Abstract: At approximately 8:45 a.m. on October 22, 2001, an employee, a fumigator, was ascending a ladder, carrying a roll of tarp balanced on his shoulders, to a second-story roof to perform tenting. The eaves were about 19 feet above ground level. When the employee stepped off the ladder onto the roof, the ladder slipped. The employee lost his balance and fell approximately 20 feet to the ground. The ladder had not been adequately secured to prevent movement during use. The injured employee was transported to Scripps Mercy Hospital in San Diego by AMR Ambulance. He sustained serious injuries, which included a C2 cervical spine fracture, and a scalp laceration.