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UNITED STATES
DEPARTMENT OF LABOR
MINE SAFETY AND HEALTH ADMINISTRATION

North Central District
Metal and Nonmetal Mine Safety and Health


Accident Investigation Report
Surface Nonmetal Mine
(Limestone)


Fatal Fall of Person Accident


Lannon Quarry (I.D. No. 47-00097)
Lannon Stone Products, Inc.
Lannon, Waukesha County, Wisconsin


May 10, 1996

By

William T. Owen
Mine Safety and Health Inspector

Originating Office
Mine Safety and Health Administration
Federal Building, U.S. Courthouse
515 West First Street, #228
Duluth, MN 55802-1302


James M. Salois
District Manager


GENERAL INFORMATION



Lynn A. Mathews, plant operator/lead man, age 52, was severely injured at about 10:00 a.m. on May 10, 1996, when he fell from the crushing plant he was helping to install. He died of these injuries two days later. Mathews had 10 years mining experience, all at this operation. He had supervised the construction crew during construction of the new plant for about two weeks.

MSHA was notified by a telephone call from OSHA at 2:00 p.m. on the day of the accident. An investigation was started May 13, 1996, after the district learned that Mathews had died of injuries sustained from the fall.

The Lannon Quarry, a multiple bench, open pit limestone quarry, owned and operated by Lannon Stone Products, Inc., was located at Lannon, Waukesha County, Wisconsin. The principal operating official was J. Dale Dawson, president. The quarry and plant were normally operated one shift a day, six days a week. A total of 10 persons was employed.

Limestone was mined by typical multiple bench methods. Quarry rock was drilled, blasted, crushed, sized, and stockpiled for sale as construction aggregate. The quarry had been in operation since 1967.

Mathews had received training in accordance with 30 CFR Part 48. Annual refresher training had been completed on February 14, 1996.

The last regular inspection at this mine was completed December 7, 1995.

PHYSICAL FACTORS INVOLVED



The accident occurred at the new primary crusher location in the plant where the crusher framework, crusher, feeder, and conveyor system were being installed. The new structural steel framework had been fabricated and painted off-site. The main frame beams were 10 feet 7 inches above ground level and about 35 feet in length. A series of vertical steel I-beams with braces had been mounted on the main frame beams on the south end. They extended about 12 feet in height and supported the crusher hopper and feeder.

The crusher was mounted on the north end of the main frame beams. A handrail had been installed on the perimeter of its work deck. A travelway or scaffolding was not provided on the east side of the framework where bolts were to be installed at the top of the steel I-beam supports to secure the hopper.

Mathews had used a wooden plank measuring 2 inches thick, 12 inches wide, and 16 feet long, placed across the hopper framework, when installing bolts earlier. He had used the plank to sit on while installing bolts to the framework on the west side. Apparently, Mathews fell with the board as he was moving the plank to the east side.

A harness-type safety belt was available on the site but was not used.

The weather was cool, with a slow, light, intermittent rain at the time of the accident.

DESCRIPTION OF THE ACCIDENT



On the day of the accident, Lynn Mathews (victim) arrived for work at about 6:30 a.m., his normal starting time. He spoke with Dale Dawson, president, about some parts that they needed for the new crusher. Mathews then went to the crusher area where he and Don Braier, laborer, discussed the previous day's problems with installing bolts in the I-beam supports for the crusher hopper. Mathews decided to install the problem bolts himself. Mathews was the regular plant operator and usually conducted the routine maintenance of the plant. He had supervised some of the new installation and did some work himself. Four other employees were installing a feeder ramp bulkhead near Mathews but they could not see him from their locations.

At about 9:00 a.m., Braier, who had been working on the bulkhead, walked around to the feeder area to ask Mathews if he could use the cutting torch. Braier took the torch and returned to the other side.

The four men installing the bulkhead decided to take a break and left for the shop at about 9:45 a.m. Ervin Jordan, laborer, the last to leave, observed Mathews standing on the railed work deck next to the crusher.

The four men returned from break at about 10:00 a.m. and continued work on the bulkhead. A few minutes later, Braier and Jordan went to the back side of the bulkhead to retrieve a tool. Then, Braier saw Mathews lying on the ground. Jordan immediately went to help Mathews while Braier ran to the other side of the construction area to summon help. Dale Dawson, who was in his car observing the work being done on the other side, called the office on his radio to request emergency assistance.

Mathews was unconscious and having difficulty breathing. Jordan and Braier each cleared his airway once before emergency personnel arrived. The ambulance service arrived a short time later and transported Mathews to a local hospital where he died without regaining consciousness. The Medical Examiner reported the cause of death as blunt trauma injuries to the head and chest.

CONCLUSION



The direct cause of this accident was failure to use a safety belt and lanyard when moving the wooden plank used to install bolts to the elevated hopper. Wet weather conditions may have contributed to slippery footing, increasing the need for fall protection.

VIOLATIONS



Citation No. 4520960
Issued on May 14, 1996 under the provisions of Section 104 (d) (1) for violation of 30 CFR 56.15005:

On 5-10-96 at approximately 10:00 a.m., an accident occurred in which the working foreman/plant operator fell from the new primary crusher framework to the ground. Injuries received resulted in his death on 5-12-96. A safety harness was provided at the site but was not being worn when this accident occurred. This violation is an unwarrantable failure.

This citation was terminated on May 16, 1996 after reviewing the standard and the company policy on the use of safety harnesses with the operator.


Citation No. 4421221
Issued on May 14, 1996 under the provisions of Section 104 (a) for violation of 30 CFR 50.10:

On 5-10-96 at approximately 10:00 a.m., an accident occurred in which the working foreman/plant operator fell from the new primary crusher framework to the ground. MSHA was made aware of this serious injury accident by a phone call from OSHA to the North Central District Office 5-10-96 at approximately 2:00 p.m. The Assistant District Manager subsequently called the operator and, after receiving confirmation of this occurrence, advised the operator to immediately report any change in the victim's condition. On 5-13-96 at approximately 8:00 a.m. the Assistant District Manager called the operator and was advised that the victim had died 5-12-96.

This citation was terminated on May 16,1996 after the reporting requirements of the Act and Part 50.10 were discussed with the operator.


Citation No. 4520959
Issued on May 14, 1996 under the provisions of Section 104 (a) for violation of 30 CFR 50.12:

On 5-10-96 at approximately 10:00 a.m., an accident occurred in which the working foreman/plant operator fell from the new primary crusher framework to the ground. Injuries received resulted in his death on 5-12-96. The company failed to preserve the accident site. Further construction work was conducted in the area, until being halted 5-13-96.

This citation was terminated on May 14, 1996 after the preservation of evidence requirements of the Act and Part 50.12 were discussed with the operator.


/s/ William T. Owen
Mine Safety and Health Inspector


Approved by: James M. Salois, District Manager

Related Fatal Alert Bulletin:
Fatal Alert Bulletin Icon [FAB96M20]