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Accident Summary Nr: 202353140 - Employee injures arm in fall

Accident Summary Nr: 202353140 -- Report ID: 0352410 -- Event Date: 05/19/2004
Inspection NrDate OpenedSICNAICSEstablishment Name
30758044905/19/20041771238110D.W. Burt Concrete Construction, Inc.

Abstract: On May 19, 2004, Employee #1 was removing concrete shores from the underside of a cured concrete floor. He was wearing a personal fall arrest harness equipped with a built-in lanyard strap; however he had removed his lanyard attachment from its anchorage point. After losing his balance, he fell over an unprotected side of the third floor to the ground. Employee #1 was hospitalized for a broken right arm.

Keywords: CONCRETE FORM WORK, FRACTURE, CONSTRUCTION, FALL, FALL PROTECTION, ARM, CONCRETE
Accident Details
End Use Project Type Project Cost Stories Non-building Height Fatality
Single family or duplex dwelling New project or new addition $5,000,000 to $20,000,000 4 40

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Occupation Construction
1 307580449 Hospitalized injury Fracture Construction trades, n.e.c. Distance of Fall: feet
Worker Height Above Ground/Floor: 30 feet
Cause: Stripping and curing concrete
Fatality Cause: Fall from/with structure (other than roof)

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