| Report Date | September 11, 2018 |
|---|---|
| Injury Time | 07:45 PM |
| State | WV |
| Injury Date | 09/10/2018 |
| Longitude | -80.2149 |
| Well Lease | Yost |
| Pad | Yost |
| Country | United States |
| Latitude | 39.6296 |
| Township/City | Blacksville |
| 911 Address | 218/Daybrook Run Rd. |
| Weather | 80 deg - Rain |
| Well Number | 11H |
| Well Field | Blacksville |
| Position | Floorhand |
| Company | Highlands Drilling |
| Personnel/Witness Name | Adam Coffman |
| Days Into Hitch | 5 |
| Years With Company | 0.01 |
| Years In Oil/Gas | 0.01 |
| Personnel/Wittness Phone | (000) 000-0000 |
| Witness Name | Anthony Honaker |
| Time Lost | no |
| Task | Climbing a ladder out of the cellar. |
| Summary | Employee Adam Coffman was in the cellar making repairs to the diverter, once finished with his repair Adam was exiting the cellar up a ladder when he slipped on one of the rungs of the ladder and reached out to grab a rung above him. He stated at this time that it strained his arm when catching himself. The night rig manager was close to the employee when this happened. Adam said he had strained this arm 9 months ago. Adam has been a employee for 5 days. |
| Witness Statement | I was standing outside the cellar but didn't realize Adam had slipped and caught himself with his left arm. |
| Drug Test | no |
| Injury Location | arm |
| Treatment | ice |
| Proper PPE | Yes |
| Contributing Factors | rain made ladder wet. |
| Notification Timeline | notified immediately |
| Corrective Action | Slow down and ensure proper footing |
| Supervisor Phone | (304) 539-8276 |
| Supervisor Email | Email hidden; Javascript is required. |
| Supervisor Name | Anthony Honaker |
| HSE Name | Mike Lawrence |
| Supervisor Office Phone | (000) 000-0000 |
| HSE Phone | (304) 542-8238 |
| HSE Office Phone | (000) 000-0000 |
| Comp. Man Name | Jamie Czerneski |
| Comp. Man Email | Email hidden; Javascript is required. |
| HSE Email | Email hidden; Javascript is required. |
| Comp. Man Office Phone | (000) 000-0000 |
| Comp. Man Phone | (724) 705-5435 |
| NNE Name | Jay Hewitt |
| NNE Email | Email hidden; Javascript is required. |
| NNE Phone | (304) 382-1825 |
| NNE Office Phone | (000) 000-0000 |
| NNE HSE Name | Andy Travis |
| NNE HSE Office Phone | (304) 212-0415 |
| NNE HSE Email | Email hidden; Javascript is required. |
| NNE HSE Number | (304) 951-0909 |
| Date Updated | March 18, 2021 |
| Approval Status | Unapproved |
| Employee's Other Reports |
