University of Washington Accident / Incident...
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University of Washington Accident / Incident Report Report Number:2020-04-003 Contact EH&S at 206-543-7262 Person Reporting Incident Last Name:Kopec First Name:Jeffrey Phone:+1 206 221-3127 Email:[email protected] Occupation/Position:MAINTENANCE SUPERVISOR 2 Department:UWF: OPS: M&C: Central/Southwest Maintenance Zone Date Reported(yyyy/mm/dd):2020/04/03 Time of Reporting:07:10 AM Person Involved or Affected Last Name: First Name: Phone: Email: Occupation/Position: Department:UWF: OPS: M&C: Building Trades 14 Incident Details Date of Incident(yyyy/mm/dd):2020/03/31 Time of Incident:9:00 AM When Shift Begins:7:00 AM Campus:Seattle Incident Location/Parking Lot:MECH ENGR BLDG Room:011 Other: Incident Details: Attempting to remove flow control valvefrom the heating system, 2". Overexerted trying to remove valve. Attachment:No Supervisor Last Name:Kopec First Name:Jeffrey Phone:+1 206 221-3127 Email:[email protected] Occupation/Position:MAINTENANCE SUPERVISOR 2 Department:UWF: OPS: M&C: Central/Southwest Maintenance Zone Classification Level 1: Injury or Exposure, no first aid required, Injury involving lost work days, Type of Incident Injury Description: Sprain, Strain, Twist, Body Parts Affected: Back, Cause of Injury or Damage: Overexertion, Overly Forceful Motions, Possible Causes Equipment: Environment: Policies / Procedures: Other, Human Factors: Other, Suggested corrective action by the affected party Ask for help next time Page 1 of 2 ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
Transcript of University of Washington Accident / Incident...
University of WashingtonAccident / Incident Report
Report Number:2020-04-003 Contact EH&S at 206-543-7262
Person Reporting Incident
Last Name:Kopec First Name:Jeffrey
Phone:+1 206 221-3127 Email:[email protected]
Occupation/Position:MAINTENANCE SUPERVISOR 2 Department:UWF: OPS: M&C: Central/SouthwestMaintenance Zone
Date Reported(yyyy/mm/dd):2020/04/03 Time of Reporting:07:10 AM
Person Involved or Affected
Last Name: First Name:
Phone: Email:
Occupation/Position: Department:UWF: OPS: M&C: Building Trades 14
Incident Details
Date of Incident(yyyy/mm/dd):2020/03/31 Time of Incident:9:00 AM When Shift Begins:7:00 AM
Campus:Seattle Incident Location/Parking Lot:MECH ENGR BLDG
Room:011 Other:
Incident Details: Attempting to remove flow control valvefrom the heating system, 2".Overexerted trying to remove valve. Attachment:No
Supervisor
Last Name:Kopec First Name:Jeffrey
Phone:+1 206 221-3127 Email:[email protected]
Occupation/Position:MAINTENANCE SUPERVISOR 2 Department:UWF: OPS: M&C: Central/SouthwestMaintenance Zone
Classification
Level 1: Injury or Exposure, no first aid required, Injury involving lost work days,
Type of Incident
Injury Description: Sprain, Strain, Twist,
Body Parts Affected: Back,
Cause of Injury or Damage: Overexertion, Overly Forceful Motions,
Possible Causes
Equipment:
Environment:
Policies / Procedures: Other,
Human Factors: Other,
Suggested corrective action by the affected party
Ask for help next time
Page 1 of 2ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
Supervisor's Comments
Root Causes:(Please look at all the factors that may have contributed to the accident.Such factors may include equipment, environment, policies,
procedures, and personnel.)
Over exertion.
Recommendations/Preventive Measures:Ask for help when a large amount of force is required.
Corrective Actions Target Date (yyyy/mm/dd):2020/04/03
Corrective Actions Complete Date (yyyy/mm/dd):2020/04/03
Other Comments:Ask for help when removing large pipe.
