Accident Report Detail

Accident Summary Nr: 201989324 - Employee injures head when struck by form

Accident Summary Nr: 201989324 -- Report ID: 0950411 -- Event Date: 05/19/2003
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
306757196	05/19/2003	1771	238110	Suntec Concrete, Inc.

Abstract: On May 19, 2003, Employee #1 was removing a section of metal concrete form when the piece of form broke loose striking him in the head and causing him to fall. He was hospitalized with laceration.

Keywords: CONCRETE FORM WORK, HEAD, CONSTRUCTION, LACERATION, FALL, STRUCK BY, FALLING OBJECT

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Multi-family dwelling		New project or new addition		$5,000,000 to $20,000,000	5	60

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	306757196			Hospitalized injury	Cut/Laceration	Construction laborers	Distance of Fall: feet Worker Height Above Ground/Floor: feet Cause: Forming Fatality Cause: Struck by falling object/projectile

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