A school custodian who was working alone survived a fall from a ladder only to die from a blood clot a few days later. The victim fell about five feet to the floor while attempting to change a burned-out light bulb in a school auditorium.

The worker had been standing on the second step from the top of a six-foot stepladder when he lost his balance and fell. He called 911 on his cell phone for help. The custodian complained of severe pain in his ankles and knees and was taken to hospital, where it was determined he?d suffered a bad break in his right leg.

The 39-year-old man was told he would require surgery but he died as the result of a blood clot before he reached the operating room. The blood clot originated from deep vein thromboses in the calves of both ladders.

A state occupational safety and health branch investigated the fatality and made the following recommendations:

• A job hazard analysis (JHA) on all custodial staff duties should be performed by a safety professional and standard operating procedures for these tasks should be developed to ensure work is performed in the safest manner possible.
• Schools should provide safety training to custodial staff to ensure they are aware of the standard operating procedures.
• A person or persons with knowledge of safety procedures and rules should assign and direct the work of custodial staff.
• Schools should consider replacing lights at heights with long-life bulbs and should purchase and use flood light bulb changers with extension poles for changing lights.