Accident Report Detail
Accident Summary Nr: 201780731 - Employee Is Killed in Fall from Formwork
| Inspection Nr | Date Opened | SIC | NAICS | Establishment Name |
|---|---|---|---|---|
| 106401938 | 11/18/2004 | 1542 | 236220 | K & A Construction Corp. |
Abstract: At about 4:55 p.m. on November 17, 2004, Employee #1, a 65-year-old worker, and a coworker were constructing the formwork for a roof concrete beam. Employee #1 lost his balance when he stood on the 8-in. wide formwork and reached for lumber, which was handed up by the coworker. Employee #1 fell head first from formwork to the concrete floor about 8 ft, 3 in. He fractured his head and was killed.
| End Use | Project Type | Project Cost | Stories | Non-building Height | Fatality | ||
|---|---|---|---|---|---|---|---|
| Other building | New project or new addition | $50,000 to $250,000 | 2 | 18 | X | ||
| Employee # | Inspection Nr | Age | Sex | Degree of Injury | Nature of Injury | Occupation | Construction |
|---|---|---|---|---|---|---|---|
| 1 | 106401938 | Fatality | Fracture | Brickmasons and stonemasons | Distance of Fall: feet Worker Height Above Ground/Floor: 8 feet Cause: Forming Fatality Cause: Fall, other |
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