Abstract: At 11:00 a.m. on February 19, 2020, an employee and a coworker who worked as audio and video installation technicians were installing speakers in four conference rooms. The coworker was the foreman at the job site. The employee climbed an 8-foot-tall A-frame ladder to install an anchor for a speaker. When the employee was descending the ladder, he was coming off the 4th step when he missed a step and fell approximately 4 feet. The employee fell backwards striking his lower back on the corner of a credenza desk. The employee stated he had received ladder safety training recently, but he attempted to climb down the ladder holding a screwdriver and a crimping tool in his hands. He claimed to have maintained 3 points of contact with the ladder. The employee fractured his vertebrae and ribs and was hospitalized for one day.