Abstract: On August 17, 2001, a 29 year-old tamale vendor and cook working from a cart in front of a market suffered fatal burns to the face, chest, arms, hands, and legs when there was a flashback of flame while she was attempting to light the propane burners in the cart. It was determined that either the pilot light and/or the burners on the cart probably went out after they were lit earlier that morning. Employee #1 went to re-light the burners without letting the LPG gas that had accumulated inside the cart escape. The flashback occurred when the fugitive gas under the cart ignited, sending flames directly into Employee #1 face. Employee #1 was not provided written instructions or a safe tool for lighting the propane burners. There was no means him to determine if the propane bottles needed replacement. There was no training on how to vent the LPG gas from the cart before attempting to re-light the burners when they go out.