Abstract: At approximately 11:50 a.m. on February 20, 2009, an employee, a laborer was moving equipment for railcar entry from one car to another, including shovel, broom, and ladder. A coworker, another laborer, saw the employee move the ladder towards the second railcar and looked away to fill out paperwork for confined space entry. While filling out a permit, the coworker heard the ladder hit the rail car and looked up to see the employee falling to the ground. The employee was still breathing and moaning. The coworker told another coworker of Jesco Phillips Services, who was operating a vacuum truck to get help. The plant manager and the supervisor arrived within two minutes and began to administer cardiopulmonary resuscitation to the employee. The employee had a weak pulse and after a few minutes of cardiopulmonary resuscitation, employee appeared to be dead. An ambulance arrived 15 minutes after fall and declared the employee dead. Preliminary information from coroner's office indicated that fall did not cause death.