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ACCIDENT / INCIDENT Page No. Page 1
INVESTIGATION
Issued Date 18/11/2023
REPORT
DESIGN AND BUILD MEP CONTRACT FOR DETAILED DESIGN, AUTHORITY SUBMISSION, DELIVERY,
INSTALLATION, TESTING & COMMISSIONING, OBTAIN CERTIFICATE OF COMPLETION & COMPLIANCE, SUPPORT
DURING DEFECTS LIABILITY PERIOD, AND MAINTENANCE OF PHASE 2 DATA CENTRE FOR BRIDGE DATA
CENTRE MALAYSIA III SDN BHD ON HS(D) 78142 PTD 32674, MUKIM OF BUKIT BATU, DISTRICT OF KULAI
STATE OF JOHOR, MALAYSIA

1. Reported by 2. Details on the Accident / Incident

Name VINOTHKUMAR AL NARJAPPAN Location MY06,Phase2,Roof
top-staircase14
Contractor GENSIS DC Sdn Bhd Date 17/11/2023
Date 18/11/2023 Time 5.35pm
3. Type of Accident / Incident
LTI MTI FAI Fire Property damage Near Miss Environmental” Loss Item
4. Details on Injured Person 5. Witness
Name MD TAHAZZAT ALI Age 40 Name Designation Contractor
Contractor GENSIS Nationality BANGLADES MD IMRAN HELPER GENSIS
H HUSSAIN
Designation HELPER Experience 10YEARS

Nature of CUT(HEAD) N/A N/A N/A

injury
6. Description of Accident / Incident
On 17/11/2023 Around 05:35 PM,At Roof Top(staircase 14) Two Workers Doing Work At CU Unit Using Ladder,
Suddenly 1 Of The Guy Fall Down From Ladder, His Head Hit Cable Tray Cover And He Got Injured At Head
(Right).And Then The Witness Informed With Supervisor Then The Supervisor Arrange To Bring Victim To Clinic.

7. Immediate Action
• Immediately Gensis ESH personnel bring the guy to Clinic Kelapa Sawit for medical treatment.
• The workers referred to doctor, and doctor advised to sews up the wound (5 stitches) with medicines.

8. Acknowledgement
Immediate Superior Safety Officer Project Manager
Reported by

Toh Huat Kee Muhamad Raihan Mohd Khirol Izam

Vinothkumar
9. Notification (by SSHO / Plant Man ager Office)

AUTHORITY :
BOMBA/POLICE Yes / No Yes /
SOCSO Yes / No SITE OFFICE Yes / No HQ
/DOE/ DOSH No

PMX MALAYSIA SDN BHD Reg. No. 202201018355 (1464052-K)

Unit 30-01 Level 30, Tower A Vertical Business Suite Avenue 3, Bangsar South, No.8 Jalan Kerinchi, 59200 Kuala Lumpur,
W.P. Kuala Lumpur, Malaysia
Tel: +60 3-5569 3881
 Doc.R
ACCIDENT / INCIDENT Page No. Page 1
INVESTIGATION Issued Date 17/11/2023
REPORT
DESIGN AND BUILD MEP CONTRACT FOR DETAILED DESIGN, AUTHORITY SUBMISSION, DELIVERY,
INSTALLATION, TESTING & COMMISSIONING, OBTAIN CERTIFICATE OF COMPLETION & COMPLIANCE, SUPPORT
DURING DEFECTS LIABILITY PERIOD, AND MAINTENANCE OF PHASE 2 DATA CENTRE FOR BRIDGE DATA
CENTRE MALAYSIA III SDN BHD ON HS(D) 78142 PTD 32674, MUKIM OF BUKIT BATU, DISTRICT OF KULAI
STATE OF JOHOR, MALAYSIA
10. Root Cause Analysis

Finding:-
• Slippery condition raining

11. Recommended Corrective Action / Preventive Action

No Item Responsibility Due Date
. Make sure workers are careful when working on ladders. Gensis Immediate
1 Ensure the buddy system is more thorough when holding the ladder Gensis Immediate
2 Implementing safety training. Gensis Immediate
3 12. Proposed follow-up date :

Lead Investigator Hasanuddin Mohamad

Main/Sub Con Safety Muhamad Raihan Bin Abu Bakar

Main/Sub Con Manager Mohd Khirol Izam Bin Abd Rahim

13. Comments
Comment PMX Safety and Health Comment :
PMX Project Manager
Officer
Muhamad Raihan Mohd Khirol Izam

Date : Date :
14. Follow-up Status on Corrective and Preventive Action by Lead Investigator (as per item#11 & 12 agreed)
No. Item Due Date Status Remarks Initial

15. Comments and Sign-Off

Confirmed by: Project Manager Comment: Verified by:
SHO/Safety Manager

Date : Date :

PMX MALAYSIA SDN BHD Reg. No. 202201018355 (1464052-K)

