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Nail gun safety under fire as injuries soar; Dangerous models sold despite years of warnings


Andrew McIntosh amcintosh@sacbee.com

With a 2 1/2-inch nail deep in his chest, construction worker Manuel Murillo slid into a pickup truck, bracing himself for a desperate seven-mile drive down a snowy Sierra road.

His friend and co-worker, Salvador Cardenas, was driving. When they finally got cell phone reception, Murillo, 30, called his wife in nearby Portola to tell her there had been an accident. He had shot himself with a nail gun while working on a mountain cabin. And he was going to die.

"I love you," he said, before hanging up.

Murillo had been struck down by a popular tool of his trade -- the air-powered nail gun -- equipped with a mechanism that allowed automatic firing.

As the tool's popularity surged during the building boom of the 2000s, a Sacramento Bee investigation found, nail gun injuries also took off despite decades of warnings from researchers and doctors that the guns are dangerous, especially in the automatic mode known as "contact trip."

Driven by compressed air, the brawniest nail guns can blast 30 nails a minute that travel up to 490 feet per second, qualifying the nails as low-velocity missiles. In contact trip mode, with one pull of the trigger, they fire those missiles whenever the muzzle makes contact with a surface -- including heads, hands, eyes and even chests.

Yet the tool's hazards have been largely unaddressed by regulatory agencies. Inspectors charged with protecting the state's workers at Cal-OSHA visit a fraction of active work sites to see whether nail guns are being safely used. The agency more typically investigates after an accident has occurred -- as it did with Murillo.

Cal-OSHA's efforts to promote safer firing systems also have been derailed. Meanwhile, the federal Consumer Product Safety Commission has done little, even as its staff documented the growing injury toll among nonprofessionals.

Novice construction workers and journeymen carpenters, home do-it-yourselfers and even passers-by are among those getting hurt.

California companies reported 1,890 nail gun injuries leading to missed work days from 2003 to 2006, according to the U.S. Bureau of Labor Statistics. That tally includes a small portion of those injured in part because undercounting is widespread, according to a 2006 report by the state Legislative Analyst's Office.

A more comprehensive national estimate found that 42,000 people with nail gun injuries -- more than 100 a day -- show up at U.S. hospital emergency departments annually. Others are treated at clinics or at home.

Treating the wounds costs the United States at least $338 million a year in emergency medical care, rehabilitation and workers' compensation, according to a Consumer Product Safety Commission estimate. That's 10 times the cost of treating jigsaw, power sander or band saw injuries, and double that for handsaws.

Who gets hurt Injury victims and their relatives accuse manufacturers of sacrificing safety to boost the sale of the guns and the nails that go with them, which load into magazines or come in coils. The faster the tool, the greater its appeal -- and the more nails it uses.

That allegation is among those made by Manuel Murillo's widow, Brenda, who is raising the couple's three children.

Her wrongful death lawsuit against toolmaker Hitachi-Koki U.S.A. accuses Hitachi of selling Murillo a finishing nail gun that was negligently designed, defective and of "dangerous character and condition," according to a complaint filed in July in Los Angeles Superior Court.

Hitachi Vice President Benjie Hopkins declined to respond, citing the pending litigation.

On April 19, 2006, Murillo was installing pine paneling inside a remote vacation home owned by Michael James Flynn, a Rancho Santa Fe attorney. Cardenas was helping and Murillo's oldest son, Carlos, 10, had tagged along.

Working on scaffolding 7 feet off the ground, Murillo and Cardenas shared the Hitachi gun. At one point, Cardenas recalled during a tearful interview, he heard the tool fire and Murillo yell. When he turned to look, Murillo was grabbing his chest.

Murillo had bought the gun just a few weeks before at a local hardware store, according to a Plumas County Sheriff's Department report. It had two firing modes, a contact trip and a semiautomatic single shot, with a toggle switch between the two.

Murillo's gun was switched to contact trip, according to the state investigation into his death.

The gun was hanging from the end of the scaffolding, at chest level. Cardenas thinks that as Murillo turned sideways to pass the gun, he accidentally bumped into it.

Rushing down the unplowed Plumas County road, Cardenas said he temporarily lost control and hit a pine tree -- then recovered and continued. "I wanna hear you breathe," he told Murillo, as his eyes rolled back in his head.

Finally, at an intersection, they met the ambulance called by Murillo's wife. Murillo stepped out of the truck -- and collapsed.

