On September 17, 2005, a 22-year-old male Fire Fighter Trainee participated in a bunker gear donning drill and a warm up jog. After jogging about 350 yards, the Trainee suddenly collapsed. Crew members and instructors notified Dispatch and began cardiopulmonary resuscitation (CPR). The fire engine company stationed across the street arrived at the scene within 3 minutes, and an ambulance arrived 7 minutes later. Additional advanced life support treatment was begun, and the ambulance transported the Trainee to the hospital. Despite advanced life support and CPR for 50 minutes, the Trainee died. The death certificate and autopsy, completed by the District Medical Examiner, listed "hypertrophic and arteriosclerotic cardiomyopathy" as the cause of death. The physical exertion associated with the Trainee's physical fitness training probably triggered his sudden cardiac death. NIOSH investigators offer the following recommendations to potentially prevent similar incidents and to address general safety and health issues: 1. Ensure that fire fighters are cleared for duty by a physician knowledgeable about the physical demands of firefighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. Encourage fire fighters to provide accurate medical history information to the Fire Department physician. 2. Perform pre-placement medical evaluations consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. Although unrelated to this fatality, the Fire Academy should consider these additional recommendations based on health and safety considerations: 1. Provide fire fighters with medical evaluations and clearance to wear self-contained breathing apparatus (SCBA); and, 2. Provide automated external defibrillators (AEDs) as part of the basic life support equipment during physically demanding training.