Abstract: Employee #1, on his first day back after an extended medical leave for a back injury, was working from a two- or three-level scaffold that was next to a cinderblock wall inside a large building. He was smoothing the adjacent wall surface, but occasionally helped two coworkers who were beginning to dismantle the scaffold. The scaffold still had cross-braces in the back, but the guardrails had been removed and the work/walking surface was minimally planked with only two boards. Seven hours into his work shift, Employee #1 clutched his chest momentarily and made some low sounds of pain. He stumbled back against the cross support and then slipped through a gap between the floor planks, striking his head on a lower section of the scaffold as he fell. Employee #1 was transported to the hospital, where he died the following morning. He fell due to heat-related causes, but died of head injuries sustained in the fall. The ambient temperature was over 100 degrees F, and all three men took regular water breaks. The coworkers later stated that they observed Employee #1 looking fatigued and red in the face, outward signs of heat stress.