Abstract: On June 18, 2003, Employee #1, of Broussard Bros. Inc., had just finished patching a wall around a second-floor window and was descending an extension ladder. The top of the ladder was leaning unsecured against the edge of the roof and the bottom was resting on the ground. The ladder shifted and the employee fell. Employee #1 was taken by paramedics to Huntington Memorial Hospital where he was treated for a skull fracture and concussion. Investigation revealed the ladder used to gain access to the roof top was not tied to the building on top and was not secured or blocked at the bottom to prevent displacement. It was also determined the employer did not provide training on safe use of ladder by allowing employees to carrying tools and equipment while climbing up and down the ladder.