Abstract: At 11:00 a.m. on September 8, 2009, a warehouse supervisor (Employee #1) was performing his normally assigned duties for his employer (Employer #2). Employer #1 is an apparel wholesaler that has offices on the 8th floor and a warehouse on the 3rd floor of the 11-story building. The freight elevator was originally installed and permitted sometime in 1920's. This freight elevator is so configured that it is manually operated by a lever control on the inside of the elevator cab and the door can only be opened manually from the inside. Therefore, if the elevator operator leaves the elevator and accidentally closes the door behind him, there is no exterior way of opening the door. According to Employer #2's building engineer and employees from Employer #1, the glass for this vision panel has been intentionally broken out in the past to gain access to the inside of the elevator door to open it. Employer #2 as the building owner and manager maintains the elevators and maintains a contract with an elevator service company. This worksite is a multi-employer worksite. Employee #1, a warehouseman, was standing in front of the freight elevator on the third floor. He stuck his head through one of the three elevator door vision panels. The vision panel dimension was 8 inches by 13 inches. The panel he placed his head through was missing its security glass. According to two coworkers in the elevator, they were traveling from the 10th floor to the 3rd floor. As they reached the 3rd floor, they saw Employee #1 through the vision panel as he was falling to the floor outside of the elevator. When they opened the elevator, they observed Employee #1 on the ground bleeding from the nose and mouth. Emergency services were called. Employee #1 was taken to the Los Angeles County USC Medical Center, where he later died. The death certificate lists the cause of death as "severe craniocerebral trauma".