Abstract: At 1:00 p.m. on July 3, 2024, Employee #1 was working with a crew of seven in a 40-acre tomato field near Farmington, MO. The employees were driving wooden stakes into the ground or planting seeds. The crew wore long-sleeved cotton shirts, pants, and hats, and had access to shade along the edges of the field and water from 5-gallon coolers. Shortly before 3:00 p.m., with the heat index at 101°F, Employee #1 reported feeling unwell to the crew lead and was directed to rest in the shade and drink water. The crew lead noted that Employee #1 had stopped sweating and called the field manager, who transported Employee #1 to Parkland Health in Farmington, MO. Employee #1 was later medically evacuated to BJC in St. Louis, where he remained unconscious until dying on July 4, 2024, due to heat-related illness.