Abstract: At approximately 9:00 a.m. on December 26, 2013, Employee #1, a sheet metal installer, was climbing down an extension ladder on a residential job site. He was working for a sheet metal fabrication company that engaged in removing and installing sheet metal panels and water proofing buildings being remodeled and or newly constructed. Employee #1 had removed screws from 1 ft by 1 ft metal sheets after climbing a secured fully extended 24 ft WERNER portable fiberglass extension ladder (with 21 ft working length) placed against a 16 in. thick steel beam at an elevation of 15.75 ft. After untying the rope off the ladder, he climbed about 6 ft down the ladder. The ladder slid from underneath him, causing him to fall along with the ladder at an approximate height of 11 feet on a concrete floor. His left lower leg became stuck between the rungs. Upon impacting the floor, Employee #1 suffered serious multiple fracture injuries of his left lower leg and ankle. Emergency medical personnel were summoned. They arrived and transported him to a medical center for treatment, which included surgery. Following the surgical procedures and additional treatment, Employee #1 was then hospitalized for five days.