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Accident Summary Nr: 201691987 - Employee Is Injured in Fall from Ladder

Accident Summary Nr: 201691987 -- Report ID: 0950662 -- Event Date: 01/12/2004
Inspection NrDate OpenedSICNAICSEstablishment Name
30127873501/23/20041761238160Coastal Roofing Co Inc

Abstract: On January 12, 2004, Employee #1 was finishing a roofing job at the Huntington Beach Ford dealership. He was climbing an extension ladder and carrying a bucket of mastic when he lost his footing and fell to the ground. He suffered a severe head contusion and a broken collarbone and was transported to UCI Medical Center for hospitalization.

Keywords: FRACTURE, HEAD, EXTENSION LADDER, COLLARBONE, LADDER, CONSTRUCTION, ROOFER, FALL, LOST BALANCE, CONTUSION
Accident Details
End Use Project Type Project Cost Stories Non-building Height Fatality
Commercial building Alteration or rehabilitation Under $50,000 1 20

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Occupation Construction
1 301278735 Hospitalized injury Concussion Roofers Distance of Fall: feet
Worker Height Above Ground/Floor: 10 feet
Cause: Roofing
Fatality Cause: Fall from/with ladder

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