DATE: 

Spring 2015

TIME: 

After 4:45 p.m. 

VICTIM:

Farm land owner in his 80s

INDUSTRY/NAICS CODE:

Real Estate & Rental & 

Leasing/53

EMPLOYER: 

Self-employed

SAFETY & TRAINING:

On-the-job 

SCENE: 

Farm Field

LOCATION:

Michigan

EVENT TYPE:

Machine

___________________________

INCIDENT HIGHLIGHTS

REPORT#: 15MI031 REPORT DATE: 10/23/18

Owner of Farm Land Died Due to a Tractor 

Overturn to the Side into a Ravine 

________________________________________________________

SUMMARY 

In spring 2015, a male farm land owner in his 80s died when his 

585 International tractor equipped with a front end loader and 

from which he had removed the rollover protection structure, rolled 

over to the side into a ravine. Strapped to a carrying mechanism on

the rear of the tractor was a tank containing herbicide. The decedent

had been in his rented field conducting weed-killing hand spraying

activities at the field/woods edge. As he was returning home in the

rain, he came across a washout of the ravine edge on the passenger

side of the tractor. The tractor rolled to the side down the ravine wall,

pinning him underthe tractor. When a family member could not reach 

him on his cell phone... READ THE FULL REPORT> (p.3)

________________________________________________________

CONTRIBUTING FACTORS

Key contributing factors identified in this investigation include:

• Decedent removed the rollover protection structure and did not

replace it with an equivalent means of protection.

• Field crop planted two-three feet from ravine wall edge.

• Cell phone model could not track incoming weather pattern.

LEARN MORE> (p.5)

______________________________________________________ 

RECOMMENDATIONS

MIFACE investigators concluded that, to help prevent similar 

occurrences, employers should: 

• Tractor owners should ensure their tractors have a manufacturer

approved, certified, tractor specific rollover protection structure

(ROPS) and seatbelts installed.

• Establish crop-planting limits/boundaries to maintain farm

machine access to other fields/areas..... LEARN MORE> (p.6) 

https://oem.msu.edu
Page 2

Michigan Fatality Assessment and Control Evaluation (FACE) Program

MIFACE (Michigan Fatality Assessment and Control Evaluation), Michigan State University (MSU) Occupational & Environmental 

Medicine, 909 Fee Road, 117 West Fee Hall, East Lansing, Michigan 48824-1315; http://www.oem.msu.edu. 

This information is for educational purposes only. This MIFACE report becomes public property upon publication and may be printed 

verbatim with credit to MSU. Reprinting cannot be used to endorse or advertise a commercial product or company. All rights reserved. 

MSU is an affirmative-action, equal opportunity employer.
REPORT#: 15MI031 Page 3

SUMMARY 

In spring 2015, a male farm land owner in his 80s died when his 585 International tractor, equipped with a front end 

loader and from which he had removed the rollover protection structure, rolled over to the side into a ravine. 

Strapped to a carrying mechanism on the rear of the tractor was a tank containing herbicide. The decedent had been in 

his rented field conducting weed-killing hand spraying activities at the field/woods edge. As he was returning home in 

the rain, he came across a washout of the ravine edge on the passenger side of the tractor. The tractor rolled to the side 

down the ravine wall, pinning him under the tractor. When a family member could not reach him on his cell phone, the 

family member called another family member to look for him. The family member and the farmer who rented the land 

were walking to where the decedent was last seen and found the overturned tractor. The family member called another 

family member who called for emergency response. The decedent was declared dead at the scene. 

INTRODUCTION 

In spring 2015, a male farm land owner in his 80s died when his tractor, from which he had removed the rollover 

protection structure, rolled over to the side into a ravine. MIFACE personnel contacted one of the decedent’s family 

members who agreed to meet the MIFACE interviewer at the family home. Several family members were present at the 

interview, and then one of the family members took the MIFACE researcher to the incident site. MIFACE reviewed the 

death certificate and police report during the writing of this report. Pictures used in the report are courtesy of the 

responding police department and those taken at the time of the MIFACE site visit. 

EMPLOYERS

The decedent had owned and operated with other family members a 100-head dairy farm in the mid-1970s. Through the 

years he sold the dairy cows and began to raise pigs, eventually raising 6,000 head/year. He closed the dairy sometime 

in 1986 or 1987. He grew cash crops, corn feed, hay, wheat and soybeans on 1,100 acres. Upon retirement from growing 

crops, he rented his acreage to area farmers. He also maintained the wood lines and other areas surrounding the farm 

fields as part of the agreement from the farmer renting his field. He continued to manage the pig operation. 

