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Occupational Safety and Health Administration OSHA

Accident Report Detail

Accident: 102109.015 - Employee Is Crushed When Concrete Form Falls

Accident: 102109.015 -- Report ID: 0111400 -- Event Date: 11/20/2017
InspectionOpen DateSICEstablishment Name
1278468.01511/20/2017J.L. Marshall & Sons, Inc
At 12:45 p.m. on November 20, 2017, Employee #1, employed by a construction cont ractor, was working at a multiemployer construction project, a new one-story com mercial building. He climbed a 14-foot steel form, used in the construction of a concrete column, to disconnect it from a crane. The form, which weighed more than 1,000 pounds, was not adequately braced, and it toppled over. Employee #1 fell with the form and was crushed when the form hit the ground. Emergency serv ices were called, and Employee #1 was transported to the hospital. He was admit ted and treated for crushing injuries, including a fractured pelvis and other fr actures, deep lacerations, and bruised internal organs.
Keywords: brace, concrete form work, construction, crane, crushed, fall, fall protection, falling object, fracture, laceration
End Use Proj Type Proj Cost Stories NonBldgHt Fatality
Commercial building New project or new addition   1 14
Employee # Inspection Age Sex Degree Nature Occupation Construction
1 1278468.015 58 M Hospitalized injury Carpenter FallDist:
Cause: Forming

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