Abstract: On August 20, 2009, a worker was installing steel sheeting on a lean to roof above a grain pit located at Consolidated Grain and Barge (CGB) grain elevator. Two workers of Pro-Build arrived at the site and removed the old roof and replaced some of the structural wood framing. The workers noticed that the weather was changing, and it looked like rain. They then began to hurry up to get the roof on. Demolition materials were lying on the ground, where a ladder had been placed. Employee #1 was on the ladder approximately 15 ft above the ground installing screws, when the ladder slipped on a piece of sheet metal roofing, causing the bottom of the ladder to slip. Employee #1 then jumped from the ladder. After hearing the noise of the fall, Employee #2 hollered for help because he was afraid to use the ladder that had slipped. After no reply for help, Employee #2 climbed down an interior wall and ran to the main office of Consolidated Grain and Barge to call emergency medical help and get first aid supplies. Employee #2 and an employee of CGB returned to the accident scene and tried to get Employee #1 to respond. When EMS arrived, they transported Employee #1 to the hospital in West Union and then transported him to the Mayo Clinic in Rochester, MN. Employee #1 died later that day.