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Incident and Investigation Report Sample

James Morrow, a fabricator, suffered an injury to his finger while assisting with tack welding. Hayden Rapsey was performing tack welding on a plate that James was holding with both hands nearby. When Hayden raised the hot welding gun, the welding wire touched and burned James' finger through his glove. James received first aid onsite. An investigation found that the welding helmet limited visibility and the usual habit was to raise the welding gun without checking for nearby hands. To prevent recurrence, personnel will avoid holding parts within 300mm of welding and find alternative ways to position parts, or weld with one hand while holding with the other to maintain control.

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611 views3 pages

Incident and Investigation Report Sample

James Morrow, a fabricator, suffered an injury to his finger while assisting with tack welding. Hayden Rapsey was performing tack welding on a plate that James was holding with both hands nearby. When Hayden raised the hot welding gun, the welding wire touched and burned James' finger through his glove. James received first aid onsite. An investigation found that the welding helmet limited visibility and the usual habit was to raise the welding gun without checking for nearby hands. To prevent recurrence, personnel will avoid holding parts within 300mm of welding and find alternative ways to position parts, or weld with one hand while holding with the other to maintain control.

Uploaded by

mehdi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Incident and Investigation Report

COMPLETE BOTH SIDES OF REPORT


Form: OHS-07
Issue 2
Issued: 29-1-12
INJURED PERSON’S DETAILS (if any)
Name of injured person: James Morrow
Area/Location: Macfab Engg
Position: Fabricator Phone: 0497 097 687
Employee Contractor Company:
DETAILS OF THE INCIDENT
Date of incident: 22-March-2021 Time: 11:00 am / pm
Exact location of incident: Structure Bay- New Shed
Operation the worker/contractor was engaged in at time of incident:

DETAILS OF TREATMENT (if any)


What treatment was provided [please tick] Nil First Aid
Medical PractitionerDetails: Hospital Details:

Details of treatment: The scratched area was sanitized and first aid was provided.

Was there any time lost (please tick) Nil Remainder of day
Workers Compensation claim lodged: YES NO
ABOUT THE INJURY (TICK APPROPRIATE BOX)
CAUSE OF INJURY NATURE OF INJURY
Pushing / Pulling Hit by Cut Puncture
Trip/slip/fall Hit against Bruise Burn
Falling object Chemical Sprain/ strain Abrasion
Vehicle Other (describe) Electric shock Other (describe)
Fracture
WHAT BODY PART WAS AFFECTED?
Head Hand (right) Hand (left) Fingers
Face Knee (right) Knee (left) Ankle(right)
Eye (right) Leg (right) Leg (left) Ankle (left)
Eye (left) Nose Ears Other (describe)
Trunk / Back Foot (right) Foot (left) Belly
Neck Arm (right) Arm (left)
THE INCIDENT
James was holding the plates with both hands as below image, While Hayden was tack welding the other
side of plate. After he finished the tack welding, he raised the welding gun up and as the welding wire was
hot it hit the James Hand make a hole in the gloves and injure his finger..
Incident and Investigation Report
COMPLETE BOTH SIDES OF REPORT
Form: OHS-07
Issue 2
Issued: 29-1-12

Were there any witnesses: [please tick] Yes No (if yes, list names below)
Name: Hayden Rapsey Phone: 0438 287 422
Name: Phone:

Incident Analysis
What contributed to the incident: [describe the factors that contributed to the incident]

Work Organisation: MacFab Engineering

Work Methods

Work Environment

Work Equipment/
Plant

Employees/Behaviour

While using welding helmet, the fabricator cannot see around. As the usual habit,
Conclusions: the fabricator raise his hand after welding while holding the gun without knowing
that James's hands is close to the welding location.

PREVENTION
What was the IMMEDIATE action taken following the incident?
Hayden and James reported the case straightaway to leading hand (Rick Zamudio) and Manager (Ash Faizan).
James was given first aid and the incident was reported.

What action will be taken to prevent a recurrence?


During fabrication personnel should avoid holding the parts that is near the position of welding,(Less than 300mm.)
In that case, the fabricator need to find other way to restrain the part or hold the part with one hand and do the tack
welding with the other hand. When the fabricator hold the plate himself, he has the better idea of controlling the
process.

INVESTIGATION OF INCIDENT
Incident and Investigation Report
COMPLETE BOTH SIDES OF REPORT
Form: OHS-07
Issue 2
Issued: 29-1-12
Person Had Name: James Morrow Position:Fabricator
Incident Signature: Date: 22-March-2021

Incident Name:Mehdi Nouri Position: Production Assistant


Investigate by Signature: Date:22-March-2021

Manager Name:Ash Faizan Position: Production Manager


Signature: Date:22-March-2021

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