EHS Review
Last Name:Konnur First Name:Manisha Phone Number:+1 206 221-1759
Email:[email protected]
Occupation/Position: Department:
Comments:forwarded to Natalie Daranyi, Erin McKeown - MK 4/3
Page 2 of 2ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
University of WashingtonAccident / Incident Report
Report Number:2020-04-012 Contact EH&S at 206-543-7262
Person Reporting Incident
Last Name:Jung First Name:Daniel
Phone:+1 206 790-1874 Email:[email protected]
Occupation/Position:WINDOW WASHER LEAD Department:UWF: OPS: BSD: Custodial Area WW
Date Reported(yyyy/mm/dd):2020/04/13 Time of Reporting:09:12 AM
Person Involved or Affected
Last Name: First Name:
Phone:+1 Email:
Occupation/Position: Department:UWF: OPS: BSD: Custodial Area WW
Incident Details
Date of Incident(yyyy/mm/dd):2020/04/13 Time of Incident:11:30 AM When Shift Begins:7:00 AM
Campus:Not assigned to Campus Incident Location/Parking Lot:Bill & Melinda GatesCenter for Computer Science &
Room:100B Other:
Incident Details: A window washer was using the electric lift (JLG 40N) in the main atrium at CSE 2. As the window washerwas travelling to the last area of service with the lift, two cracks occurred on the floor tiles. Thewindow washer (also the lift operator) did not hear/feel/notice the first crack but did for the secondcrack. immediately after the second crack, the worker stopped the work and called their supervisor.The supervisor said to halt all work at the site until further notice. The supervisor then arrived atCSE 2 to take some pictures (please see attachment) Attachment:Yes
Supervisor
Last Name:Jung First Name:Daniel
Phone:+1 206 790-1874 Email:[email protected]
Occupation/Position:WINDOW WASHER LEAD Department:UWF: OPS: BSD: Custodial Area WW
Classification
Level 1: Near miss (No incident occurred but it could have), Property damage only,
Type of Incident
Injury Description: None,
Body Parts Affected: None,
Cause of Injury or Damage: None,
Possible Causes
Equipment: Defective Material,
Environment: Other,
Policies / Procedures:
Human Factors:
Page 1 of 2ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
Suggested corrective action by the affected party
The window washer followed all rules/regulations/policies/practices appropriately.
Supervisor's Comments
Root Causes:(Please look at all the factors that may have contributed to the accident.Such factors may include equipment, environment, policies,
procedures, and personnel.)
from the looks of the floor tiles, they appear to be very thin. It also appears that there are othertiles in the area that have cracked from other incidents (ie heavy objects falling on the tiles).
Recommendations/Preventive Measures:need to install stronger/thicker floor tiles when designing building to have a lift be used.
Corrective Actions Target Date (yyyy/mm/dd):2020/04/09
Corrective Actions Complete Date (yyyy/mm/dd):2020/04/09
Other Comments:The window washer followed all rules/regulations/policies/procedures/practices as required by UW.
EHS Review
Last Name:Konnur First Name:Manisha Phone Number:+1 206 221-1759
Email:[email protected]
Occupation/Position: Department:
Comments:forwarded to Natalie Daranyi - MK 4/13
Page 2 of 2ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
University of WashingtonAccident / Incident Report
Report Number:2020-04-018 Contact EH&S at 206-543-7262
Person Reporting Incident
Last Name:Som First Name:Puthea
Phone: Email:[email protected]
Occupation/Position:MATERIALS MAINTENANCE ANDLOGISTICS TECHNICIAN
Department:SOM: Comparative Medicine: AnimalFacility
Date Reported(yyyy/mm/dd):2020/04/22 Time of Reporting:01:28 PM
Person Involved or Affected
Last Name: First Name:
Phone: Email:
Occupation/Position:Contractor Department:
Incident Details
Date of Incident(yyyy/mm/dd):2020/04/22 Time of Incident:6:30 AM When Shift Begins: N/A
Campus:Not assigned to Campus Incident Location/Parking Lot:UWMC S1 Mobile OfficeUnit (S-1 Parking Lot)
Room: Other:
Incident Details:
was walking towards the building when she tripped on something. She said she slipped but shelanded on both knees. I walked into the Breakroom of ARCF at 6:50AM and saw she was holding her legs. Iasked what happened and she said she slipped and fell. I asked her if she needed to go home orattention, she told me she was fine and she will be ok. She was pretty bruised up from what
noticed Attachment:No
Supervisor
Last Name:Som First Name:Puthea
Phone: Email:[email protected]
Occupation/Position:MATERIALS MAINTENANCE ANDLOGISTICS TECHNICIAN
Department:SOM: Comparative Medicine: AnimalFacility
Classification
Level 1: Injury or Exposure, no first aid required,
Type of Incident
Injury Description: Bruise, Contusion,
Body Parts Affected: Knees,
Cause of Injury or Damage: Fall of Less than 6', or on Stairs,
Possible Causes
Equipment: Other,
Environment: Other,
Policies / Procedures: Other,
Human Factors: Other,
Page 1 of 2ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
Suggested corrective action by the affected party
Watch your surroundings especially when you are walking.