By the time paramedics loaded him into the ambulance, he had stopped breathing. When the ambulance reached Eastern Plumas District Hospital, Murillo was blue.

Nurses revived him, getting a faint pulse. But during surgery to remove the nail from a coronary artery, Murillo's heart stopped again.

For the next 45 minutes, doctors worked to save him. In the tiny hospital's waiting room, Murillo's wife, sister, mother and other relatives waited for news.

When Brenda Murillo learned the white sheet had been pulled over her husband's body, a Plumas County sheriff's report states, she was so overwhelmed she could not speak to police officers.

Police notified Flynn, the cabin owner, who flew up the next day. A friend to Murillo and godfather to one of his children, Flynn later gave the eulogy at Murillo's funeral, attended by more than 300.

"It was an unspeakable tragedy," Flynn said. "He was literally one of the best human beings and the hardest-working people I ever met."

Murillo's death would strike a familiar chord for four doctors in Truckee, who had saved another man nearly killed in a similar accident in the early 1990s.

Leading that man's treatment at Tahoe Forest Hospital was Dr. Kenneth W. Kizer, then with the UC Davis School of Medicine. Kizer went on to become director of the California Department of Health Services.

The doctors removed a 3 1/4 -inch nail from the man's lung. Later, in the Journal of Trauma, they urged a review of nail gun design features to reduce injuries.

Although they had saved their patient, the doctors wrote, "It is easy to see how it might not have turned out this way."

Kizer, who now lives in Orange County, was saddened that his team's prediction had come true.

But "given the environment in which these are used, which is largely uncontrolled," he said, "the number of injuries is not surprising."

Contact guns targeted Emergency room physicians, forensic engineers, attorneys and occupational safety researchers believe that a majority of nail gun injuries could be prevented by limiting the guns to a one-at-a-time sequential firing system.

Ed Jazlowiecki , a Connecticut attorney, in December won a $3.4 million jury verdict against nail gun manufacturer Stanley Bostitch Inc. on behalf of a man partially paralyzed after being shot in the head with a nail that had bounced off metal after being fired by a contact trip gun.

Jazlowiecki accused Bostitch of continuing to sell contact guns knowing that sequential guns -- which it also sells -- are safer and despite being hit with 25 lawsuits over two decades from nail gun users who suffered brain injuries, 20 of which Bostitch acknowledges settling out of court.

"They're taking the same approach as Ford did with the Pinto," Jazlowiecki said, referring to Ford's reticence to retire the 1970s-era car amid evidence its gas tanks exploded when hit from behind.

"They set aside money for lawsuit payouts," he said of Bostitch. "They make so much money from the nails."

"Nobody at this company thinks that way," countered Ted Morris, the assistant general counsel for Stanley Bostitch. The company is appealing the ruling in Jazlowiecki's suit, saying the worker misused his tool.

Morris acknowledged that sequential guns have a safety advantage over contact trip guns and said his company would comply if contact guns were outlawed. But, for now, most customers prefer them, Morris said.

"We are not required to offer only the safer alternative under product liability law," he said. "The Pinto had a defect. There is nothing defective about Bostitch nailers."

Mark Ezra and the late H. Boulter Kelsey Jr., a team of St. Louis-based forensic engineers, studied nail guns for years. Their research concluded that the contact trip feature, together with the trigger's location on most nail guns, contribute to serious injuries.

Despite nail gun makers' warnings not to carry the tool by the trigger, many users do just that -- and it's easy to see why, Kelsey said in an article published in the Journal of the National Academy of Forensic Engineers.

"The center of gravity of the tool is just above the trigger," he wrote. "This configuration of the handle and trigger vis-à-vis the center of gravity ... encourage the user to maintain the holding grip on the tool with the same fingers that are used to actuate the trigger."

Industry flip-flopped Following repeated calls for safer firing mechanisms and millions of dollars in legal payouts to injury victims, the nail gun industry in 2003 started to make semiautomatic guns that require users to pull the trigger each time they fire.

"No one wants to see injuries," said John Kurtz, executive vice president of ISANTA, the International Staple, Nail and Tool Association. "It's a no-brainer."

The industry group also agreed to ask manufacturers that sell the larger framing guns to ship them with an even safer system, which shoots a nail only when the muzzle is placed on a target and the trigger is pulled -- in that sequence -- known as a sequential mode.

Yet many manufacturers continue to ship those guns with a kit to convert them back to the more dangerous contact mode. In addition, some companies have ignored ISANTA's voluntary standard, continuing to ship only the contact trip systems.

