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Occupational Safety and Health Administration OSHA

Accident Report Detail

Accident: 201076056 - Employee Sustains Multiple Injuries In Fall

Accident: 201076056 -- Report ID: 0950632 -- Event Date: 12/02/2010
InspectionOpen DateSICEstablishment Name
31268509212/09/20101541Rudolph & Sletten
At approximately 6:45 a.m. on December 2, 2010, Employee #1 was working as journeyman carpenter at a jobsite in La Jolla, CA. Employee #1 was assigned the job of replacing a pair of screw jacks on a metal form in a parking garage. Employee #1 climbed the metal falsework support form to reach the two screw jacks. He climbed down to retrieve the replacement jacks, and his feet slipped on the form. Employee #1 tried to hold onto the header beam he had just released from the form, but it slipped out, and he fell backward approximately 5 to 6 feet. He landed partially on the concrete deck and partially on an excavated dirt pit below, and suffered a broken clavicle and dislocated shoulder from the fall. The 6-foot long metal beam fell off the top of the form and fell 11 feet on to Employee #1. Employee #1 deflected the beam with his left hand and fractured his wrist. Employee #1 was transported to Scripps Memorial Hospital, where he was hospitalized for more than two days.
Keywords: fracture, shoulder, collarbone, climbing on column, fall, fall protection, wrist
End Use Proj Type Proj Cost Stories NonBldgHt Fatality
Commercial building New project or new addition $20,000,000 and over 5
Employee # Inspection Age Sex Degree Nature Occupation Construction
1 312685092 Hospitalized injury Fracture Carpenters FallDist:
FallHt:6
Cause: Forming
FatCause: Fall from/with structure (other than roof)

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