Captain Suffers Sudden Cardiac Death During Physical Fitness Training - California
Death in the Line of Duty…A summary of a NIOSH fire fighter fatality investigation
F2012-14 Date Released: January 2015
On April 3, 2012, a 50-year-old male career fire captain (the Captain) was working an 8-hour overtime shift at a remote fire camp. Soon after arriving at the camp, the Captain participated in a morning physical training hike with his crew. The Captain was assigned the “sweeper” position during the hike. At the 1.4-mile point, one crewmember was lagging behind and the Captain advised him to walk faster to finish the hike on time. Approximately 35 minutes later, the crew became aware that the Captain had not yet returned to camp and a search party was assembled. Approximately 23 minutes later, the crew found the Captain unconscious along the trail. Dispatch was notified and a helicopter, an engine, and an advanced life support squad were sent to the scene. Despite cardiopulmonary resuscitation and advanced life support on the scene, in transport, and at the hospital’s emergency department (ED), the Captain died at 1220 hours. The autopsy revealed “coronary atherosclerosis,” but “no acute intraluminal coronary thrombus” suggesting an acute heart attack did not occur and normal vitreous chemistries suggesting the Captain was not dehydrated. The coroner’s office attributed the cause of death to “atherosclerotic heart disease.” Given the Captain’s underlying coronary heart disease (CHD) disease, NIOSH investigators concluded that the physical stress of the physical fitness training probably triggered a primary cardiac arrhythmia causing his sudden cardiac death.
NIOSH investigators offer the following recommendations, although it unclear if this recommendation would have prevented the Captain’s death.
Review County policies regarding work restrictions for fire fighters with coronary heart disease identified by various screening tests and risk assessment models/databases.
The following recommendations would not have prevented the Captain’s death, but are offered to strengthen the already impressive FD safety and health program.
Provide annual medical evaluations to ALL fire fighters consistent with NFPA 1582 or the IAFF/IAFC Wellness Fitness Initiative.
Perform an annual physical performance (physical ability) evaluation for all members.
Discontinue exercise stress tests on asymptomatic fire fighters who are at low risk for coronary heart disease (CHD).
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.