Face Investigation #94-NJ-028-01


Company Owner Dies After Falling 15 Feet Down an Freight Elevator Shaft


DATE: June 30, 1994

SUMMARY

On December 1, 1993, the 46 year-old owner of a clothing manufacturing company was killed after falling 15 feet down a freight elevator shaft. The incident occurred in a large three-story warehouse where the victim was renting space for his clothing manufacturing business. At about 5 p.m., the owner was trying to move a customer order from his second floor work shop to the loading dock on the first floor. Because the call buttons on the freight elevator were not functioning, the victim went to the first floor to raise the elevator to the second floor. Not realizing that the elevator was on the second floor, the victim opened the elevator door in the dark vestibule and stepped into the empty elevator shaft, falling 15 feet into the warehouse basement. NJDOH FACE investigators concluded that, in order to prevent similar incidents in the future, these safety guidelines should be followed:

 

INTRODUCTION

On December 2, 1993, NJDOH FACE personnel were notified through a newspaper article of a work-related fatal fall that occurred the previous day. On December 20, 1993 FACE investigators visited the site to interview the employer representative (It should be noted that the representative was the victim's son who had just taken over the company and was not familiar with company procedures). Investigators also observed the elevator and photographed the scene. Additional information was derived from the OSHA compliance officer, written witness statements, and the police and medical examiner's reports.

The victim was the 46 year-old male owner of a small clothing manufacturing company that specialized in manufacturing fashion sportswear such as athletic jackets. The company had been in business for two years and employed 16 non-unionized workers. The company did not have any type of safety and health program.

 

INVESTIGATION

The incident occurred at a large, old, three-story industrial building located in an urban area. The building was owned by a third party who rented space to a number of small companies. The building was divided into separate sections which were separated by fire doors. The basement, first, and third floors in this section of the building were unused and empty, with third the floor sealed off. The victim's company was located on the second floor of the building in a large open loft area. The company could be reached by two stairways, a main stair in the front and a small back stair. Near the back stairway was a large freight elevator servicing all the building's floors and basement. The first floor elevator entrance was in a dark corridor near the building's loading dock. The second floor entrance was through a locked corridor accessed by the two companies that shared the floor. The elevator also reached the third floor and basement, however the third floor elevator entrance had been sealed off. The exterior call buttons to the elevator did not operate. To enter the elevator, the user had to go to the floor where the elevator was last used and manually open the doors. The elevator could then be operated from the inside controls. The day of the incident, a Wednesday, was a typical workday. The victim arrived for work as usual at 7 a.m., and the employees arrived about a half hour later. The day progressed uneventfully, and most of the employees went home at their usual quitting time. At about 4:50 p.m., three customers arrived to purchase materials from the victim. They parked their car at the rear of the building near the loading dock and entered through a doorway near the freight elevator. Night had already fallen and there were no lights on in the area, which one witness described as being "very dark, like in a coal mine." The three entered the second floor shop though the rear stairs and met with the company owner (victim). After discussing business for a few minutes, the victim wrote out a bill and loaded a push cart with the four bundles the customers had purchased. Going to the freight elevator, the victim looked though a small window in the door to see if the car was there. He returned to the customers and told them the elevator was not there and that he needed to go to the first floor to get it. The victim went down the stairs and opened the first floor elevator doors. Apparently not seeing the elevator in the darkness, he stepped into the empty shaft and fell 15 feet to the bottom.

A few minutes after the victim had left for the elevator, the customers and one remaining employee heard him scream. They ran downstairs but could not see or hear the victim. The area was very dark, although a single bulb from the loading dock provided some light. Finding the elevator door open, one customer went back upstairs for a cigarette lighter and some paper. He made a torch and looked into the elevator shaft and saw the victim lying at the bottom. After calling 911, the police, paramedics, and fire department arrived and tried unsuccessfully to treat the victim. He was declared dead at the scene.

The police investigation of the incident found the following factors which contributed to the fatality:

  1. The elevator was actually on the second floor at the time of the incident but apparently was not seen by the victim when he looked through the window (the interior elevator light was functioning but turned off).
  2. The exterior door interlocks on the first and second floors had failed due to age, allowing the doors to open without the car present. The exterior call buttons had also been disconnected.
  3. The elevator had never been registered or inspected by the city inspector.
  4. The first floor fluorescent light fixtures near the elevator did not have bulbs or were malfunctioning.

 

CAUSE OF DEATH

The county medical examiner attributed the cause of death to massive head and chest injuries.

 

RECOMMENDATIONS AND DISCUSSION

Recommendation #1: Building owners and employers should insure that elevators are maintained in proper working order.

Discussion: The investigation of this incident found a number of problems with the elevator that contributed to the fatality. To prevent similar incidents in the future, it is imperative that all elevators are kept in good working order. Maintenance should be a joint effort between the building owners (who are directly responsible for the elevators) and the employer/tenants (who routinely use the elevators). Building owners should ensure that all elevators are routinely maintained and inspected as per local ordinance. Employers should ensure that building owners are informed of any problems with the elevators. Further information on elevator safety can be found in the American National Standards Institute publication ANSI/ASME A17.1-1981, Safety Code For Elevators and Escalators.

 

Recommendation #2: Building owners and employers should insure that entrances, exits, and work areas are properly lit.

Discussion: The poor lighting near the elevator was also a major factor in this incident. As with recommendation #1, building maintenance such as lighting should be a joint effort between the building owners and tenants. All areas where employees may move or work should be well lit, including elevators, stairways, corridors, entrances and exits, and work areas.

 

REFERENCES

ANSI/ASME A17.1-1981, Safety Code For Elevators and Escalators. The American Society of Mechanical Engineers, New York, NY.

 

To contact New Jersey State FACE program personnel regarding State-based FACE reports, please use information listed on the Contact Sheet on the NIOSH FACE web site. Please contact In-house FACE program personnel regarding In-house FACE reports and to gain assistance when State-FACE program personnel cannot be reached.


click here to go back to the New Jersey FACE reports


click here to go back to the NIOSH FACE Web