The Bee found that for years before those changes, the nail gun industry acknowledged that contact trip tools were dangerous. At least two companies long ago invented and patented safer trigger designs, federal patent filings show.

In 1972, Stanley Bostitch introduced a sequential trigger nail gun to replace its contact trip guns, touting its safety, court documents in one lawsuit show. Morris, the Bostitch attorney, said the company offered the design free to competitors.

A year later, Bostitch reintroduced the contact trip option after company officials said sales had suffered and that customers were finding dangerous ways to alter sequential guns to fire on contact or simply with the pull of a trigger.

Duo-Fast started selling a fully sequential nail gun in the mid-1990s called "First Place." Its slogan was "helps protect humans from human error."

Brochures touted the gun as "A lasting solution to the vicious cycle of injuries, human tragedy and financial losses."

Today the company, owned by Illinois Tool Works since 1999, sells more than a dozen nail guns that use up to six firing systems; four are contact trips or include a contact trip option.

In Duo-Fast's user manual, consumers are told that the contact trip is "the standard system" and that the sequential mode "may reduce the risk of personal injury" and is "preferred where precision fastener location is more important than speed of operation."

However, Ezra and others challenged the assumption, also common among builders, that contact guns are significantly faster. He cited studies by engineering experts and carpenters that show they aren't much faster and reduce the labor cost of an average house by a couple of hundred dollars.

Those savings, Ezra maintains, are offset by the cost of more injuries and higher insurance rates.

Ban is urged Hester Lipscomb, an occupational epidemiologist at Duke University in Durham, N.C., has spent a decade studying nail gun injuries.

"When people get shot, the cases are portrayed in the media as bizarre accidents," Lipscomb said. "I never call nail gun injuries 'accidents.' That implies they couldn't be prevented and that's not true."

Her research has found that between half and two-thirds of injuries would not have happened with sequential guns.

In her published research reports and at recent construction safety conferences, Lipscomb has urged federal officials to ban contact guns using the federal Occupational Safety and Health Act's "general duty clause." It says employers have a duty to provide a workplace free of known hazards that may cause death or serious injury.

Such a ban likely would have prevented the injury of Highway Patrol Officer Ronald Harris Jr., who became one of an estimated 550 bystanders injured annually by nail guns.

Driving home from the gym on May 16, Harris was hit in the eye by a stray nail that had traveled 75 feet from a house being built on the other side of the Riverside County road -- and through his open car window.

Two framers for Quality Structures Inc. were assembling a wall frame on the second floor of the Temecula house. Both had their nail guns in contact mode, according to a subsequent Cal-OSHA investigation report.

State investigators surmised that Harris likely was hit by a nail from a double fire, in which the device kicked back and fired a second nail, the state report said.

After being knocked sideways into his passenger seat, Harris pulled over to call for help. At first he was so dazed he could not remember the code to unlock his cell phone.

"You got hit by a nail, you said?" one police dispatcher asked incredulously, in a tape of his 911 call.

"I got a freaking shot to the head," an agitated Harris told a second dispatcher.

Today, Harris, 36, has a damaged left pupil and has had to adjust his work schedule to avoid the midday sun. "On a bright sunny day, it gives me a washout," he said. Harris' doctor has ordered glaucoma tests every six months after he turns 40. Harris has hired a lawyer.

Quality Structures, the framing subcontractor, denies responsibility for the incident.

"I consider myself very fortunate that I'm not permanently disabled," Harris said.

Harris was fortunate. In 1988, Eugene Doran, 40, of Andover, Md., became a quadriplegic while getting a haircut. A carpenter in a neighboring store had fired a 3-inch nail through a wall, severing Doran's spine.

Doran received a settlement of $15.35 million from the nail gun manufacturers Amca International Inc. and Desa Industries Inc., the company that had rented the carpenter the gun, and its franchisee.

Statistics elusive Nobody in California collects comprehensive data about nail gun injuries, a void that has favored those contractors and nail gun manufacturers who adamantly oppose government efforts to regulate firing systems -- and have even lobbied against calling it a gun.

Injury data from the federal Bureau of Labor Statistics -- based solely on private employers' self-reporting from 2002 to 2006 -- found California annually had between 310 and 540 nail gun injuries causing missed work, said labor bureau spokesman Shane Stephens.

But if injuries are not recorded on a company's injury and illness log, they don't make it into the bureau's data. And, if a company has fewer than 10 employees, the bureau does not count their injuries.

