Abstract: At approximately 10:30 a.m. on August 25, 2008, an employee was hanging trim on a residential home using his personal nail gun, Hitachi Koki Model Number NR83A2, Serial Number 170109, while standing on a six foot ladder. The nail gun was up on the top cap of the ladder and the employee was climbing up the ladder with a piece of trim when the nail gun fell off. The employee caught the falling nail gun with his right hand and with the shaft of the nail gun aimed at his abdomen. The employee grabbed the trigger of the nail gun with his right thumb causing the nail gun to discharge into his stomach. The employee transported himself to U.S. Healthworks in Escondido, California. The employee was seen by a physician, who referred him to the emergency room at Palomar Hospital in Escondido, California. The employee was in the hospital for three days and had surgery.