Abstract: At 2:30 p.m. on September 13, 2017, Employee #1, employed by a concrete construction company, was engaged in forming work at the construction site for a one-story residential structure. He was spraying a form with form oil when the hose became wrapped around his foot. Employee #1 lost balance and, as he reached across the form rack to regain balance, his fingers became pinched/caught in the form rack. Employee #1 began to fall, a fall height of approximately 5 feet. As he fell, a rack hook caught his bicep and ripped it open to the forearm. Emergency services were called, and Employee #1 was transported to the hospital. He was admitted and treated for a laceration to his left arm with severed nerves in the bicep down to the forearm. During the subsequent investigation, it was determined that this injury occurred during Employee #1's third day working for the employer. This was Employee #1's first time performing this procedure.