An employee was on a step ladder placing interior vertical door trim. As the employee changed positions, the ladder tipped over, causing the employee to fall approximately 6 feet to the cement floor. The employee sustained fractures to the orbital wall, maxillary sinus, sphenoid, temporal portion of the skull, and bilateral distal radii. The employee also sustained pneumocephalus, a subarachnoid hemorrhage, and an acute subdural hematoma as well as loose teeth. The employee was hospitalized.