Lessons Learned

Reports on incidents that involve injury, exposure (real or potential), or significant damage property. Lessons Learned detail what happened and how similar incidents can be avoided in the future.

Fall from Fixed Ladder with Grab Bars Results in Injury and Fine

October 24, 2018

What happened?

A campus employee was holding onto the grab bars at the top of a fixed vertical ladder and was beginning to descend when one of the grab bars broke off, causing the employee to fall about 13 feet. The employee sustained significant injuries to several toes. The incident occurred on a roof mounted cooling tower.

Vacuum Chamber Over-pressurization

October 22, 2019

What happened?

A vacuum chamber over-pressurized while a researcher was returning the vacuum to atmosphere by venting with nitrogen from a gas cylinder. The chamber was left to fill while the researcher worked on other tasks. By the time the researcher returned, the chamber had over-pressurized and the view window shattered.

Dry Scraping Causes Chemical Explosion

November 13, 2015

What Happened?

A postdoctoral researcher was synthesizing potentially explosive material in a fume hood, following a well-established procedure published in a peer-reviewed journal. The researcher was transferring a residual amount of the synthesized material using a plastic spatula when the material exploded in his hands. The shattered glassware caused some minor cuts to the researcher’s hands.

Glass Reactor Over-pressurization Causes Serious Injury to Grad Student Researcher

October 31, 2011

What Happened?

A recent lab accident caused serious injury to a UCB graduate student due to an over-pressurization that caused a glass reactor to fail. Glass was sprayed at the researcher who received cuts to his lip, chin, chest, and serious cuts to his hands. 911 was called and the researcher was taken by ambulance to the hospital. The cuts to the hand were serious enough to require stitches and surgery on the palm.

Forklift Rollover

December 31, 2006

What Happened?

A veteran forklift operator with 20 years of experience started his day just as he had often done, then soon realized just how fast things can change. Due to an oversized load, the operator was transporting a dumpster bin on the forks of his forklift while he was traveling in reverse. While in reverse, he hit a curb, causing the forklift to roll over onto its side.

The stunned operator was transported by ambulance to the hospital emergency room, where he was treated for a fractured leg. 

Improper Hazardous Material Disposal

September 30, 2002

What Happened?

A can of epoxy hardener was included in a salvage cart (see photo) and spilled at some point in the process of moving the salvage cart. An employee came in contact with the spilled material and was instructed to immediately wash with soap and water. EH&S then cleaned up the spill (see photos).

Lessons Learned

Please remind your staff of proper disposal methods for hazardous materials.

Paper Cutter Guards

November 30, 2000

Don't lose your thumb! Paper cutters such as the one here are not safe or legal. Cal/OSHA has cited campus departments for allowing unguarded paper cutters in the workplace in prior years.

a hand on a paper cutter with no finger guard

Lessons Learned

Please be sure all paper cutters in your department have a guard like the one seen here.

Bolt and Brace Your Shop Equipment

October 31, 2002

What Happened?

Someone was using the vice pictured below to hold an item in the process of a normal workday. In the process of performing a task, the vice toppled off the surface onto the person's foot causing a serious injury. The person was not wearing steel-toed boots.

Employee Receives Electrical Shock

March 31, 2004

What Happened?

A university employee was changing ballasts above a drop ceiling in a department reception area. The employee received an electrical shock from a 277volt circuit and was knocked off a step stool that she had placed on top of the reception desk. She fell from a height of 46.5 inches, but received only minor injuries and returned to work the following day.