FIRE FIGHTER FATALITY INVESTIGATION AND PREVENTION PROGRAM
Captain Suffers Fatal Heart Attack During Fire Control Training – North Carolina
On October 14, 2013, a 48-year-old male career fire department Captain was an instructor with the fire department’s (FD) 6-month fire fighter recruit program. After practice drills in the morning wearing station uniforms and six live fire drills wearing full turnout gear and self-contained breathing apparatus (SCBA), the Captain suggested taking a break. He and a co-instructor doffed their turnout coat and SCBA and walked across the training ground to obtain water. After drinking some water, they proceeded into the training building. The Captain entered the SCBA refill room to locate spare cylinders for the next drills. As the co-instructor entered the room, the Captain vomited and complained of chest pain. The co-instructor notified the other training captain as the Captain asked the co-instructor to call an ambulance. Oxygen equipment was retrieved, and oxygen was administered to the Captain as his vital signs were taken. The ambulance arrived a few minutes later just as the Captain became unresponsive. Cardiopulmonary resuscitation (CPR) was begun along with advanced life support (ALS) including 10 defibrillation attempts without a change in the Captain’s clinical condition. After 43 minutes of resuscitation efforts at the scene, the paramedics notified medical control of the incident, and the attending physician pronounced the Captain dead at 1632 hours.
The death certificate completed by the county medical examiner and the autopsy report completed by the state medical examiner listed “coronary artery thrombus” as the cause of death. The autopsy report also listed “chronic ischemic heart disease” as a contributing factor. Given the Captain’s previously unidentified coronary artery disease (CAD), NIOSH investigators concluded that the physical stress of the training probably triggered a coronary artery plaque rupture. The rupture likely caused a blood clot that occluded his coronary artery, causing a fatal heart attack.
It is unlikely that the following recommendations would have prevented the Captain’s death; however, NIOSH makes the recommendations to address general safety and health issues and to prevent similar incidents in the future.
Include medical monitoring in rehabilitation programs.
Provide annual medical evaluations to all fire fighters in accordance with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments.
Discontinue routine screening chest x-rays for members unless clinically indicated.
The National Institute for Occupational Safety and Health (NIOSH), an institute within the Centers for Disease Control and Prevention (CDC), is the federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. In 1998, Congress appropriated funds to NIOSH to conduct a fire fighter initiative that resulted in the NIOSH Fire Fighter Fatality Investigation and Prevention Program which examines line-of-duty-deaths or on duty deaths of fire fighters to assist fire departments, fire fighters, the fire service and others to prevent similar fire fighter deaths in the future. The agency does not enforce compliance with State or Federal occupational safety and health standards and does not determine fault or assign blame. Participation of fire departments and individuals in NIOSH investigations is voluntary. Under its program, NIOSH investigators interview persons with knowledge of the incident who agree to be interviewed and review available records to develop a description of the conditions and circumstances leading to the death(s). Interviewees are not asked to sign sworn statements and interviews are not recorded. The agency's reports do not name the victim, the fire department or those interviewed. The NIOSH report's summary of the conditions and circumstances surrounding the fatality is intended to provide context to the agency's recommendations and is not intended to be definitive for purposes of determining any claim or benefit.