Abstract: Employee #1, an experienced stock clerk in the warehouse section of a retail department store, was using a 10 ft aluminum single ladder to access an 8 ft 8 in. high stock shelf. After straightening the cartons on the 3 ft 9 in. wide shelf, the employee began to descend while facing the ladder. When he was at about the third rung from the top, he suddenly toppled over backward and landed on the back of his head and shoulders. He was found lying on the floor with eyes open, but evidently unconscious. Paramedics soon arrived, took his vital signs, and transported him to a nearby hospital, where he died two days later. An autopsy determined head and chest injuries as the cause of death, complicated by spontaneous intracerebral hemorrhaging due to hypertensive cardiovascular disease. The ladder belonged to an outside contractor who was not present at the time of the accident. Manually-propelled mobile ladder stands were available.