Incident alert

LOCATION:
CEMENT PLANT
ACTIVITY:
ACCESS & EGRESS & WORKING AT HEIGHT
SUB ACTIVITY:
N/A
ALERT STATUS:
Normal
DATE ISSUED:
02/03/2021 18:40:48
INCIDENT No:
03589

TITLE
Fatal 3 - Fall whilst descending a ladder resulting in a fractured leg
COUNTRY OF ORIGIN
ACCIDENT / INCIDENT DETAILS

A third party service provider was installing a communications system at the weighbridge using a ladder. As he stepped off the bottom rung the ladder pivoted backwards. The individual lost his footing and fell backwards with the ladder.

He landed on a concrete surface and sustained a fracture to his left femur.

He was taken to hospital and underwent an operation to pin the fracture. He was walking with the of aid of crutches a week after the incident. The incident is reportable to the HSE under RIDDOR regulations due to the nature of the facture. The individual remains off work.

A review following the incident revealed the following;

  • The contractor reporting in process and subsequent authorisation was not adequately followed.
  • The risk assessment had not been reviewed prior to the task taking place, this could have identified that the use of the ladder could have been eliminated from the task.
  • A risk assessment was in place for the task but was not sufficiently followed nor did it contain enough detail for the hazards identified. No specific reference was made to the security of the ladder.
ACCIDENT / INCIDENT IMAGES




LEARNING POINTS / ACTIONS TAKEN

  • Improve contractor management, supported by the use of a contractors authorisation process on site that includes a review of task specific risk assessments prior to work commencing.

  • Continue to promote the STOP and THINK process for when circumstances and or the task changes.

  • Review working at height procedures and practices on site.

  • Continue focus on visible felt leadership and front-line supervision.

  • Review competencies and ability of individuals to use ladders. The descent of the individual, as shown by the CCTV footage, seemed unsteady with his weight positioned outside of the ladder footprint.


LEARNING POINTS / ACTIONS IMAGES




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