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Accident Summary Nr: 201521796 - Employee injured in fall from roof

Accident Summary Nr: 201521796 -- Report ID: 0111500 -- Event Date: 08/14/2003
Inspection NrDate OpenedSICNAICSEstablishment Name
12315307408/19/20031761238160Landmark Exteriors, Inc.

Abstract: On August 14, 2003, Employee #1 carried a roll of roofing material onto a residential roof. As he lifted the roll, it hit the eave of a dormer. He lost his balance, struck a ladder jack scaffold, then a lower roof level, and then fell to the ground (a total fall of about 20 ft). Employee #1 was hospitalized for a fractured right shoulder and pelvis.

Keywords: FRACTURE, ROOF, SHOULDER, STRUCK AGAINST, PELVIS, FALL, LOST BALANCE, SLOPE, SCAFFOLD
Accident Details
End Use Project Type Project Cost Stories Non-building Height Fatality
Single family or duplex dwelling Maintenance or repair Under $50,000 2

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Occupation Construction
1 123153074 Hospitalized injury Fracture Occupation not reported Distance of Fall: feet
Worker Height Above Ground/Floor: 21 feet
Cause: Roofing
Fatality Cause: Fall from roof

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