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Occupational Safety and Health Administration OSHA

Accident Report Detail

Accident: 201032752 - Employee Injures Head In Fall From Concrete Form

Accident: 201032752 -- Report ID: 0950635 -- Event Date: 11/18/1999
InspectionOpen DateSICEstablishment Name
12606694312/07/19991771Sure Forming System
At approximately 1:30 p.m. on November 18, 1999, Employee #1, a carpenter, was hanging a plumb bob on a concrete form high above the ground. His hands slipped and he fell about 12 ft, landing in a concrete hopper. Employee #1 suffered a contusion on his head and was transported by Los Angeles County paramedics to Harbor General Hospital, where he remained for five days. As his release, he was treated as an outpatient and underwent therapy.
Keywords: concrete form work, head, carpenter, work rules, slip, construction, climbing on column, fall, fall protection, contusion
End Use Proj Type Proj Cost Stories NonBldgHt Fatality
Single family or duplex dwelling New project or new addition Under $50,000 2 5
Employee # Inspection Age Sex Degree Nature Occupation
1 126066943 Hospitalized injury Bruise/Contus/Abras Carpenters

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