Abstract: On August 4, 2001, Employee #1, the backman on Layup Line Number 1, entered the scissor lift pit to retrieve wooden stiles and other debris from the door manufacturing process. As he was removing the stiles, the main hydraulic hose line, which was leaking, lost over 90 percent of its hydraulic fluid over a short period of time. The equipment was not locked or tagged out, nor was a maintenance safety device or safety bars in place to prevent the lift from falling. The scissor lift was not braced to prevent the decent of the lift when the hydraulic systems failed. As a result of the loss of hydraulic fluid, the lift began to descend slowly on top of Employee #1, which crushed him between the scissor lift table and the scissor lift arm mechanism.