OCC Inquest - Lalonde 2016
Verdict of Coroner's Jury
Office of the Chief Coroner
The Coroners Act - Province of Ontario
Given Name(s): Nicholas
Held at: 20 Weber St. E., Kitchener
From: January 27th
To: January 29th, 2016
By: Dr. John Ewen, Coroner for Ontario
having been duly sworn/affirmed, have inquired into and determined the following:
Name of deceased: Nicholas Lalonde
Date and time of death: October 11, 2013 at 12:43 hours
Place of death: 185 King Street, North, Waterloo, ON
Cause of death: Multiple blunt force injuries due to a fall from the 12th floor to the 8th floor; mast climber
By what means: Accident
(Original signed by: Foreperson and Jurors)
The verdict was received on the 29th of January, 2016
Coroner's name: Dr. John Ewen
(Original signed by coroner)
We, the jury, wish to make the following recommendations:
Inquest into the death of:
To the Ministry of Labour
- Ministry of Labour shall institute a policy whereby inspectors are required to include within their inspection / investigation a consideration of all prior contacts with the Ministry of Labour involving the workplace parties.
- Ministry of Labour shall arrange for the Inspection Compliance and Enforcement ("ICE") system to generate a report on a bi-weekly basis that would identify workplace parties with two or more field visits.
- In so far as "ICE" is a provincial system we recommend attempts be made to extend its database beyond Ontario into other provinces and territories as the construction industry does not limit itself to provincial borders.
- Ministry of Labour and the Ontario College of Trades shall explore a formal information sharing agreement to faciliate the regulation and certification of trades people.
- Ministry of Labour shall include a crane blitz and fall blitz within its inspection blitz program in the next fiscal year.
- Ministry of Labour shall conduct a public awareness campaign with respect to the dangers of all hazards, with a particular focus on fatalies.
- Ministry of Labour shall include a component on crane operation, signalling and hazards and the legislation / regulations governing same in the Entry Level Construction Training.
- We recommend the above training exceed 8 hrs. and a follow up session within 6 months.
- Ministry of Labour shall increase, overall, the number of proactive construction site inspections it conducts.
- Ministry of Labour shall increase, overall, the number of inspectors it employs.
- Ministry of Labour shall mandate permanent visible anchors be installed and communicated to all construction workers, through verbal and documented instructions.
- The Ministry of Labour should mandate all construction companies post clearly the Ministry of Labour's phone number and their ability to communicate any concerns at the job sire in confidence.
- Develop a health and safety policy that includes clear, progressive discipline for failure to follow that policy and / or any provisions of the Occupational Health and Safety Act and the regulations thereto. Implement that policy forthwith upon commencement of your next project.
- Provide formal training to any site supervisor you employ in the areas of health and safety (including the Occupational Health and Safety Act and regulations) crane operation / signalling / rigging and fall protection with such training to be completed prior to the commencement of your next project.
- File with the Ministry of Labour along with their notice of a project a list of subcontractors.
- Create and provide a package for each subcontractor to provide a list of active on site workers listing up to date credentials.
To Central Construction
- Develop a health and safety policy that includes clear, progressive discipline for failure to follow that policy and / or any provisions of the Occupational Health and Safety Act and the regulations thereto. Implement that policy forthwith upon commencement of your next project and thereafter.