Abstract: At approximately 9:50 a.m. on September 1, 2009, Employee #1, a job coach, worked at a private school providing life skills to disabled persons. Some of his duties included using power tools to maintain the landscape. He was using a gasoline powered hedge trimmer to trim hedges. He was trimming the top of a hedge from the third step of an 8 ft A-frame ladder. He reached out to trim the far top of the hedge, and the ladder tipped over into the hedge. He fell onto the top of the hedge with his left hand at the rear of the operating powered hedge trimmer and his right hand on the forward guide handle. When he landed on the hedge the trimmer throttle control wedged on a branch keeping the trimmer running at full speed. The trimmer twisted from his grip, striking his right middle finger tip, amputating the tip of the finger at the first knuckle. Employee #1 was hospitalized.