Accident Report Detail

Accident Summary Nr: 202507208 - Employee Is Injured by Falling Wooden Forms

Accident Summary Nr: 202507208 -- Report ID: 0950663 -- Event Date: 07/15/2009
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
311073811	07/20/2009	1799	561790	C. Overaa And Company

Abstract: At approximately 2:00 p.m. on July 15, 2009, Employee #1 had rigged a load of wooden forms that weighed approximately 780 pounds during construction of a Hydrogen Tie-In Project at the Chevron Richmond Refinery. The forms were being lifted by a Gradall forklift with slings attached to the mast of the forklift. A shackle with a screw pin connection was used to connect a top sling to two lower slings. The pin dislodged from the shackle during the lift, and the load fell approximately 8 feet and struck Employee #1, who was standing under the load. He suffered multiple rib fractures, a punctured lung, and a fractured femur. He was hospitalized with his injuries.

Keywords: FRACTURE, RIGGING, HOISTING MECHANISM, CONSTRUCTION, EQUIPMENT FAILURE, INDUSTRIAL TRUCK, MECH MAT HANDLING, STRUCK BY, SLING, FALLING OBJECT

Accident Details
End Use		Project Type		Project Cost	Stories	Non-building Height	Fatality
Refinery		New project or new addition		$5,000,000 to $20,000,000	1

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	311073811			Hospitalized injury	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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