It's as though they never happened.

That was the case for Arcadio Rendon, who had a nail ricochet off a metal bracket and into his left eye in Temecula in November 2000.

Four years later, Rendon received a settlement of $60,000 after claiming his employer, who picked him up as a day laborer and paid him cash, never provided safety goggles or a face shield, according to documents his lawyer filed with the Department of Industrial Relations.

Rendon's case was never reported to Cal-OSHA, even though it is part of the same department.

Nationally, the labor bureau survey identified between 2,970 and 3,810 nail gun injuries a year between 2002 and 2006. Among those cases, The Bee identified four nail gun misfire deaths in addition to Murillo's -- in Florida, Massachusetts, Maryland, and a 2007 tragedy in Idaho, where Roseville-born Damon Huhtala was killed after tripping and firing a nail into his brain.

Lipscomb, using data from the federal Consumer Product Safety Commission's National Electronic Injury Surveillance System, sets the number of nonfatal injuries far higher.

In an April 2007 report for the Centers for Disease Control and Prevention, Lipscomb estimated that nail gun injuries seen by hospital emergency departments had increased more than threefold in a decade, from about 12,000 in 1995 to about 42,000 in 2005. Looking at just the nonprofessionals in that group, the trend was similar, with emergency room visits rising from 4,200 in 1991 to 14,800 in 2005.

Lipscomb said her data highlight the need not only for safer firing control systems and better training, but also for improved consumer safety information at tool rental companies and hardware stores.

The federal Consumer Product Safety Commission has raised some of those concerns over the years. In 1998, commission officials met with representatives from ISANTA, the industry group, to discuss the growing number of injuries from contact trip guns.

ISANTA and its member companies argued that nail guns were professional tools without significant consumer use, giving the commission no jurisdiction, meeting minutes show. The commission countered that consumers could buy or rent nail guns.

Since then, annual sales of nail guns and other pneumatic tools to nonprofessionals have exploded, hitting $1.3 billion in 2006, up from $850 million in 2001, according to market research firm Mintel International Group Ltd.

During that explosion, Cal-OSHA officials became concerned about the "ever-increasing number of nail gun injuries" at California construction sites, saying in one report that "almost all accidents" were due to human error and citing improper handling and carelessness, along with "the conflicting demands of production versus safe work practices."

In July 2004, documents show, a safety engineer proposed prohibiting the use of contact trip guns for carpentry, except for nailing roof tiles or attaching sheets of plywood to roof trusses.

That proposal was diluted two years later, when an industry advisory committee met in Sacramento.

Written minutes indicate that Conrad Tolson, a senior safety engineer with the Cal-OSHA Standards Board, said his review of California nail gun accident reports found that "workers were typically carrying the tool with their finger on the trigger and the accident occurred when the workpiece accidentally made contact with another worker or the worker's own body."

"Therefore, it appeared to (Tolson) that sequential activation would help reduce accidents," the minutes say.

The nail gun industry and framing contractors resisted, saying the injury problem was exaggerated and that enforcing a ban on contact guns would be impossible.

Their solution? More training.

Cal-OSHA had proposed changing the title of its regulations from "pneumatically driven nailers and staplers" to "nail guns" -- to reflect what workers call them.

Contractors and the tool industry group fought that plan, too. Explaining why, Kurtz, ISANTA's vice president, told The Bee: "It's not a firearm. It's a tool."

Because the standards board operates on a consensus basis, all that was approved in December was a plan to make companies develop a "Code of Safe Practices" for nail guns and require safety training for new hires.

Novices vulnerable Many of the California injury cases The Bee reviewed involved novice, nonunion carpenters or other new hires who received little training of any sort.

Miguel Ramirez, then 20, and on his first day with Enterprise Builders in Rancho Cucamonga, blasted a nail off a metal bracket and into his skull in March 2005. Cal-OSHA inspectors found that Ramirez hadn't been given a face shield at the San Bernardino County job site.

After Ramirez started to faint with "a hole in his face," co-workers rushed him to Loma Linda Medical Center, where the nail was removed.

Three days later, Ramirez couldn't recognize his brother. Five months later, because of his head injury, he still remembered little about the accident, state documents show.

Lipscomb's research confirmed that rookie nail gun users face a high risk. When she studied nail gun use by 772 apprentice carpenters in 2005, 347 or 44.5 percent of them reported injuries.

After adjusting for experience and training, however, Lipscomb found that contact trip users had an injury rate twice as high as those working in sequential mode.

