Death in the line of duty…A summary of a NIOSH fire fighter fatality investigation

On December 23, 1995, a 59- year-old male career Captain was dispatched to a residential fire. As he proceeded down the stairway into the basement to search for fire extension, his right hand/thumb touched a fire/burglar alarm panel causing a severe electrical shock. Although he did not lose consciousness, he suffered multiple fractures in his right thumb and incurred significant heart damage. Due to the heart damage (both to the heart muscle and its electrical system), the Captain was not cleared to return to full duty and he retired approximately 7 months later. On May 30, 2001, after trimming tree limbs at his home, he suffered an unwitnessed collapse. Despite cardiopulmonary resuscitation (CPR) and advanced life support (ALS) administered on the scene and at the hospital for approximately 30 minutes, the victim died. The death certificate and the autopsy, both performed by a pathologist for the State Medical Examiner's office, listed "arteriosclerotic coronary heart disease" as the immediate cause of death, with "hypertensive heart disease" as a contributing, but not an underlying, cause of death. It is unlikely that any of these recommendations could have prevented the electrocution, subsequent cardiac complications, and eventual sudden cardiac death of this retired fire fighter. Therefore, the following recommendations address health and safety generally. They include some preventive measures that have been recommended by other agencies to reduce the risk of sudden incapacitation among fire fighters. These recommendations have not been evaluated by NIOSH, but they represent published research or consensus votes of technical committees of the NFPA or fire service labor/management groups: 1. Conduct annual medical evaluations to determine fire fighters' medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others. The Department and Union should negotiate the content and frequency to be consistent with NFPA 1582

and, 2. Phase in a mandatory wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity.