Accident Report Detail
Accident Summary Nr: 201340544 - Employee injured in fall from concrete form
| Inspection Nr | Date Opened | SIC | NAICS | Establishment Name |
|---|---|---|---|---|
| 302753538 | 04/26/1999 | 1542 | 0 | Dondlinger & Sons Construction Co. Inc. |
Abstract: Employee #1 fell approximately seven feet to the ground from a Symons concrete form. Employee #1 was wearing a full-body harness with a positioning chain and hook connected to both "D" rings on his hips. Employee #1 was on the form to remove dog bolts to facilitate form removal. The positioning hook was attached to a 4-inch by 4-inch piece of wood. However, the hook did not latch closed due to the size of the piece of wood. Employee #1 shifted his weight and the hook rolled off the wood, causing him to fall from the form. Employee #1 was hospitalized with bruises, contusions, and abrasions.
| End Use | Project Type | Project Cost | Stories | Non-building Height | Fatality | ||
|---|---|---|---|---|---|---|---|
| Other building | New project or new addition | $1,000,000 to $5,000,000 | 7 | 14 | |||
| Employee # | Inspection Nr | Age | Sex | Degree of Injury | Nature of Injury | Occupation | Construction |
|---|---|---|---|---|---|---|---|
| 1 | 302753538 | Hospitalized injury | Bruise/Contus/Abras | Construction laborers | Distance of Fall: feet Worker Height Above Ground/Floor: 7 feet Cause: Forming Fatality Cause: Fall from/with structure (other than roof) |
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