The paper presents case study findings on the effect of poor health and safety performance and the high rate of non-compliance by construction stakeholders in South African construction sites. A case study of the Tongaat mall collapse, which was caused by a failure of columns, was conducted. The accident was studied to assess whether or not stakeholders were compliant with the provisions of health and safety legislation. The study also evaluates whether the inquiry that was established to investigate the accident managed to hold the stakeholders accountable for their actions or inactions.  The findings from the case study suggest that the non-compliance of stakeholders led to an accident that could have been avoided. Furthermore, gaps were identified in the legislation in so far the regulating body was responsible for holding non-compliant parties accountable.   The research provides select contributing factors to the slow progress in health and safety performance in the industry. Understanding and addressing the issues highlighted in the research may contribute towards increasing the improvement of health and safety performance in the South African Construction Industry.