Accident Report Detail

Accident Summary Nr: 201404852 - Employee injured in fall from top of concrete form

Accident Summary Nr: 201404852 -- Report ID: 0552651 -- Event Date: 11/22/2000
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
127082998	02/13/2001	1799	0	Agricultural Building & Design Inc

Abstract: Employee #1 was climbing a fourteen foot high concrete form. When he got to the top, his hand slipped off the top of the form, allowing Employee #1 to fall to the ground. Employee #1 was hospitalized with a fracture.

Keywords: CONCRETE FORM WORK, FRACTURE, SLIP, FALL

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Other building		New project or new addition		$500,000 to $1,000,000		14

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	127082998			Hospitalized injury	Fracture	Construction laborers	Distance of Fall: feet Worker Height Above Ground/Floor: 14 feet Cause: Forming Fatality Cause: Fall, other

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