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Occupational Safety and Health Administration OSHA

Accident Report Detail

Accident: 105647.015 - Employee Falls From Concrete Form, Incurs Multiple Fractures

Accident: 105647.015 -- Report ID: 0522500 -- Event Date: 05/09/2018
InspectionOpen DateSICEstablishment Name
1316677.01505/17/2018Shook Construction Co.
At 4:30 p.m. on May 9, 2018, Employee #1 and a coworker, employed by a construct ion company, were engaged in concrete form work for a sewer/water treatment plan t. They were working from a scaffold platform attached to a form wall and setti ng and pinning concrete form panels. Needing to place a pin at the top of the f orm wall, Employee #1 climbed around a corner of the wall and up to the top. Af ter setting the pin, as he attempted to return to the scaffold platform, Employe e #1 fell backwards, a fall height of 24 feet. Emergency services were called, and Employee #1 was transported to the hospital. He was admitted and treated fo r injuries that included a fractured pelvis, multiple fractured ribs, and a frac tured vertebra.
Keywords: concrete form work, construction, fall, fall protection, fracture, pelvis, rib, scaffold, vertebra, wall
End Use Proj Type Proj Cost Stories NonBldgHt Fatality
Sewer/water treatment plant New project or new addition   1 30
Employee # Inspection Age Sex Degree Nature Occupation Construction
1 1316677.015 38 M Hospitalized injury Carpenter apprentices FallDist: 24
Cause: Pouring concrete foundations and walls

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