An employee was installing a downspout from a ladder. The ladder was leaning on the side wall of a two-story house. The employee dropped the downspout and tried to catch it with his foot. The employee lost balance and tried to get his foot on the ladder, but missed the rung. The employee fell 12 - 15 feet from the ladder to the mulch bed resulting in fractures to his left arm, the first two left ribs and left scapula. The employee was hospitalized.