Supervisor's Comments
Root Causes:(Please look at all the factors that may have contributed to the accident.Such factors may include equipment, environment, policies,
procedures, and personnel.)
It may have been wet because of the rain. She may have tripped on something in the parking lot. It mayhave been dark.
Recommendations/Preventive Measures:Watch where you are walking, pay attention to your surroundings.
Corrective Actions Target Date (yyyy/mm/dd):2020/04/24
Corrective Actions Complete Date (yyyy/mm/dd):
Other Comments:This happened in the parking lot before she was scheduled to start her shift.
EHS Review
Last Name:Konnur First Name:Manisha Phone Number:+1 206 221-1759
Email:[email protected]
Occupation/Position: Department:
Comments:forwarded to Scott Nelson - MK
Page 2 of 2ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
University of WashingtonAccident / Incident Report
Report Number:2020-04-019 Contact EH&S at 206-543-7262
Person Reporting Incident
Last Name:Jung First Name:Daniel
Phone:+1 206 790-1874 Email:[email protected]
Occupation/Position:WINDOW WASHER LEAD Department:UWF: OPS: BSD: Custodial Area WW
Date Reported(yyyy/mm/dd):2020/04/23 Time of Reporting:07:24 AM
Person Involved or Affected
Last Name: First Name:
Phone: Email:
Occupation/Position: Department:UWF: OPS: BSD: Custodial Area WW
Incident Details
Date of Incident(yyyy/mm/dd):2020/04/23 Time of Incident:7:00 AM When Shift Begins: N/A
Campus:Seattle Incident Location/Parking Lot:W.H. FOEGE BIOENG
Room: Other:
Incident Details: Neck is sore from using the extension pole to wash windows the last few days Attachment:No
Supervisor
Last Name:Jung First Name:Daniel
Phone:+1 206 790-1874 Email:[email protected]
Occupation/Position:WINDOW WASHER LEAD Department:UWF: OPS: BSD: Custodial Area WW
Classification
Level 1: Injury or Exposure, no first aid required,
Type of Incident
Injury Description: Other,
Body Parts Affected: Neck,
Cause of Injury or Damage: Ergonomic Issues, Repetitive Motions, Awkward Posture,
Possible Causes
Equipment:
Environment: Ergonomics Issues,
Policies / Procedures:
Human Factors: Other,
Suggested corrective action by the affected party
Change up tasks more frequently
Supervisor's Comments
Root Causes:
Page 1 of 2ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
(Please look at all the factors that may have contributed to the accident.Such factors may include equipment, environment, policies,
procedures, and personnel.)
the affected worker was working with an extension pole for a majority of the work this last week.
Recommendations/Preventive Measures:switch up the access equipment, for example, if they are going to use an extension pole frequently,perhaps try to use a ladder to access so that an extension pole is not the only equipment being used.
Corrective Actions Target Date (yyyy/mm/dd):2020/04/23
Corrective Actions Complete Date (yyyy/mm/dd):2020/04/23
Other Comments:
EHS Review
Last Name:Konnur First Name:Manisha Phone Number:+1 206 221-1759
Email:[email protected]
Occupation/Position: Department:
Comments:forwarded to Denise Bender - MK 5/6
Page 2 of 2ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
University of WashingtonAccident / Incident Report
Report Number:2020-04-023 Contact EH&S at 206-543-7262
Person Reporting Incident
Last Name: First Name:
Phone:+1 Email:
Occupation/Position: Department:UWF: OPS: TS: Shuttles Staff
Date Reported(yyyy/mm/dd):2020/04/23 Time of Reporting:03:47 PM
Person Involved or Affected
Last Name: First Name:
Phone:+1 Email:
Occupation/Position: Department:UWF: OPS: TS: Shuttles Staff
Incident Details
Date of Incident(yyyy/mm/dd):2020/04/23 Time of Incident:8:30 AM When Shift Begins: N/A
Campus:Seattle Incident Location/Parking Lot:
Room: Other:SCCA House
Incident Details: I was driving vehicle up the alley behind the SCCA house. I had no passengers aboard. Just beforethe door to the lobby the brick wall of the building ends at a blind corner. Directly five feet backfrom this corner are the sliding doors of the building. This 5 feet, and room ahead of it serve as arain shelter for patients. It additionally allows the shuttle to leave the alley clear for traffic. Ialways stop before this corner, then move forward extremely slowly. I also turn the bus to the right,then pull in strait and align the bus parallel with the building. On this particular run I misjudged theclearance of the right rear of the bus. A protruding screw we later discovered, by seeing marks on therubber edge guard of the building and screw, nicked the guard. this broke the mortar, and moved thebricks forward. the three bricks were undamaged, but a four brick was damaged. The vehicle only showedsome black scuffs from the contact with the rubber. These came off easily. Neither the manager or myselfcould see any damage to the vehicle. Building staff and U.W. transportation managers were contactedimmediately. Attachment:No
