Horrific nail gun injuries hit pros and handymen alike



The white paper cup was taped onto the construction worker’s chest, rising and falling as he lay on the hospital emergency room table, fully conscious.

Staring down at him was Dr. M.L. (Mary Lee) Myers, a heart surgeon at London Health Sciences Centre—University Hospital, in western Ontario. Under the flimsy cup, Myers quickly found the reason for the man’s emergency room trip: a 10 cm-long steel nail embedded deep in his chest.

Earlier that day, the carpenter had inadvertently blasted the metal projectile into his own heart while he framed a two-storey house using an automatic, air-powered nail gun. Had he yanked the nail out, he’d have bled to death; instead, the metal had become a plug in his perforated heart and had saved him—at least for now.

Myer’s team put the 25-year-old worker under general anaesthesia (she cannot identify him for privacy reasons), and rushed him into surgery. They removed the large nail from the right side of his heart and repaired the tears. He survived, and checked out of hospital four days later, but the case left Myers troubled— about her patient’s close call and the growing number and severity of nail-gun injuries.

That concern soon became a call for action. In a recent paper in The Canadian Journal of Surgery, Myers and partner Dr. L. Ray Guo reported the case and called on nail-gun makers to modify the engineering and design of their tools’ firing systems. A simple change, the doctors contend, could stop misfires from blasting nails into hands, knees, thighs, eyes and even skulls.

Most nail guns operate in what is called “contact mode.” When users depress the trigger, the tool fires each time its nose or “workpiece” makes contact with the wood. Increasingly, the tools are firing each time the nail gun bumps or makes inadvertent contact with a workers’ own body or that of a coworker—especially if they are carrying it around by the trigger, a common practice but one that’s not recommended. In their study, Myers and Guo said projectiles fired by nail guns are so powerful they qualify as low velocity missiles. “They are potentially lethal weapons, for sure, in untrained and irresponsible hands,” Myers told Maclean’s.

Statistics Canada has no national nail-gun injury statistics, but some provinces have started keeping track. In British Columbia, for example, 241 workers in the housing construction sector alone reported being struck by nail-gun blasts between 2003 and 2005. The average injury kept a carpenter off work for 17 days, and the average claim to the province’s occupational health sys-

tem was $3,338, for a total bill of $804,542. The numbers in the U.S. are even more startling. Data gathered by the U.S. Product Safety Commission found that 42,000 people a year show up at hospital emergency departments with nail-gun injuries—more than 100 a day. Even more are treated at day clinics. Treating the wounds costs at least US$338 million a year in emergency medical care, rehabilitation and workers’ compensation, the commission found. The U.S. has also seen some horrific fatalities:

• In 2007, Idaho construction worker Damon Huhtala, 26, was killed instantly after tripping, tumbling backwards and accidentally firing a large nail into his brain stem with his nail gun.

• Labourer Juan Delgado, then 41, shot himself in the head in July 2006, two hours after buying a Duo-Fast nail gun at a Home Depot in Houston, for a contract fence job. He died in hospital five days later, leaving behind a wife and three children in Coahuila, Mexico.

• A 2006 accidental nail-gun shooting in remote northern California killed handyman Manuel Murillo, 30. He shot a two-inch finishing nail into his heart while working in a cabin in the Sierra Nevada mountains.

• In 2004, Raymond Tassinari, 22, of Plymouth, Mass., died from a nail-gun blast to his heart while working on a home construction project.

Such incidents show that the tools can be deadly, not only for unsuspecting do-ityourselfers, but for novice and even experienced building professionals.

In 2003, novice carpenter Oleksandr Vlasiychuk of Toronto, then 20, was accidentally shot in the right side of the head by a co-worker who was operating a nail gun while they were building a house in Toronto. Vlasiychuk was placing sheets of plywood and gluing them to floor joists when he was hit by a misfired nail. A crew leader pulled the 2y4-inch nail out of his skull, Vlasiychuk said. ‘T kind of passed out when he did it,” he said.

No co-worker called an ambulance or police, but somebody—he cannot remember who— dropped him off at an emergency room while his crew vanished. Vlasiychuk’s employers, like many who experience such injuries and fear insurance increases, failed to report his mishap to Ontario authorities.

After Ontario Ministry of Labour investigators found out about it through a tip, the builder and developer, Lucky Carpentry and Governor’s Bridge Estates Ltd., were each charged with breaching the Ontario Occupational Health and Safety Act’s accident reporting rules. On Dec. 1, 2005, the companies pleaded guilty and were fined

$50,000 and $35,000 respectively.

Vlasiychuk suffered permanent damage to his peripheral vision, and five years later continues to suffer from agonizing headaches and narcolepsy, a sleep disorder that makes him sleep excessively, between 10 and 12 hours a day. He’s now taking courses to improve his English. “They said it’s unsafe for me to return to work and want me to do something else,” he says.

But nail guns can be dangerous even for those not on a work site. Every year an estimated 550 bystanders are injured in the U.S. by nails that miss targets and stray into streets or adjacent properties. In May 2007, California highway patrol officer Ronald Harris Jr. was driving home from the gym when he was hit in the eye by a nail blasted by a carpenter working on a new home 75 feet away, on the

other side of a four-lane Riverside County road. The nail sailed through his open car window and knocked him sideways into the passenger seat of his car, leaving him dazed and, after he was rushed to hospital, with a permanently damaged eye.

Investigators often call nail-gun injuries “freak” accidents. Manufacturers such as Hitachi, Stanley Bostitch and Senco insist their tools are safe, and say most injuries are due to workers’ mishandling them—specifically, carrying them around with their fingers on the trigger. But Mark Ezra, a forensic engineer in St. Louis, says it’s no accident that workers carry them that way. The weight and centre of gravity of the tools make that the only way

to carry them comfortably.

Both Ezra and Hester Lipscomb, an occupational epidemiologist from Duke University in North Carolina who has also studied the issue, say a safer trigger would prevent most injuries. Some nail guns come with “sequential triggers,” which require their users to first place the nose on the object to be nailed and then pull the trigger, repeating those steps each time, in that sequence. That avoids the gun firing when it’s accidentally bumped. Lipscomb’s research has found that between half and two-thirds of injuries would not have happened had the gun involved had a sequential trigger.

At a construction safety conference in St. John’s, Nfld., earlier this year, Lipscomb urged safety officials in Canada and the U.S. to ban the contact trip guns under the “gen-

eral duty clause” of their respective occupational health and safety laws. Such clauses dictate that employers have a duty to provide a workplace free of known hazards that may cause death or serious injury. Myers and Guo from the London Health Sciences Centre say it’s time both construction professionals and weekend handymen get more and better training when they buy or rent nail guns. Until safer trigger systems are adopted, one fellow of the Canadian Medical Association Journal, Eric Wooltorton, has already advised Canadians to keep the tools and their nails locked up “as they would any firearm and ammunition.” M

With Michael Friscolanti