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Occupational Safety and Health Administration OSHA

Accident Report Detail

Accident: 201117991 - Employee Fractures Ankles In Fall From Steel Form

Accident: 201117991 -- Report ID: 0950643 -- Event Date: 05/28/2004
InspectionOpen DateSICEstablishment Name
30082727606/09/20041611C A Rasmussen Inc
Around 9:30 a.m. on May 28, 2004, Employee #1, a carpenter, was performing a regularly assigned task of bolting taper ties to secure a form to make it ready for the concrete pour. Employee #1 was working approximately 12 ft above the ground and moved horizontally from one work point to another. Employee #1 fell from the steel form prior to reattaching his positioning device to the form at the next work point. He fractured left and right ankles requiring the surgery. Employee #1 was transported to Antelope Valley Hospital and then transferred to Torrance Memorial Hospital, where he was hospitalized.
Keywords: fracture, pouring, carpenter, construction, fall, bolting, concrete, ankle
End Use Proj Type Proj Cost Stories NonBldgHt Fatality
Highway, road, street Other $20,000,000 and over 18
Employee # Inspection Age Sex Degree Nature Occupation Construction
1 300827276 Hospitalized injury Fracture Carpenters FallDist:
FallHt:12
Cause: Exterior carpentry
FatCause: Fall from/with structure (other than roof)

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