WRITTEN SAFETY PROGRAMS and TRAINING

The decedent did not have a health and safety program for the farm. He had attended commodity-specific MSU Extension

meetings. The family member did not know if the meetings included safety and health topics.

WORKER INFORMATION

The decedent was working alone. Prior to the tractor rollover, a farmer who rented some of the land was working in one

of the fields and saw the decedent spraying. 

INCIDENT SCENE

The decedent had purchased the 585 International tractor equipped with a front 6-foot loader bucket in the mid-1980s 

from a Girl Scout troop in a neighboring state. The tractor came equipped with a factory-installed non-foldable rollover 

protection structure (ROPS). The decedent had removed the ROPS to facilitate operation in a low clearance building and 

had not replaced the ROPS with an equivalent means of protection. The family member interviewed by MIFACE indicated 

the decedent kept equipment in good working order so it was assumed that the tractor involved in the incident was in 

good working order. The decedent had four similar tractors and was very familiar with their operation. 
REPORT#: 15MI031 Page 4

At the time of the incident, a 100-gallon fiberglass spray tank was mounted to the tractor’s three-point assembly and 

powered by the tractor’s PTO. 

There was a deep ravine (depth unknown) with steep 

sides on one edge of a planted field. To access the 

northern rented fields, the decedent had to drive 

alongside the ravine. The last row of the soybean field 

planted was approximately two- to three-feet from the 

edge of the ravine. In the area of the incident, there was 

a washout of the ravine edge (Photo 1). It is unknown 

when the washout occurred. The incident occurred 

approximately 1⁄2 mile from the road near the decedent’s 

home. 

WEATHER

During the previous day, there was a period of heavy rain. 

On the day of the incident, it had been a cloudy/mostly 

cloudy day until approximately 3:30 p.m., when a light 

rain began to fall, then there was another short period of 

cloudiness. At approximately 4:30 p.m., it lightly rained, at 5:00 p.m. it was raining, and then at 5:15 p.m., it rained heavily. 

Temperatures which had been in the mid-80s dropped to the mid to low 70s. Winds were from the south to southwest 

ranging from 3-19 mph gusting up to 26 mph. [Weather Underground]. 

INVESTIGATION

The decedent primarily used the 585 International loader tractor to push broken limbs that had fallen into/near the fields 

that could cause an equipment/crop issue. This was the first time he had used the tractor to conduct spraying activities. 

On the day of the incident, the decedent was up at 7:00 a.m. and started to lay tile at the pig operation shortly thereafter. 

At approximately 3:00 p.m., the decedent went home and told a family member that he was going out to the field. He 

did not specify which field. The family member told him that it was going to rain and the decedent responded “I’ve been 

in the rain lots of times”. 

The decedent drove the tractor with the mounted sprayer tank to one of the northern sections of the property to conduct 

hand-spraying activities. It is unknown how much herbicide product was in the spray tank when he started or how much 

was remaining at the time of the overturn because the tank was damaged at the time of the incident. The decedent had 

been traveling to the west using his right hand to spray. He had been on the north end of the field. 

A farmer working in one of the rented fields saw the decedent conducting the hand spraying activities.

It is unknown when the decedent began his southbound journey home; prior to or when the rain began. Due to the rain, 

the field area was wet and muddy. The scene photographs of the responding police show that the decedent was utilizing 

the safe work practice of traveling with the loader bucket just a few feet above the ground (Photo 2). The ravine was 

located to the decedent’s right side, on the passenger side of the tractor. To avoid injury to the newly planted soybean 

Photo 1. Ravine washout
REPORT#: 15MI031 Page 5

plants, the decedent was traveling as close to the edge 

of the ravine as possible. While traveling home, the 

driver’s side tires began to pick up mud because they 

were in the field area, while the passenger’s side tires

were in the grassy area of the wooded tree line/ravine

edge. Upon coming to a washout at the top of the ravine 

the tire tracks show the tractor sliding off the edge and 

overturning into the ravine (Photo 3). The decedent was 

pinned beneath the overturned tractor. 

It was approximately 6:00 p.m. and the decedent had 

not yet returned home for dinner. His wife called 

another family member and indicated the decedent was 

not home, and asked whether the decedent was at this 

family member’s home. Replying no, his wife asked the 

family member to go look for the decedent. The family 

member did not know exactly where to look for him so 

he called the farmer renting the field and asked if he had 

seen the decedent. The farmer replied yes, he had seen 

the decedent and told the family member the location where the decedent had been working. The family member drove

a golf cart to the last known sighting of the decedent and saw the tractor’s wheel marks where the decedent had traveled 

through the field. 

