Abstract: Employee #1 operated a gravel truck with a "pup" type trailer. (A "pup" type trailer has a long tongue and is pulled behind the gravel truck.) Employee #1 was the second in a line of three truck-trailers waiting to be loaded. The trucks were parked in a semi-circle around a gravel pile on a slight incline. Employee #1 walked ahead to talk with a coworker. When it became time to move ahead, the coworker entered his cab, looked in the mirror, and observed Employee #1 removing his glasses and a handkerchief. The coworker looked ahead and slowly pulled forward. Again, the coworker glanced in his mirror and observed Employee #1 huddled on his side with the left front tires of the "pup" trailer rolling over him. The coworker "punched" the throttle to get the tires off Employee #1. No blood alcohol was noted. Coworkers stated Employee #1 was pale and withdrawn that morning. Employee #1 had been seen at the hospital three times in four years with chest pain. An autopsy showed vascular congestion in the brain with perivascular hemorrhage in one area. This is an anoxic finding and may have resulted from the event.