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46-Year-Old Airport Firefighter Suffers Fatal Heart Attack Responding to Call—Pennsylvania

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Death in the Line of Duty…A summary of a NIOSH fire fighter fatality investigation

F2019-14 Date Released: December 16, 2019

Executive Summary

On March 20, 2019, at approximately 0058 hours, a 46-year-old career firefighter (FF) failed to respond to the apparatus for a call. A fellow firefighter went to find the FF and discovered him unconscious on the floor in a hallway leading to the apparatus bay. Crew members initiated cardiopulmonary resuscitation (CPR) and notified in-house paramedics, who provided advanced cardiac life support (ACLS) and transported the FF. The emergency department (ED) staff continued resuscitation efforts for nearly 20 minutes. The FF never regained an organized cardiac rhythm and was pronounced dead at 0151 hours.

The Medical Examiner’s report listed the cause of death as “acute myocardial infarction due to hypertensive and atherosclerotic cardiovascular disease.” The autopsy found a large portion of the left ventricle wall was damaged due to a heart attack (myocardial infarction). There was severe atherosclerotic plaque in several of the major coronary arteries and evidence of prior stenting in the descending aorta. National Institute for Occupational Safety and Health (NIOSH) investigators concluded that the sympathetic nervous system activation associated with the alarm response likely triggered a heart attack in an individual with underlying cardiovascular disease.

Key Recommendations

NIOSH offers the following recommendations to reduce the likelihood of heart attacks and sudden cardiac arrest among firefighters at this and other fire departments across the country.

  • Ensure firefighters are cleared for duty by a physician knowledgeable about the physical demands of firefighting, the personal protective equipment (PPE) and self-contained breathing apparatus (SCBA) used by firefighters, and the various components of National Fire Protection Association (NFPA) 1582.
  • Develop a tracking system that ensures that firefighters who require follow-up by another provider receive the follow-up, and that results are reviewed by the physician providing medical clearance or return to duty.
  • Adopt a mandatory comprehensive wellness and fitness program for firefighters.


Read the full report