Abstract: At about 7:00 a.m. on July 10, 2000, Employee #1, a pre-loader with the United Parcel Service, was injured when he was struck on the head, neck and shoulders by a box from the top of a stack of boxes positioned behind a truck to be loaded. Another worker in the immediate area found Employee #1 and reported the accident to a supervisor. Employee #1 twice refused medical assistance, and then he was excused from work and drove himself home. After an episode of passing out at home, Employee #1 drove himself to a clinic. He was then transported to a trauma facility, where he was hospitalized with a concussion and a cervical fracture. The employer was cited for permitting material to be stacked in a unstable manner.