Accident Report Detail

Accident Summary Nr: 201561842 - Employee Is Killed in Fall from Scaffold

Accident Summary Nr: 201561842 -- Report ID: 0854910 -- Event Date: 04/02/2007
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
310455175	04/02/2007	1771	238110	Formco Foundations Inc

Abstract: At approximately 2:30 p.m. on April 2, 2007, an employee was standing on a scaffold. The platform of the scaffold was located 25 feet above a wooden deck. He was holding a two and one half inch rubber hose, attempting to pour a concrete wall. The hose had plugged and he attempted to clear the hose, "shoot the rabbit." He placed a sponge rubber plug in the hose and forced it through the hose with compressed air. As the sponge cleared the end of the hose, the hose jerked and knocked the employee from the scaffold. The employee was wearing no fall protection. The scaffold appeared to consist of two 2 by 8 planks, with no guard railings. The employee fell and struck the deck. He was killed.

Keywords: DECKING, PLATFORM, HEAD, FALL, FALL PROTECTION, CONCUSSION, WORK SURFACE, SCAFFOLD

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Single family or duplex dwelling		New project or new addition		$500,000 to $1,000,000	3		X

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	310455175			Fatality	Concussion	Occupation not reported	Distance of Fall: feet Worker Height Above Ground/Floor: 25 feet Cause: Pouring concrete for piers, and pylons Fatality Cause: Fall from/with scaffold

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