Abstract: Employee #1, an emergency room nurse at medium-sized community hospital, was assisting an ER physician with a lumbar puncture to screen for bacterial meningitis. She was holding the patient steady on her side, with the lumbar spine facing the physician. The bed was in a very low position at the insistence of the physician, and Employee #1, who is 5 ft 11 in. tall, had to bend over a great deal. The patient weighed 350 lb and was being uncooperative. When Employee #1 realized she could not steady the patient alone, she called out for help, but there was no prompt response. Employee #1 continued with her task as best she could, and finally felt a "pull" in her back. She worked modified duty for several weeks and had periodic back therapy. She underwent surgery to repair her back on September 19, 1999.