It may be in your best interest to exercise caution when heading over to the local gym. It is not the flooring at the gym that should have you concerned. What it is specifically is something else entirely: The gym equipment.

Some people are losing balance, tumbling off equipment, dropping weights and pushing themselves beyond their limits. In the process, they are tearing muscles, straining backs, breaking bones, even dying. The lesson learned from these experiences is that, whether you exercise in the privacy of a home or at a public gym, exercise equipment could be risky.

Accidents happen and are difficult if at all possible to predict. Nobody knows this better than U.S. Senate Minority Leader Harry Reid of Nevada who recently suffered severe eye injuries after a latex exercise band snapped during a workout at his Las Vegas home. The Democratic leader reportedly filed a $50,000 lawsuit against the exercise band’s manufacturer.

According to the U.S. Consumer Product Safety Commission, approximately 460,000 injuries involve exercise equipment, most of which happen on treadmills. The injuries are usually treated in hospital emergency rooms  In spite of these risks, consumers looking to avoid injury when exercising are largely on their own. Local and state authorities are not inspecting how gym or fitness centers are placing equipment; regardless of whether it is dumbbells, elliptical machines or treadmills.

In Sacramento, California, annual city fire inspections only check to ensure that gym equipment is not blocking fire exits. However, a lawsuit by a south Sacramento grandmother against one of the country’s biggest fitness chains is likely to be a “a game changer,” at least in how gym equipment is situated. In January 2011, Etelvina Jimenez, around 60 at the time, apparently fainted while she was on a 24 Hour Fitness treadmill. At some point, she fell backward and struck her head. She fractured her skull in several places. Following the accident, she spent about four months in Sacramento hospitals.

She underwent several surgeries to remove blood clots and relieve pressure on her skull. In hospital photos, ther is a circle of stitches, which arcs around the top of her shaved head. These stitches almost look like miniature railroad tracks. “She survived, but she’ll never be the same,” said Moseley Collins, an El Dorado Hills personal injury attorney, adding that “she is walking and talking but her brain is impaired.”

Jimenez is presently suing 24 Hour Fitness for $3.8 million in damages to cover her lost wages and future long-term care, including physical therapy, neuropsychology counseling and household “chore services.” Additional damages to the complaint accuses 24 Hour Fitness of providing an inadequate safety zone behind the treadmill. A mandatory settlement conference is scheduled for January 12, 2017. If no settlement is reached, the case will go to trial on February. 27, 2017.

Attorneys for 24 Hour Fitness USA Inc. declined to comment on the lawsuit and referred questions to a company spokesperson. “As a matter of policy, 24 Hour Fitness does not comment on litigation,” said an emailed statement from the San Ramon-based company. Founded by Sacramento Kings co-owner Mark Mastrov, 24 Hour Fitness has more than 400 clubs in 13 states. Treadmill injuries – at home or in the gym – are the most common injury on exercise equipment, according to safety commission data. Roughly 24,000 people a year are treated in emergency rooms for treadmill injuries, including broken bones, abrasions and burns.

In the insurance industry, accidents experienced by individuals during gym or health club workouts are often referred to as “member malfunctions.” They include people who suffer knee injuries doing squats, wrist sprains from rolling off an exercise ball, back strains performing deadlifts and smashed fingers when replacing dumbbells.

But treadmill accidents are the most frequent accidents experienced. “Ninety-nine percent of the time in these accidents, it's operator error. People get distracted,” according to Ken Reinig, owner of Reinig Insurance Solutions, the Lakewood, Colorodo-based firm that insures about 1,100 independent health clubs and gyms nationwide, adding that “treadmills are unique in that once the treadmill is set to its desired speed or incline, the machine doesn’t know if you lost your balance or are reaching for a water bottle or changing the music channel. With every other piece of equipment, if you run into difficulty, the machine stops.”

During the next workout, be aware of your surroundings and be careful when using the equipment. Do not get distracted.

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