Conducting
an Accident Investigation
Course 102
Safety Certified Supervisor Series
MODULE 7: WRITING THE REPORT
The Accident Report Form
Section II. Description of the accident
This section presents a descriptive narrative of the events leading up to, including and immediately after the accident. It's important that the narrative paint a vivid "word picture" so that someone unfamiliar with the accident can clearly see what happened. The format you choose is important. You may want to eliminate or keep event numbers. See the example below.
Section II: Description of the Accident. Event -3. Employee #1 returned to work at 12:30 PM after lunch to continue laying irrigation pipes. Event -2. At approximately 12:45 PM employee #1 began dumping accumulated sand from an irrigation mainline pipe. Event -1. Employee #1 oriented the pipe vertically and it contacted a high voltage power line directly over the work area. Event 0. Employee #2 heard a 'zap' and turned to see the mainline pipe falling and employee #1 falling into an irrigation ditch. Event +1. Employee #2 ran to employee #1 and pulled him from the irrigation ditch, laid him on his back and ran about 600 ft to his truck and placed a call for help on his mobile phone. Event +2. Employee #2 than ran back to find employee #1 had fallen back into the ditch. Event +3. Employee #2 jumped back into the ditch and held employee #1 out of the water until help arrived. Event +4. Two other ranch employees arrived and assisted employee #2 in getting employee #1 out of the ditch. Event +5. Approximately one minute later, paramedics arrived and began to administer CPR on employee #1. They also used a heart defibrillation machine in an attempt to stabilize employee #1's heart beat. Event +6. At approximately 1:10 PM an ambulance arrived and transported employee #1 to the hospital where he was pronounced dead at 1:30 PM.
