Abstract: On July 18, 2011, Employee #1, a 29-year-old male, his coworker, and a driver were picking up containers of trash, on a routine trash collection route through a residential area. After picking up the trash containers at one residence, the workers traveled to the next driveway, on a street in Wallingford, PA. At the approximate property line between the two residences, a bee or wasp nest was in a tree. Somehow, this nest became disturbed, possibly by truck exhaust. Employee #1 told his coworker that he had been stung by a bee, and the coworker observed Employee #1 swatting at the bees. All three workers returned to the truck. Employee #1 stepped onto the rear left riding step of the slow moving trash collection truck. The truck driver looked into the side view mirror and observed Employee #1 falling onto the street. Employee #1 struck his head on the street. The truck driver stopped the truck, and with the coworker, tried to assist Employee #1. They called emergency medical services. Emergency medical services arrived at the scene and transported Employee #1 to the nearest trauma hospital, Crozer-Chester Medical Center. On July 27, 2011, Employee #1 was transferred to Bryn Mawr Rehabilitation Center but began to decline upon his arrival. Employee #1 became unresponsive on July 28, 2011. He was transported to Paoli Memorial Hospital, where he was pronounced dead on July 29, 2011. The Chester County Coroner's Office considered this incident to be an accidental death and determined that the cause of death was a closed head injury.