Accident Report Detail

Accident Summary Nr: 51726.015 - Employee falls through elevator shaft and is killed

Accident Summary Nr: 51726.015 -- Report ID: 0626700 -- Event Date: 08/29/2013
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
936636.015	08/29/2013		238110	United Forming, Inc.

Abstract: At 12:00 p.m. on August 29, 2013, Employee #1 was stripping forms to move to the next level of the pour for the elevator shaft. The employee fell from the working platform, down the shaft, to the underground portion of the shaft, and hit the slab below. Employee #1 was killed from severe lacerations to his back, head, and multiple broken bones.

Keywords: Back, Concrete Slab, Elevated Work Platform, Elevator, Elevator Shaft, Fall, Fracture, Head, Laceration, Struck Against

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	11	110	X

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation	Construction
1	936636.015	31	M	Fatality		Concrete and terrazzo finishers	Distance of Fall: 110 feet Worker Height Above Ground/Floor: 110 feet Cause: Forming Fatality Cause:

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