FFFIPP – Investigation Steps

Who notifies us about line-of-duty deaths?

• The United States Fire Administration (USFA)
• Fire department representatives
• The International Association of Fire Fighters (IAFF)
• State fire marshal’s offices
• Media coverage

How do you submit a notification?

For NIOSH to conduct a firefighter fatality investigation, NIOSH requires the cooperation of the fire department and, if applicable, the local firefighter’s union. To submit a LODD notification, send an email to NIOSHFireTrauma@cdc.gov or NIOSHFireMedical@cdc.gov. Determine which email to use by the type of fatality the firefighter experienced. For help, look at fatality types on our Investigations page.

In the email, please include:

• Points of contact for fire department leadership and union representative(s), if applicable. The NIOSH Fire Team will contact them to gather the necessary information.
  • For each contact, please include:
    • Name
    • Email
    • Phone number.
  • The email should also briefly describe the incident.
  • Confirm that all parties are willing to cooperate in the investigation process.

How do we prioritize fatalities for investigations?

Unfortunately, we are unable to investigate every fatality due to the program’s limited resources. We continually balance initiating new investigations with the time need to complete ongoing case reports. Once notified of a line-of-duty death(s) or serious injury incident, we review each event to prioritize it for a NIOSH investigation using a decision flow chart developed by NIOSH with the assistance from the fire service community.

How do we conduct a site visit?

A NIOSH representative contacts the fire department to enlist their cooperation and schedule a site visit. For traumatic injury deaths, we work to conduct a site visit within three weeks of the incident to evaluate the fire building prior to demolition. Medical investigations, we wait until the autopsy report becomes available before conducting a site visit. A fire department’s decision to participate is voluntary. However, past participants recognize the value of an objective, independent investigation that focuses on developing recommendations to prevent injuries and deaths.

Once NIOSH and the fire department agree on the date for a site visit, NIOSH requests certain materials/records be made available before or during the site visit. These can include any of the following:

• Blueprints of the structure (if applicable)
• Photos and Videos (if applicable)
• Department standard operating procedures
• Dispatch records
• Training records for the fallen firefighter, incident commander, and officers
• The fallen fire fighter’s medical records
• Coroner/medical examiner’s reports
• Death certificates
• Police reports (if applicable)

Interviews

One of the most important components of the site visit is our interviews of fire department personnel and firefighters who were on the scene at the time of the incident. Interviews are voluntary and witness statements are not made under oath or reviewed by the witness. We use our interview notes and the applicable documents to describe the conditions and circumstances leading to the fatalities. These incident circumstances provide the context for our final report. If requested, we will not release the interview notes or other protected information under the Freedom of Information Act (FOIA).

We may work closely with other investigating agencies as a reference for the investigation. When we do not have the necessary subject matter expertise, we enlist the help of others, such as experts in building construction or fire growth modeling. For cases that could be due to respirator or personal protective clothing performance, we request the equipment or clothing be sent to the NIOSH National Personal Protective Technology Laboratory or an appropriate certified independent lab for evaluation.

How do we prepare a report?

Once the investigation is complete, we describe the sequence of incident events, identify contributing factors, and develop and provide recommendations for a draft report. To ensure the draft report is factually accurate, we ask each department, union (if present), or family (where applicable) to review the draft report. Typically, only medical draft reports involve the family for medical history and information. For traumatic injury incidents, fire service subject-matter experts also review the entire draft report. Reports are anonymous and do not name the fire department, fallen firefighter, or other fire fighters involved in the incident.

How do we share the report?

The fire department, union (if present), and family (where applicable) are given the final NIOSH report and have about a week to review. Then we post it on the NIOSH website and notify FF Safety Announcement subscribers of each posting. All NIOSH reports and publications are public domain information and may be freely copied and reproduced for training and educational purposes.