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Occupational Safety and Health Administration OSHA

Accident Report Detail

Accident: 201580107 - Employee Crushed By Concrete Form

Accident: 201580107 -- Report ID: 1032300 -- Event Date: 03/04/1999
InspectionOpen DateSICEstablishment Name
30118615103/05/19991629Advanced American Diving Service, Inc.
On March 4, 1999, Employee #1 was working as the lead man of a form stripping crew under a new concrete pier. Support beams for the form work had been removed leaving large 12 ft by 12 ft pre-manufactured forms and filler plywood adhered to the under side of the concrete pier. A single chain and job-made metal clips wired to the chain secured the 12 ft by 12 ft sections. While pulling construction debris from the water, the crew pulled under some forms that were not stripped. As Employee #1 crossed the barge, one of the 12 ft by 12 ft panels weighing 1,800 lbs pulled loose from the ceiling. Either the form knocked the clip off or the clip had already fallen off, allowing the panel to fall on Employee #1, crushing him.
Keywords: chain, concrete form work, pier, work rules, construction, crushed, falling object, equipment approval
End Use Proj Type Proj Cost Stories NonBldgHt Fatality
Shoreline development, dam, reservoir New project or new addition $1,000,000 to $5,000,000 15 X
Employee # Inspection Age Sex Degree Nature Occupation Construction
1 301186151 Fatality Other Concrete and terrazzo finishers FallDist:
FallHt:
Cause: Forming for piers or pylons
FatCause: Struck by falling object/projectile

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