Abstract: At approximately 10:30 a.m. on September 20, 2007, Employee #1, a foreman/electrician, was working at a construction site in San Francisco, CA. He stepped over or through the standard guardrail erected between 10 and 12 ft from the edge of the building. The south crane operator saw him at the edge of the ninth (uppermost) floor, looking down, just before he fell. Employee #1 dropped approximately 52 ft, landing on a fourth floor atrium. He sustained life threatening injuries and was transported to San Francisco General Hospital, where he remained in critical condition for three weeks and was given a less than 50 percent change of survival. Later, as his health began to improve, Employee #1 was transferred to Kaiser Permanente--San Francisco Medical Center for rehabilitation and further treatment. Although tie-off points were provided for work needing to be done outside the railed area, Employee #1 was not wearing personal fall arrest equipment, nor was he using any of means of fall protection. The employer was cited for a violation of T8CCR 1670(a), concerning Personal Fall Arrest Systems, Personal Fall Restraint Systems, and Positioning Devices.