Death of worker prompts review

Edgar Malloy hung bleeding from the fan blades of a rooftop cooling tower as work went on as usual in the Henderson offices beneath him.

At least three hours passed before anyone at City Hall figured out where Malloy had gone or what had happened to him.

When the 62-year-old maintenance worker was finally discovered, he was rushed to a Henderson hospital and then to University Medical Center, where he died the next day.

The Feb. 7 accident is changing the way Henderson keeps track of its employees, especially maintenance workers on service calls.

Assistant City Manager Bristol Ellington said the new "automated" system in the works should help improve safety and communication.

"There needs to be something in place," he said, because the old way to keep tabs on people wasn't working.

"There was a sign-out sheet that wasn't being adhered to by any of the employees," Ellington said.

During the state probe of Malloy's death, one Henderson maintenance worker told investigators that the city had "no system in place" to keep track of staff members on service calls.

"It's very independent," the worker said in a written statement. "If you fall over on a roof somewhere, no one will know."

The employee, whose name was withheld by investigators, added that he and his co-workers only went looking for Malloy because they were worried he might be having trouble with his diabetes.

"Otherwise (we) might not have," the employee wrote.

Ellington said the city also is reviewing whether to start using two-person teams for certain jobs.

Until that determination has been made, department heads have been directed to sign off on two-man teams when workers request them, he said.

The maintenance worker interviewed by state investigators said one of his "gripes" was that his bosses with the city would not allow service technicians to work in pairs.

"They say they can't justify that," the worker wrote.

The Nevada Occupational Safety and Health Administration documented 12 safety violations, 11 of them serious, during its investigation of Malloy's death.

OSHA's investigation report did not address the city's methods of keeping track of workers on service calls.

Most of the violations concerned a lack of adequate equipment and safety procedures for work inside the cooling towers used to air-condition City Hall.

OSHA ended up fining the city $5,625.

Henderson safety officer Michael Francis said the city isn't adding new procedures so much as "beefing-up" the existing ones as a result of the OSHA investigation and its own internal probe.

Francis added that the accident was not caused by too little training or too few safeguards.

"We had the things in place to prevent it," he said.

Malloy went up to the roof to check on a vibration alarm indicating a problem with one of the cooling towers used to air-condition City Hall.

Investigators believe he inadvertently reactivated the cooling tower in course of resetting the unit's vibration sensor.

When the fan started up, his jacket and right arm became entangled. The spinning blades crushed his right elbow and fractured his skull.

The Clark County coroner's office has ruled Malloy's death an accident, the result of blunt-force injuries and "industrial fan trauma."

City officials could not pinpoint precisely when the accident occurred, but they were able to narrow it down using cell phone records and electronic logs showing when Malloy used his access card to open certain doors in City Hall.

Malloy accessed the roof at 9:19 a.m. His co-workers began trying to reach him on his city-issued cell phone a little over an hour later.

Sometime between 10:24 a.m. and 1:31 p.m., 10 calls from five different co-workers went unanswered.

Finally at 1:45 p.m., almost 41/2 hours after Malloy went up on the roof, a fellow air-conditioning technician found him pinned inside cooling tower No. 3.

"Had he been found sooner, would he still be alive? We don't know that," Ellington said. "It's a tragic event that we hope will never happen again."

Malloy's fatal mistake came when he climbed inside the tower without shutting off power to the unit, a procedure known as "lock out, tag out." For people who work on and around electric-powered equipment, there is no more basic a safety step.

Malloy was an 11-year employee of the city with more than 40 years of experience as a heating and air-conditioning technician.

According to the city's investigation report, he completed refresher courses in lock-out, tag-out procedures nine times between 1997 and 2006.

On the morning of the accident, he attended a short meeting of facilities maintenance staff that included a reminder about powering down equipment before working on it.

Yet even though the OSHA report indicates Malloy had handled service calls before like the one he was on when he was killed, his lock-out, tag-out equipment was found downstairs in his truck after the accident.

That is the part of the story Henderson's safety officer just can't figure out. Francis said it is difficult to understand -- and impossible to know for certain -- why a man as seasoned as Malloy would do what he did.

"It wasn't like this was his first time working on this piece of equipment," Francis said. "It's a mystery to everyone here."

Contact reporter Henry Brean at hbrean@ reviewjournal.com or 702-383-0350.