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Occupational Safety and Health Administration OSHA

Accident Report Detail

Accident: 200122455 - Employee Is Killed In Fall From Form Work Being Dismantled

Accident: 200122455 -- Report ID: 0523400 -- Event Date: 08/04/2003
InspectionOpen DateSICEstablishment Name
30527911908/05/20031542C.D. Smith Construction, Inc.
On August 4, 2003, Employee #1 fell 25 feet from concrete form work being dismantled at a pumping station and died later that same evening.
Keywords: concrete form work, head, dismantling, construction, fall, concussion, pumping station
End Use Proj Type Proj Cost Stories NonBldgHt Fatality
Sewer/water treatment plant New project or new addition $5,000,000 to $20,000,000 2 25 X
Employee # Inspection Age Sex Degree Nature Occupation Construction
1 305279119 Fatality Other Construction laborers FallDist:
Cause: Forming
FatCause: Fall from/with structure (other than roof)

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