The family member followed the tractor’s tire tracks and 

saw the decedent’s overturned tractor approximately one 

hour later. He called via cell phone to another family 

member, who called for emergency response. The 

decedent was declared dead at the scene. 

While the event was unwitnessed, a possible scenario was 

developed from the available information. Wet conditions 

believed to be present with soil type and grass surface may 

have combined with turning, braking and movement of 

spray solution in the tank to cause a magnified turn into 

the ravine when the washout was encountered. There was 

no indication the brake pedals were locked together. If 

they were not, the application of braking to the ravine side 

brake could have increased the magnitude of the turn. The 

“pendulum” effect of a less than full spray tank combined 

with the “unloading” of front wheels may have allowed 

the front wheels to slide on the wet grass toward the 

ravine. If the washout was encountered at the same time it would be difficult to impossible to correct.

Photo 2. Tractor after removal from ravine. Note height of

bucket arms and fiberglass tank positions

Photo 3. Tractor overturned in ravine. Note steepness of 

walls and washout
REPORT#: 15MI031 Page 6

 CAUSE OF DEATH 

The death certificate listed the cause of death as blunt force trauma. No autopsy or toxicological blood tests were 

performed by the medical examiner. 

CONTRIBUTING FACTORS 

Occupational injuries and fatalities are often the result of one or more contributing factors or key events in a larger 

sequence of events that ultimately result in the injury or fatality. The following unrecognized hazards were identified as 

key contributing factors in this incident:

• Decedent removed the rollover protection structure and did not replace it with an equivalent means of protection.

• Field crop planted two to three feet from ravine wall edge.

• Cell phone model could not track incoming weather pattern.

• Working alone.

• Possible operator fatigue. 

RECOMMENDATIONS/DISCUSSION

Recommendation #1: Tractor owners should ensure their tractors have a manufacturer-approved, certified, tractor 

specific rollover protection structure (ROPS) and seatbelts installed.

Discussion: Rollover protective structures (ROPS), when used in combination with a seatbelt, are 98 percent effective in 

preventing death and serious injury in the event of a tractor overturn. The tractor had originally been equipped with a 

factory-installed non-foldable rollover protection structure. The decedent removed the solid bar ROPS because he could 

not drive it into a storage building (an excepted practice under OSHA/MIOSHA standard 1928.51(b)(5)). He did not ensure 

that equivalent protection was provided – such as a foldable ROPS. If the decedent had a tractor dealership install a 

foldable ROPS – when the unit was used for a non-excepted practice, and if the ROPS and seatbelt were used as intended, 

the decedent might have survived the tractor overturn. 

To maintain the operator safety, tractor operators should ensure that all of their tractors are equipped with a tractorspecific ROPS and seatbelt certified/approved by the manufacturer. To maintain the zone of protection provided by the 

ROPS, the seatbelt must be used. Operators should assure any unit where the ROPS has been removed for authorized 

operations is only used for those operations. Older tractors manufactured prior to 1976 do not come equipped with a 

ROPS. To assist farmers in finding a ROPS for these older tractors, the University of Kentucky Extension program 

developed the Kentucky ROPS Guide, which can be used by any US or Canadian farmer to locate retrofit ROPS for older 

tractors or even “gray market” tractors (i.e., non-U.S. made tractors imported without manufacturer authorization). The 

guide is available online at http://www.ca.uky.edu/rops. 

Recommendation #2: Establish crop-planting limits/boundaries to maintain farm machine access to other fields/areas. 

Discussion: The outside row of soybeans was planted approximately two- to three- feet from the edge of the ravine edge. 

This limited distance between the edge of the field and the ravine narrowed the traveling room the victim had to avoid 

injury to the crop. A planting boundary should be established so that the outside planting row does not impinge on an 

access area to other fields/areas. The grass boundary from the edge of the ditch should be at least equal to the depth of 

the ditch. A good rule of thumb is to stay back from the edge of the ditch as far away from the bank as the ditch is deep. 

The weight of the tractor could cave the bank in if too close to the shear line. 
REPORT#: 15MI031 Page 7

When a ditch/ravine depth is unknown, if possible, make a 

best effort to have marking posts several feet away from the 

edge of ditch when equipment movement occurs between 

the crop field edge and the ditch/ravine edge. It is unknown 

how well the ditch was defined at the time of the incident. 

The path, as shown in Photo 4 (taken at the time of the 

MIFACE site visit) has tall grass and shrubbery at the very 

edge of the ditch and growing up from the sides of the ditch, 

making it difficult to determine the ditch edge.

