On April 23, 2005, a 27-year-old male career fire fighter (the victim) sustained a fatal head injury when he fell from an enclosed-cab quinta. The incident occurred shortly after leaving the station while the truck was en-route to a reported structure fire. It is believed the victim reached to close a rear passenger door that had opened during a turn to the right, when he fell out of the quint and landed on the pavement. The victim was treated at the scene and transported to a local hospital by ambulance. He died two days later from his injuries. NIOSH investigators concluded that, to minimize the risk of similar occurrences, fire departments should: 1. consistently enforce and repeatedly train members on standard operating procedures/guidelines (SOPs/SOGs) that require all persons responding in emergency vehicles to be secured by seat belts or safety restraints at all times the vehicle is in motion; and, 2. ensure that all seating areas, including seat belts and doors, are inspected during routine maintenance checks and that safety concerns are documented and addressed. Additionally, states should ensure that fire apparatus design incorporates all applicable safety standards and that passenger doors are constructed to remain securely latched under conditions of normal and expected use.