Rock fall head injury - White Rocks - West Desert, Utah - 10/10/2025

October 10, 2025 - Little Pico route at Lunar Wall - White Rocks, Utah West Desert - skull fracture from rockfall

Route highlighted in red, the dislodged rock came from where the route moves to the right. 

Narrative:

A party of six climbers spent a few hours top rope cragging at the Lunar Wall. As the climbing started to wind down, a climber on Little Pico reached for a hold near the top of the route where it moves significantly to the right and immediately upon weighting it, dislodged an approximately dinner plate sized rock in the direction of the belayer and another member of the party who was sitting on a rock directly in front of the belayer. The climber called out "rock!", the person sitting on the rock in front of the belayer heard the climber yell and was able to turn their face away but was struck on the back right side of the head. The rock fell about 40 feet and appeared to crumble and break into pieces upon impacting the injured's head. The injured was not wearing a helmet as they had just come back from a break at the parking / camping area below and had not yet put their helmet back on. The climber fell when they dislodged the rock and was automatically top rope belay caught by the belayer's assisted braking device (megajul). 

The injured person was knocked off the rock they were sitting on and caught by the arms of the belayer standing just below them. The injured asked with a confused look on their face "what just happened?", the belayer had seen in their peripheral vision the rock strike the head of the injured and told them "a rock just hit your head, we are going to make sure you are ok". The belayer immediately felt blood pooling in their hand that they placed to support the back of the injured's head. The belayer does not recall catching the climber's fall or even thinking about the climber in the moment of catching the injured in front them. Had an ATC been used instead of an assisted braking device, the climber may have been dropped 30+ feet to the ground in that moment. 

All five of the non-injured people in the party are experienced ski patrollers, and several are rope rescue team members and/or have been in other rock climbing accidents response. Everybody quickly jumped into response mode. While the belayer physically supported the injured, another member grabbed a spare clothing layer and helped hastily apply it as an improvised pressure dressing to the injured's head. The bleeding appeared to be venous not arterial which made controlling the bleed easier and in a very hasty evaluation no loose or dislodged parts of the skull were felt. The scalp had an obvious several inch laceration but there did not appear to be an avulsion. Another member of the team came over and put his belay device on the belay side of the rope of the climber who was still held on the wall by the megajul on the harness of the belayer now holding the injured. The second climber ensured the belay was ready to be transferred to his harness and then unclipped the rope from the megajul of the initial belayer. The climber who dislodged the rock was lowered to the ground and immediately assisted in the emergency response. 

As soon as bleeding was controlled enough the situation was quickly assessed by the team. The injured was conscious, A&O x 3, and ambulatory, but mildly confused, and had experienced a non-trivial amount of blood loss. The area is a nearly two hour drive from a trauma center and there was about 500 feet of walking down 100' vertical relief low angle terrain to get back to the car. Cell service was spotty in the area. One team member announced he was going to get to good cell service to call 911, then ran down the low angle, hopped on his dirt bike and sped off around the corner to better service. Two team members were under the arms of the injured helping her navigate the low angle terrain down to the car. Another team member helped find the smoothest route down the low angle. Halfway down the low angle terrain, the only other climbing party in the area had heard the commotion and brought their first aid kit to meet the injured. The hasty clothing layer that was acting as a pressure dressing on the injured's head was replaced by gauze rolls wrapped around the back of the head, over the forehead, under the nose, and over the chin. Bleeding was assessed to be adequately controlled even if not fully stopped. The injured kept responding appropriately to encouragement and questions but also kept repeating "I'm so sorry" as she was helped to the car. The injured self reported neck pain but no spine pain and was ambulatory with no neuro deficits, the c-spine was not thought of by any of the team members in the moment and was not properly assessed.

At the car the injured was helped into the backseat and was carefully driven the approx 5 miles to the intersection with the main gravel road in the area. During the car ride the injured started perseverating and exhibiting signs of shock. At the main gravel road junction, Skull Valley Tribal Reservation had a response pickup truck, Dugway Military EMS had an ambulance, and upon arrival the climbers were told that a medical helicopter was only a few minutes away. The injured self transferred from the car to the ambulance gurney and was put in the ambulance where IV's were established, vitals taken, and IV pain meds pushed. The injured was mildly combative but calmed down measurably with IV pain meds. Vitals after pain meds were very good and stable but injured remained in a heightened stress mental state. A precautionary c-collar was applied to the injured and she was transferred to the helicopter for the short flight to the University of Utah Health emergency department. 

At the hospital, the injured climber was rapidly checked, scanned, and cleared from immediate need. The findings were a skull fracture that extended into the occipital condyle, a subdural hematoma, and a 9 cm scalp laceration that was neatly sutured up with 16 sutures a few hours after arrival at the hospital. The injured climber remained at the hospital overnight and late into the next day until it was their turn in the MRI to check her spine for approval to remove the c-collar and be discharged from the hospital. 

For those who are curious the charges came to $102,000 before insurance. $45,000 of that was the helicopter response, the rest the level two trauma activation and the 30 hours in the hospital. 

The injured climber self limited movement of the neck for the first 10 days at home and then with the blessing of a consulting spine surgeon, she began to move the neck freely within the pain-free range of motion. The injured experienced a complete loss of smell and a reduction in the ability to taste but has been slowly regaining those senses. Neuro doctor strongly recommended no other knocks to the head for at least a year, no heavy lifting for 6 weeks, and quickly transitioning to rest when any activities or work noticeably increase the headache or other symptoms.

Lessons Learned: 

-Hard rule: No people or dogs within 50 feet of any route being climbed unless they have a helmet AND are actively watching the climber AND are in a position to instantly adjust their location. 

