Abstract: On September 30, 2003, an employee, an electrician, was standing on a portable 6-ft metal stepladder on the second step from the top repairing a light fixture. The employee fell backwards off the ladder and landed 12 feet below onto hard pavement. The employee hit his head on the pavement, sustaining severe head injuries. He was initially discovered lying on the ground by the groundskeeper, approximately 10 minutes after the fall; the company medical department responded immediately and within minutes emergency personnel arrived. The employee was transported to Lahey Clinic. The employee died at approximately 7:30 p.m. on September 30. The cause of death as determined by the Medical Examiner was accidental blood trauma.