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Occupational Safety and Health Administration OSHA

Accident Report Detail

Accident: 307391987 - Employee Struck By Falling Form

Accident: 307391987 -- Report ID: 0950611 -- Event Date: 02/16/2005
InspectionOpen DateSICEstablishment Name
30739198703/17/20051542Mitchell Engineering

At approximately 1:30 p.m. on February 16, 2005, Employee #1, an apprentice pile driver working for Mitchell Engineering Obayashi Corp dba Mitchell Engineering Obayashi, J.V., was preparing to install a steel form located inside the pit of a coffer dam that was approximately 41 feet deep. A 16-foot by 7-foot steel form had already been landed in place in the pit. As he knelt to plug in the portable saw to trim a piece of timber, other workers shouted to him to look out for a falling form. Employee #1 tried to run to avoid being hit, but the form struck him on his right rear pelvis area, knocking him to the ground. He was taken to SF General Hospital by ambulance; treated for spinal fractures, dislocated discs, and nerve damage, and hospitalized for six days. Employee #2 also sustained minor knee injuries and bruises when he tripped, trying to run from the falling form.

Keywords: spine, iron worker, construction, steel column, dislocated, struck by, falling object
Accident Details
End Use Proj Type Proj Cost Stories NonBldgHt Fatality
Bridge Maintenance or repair $500,000 to $1,000,000 41

Employee Details
Employee # Inspection Age Sex Degree Nature Occupation Construction
1 307391987 Hospitalized injury Dislocation Structural metal workers FallDist:
Cause: Forming
FatCause: Struck by falling object/projectile

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