Abstract: At approximately 2:00 p.m. on November 4, 2002, three employees were trimming trees. One employee, the crew foreman, was working in the tree and two coworkers were on the ground. The employee was pruning ficus trees approximately 14 ft above the ground. As he was finishing this tree, he released his flip line to come down the tree and noticed a lateral branch that needed to be cut off. He was holding on to a branch with one hand and moved out by walking toward the branch. He leaned out onto a limb to reduce the length of the limb and the limb broke off from the tree and fell. The employee fell to the ground and suffered serious lip, leg, lower back and head injuries. He was wearing his climbing saddle with flip line and had his climb line in the tree; however, he was not secured to the tree with the climb line or a lanyard at the time of the fall. He was taken to San Francisco General Hospital and hospitalized as a result of his injuries.