Contractors argue that many nail gun injuries are minor. Lipscomb agrees that most are categorized as minor but adds: "Ask a guy who nailed two fingers together if it is minor."

In addition, seemingly minor puncture wounds may turn out to be anything but.

Fairfield carpenter Jack Sperduto fired a nail into his hand at Travis Air Force Base in 1998. The wound left behind nerve damage and pain so excruciating that years of treatments, surgeries and drugs didn't relieve it, leaving his hand useless and his head filled with suicidal thoughts, medical reports show.

Sperduto sued Senco, the manufacturer, and won $960,000.

Pressure to produce Production demands have contributed to the rise in injuries, according to a 2006 report by the Cal-OSHA Standards Board -- particularly where the state's housing boom was most intense.

Some construction workers are jury-rigging the guns so that they fire faster by removing an easily accessible safety spring. Rental outlets say guns occasionally are returned minus the spring.

Isidro Mejia Lopez, then 39 and working on a house in Palmdale, made newscasts around the world in 2004 after a co-worker fired six large nails into his face, neck and skull.

Lopez was shot when he got tangled up with another worker and, as the two fell, Lopez hit the co-worker's nail gun muzzle in midair.

Cal-OSHA later determined that the co-worker had removed his tool's safety spring, allowing it to pump out six nails. Lopez survived, but even after extensive rehabilitation, his speech is slurred.

Safety-savvy workers have come under pressure to adopt dangerous work methods, too.

Edward Ramos was a carpenter with Ralph Rocca Construction Inc. in Apple Valley in June 2005 when his boss directed him to use his nail gun to attach metal hurricane straps to wood trusses, a state investigation report says.

Ramos told crew leader Randy Cannon that the smaller palm hammer was better for the job because big nail guns are awkward in tight angles. Cannon said the palm hammer was "in the shop," Cal-OSHA documents state.

Ramos repeatedly said he didn't want to use the nail gun. He had no safety glasses or other eye protection. Cannon responded that he had "faith that (Ramos) could get it done using the nail gun."

A short time later, Ramos felt something slam into his face. His right eye started bleeding.

A co-worker drove Ramos to Victor Valley Hospital. From there, he was airlifted to Loma Linda University Hospital, a nail lodged in his brain.

SAFETY TIPS FOR USING NAIL GUNS 1. Pick a firing system suited for your job. Avoid a contact trip nail gun if you¹re mostly firing single shots. If space is too tight for a big nail gun, use a hammer. 2. Read the manufacturer's operating manual before you turn it on. Don't let an inexperi- enced worker, relative or friend use a nail gun without training. 3. The nail gun user and everyone working at the site should wear safety glasses. A hard hat, protective footwear and hearing protection also should be worn. 4. Keep your finger off the trigger when not firing nails. Keep your hands and feet away from the muzzle of the nail gun. 5. Never rest the nail gun against any body part, or try to climb a ladder with the gun cradled against your body. Never point a nail gun at anyone. 6. Watch out for other crew, family members or friends working nearby. 7. Never use bottled gas to power air- powered nail guns. 8. Always disconnect the nail gun from its air or electrical power source before reloading nails, trying to free a jammed nail or carrying the device out of your work area. 9 Never use your foot or knee to support wood you are nailing. 10. Never use a nail gun with a missing push lever and muzzle safety spring.

MORE ONLINE: Videos about nail gun injuries, demonstration on how nail guns fire and an interactive map detailing injuries. www.sabee.com

VIDEO ‘Death in the Sierra' Salvador Cardenas talks about his friend Manuel Murillo, who died after being shot in the chest with a nail gun in April 2006 while the two worked at a vacation cabin in remote Plumas County.

‘Just driving down the street' CHP Officer Ronald Harris tells his story about being shot in the left eye by an errant nail fired from a nail gun more than 75 feet away while he was driving home from the gym last May.

‘Keeping them safe' Find out what Otto Construction, a Sacramento-based general contractor, has done to help reduce the number of nail gun injuries and make its construction sites safer for employees.

TIMELINE Check out a rundown of the key research on nail gun injuries and calls for more safety since 1987.

INTERACTIVE Watch how the different types of nail guns fire and use our map to see details of nail gun injuries reported to Cal-OSHA since 1997.

Call The Bee's Andrew McIntosh at (916) 321-1215.


Copyright © 2005 LexisNexis, a division of Reed Elsevier Inc. All rights reserved.  
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