New project or new addition $1,000,000 to $5,000,000 2 30

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Occupation Construction
1 300883774 Hospitalized injury Fracture Construction laborers Distance of Fall: feet
Worker Height Above Ground/Floor: 4 feet
Cause: Interior tile work (ceramic, vinyl, acoustic)
Fatality Cause: Fall from/with scaffold

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