Abstract: On January 21, 2004, Employee #1, a paint spray booth operator for GST Autoleather, Inc., a hide tannery and finishing manufacturer, was going to the control box on the east side of the conveyor system to manually turn the paint sprayers off for spray booth number three at the end of a particular cycle of materials, when she either lost her balance and fell through an opening approximately 14-in. wide, or, had reached into the conveyor system through the 14-in. opening to retrieve something. In either instance, her right arm was caught by the conveyor bands and she was pulled into an 8-in. roller. The roller measured 6 in. above the concrete floor and was rotating at 40 rpm. Employee #1's arm was apparently pulled between the conveyor bands and roller, and her head became wedged under the roller. Employee #1 received fatal injuries and was pronounced dead at the scene. The paint sprayers had to be turned on/off manually for the past three to four months due to problems with the machines' PLC system. The conveyor system used various size rollers to guide material and had conveyor bands that rotated the rollers. There were no witnesses to the incident from the point when Employee #1 was going to the control box. Evidence gathered and observed at the scene revealed what had probably happened.