Abstract: The cow elephant Tamba was being brought into an examining room for an estrous check by a bull elephant. The viewing room she had just left contained other cow elephants. She was fed her nutritional supplement by the senior elephant keeper before the examination room door was closed. Employee #1 was walking at Tamba's right side, out of her field of vision, when she apparently sensed that another cow was sticking her trunk through the open door, and quickly swung her head to the right to strike back. She struck Employee #1 in his head with her head, knocking him into the steel-clad corner of an 8 inch thick concrete door. Employee #1 sustained severe head and brain injuries, but is recovering. The door between the examination room and the viewing room should have been closed immediately after the cow left the viewing area. This would prevent the cow from becoming distracted or excited.