Abstract: At approximately 4:00 p.m. on June 26, 2003, Employee #1, a 51-year-old employee, and coworkers were attempting to tie in reinforced steel to a floor slab of a culvert in a wooded area. The weather conditions were 96 degrees Fahrenheit, 37 relative humidity, and 99 degrees Fahrenheit heat index. Water and Gatorade were available, as well as frequent breaks. A coworker and the site superintendent noticed that Employee #1 was having trouble working and appeared sick. They told him to take a break and to go sit in the shade, but Employee #1 insisted that he was okay and continued to work. Soon after this incident, Employee #1 exited the hole where the culvert was being constructed, and staggered along the side of the road, crossing the road. Once he crossed the road, Employee #1 stood briefly, staring into the woods, and collapsed. Employee #1 rolled into the ditch next to the road. Employee #1's coworkers pulled him out of the ditch and proceeded to perform CPR. The superintendent attempted to call for emergency medical services with his cell phone, but was unsuccessful. The superintendent drove to a convenience store, located approximately 2.5 miles from the job site, where emergency services were called. The Fire Department and an ambulance responded. Employee #1 was hospitalized at Duke University Medical Center in North Carolina and pronounced dead due to due to ischemic heart disease and hypertension. No autopsy was performed. Employee #1 had a history of high blood pressure and liver disease.