sba 1 accident form 1.rtf

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 Kabiru A. Diso NC 4 0851 Incident & Accident Report Form Use this form to report any personal injuries, near misses a nd any dangerous occurrences which take place on construction site premises. DETAILS OF THE ACCIDENT / INCIDENT Date 16 th July, 2013 Time 15:30hrs Describe the injury or incident: What happened? How did it happen? In July 2013, an adult male construction labourer (the victim) sustained fatal injuries after falling off a collapsed steel beam connection at a steel building construction site. The steel beam connector was 26' 5½" long, 8' 3" wide and 8" thick, and weighed approximately six tons. The connector was positioned on the building's steel structural frame composed of vertical steel columns and horizontal steel beams. The beam connector was not secured to the steel framework at the time of the incident. At approximately 9:20 a.m., the victim and a co-worker were on the structural frame using pry bars to adjust the beam connectors into their final positions before they were to be permanently secured to the steel framework. The southern section of the connectors rested on the horizontal steel beams and its northern section was suspended (cantilevered) without the support of the steel beams. After the two workers finished adjusting the beam connector, they both walked northward on the beam near its east end. The connec tor suddenly tilted downward at its nor th sid e, rotated to a near ver tical position, and became wedged in between the steel supports. The co-worker secured himself with his elbows onto the connector in front of him and climbed up. The victim fell to the floor below. The failed steel beam connector then fell, struck the victim, and crashed through the concrete slab floor below.  The co-worker immediately ran down to the victim and removed him fr om the collapsed zone. One of the workers called 911. Both police and an emergency service unit responded within minutes. The victim was transported to a hospital where he died an hour later. The post incident investigation found that a number of steel columns including the ones in the collapsed zone were erected out of plumb. The out-of-plumb columns led to increase spacing between the columns resulting in reduced beam support for the connector located in-between these columns. The integrity of the initially failed slab was further compromised by its notched shape and cantilevered section. Were there any witnesses? If so, give their contact details (name, phone, address) 1. Mr . Lukman Sani , of 33 Murtala Moha mmed Road, kano. Phone 08037015129 2. Mr. Babangida Ahmed of 14 Ahmadu Bello Way, Kano. Phone 08188851388  __ __ 1

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Page 1: SBA 1 accident form 1.rtf

7/27/2019 SBA 1 accident form 1.rtf

http://slidepdf.com/reader/full/sba-1-accident-form-1rtf 1/2

Kabiru A. Diso NC 40851

Incident & Accident Report FormUse this form to report any personal injuries, near misses and any dangerous occurrences which take place on construction site premises.

DETAILS OF THE ACCIDENT / INCIDENT

Date 16th July, 2013 Time 15:30hrs

Describe the injury or incident:

What happened? How did it happen?

In July 2013, an adult male construction labourer (the victim) sustained fatal injuries after falling off a

collapsed steel beam connection at a steel building construction site. The steel beam connector was

26' 5½" long, 8' 3" wide and 8" thick, and weighed approximately six tons. The connector was

positioned on the building's steel structural frame composed of vertical steel columns and horizontal

steel beams. The beam connector was not secured to the steel framework at the time of the incident.

At approximately 9:20 a.m., the victim and a co-worker were on the structural frame using pry bars to

adjust the beam connectors into their final positions before they were to be permanently secured to

the steel framework. The southern section of the connectors rested on the horizontal steel beams and

its northern section was suspended (cantilevered) without the support of the steel beams. After the

two workers finished adjusting the beam connector, they both walked northward on the beam near its

east end. The connector suddenly tilted downward at its north side, rotated to a near vertical

position, and became wedged in between the steel supports. The co-worker secured himself with his

elbows onto the connector in front of him and climbed up. The victim fell to the floor below. The failed

steel beam connector then fell, struck the victim, and crashed through the concrete slab floor below.

 The co-worker immediately ran down to the victim and removed him from the collapsed zone. One of the workers called 911. Both police and an emergency service unit responded within minutes. The

victim was transported to a hospital where he died an hour later. The post incident investigation

found that a number of steel columns including the ones in the collapsed zone were erected out of 

plumb. The out-of-plumb columns led to increase spacing between the columns resulting in reduced

beam support for the connector located in-between these columns. The integrity of the initially failed

slab was further compromised by its notched shape and cantilevered section.

Were there any witnesses? If so, give their contact details (name,

phone, address)1. Mr. Lukman Sani, of 33 Murtala Mohammed Road, kano. Phone 08037015129

2. Mr. Babangida Ahmed of 14 Ahmadu Bello Way, Kano. Phone 08188851388

 _________ 

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Kabiru A. Diso NC 40851

WAS ANYONE INJURED?

Name Mr Abubakar Musa Age 37yrs > M q F Employer

Address 56 Tamandu Street, Kano Phone 0804231600

(If more than one person was injured, complete a separate “Incident & Accident Report Form.”)

TREATMENT DETAILS

  q None q First Aid q Outpatient Clinic Advised to see own GP q Hospital > Hospital Stay? how many nights?

FEW HOURS .

  q Absent from work ? how many days? q Other treatment details

DIED LATER IN THE HOSPITAL

ACTION

  q What action has been taken to prevent a reoccurrence?  

It is my candid suggestion that, the following measures to help prevent similar incidents from occurring in the future, employers

should: comply with the structural dimensions and tolerances specified by the erection design and check vertical and horizontal

alignment of the steel structural frame before erecting any beam connectors; ensure that workers use personal fall protection

arrest systems when working on the steel beam connectors that are not permanently secured to the steel framework;

Provide employees with training on the prevention of fall hazards associated with working on the unsecured beam connectors;

and secure the beams to the steel structural frame by the method specified in the erection plan as soon as the beams are erected.

Additionally the integrity and support

FORM COMPLETED BY:

Name Mr Lawal Saidu Title Projects Manager Phone 08023345632

Address NO. 134 Ibrahim Taiwo road, Kano Date 25th July 2013

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