Abstract: At approximately 10:30 a.m. on December 17, 2002, Employee #1, a foreman, and a coworker were cutting back several sycamore trees in front of a residence in Pacific Heights in San Francisco. Employee #1 used an 8-foot step ladder to climb into the trees. He placed the step ladder next to a tree for the coworker to climb into, then he relocated the ladder to another tree. He cut off some of the branches while standing on the ladder and then he climbed into the tree. He was moving from one side of the tree to the other when his foot slipped on a wet branch. He lost his balance and fell approximately 11 feet backward to the sidewalk. He sustained injuries to his head, neck, and back. He fractured his skull, fractured his right wrist, and sprained his left thumb. He was taken to the San Francisco General Hospital for further treatment. He suffered short term memory loss and was in a coma for 3 days.