Pump Operator/Paramedic Suffers Sudden Cardiac Death After Physical Fitness Training - Texas
Death in the Line of Duty…A summary of a NIOSH fire fighter fatality investigation
F2014-23 Date Released: June 24, 2015
Executive Summary
On November 16, 2014, a 40-year-old male career pump operator/paramedic (“Pump Operator”) responded to a standby call and later ran 1 mile and lifted weights in the gym during his 24-hour shift. After performing fitness training, the Pump Operator went into one of the fire station’s restrooms. A crew member entered the restroom about an hour later, and found the Pump Operator collapsed on the floor. A cardiac monitor revealed asystole (no heart beat); dispatch was notified and an ambulance responded. After further assessment, the Pump Operator was declared dead on the scene at 2238 hours.
The death certificate, completed by a justice of the peace, listed “atherosclerotic cardiovascular disease” as the cause of death. The autopsy, completed by the forensic pathologist, listed “severe atherosclerotic cardiovascular disease” with “myocardial bridging left anterior descending coronary artery” as the cause of death. Given the Pump Operator’s undiagnosed heart disease, NIOSH investigators concluded that the physical stress of physical fitness training probably triggered a heart arrhythmia, which resulted in sudden cardiac death.
Key Recommendations
- Provide preplacement and annual medical evaluations to all fire fighters consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, to identify fire fighters at increased risk for coronary heart disease (CHD)
- Perform symptom-limiting exercise stress tests (ESTs) on fire fighters at increased risk for CHD
- Ensure that fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the components of NFPA 1582
- Phase in a mandatory comprehensive wellness and fitness program for fire fighters
- Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of the fire department’s medical evaluation program
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.