Supervisor
Last Name:Massey First Name:Jon
Phone:+1 206 685-2955 Email:[email protected]
Occupation/Position:SHUTTLES MANAGER Department:UWF: OPS: TS: Fleet & Shuttles
Classification
Level 1: Property damage only,
Type of Incident
Injury Description: Property Damage Only,
Body Parts Affected: None,
Cause of Injury or Damage: None,
Possible Causes
Equipment:
Environment:
Page 1 of 2ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
Policies / Procedures:
Human Factors: Inattention,
Suggested corrective action by the affected party
I need to continue to have established very specific ways I do each driving movement. This especially inareas that are tighter, and driving relatively new equipment that has less clearance than the previousvehicles. In this case never make the cut to the right after stopping, unless there is a foot and a halfclearance. do it this way every time. Increase the margins,
Supervisor's Comments
Root Causes:(Please look at all the factors that may have contributed to the accident.Such factors may include equipment, environment, policies,
procedures, and personnel.)
Recommendations/Preventive Measures:
Corrective Actions Target Date (yyyy/mm/dd): Corrective Actions Complete Date (yyyy/mm/dd):
Other Comments:
EHS Review
Last Name:Konnur First Name:Manisha Phone Number:+1 206 221-1759
Email:[email protected]
Occupation/Position: Department:
Comments:forwarded to Daniel Eden, George Donegan, Scott Nelson - MK 4/24
Page 2 of 2ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
University of WashingtonAccident / Incident Report
Report Number:2020-04-024 Contact EH&S at 206-543-7262
Person Reporting Incident
Last Name: First Name:
Phone: Email:
Occupation/Position Department:UWF: OPS: TS: Fleet Services Staff
Date Reported(yyyy/mm/dd):2020/04/24 Time of Reporting:09:10 AM
Person Involved or Affected
Last Name: First Name:
Phone: Email:
Occupation/Position Department:UWF: OPS: TS: Fleet Services Staff
Incident Details
Date of Incident(yyyy/mm/dd):2020/04/24 Time of Incident:8:30 AM When Shift Begins: N/A
Campus:Seattle Incident Location/Parking Lot:
Room: Other:in the back of the fleet service station
Incident Details: I, , was prepping the van ( ) in order to transport a coworker ( ) to Ford inorder to pick up another vehicle ( ). In the process of pulling out, there was a loud audible snap andi immediately stopped, turned off the vehicle and went to inspect the origin of the noise. Uponinspection, the cable used to recharge the electric vehicle ( ) adjacent to the van( ) was wrappedaround the runnung board of the vehicle i was using, thus being ripped out of the charger once iproceeded to move forward. I immediately called over in order to confirm what occured as well as tosee what the next necessary step was. Attachment:No
Supervisor
Last Name:Tong First Name:Albert
Phone:+1 206 685-1564 Email:[email protected]
Occupation/Position:ASSISTANT MANAGER Department:UWF: OPS: TS: Fleet Services
Classification
Level 1: Property damage only,
Type of Incident
Injury Description: Property Damage Only,
Body Parts Affected: None,
Cause of Injury or Damage: Tools, Instruments,
Possible Causes
Equipment:
Environment:
Policies / Procedures:
Page 1 of 2ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
Human Factors: Inattention,
Suggested corrective action by the affected party
Inspect around the vehicle before using facility equipment.
Supervisor's Comments
Root Causes:(Please look at all the factors that may have contributed to the accident.Such factors may include equipment, environment, policies,
procedures, and personnel.)
Didn't do a walk around the equipment before using it.
Recommendations/Preventive Measures:Do a walk around/inspection before operating the equipment.
Corrective Actions Target Date (yyyy/mm/dd):2020/04/27
Corrective Actions Complete Date (yyyy/mm/dd):2020/04/27
Other Comments:
EHS Review
Last Name:Konnur First Name:Manisha Phone Number:+1 206 221-1759
Email:[email protected]
Occupation/Position: Department:
Comments:forwarded to Daniel Eden, George Donegan - MK
Page 2 of 2ON FILE: Affected/Injured Employee's date of birth, gender, date of hire, and hours of employment.
