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Accident Summary Nr: 767848 - Employee killed in fall in elevator shaft

Accident Summary Nr: 767848 -- Report ID: 0626300 -- Event Date: 05/13/1992
Inspection NrDate OpenedSICNAICSEstablishment Name
10679356505/14/199217990Cap Form, Incorporated
Inspection NrDate OpenedSICNAICSEstablishment Name
10679355705/14/199215420Hcb Contractors

Abstract: Employee #1, a 37-year-old labor foreman, was wrecking wooden forms over an elevator shaft opening. He was standing on the wooden forms, which consisted of multiple 2 by 10s, 4 by 6s, and a 2 by 12. He was removing the nails and cutting the boards when the formwork collapsed, causing him to fall 18 ft through the opening and land on the concrete floor of the shaft. Employee #1 was killed.

Keywords: CONCRETE FORM WORK, WORK RULES, ELEVATOR SHAFT, DISMANTLING, COLLAPSE, CONSTRUCTION, UNSTABLE SURFACE, FALL

Employee Details
Employee # Inspection Nr Age Sex Degree of Injury Nature of Injury Occupation
1 106793565 Fatality Other Occupation not reported
2 106793557 Occupation Not Listed

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