On March 9, 2004, a 16-year-old Hispanic construction laborer on a framing crew (the victim) was injured when he fell from a job-made elevated work platform (scaffold) and struck his head on a concrete slab 10 feet 3-inches below at approximately 3:00 p.m. The victim complained of a severe headache to his crew leader and to his father and uncles, who also worked on the framing crew. The construction project coordinator employed by the general contractor reportedly told the crew leader to take the youth to the hospital emergency room, less than a mile from the site. According to the victim's father, the framing subcontractor's crew leader drove him and his son to a drugstore where they purchased aspirin and, after giving aspirin to the victim, the crew leader drove them home. The crew leader returned to work and the victim's father remained at home with the victim. When the victim's uncles returned home from work at approximately 7:30 p.m., the victim was vomiting and unable to walk. The victim's father and uncles drove the victim to the crew leader's home shortly after 7:30 p.m. The crew leader drove the victim and family members to a hospital, stopping along the way at a medical clinic to seek care, but the clinic had already closed. The victim arrived at a hospital emergency room at approximately 8:30 p.m. and was pronounced dead at 9:28 p.m. by an emergency room physician. NIOSH investigators concluded that, to help prevent similar occurrences, employers should: 1. ensure that elevated work platforms meet safety requirements and that all employees are provided with fall protection when the potential for falls exists; 2. ensure that injured workers are provided with appropriate emergency medical services; 3. develop, implement, and enforce a comprehensive written safety program for all workers which includes training in hazard recognition and the avoidance of unsafe conditions. A written training plan should require training in fall protection for all employees potentially exposed to fall hazards; 4. ensure that workers who are part of a multilingual workforce comprehend instructions in safe work procedures for which they are assigned and understand their rights in the workplace; 5. pursue every feasible means to obtain the authentic age of each worker hired and establish work policies that comply with child labor laws prohibiting youths less than 18 years of age from performing hazardous work including, for example, operating power-driven circular saws. Employers should communicate these work policies to all employees; and, 6. ensure that the nearest area office of the Occupational Safety and Health Administration is notified within 8 hours of a fatality or in-patient hospitalizations of three or more workers as a result of a work-related incident at their company. Additionally, general contractors should ensure through contract language that all subcontractors have a comprehensive safety and health program that addresses all aspects of the jobs they and their employees will perform; accident investigation and emergency services procedures; and age and employment eligibility documentation for all employees that will work on the worksite. Additionally, the U.S. Department of Labor and employers should consider prohibiting youth less than 18 years of age from working at a height of 6 feet or more from ladders, scaffolds, trees, structures and machinery.