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Accident: 100979.015 - Employee Falls During Concrete Form Removal And Fractures Hi

Accident: 100979.015 -- Report ID: 0418200 -- Event Date: 11/17/2017
InspectionOpen DateSICEstablishment Name
1279016.01511/20/2017Baker Concrete Construction
At 9:00 a.m. on November 17, 2017, Employee #1, employed by a concrete construction company, was engaged in removing a concrete form at a construction jobsite. He was anchored to the form so that he could attach a crane's hook. The crane then would lower the form to the ground. When Employee #1 climbed the form, it became unbalanced and fell. Employee #1 rode the form to the ground, a fall height of 10 feet, and was injured on impact. Emergency services were called, and Employee #1 was transported to the hospital. He was admitted and treated for a fractured hip and contusions.
Keywords: anchor, concrete form work, crane hook, fall, fracture, hip, fall protection, dismantling, construction, crane
End Use Proj Type Proj Cost Stories NonBldgHt Fatality
Other building New project or new addition   9
Employee # Inspection Age Sex Degree Nature Occupation Construction
1 1279016.015 40 M Hospitalized injury Fracture Carpenters FallDist:
FallHt:
Cause:
FatCause: Fall from/with structure (other than roof)

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