Accident Report Detail

Accident Summary Nr: 202014114 - Employee Dies after Being Struck by Concrete Form

Accident Summary Nr: 202014114 -- Report ID: 0216000 -- Event Date: 03/14/2005
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
307663864	03/14/2005	1794	238910	Site Works Contracting Corp.

Abstract: Employee #1 was lowering an 8-foot by 8-foot concrete form that weighed approximately 820 pounds when the form came loose from the lifting hooks and struck him in the head. He suffered fractures and was transported to the hospital where he later died.

Keywords: CONCRETE FORM WORK, FRACTURE, CONSTRUCTION, EQUIPMENT FAILURE, STRUCK BY, FALLING OBJECT

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Commercial building		Alteration or rehabilitation		Under $50,000	1		X

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	307663864			Fatality	Fracture	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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