Abstract: Employee #1, a roofer with J. Cab & Sons Roofing, Inc., was on the roof of a new building. He and two coworkers, both of whom were on the ground, were using an A-frame hoist to haul up the day's tools and materials. The hoist consisted of an A-frame at the roof's edge, a davit that swung in to deliver loads to the roof, and a cradle for a water barrel that held the hoist in place. Employee #1 was tied to the A-frame with a 7 ft lanyard. Using the hoist, the three men attempted to lift a heavy roll of lead flashing. When Employee #1 pulled in the davit, the A-frame rolled over and fell from the roof, pulling him down with it. He fell approximately 44 ft and suffered massive head injuries. Employee #1 was killed. The A-frame hoist, although commonly used in the roofing trade, is not designed to pull up heavy loads.