(Helmets only help with small rocks, instinctively turning away from a falling object exposes your spine to being struck (helmet or no helmet). If you are laying or sitting down at the crag you will most likely not be able to rapidly roll yourself out of harms way. Additionally, in this case, a beloved dog was directly besides the injured climber, the dog would not have fared nearly as well as the climber had they been struck on the head and our hearts would have been forever broken.)

-Climbing, in any form, is deadly serious, no matter how much it is in your comfort zone or how much you have reduced other hazards. The group of climbers in this incident mostly multipitch climbs or guides and has heightened awareness, focus, and safety protocols when doing those forms of climbing. This was a chill birthday party top-rope cragging day, guards were down. 

-ABDs are awesome. The experienced belayer's full focus shifted to the injured in front of them. Had an ATC been used there easily could have been two patients if the climber was dropped. Practice transferring a belay from an otherwise occupied or incapacitated belayer.

-Medical and emergency training are awesome. There was no panic, worry, or stress at this incident at all. Everybody immediately jumped into constructive, team driven action. Thank you to all who helped clean up the gear and made it so the injured's partner could smoothly transition to driving to the hospital. 

-Assess the spine in traumas and keep a c-collar or rolled up towel for a horse collar in your car. In this case it did not bite us that we failed to remember to check the spine or improvise a stabilization, but in many incidents having those tools could make a huge difference.

-After any incident, take the time to do a writeup in whatever form is most familiar or comfortable to you, even if not shared publicly, it will help you process. Read accidents reports and have the humility to know that your time may come. 

-Count your blessings. We got both sides of the coin on this one. Incredible bad luck to have the one loose rock of the day finds it way directly to the head of the climber who had just taken their helmet off. Incredible good luck that the rock was not bigger or denser, that it did not land directly on her c-spine or face, and that it did not land on the dog. We were lucky that the climber stayed conscious and was able to help with getting herself to the car, we were lucky to have a great team of people to help, we were lucky to have a professional and rapid EMS response, we were lucky that her brain injury was not worse. Following the incident we were lucky to have lots of help and support from friends, family, and coworkers.  

Take care, be safe, and climb on.  

Good write up, thanks for sharing. Hopefully the victim heals well. As I read the account my immediate thought was spinal injury and c-collar (speaking from experience where it too did not bite the victim, me).

As you noted that the helicopter ride was $45K. Who was provider? I ask because one of the issues currently facing victims is that there are many "private" third party medical helicopters which charge an arm and a leg as they are unregulated. Insurance rarely covers the full cost as the bill beyond the standard. Whereas in Utah there is AirMed (University of Utah) and LifeFlight (IHC) which being associated with a hospital and though also not regulated have much lower costs.

Amazing.  Great job in aiding the injured and sounds like your efforts were rewarded with the injured going to heal up soon!

Allen Sandersonwrote:

Good write up, thanks for sharing. Hopefully the victim heals well. As I read the account my immediate thought was spinal injury and c-collar (speaking from experience where it too did not bite the victim, me).

As you noted that the helicopter ride was $45K. Who was provider? I ask because one of the issues currently facing victims is that there are many "private" third party medical helicopters which charge an arm and a leg as they are unregulated. Insurance rarely covers the full cost as the bill beyond the standard. Whereas in Utah there is AirMed (University of Utah) and LifeFlight (IHC) which being associated with a hospital and though also not regulated have much lower costs.

Thanks for the kind words and curiosity.

Lucky to have this most likely be a one year or less slowdown in life rather than a life changing event.  

Helicopter provider was AirMed. I know nothing about the going rate these days. Insurance is still evaluating this claim. 

Thank you for sharing this well written post. I hope everybody seeks support where needed and that you all fully recover (mentally and/or physically). You guys where lucky. As you said "We got both sides of the coin on this one". All the best!

Ouch, good save.

Better lesson learned:

- Do not sit (or belay) directly below someone who is climbing, even if you think there is no loose rock.  It is usually easy to be at least partly to one side.

This is higher priority than wearing a helmet, because not being in the rockfall path is better than being in the path with a helmet on.

It's White Rocks.  Loose rock is to be expected.  I wouldn't have groups of people or pets hanging around the base of the rock with a climber above.  Probably good advice at any area, but especially at a choss pile place like that.  Same goes for Ophir and Valley of Zion.  Glad the injury wasn't more serious and hope she is recovering.

Great write-up Menno. Thanks for sharing. 

Thank You for sharing.  The write up was very well done.  Obviously this accident could have been much worse, and I'm really glad that it wasn't.  Best wishes for a speedy recovery!

Allen Sandersonwrote:

As you noted that the helicopter ride was $45K. Who was provider? I ask because one of the issues currently facing victims is that there are many "private" third party medical helicopters which charge an arm and a leg as they are unregulated. Insurance rarely covers the full cost as the bill beyond the standard. Whereas in Utah there is AirMed (University of Utah) and LifeFlight (IHC) which being associated with a hospital and though also not regulated have much lower costs.

This is a factually incorrect statement but often still perpetuated. 

"The No Surprises Act bans the practice of balance billing by air ambulance providers. A “balance bill” is a medical bill from an out-of-network provider for the portion of the provider’s charge that is not covered by the patient’s commercial health insurer or self-funded employer health plan, calculated as the difference between the provider’s charge and the amount allowed by the payor and the patient’s coinsurance and/or deductible. Under the No Surprises Act, States and the U.S. Department of Health and Human Services (HHS) enforce the ban on balance billing. "

To learn more: transportation.gov/individu….