It does not appear that the ditch bank caved in, but the victim 

was operating the tractor too close to the ditch according to 

the police report, thus allowing the tractor to enter the ditch.

Consideration should be given to field edge clearing and 

maintenance timing. Factors to consider include but are not 

limited to: 

• Are there hidden hazards at the time of activity?

• Are control practices required when crops are present or can they be completed when the field is fallow, preplant or post-harvest?

• Can specific hazards, such as ravine edges, be effectively marked for growing season passage?

 

Recommendation #3: When working alone, establish a check-in procedure with another individual to help assure 

changing weather conditions can be communicated and prompt emergency assistance provided. 

Discussion: Agricultural workers, including farmers, regularly work alone on the farmstead. Therefore, it is important to 

establish an effective communication system for the individual who is working alone to contact other individuals who 

can provide weather updates and/or emergency assistance. The frequency of communication between individuals should

be based on the hazards to which the isolated worker is exposed. The check-in procedure could be initiated by a family 

member or the individual who is working alone and should be established based upon what is practical for the worksite 

circumstances. In this incident, the family member knew it was going to rain. The decedent and the family member could 

have discussed having the family member watch the weather radar and when the storm was close, call the decedent on 

his cell phone to alert him of the impending storm, since the decedent’s cell phone was not a model capable of monitoring 

weather patterns.

The decedent was, most likely, hurrying home to get out of the rain. The speed at which he was driving his tractor could 

have led to the tractor “bouncing” which also has a tendency to cause “oversteer” due to no suspension on the tractor. 

The decedent did not share with his family members where he was going to be hand spraying the weeds, which made it 

difficult for other family members to find him. The individual working alone should share where he/she will be working, 

and call in if changing work locations. Additionally, the decedent did not call his family member when he was leaving the 

field in which he was working and heading home. If he had notified the family member, an expected time of arrival home 

Photo 4. Field edge close to ravine edge. Arrow 

shows direction of travel
REPORT#: 15MI031 Page 8

would have been known, and when that time passed and he was not home, more timely response would have been 

initiated. 

In agricultural settings, the availability of cell phone coverage should be established if that is the means of communication

selected. Although a check-in procedure would not have prevented the tractor rollover, a scheduled time to check in with 

someone when an individual is working alone could prevent an injury from becoming a fatality.

Recommendation #4: Be aware of the dangers of fatigue and weariness when operating tractors and take frequent 

breaks.

Discussion: The decedent was in his mid-80s and had begun work early that day, laying tile, which could be considered a 

strenuous activity. He then went out to work in the field for a few hours. It is unknown how many breaks from work the 

decedent took during his workday or the duration of those breaks. The decedent was described as a hard worker, and in 

good health. It was, most likely, raining heavily when he was returning home. He may have been anxious to get home 

and out of the rain. He may also have been fatigued after a long day’s work. If the decedent was tired, he may not have 

been holding onto the wheel as tightly. If it was heavily raining, and the decedent was driving at a higher rate of speed, 

the potential of the decedent to lose grip on the wheel if the front tire(s) caught a rut, pulling the wheel free from his

grip. Effects of fatigue can include reduced alertness, slower reaction time, impaired decision making and concentration 

which can increase the risk of injury. MIFACE encourages both employers and employees to consider fatigue as a potential 

safety issue and implement strategies to manage fatigue. 

ADDITIONAL RESOURCES

• University of Kentucky College of Agriculture, Food, and Environment. Kentucky ROPS Guide. 

http://rops.ca.uky.edu/?utm_medium=301&utm_source=www

• MIFACE Investigation Report #11MI115: Farmer Run Over and Pinned Under Tractor Tire.

https://oem.msu.edu/images/MiFACE/11MI115.pdf

• National Institute for Occupational Safety and Health (NIOSH). Work Schedules: Shift Work and Long Hours. 

https://www.cdc.gov/niosh/topics/workschedules/default.html

DISCLAIMER

Mention of any company or product does not constitute endorsement by the Michigan FACE program or the National 

Institute for Occupational Safety and Health (NIOSH). In addition, citations to websites external to NIOSH do not 

constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Furthermore, NIOSH is 

not responsible for the content of these websites. All web addresses referenced in this document were accessible as of 

the publication date.

RESOURCES

ACKNOWLEDGEMEMENT

The Michigan FACE Program would like to acknowledge the decedent’s family members for providing assistance and 

information for this investigation.
REPORT#: 15MI031 Page 9