Accident Report Detail

Accident Summary Nr: 922534 - Employee killed in unprotected 30 ft fall

Accident Summary Nr: 922534 -- Report ID: 0418200 -- Event Date: 06/23/1994
Inspection Nr	Date Opened	SIC	NAICS	Establishment Name
108961426	06/29/1994	1542	0	United Forming

Abstract: Employee #1, who was employed by a form work subcontractor, was working on a hospital renovation/addition. According to a witness, Employee #1 passed through a guardrail without wearing a safety belt. He then set a 4 by 4 at an upward angle to a column, climbed it, and began work. The 4 by 4 slipped or rolled, causing Employee #1 to fall approximately 30 feet from the fourth floor to the second floor. He later died from the injuries he sustained.

Keywords: CONCRETE FORM WORK, UNSECURED, WORK RULES, SAFETY BELT, SLIP, CONSTRUCTION, FALL, UNSTABLE POSITION

Employee Details
Employee #	Inspection Nr	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	108961426			Fatality	Concussion	Occupation not reported

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