Abstract: Employees were preparing to remove a hoist from the ceiling area of an elevator shaft. A 22 ft extension ladder (11 ft unextended) was set up from the third level slab area to the top of the back wall of the elevator shaft. Employee #1 ascended to within three rungs of the top while a coworker held the ladder. Employee #1 turned, sat down on the ladder, and began releasing the hoist from the ceiling. The ladder began to slide down the wall and Employee #1 fell 32 ft to a ladder set up on the first level elevator shaft. He sustained a fractured neck and head, along with a blood clot on the brain, for which he was hospitalized. The ladder had been set up so that the horizontal distance from the top of the ladder to the foot of the ladder was in excess of 8 ft, exceeding 1/4 of the ladder length.