Unit 30-01 Level 30, Tower A Vertical Business Suite Avenue 3, Bangsar South, No.8 Jalan Kerinchi, 59200 Kuala Lumpur,
W.P. Kuala Lumpur, Malaysia
Tel: +60 3-5569 3881
 Doc.R
ACCIDENT / INCIDENT Page No. Page 1
INVESTIGATION Issued Date 14/07/2023
REPORT
DESIGN AND BUILD MEP CONTRACT FOR DETAILED DESIGN, AUTHORITY SUBMISSION, DELIVERY,
INSTALLATION, TESTING & COMMISSIONING, OBTAIN CERTIFICATE OF COMPLETION & COMPLIANCE, SUPPORT
DURING DEFECTS LIABILITY PERIOD, AND MAINTENANCE OF PHASE 2 DATA CENTRE FOR BRIDGE DATA
CENTRE MALAYSIA III SDN BHD ON HS(D) 78142 PTD 32674, MUKIM OF BUKIT BATU, DISTRICT OF KULAI
STATE OF JOHOR, MALAYSIA

CHRONOLOGY
17th nov 2023,14.30 hrs

Two workers start work at roof top using staircase 14 and install CU unit.
17th nov 2023, 16.00 hrs

Due to rain work stop at our workers rest inside the staircase 14. and workers resume work at CU unit at 5.00pm

17th nov 2023,17.00hrs

After the rain stopped the workers resumed their work.

17th nov 2023, 17.24 hrs

When during the work of installing the CU unit one of the worker slippery from the stairs because the floor was wet and
another worker was holding the ladder said while holding the ladder he could not control the ladder because the ladder
was bare.
17th nov 2023, 17.32hrs

Then The Witness Informed With HSE and site Supervisor Then The personal HSE Arrange To Bring The Victim To
near Clinic.

17TH NOV 2023, 18.20hrs

Send worker to see doctor and doctor doing treatment around 6.20pm (5 stitches) and get medicines from clinic.
PMX MALAYSIA SDN BHD Reg. No. 202201018355 (1464052-K)
Unit 30-01 Level 30, Tower A Vertical Business Suite Avenue 3, Bangsar South, No.8 Jalan Kerinchi, 59200 Kuala Lumpur, W.P.
Kuala Lumpur, Malaysia
Tel: +60 3-5569 3881
 Doc.Ref
ACCIDENT / INCIDENT Page No. Page 1
INVESTIGATION REPORT Issued Date 14/07/2023
DESIGN AND BUILD MEP CONTRACT FOR DETAILED DESIGN, AUTHORITY SUBMISSION, DELIVERY,
INSTALLATION, TESTING & COMMISSIONING, OBTAIN CERTIFICATE OF COMPLETION & COMPLIANCE, SUPPORT
DURING DEFECTS LIABILITY PERIOD, AND MAINTENANCE OF PHASE 2 DATA CENTRE FOR BRIDGE DATA
CENTRE MALAYSIA III SDN BHD ON HS(D) 78142 PTD 32674, MUKIM OF BUKIT BATU, DISTRICT OF KULAI
STATE
OF JOHOR, MALAYSIA
Attachment

Picture Description

INCIDENT AREA

INCIDENT AREA

INJURY PERSON

WITNESS WORKER FOR THE INCIDENT

PMX MALAYSIA SDN BHD Reg. No. 202201018355 (1464052-K)

Unit 30-01 Level 30, Tower A Vertical Business Suite Avenue 3, Bangsar South, No.8 Jalan Kerinchi, 59200 Kuala Lumpur, W.P.
Kuala Lumpur, Malaysia
Tel: +60 3-5569 3881
 INVESTIGATION Doc.Ref
Page No. Page 1
FORM
Issued Date 14/07/2023
DESIGN AND BUILD MEP CONTRACT FOR DETAILED DESIGN, AUTHORITY SUBMISSION, DELIVERY,
INSTALLATION, TESTING & COMMISSIONING, OBTAIN CERTIFICATE OF COMPLETION & COMPLIANCE, SUPPORT
DURING DEFECTS LIABILITY PERIOD, AND MAINTENANCE OF PHASE 2 DATA CENTRE FOR BRIDGE DATA
CENTRE MALAYSIA III SDN BHD ON HS(D) 78142 PTD 32674, MUKIM OF BUKIT BATU, DISTRICT OF KULAI
STATE OF JOHOR, MALAYSIA

Num Details Statements

01 Name: MD IMRAN HOSSAIN On 17/11/2023 around
Pmx pass no: 05:35PM,At Phase 2,MY06, Roof
EL1570 top(staircase 14) Two workers
Role:Witness
doing cablelling work at CU unit
using ladder, suddenly 1 of the guy
fall down from ladder, his head hit
cable tray cover and he got injured
at head (right).

02 Name: MD TAHAZZAT ALI Immediately Gensis ESH personnel

Pmx pass no:
EL280 Role: Victim
bring the guy to Klinik Kelapa Sawit
for medical treatment.
• The workers referred to
doctor,and doctor advised to
sews up the wound(5
stitches) with medicines.

PREPARED BY : INTERVIEWED BY : REVIEWED BY :

VINOTH SUPERVISOR MUHAMAD

KUMAR GENSIS RAIHAN
SAFETY PMX SAFETY AND
HEALTH OFFICER MOHD
KHIROL
IZAM PMX
PROJECT
MANAGER