Captain Suffers Sudden Cardiac Death While Performing Physical Fitness Training - Mississippi
Death in the Line of Duty…A summary of a NIOSH fire fighter fatality investigation
F2015-12 Date Released: October 22, 2015
Executive Summary
On May 6, 2015, a 44-year-old male career captain (the Captain) responded to a carbon monoxide (CO) call. After returning to the station, the Captain played basketball for about 1 hour as part of the fire department’s physical fitness program. He stopped playing due to a leg cramp, but when he resumed play, he collapsed. Crewmembers began cardiopulmonary resuscitation (CPR) as Dispatch was notified. An automated external defibrillator was applied and two shocks were administered. The ambulance arrived and paramedics began advanced life support. A cardiac monitor revealed asystole (no heart beat) as the ambulance transported the Captain to the emergency department (ED). Inside the ED, cardiac resuscitation efforts continued for 36 minutes. At 1937 hours, with no change in his clinical status, the Captain was pronounced dead.
The death certificate, completed by the County Medical Examiner, and the autopsy, completed by the State Medical Examiner, listed “hypertensive and atherosclerotic cardiovascular disease” as the cause of death. In 2012 the Captain experienced angina and was found to have a 99% blockage of his left anterior descending coronary artery. The blockage was successfully opened with angioplasty and a stent was placed. Since that time, the Captain has been followed by a cardiologist for his coronary heart disease (CHD). Given the Captain’s underlying CHD, NIOSH investigators concluded that the physical stress of fitness training probably triggered a cardiac arrhythmia, which ultimately resulted in his 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 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
The following recommendations would not have prevented the Captain’s death, but NIOSH investigators include them to address general safety and health issues:
- Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of the fire department’s medical evaluation program
- Discontinue routine hepatitis C virus (HCV) and human immunodeficiency virus (HIV) screening at routine exams
- Undertake prostate screening only after a discussion between the fire department physician and the fire fighter regarding the pros and cons of this testing