On July 7, 1999, a 64-year-old male career Fire Fighter/Driver/Operator and engine crew were dispatched to an anonymous 911 call reporting a fire in a densely populated residential area. Immediately upon arriving at the scene, the Fire Fighter/Driver/Operator (the victim) and crew members began to scan the area in search of fire. Crew members reported that within 2 minutes on the scene, an unrestrained pit bull terrier charged the victim from behind. A crew member witnessed the dog running toward the victim and yelled to alert him. The victim heard this warning, but was only able to partially turn around before the dog lunged at his chest, causing him to fall onto his back as he fought the animal's attack. The victim injured his knee and could not stand up. Other crew members were then able to contain the dog. The victim was transported via ambulance to a nearby hospital emergency department and admitted for knee surgery. On July 9, the morning of his scheduled surgery, the victim became acutely short of breath and unresponsive. Advanced life support (ALS) was initiated, but the victim did not survive. Autopsy findings included "hypertensive cardiovascular disease" as the cause of death and "blunt impact trauma [to the knee] with avulsion of [the] right quadriceps tendon" as the contributory condition." The anonymous 911 call was determined to be a false alarm. Other agencies have proposed a three-pronged strategy for reducing the risk of cardiovascular deaths among fire fighters. This strategy consists of (1) minimizing physical stress on fire fighters, (2) screening to identify and subsequently rehabilitate high-risk individuals, and (3) encouraging increased individual physical capacity. Recommendations relevant to this fire department include: Exercise stress tests should be incorporated into the Fire Department's periodic medical evaluation program. The Department and Union should negotiate the content and frequency to be consistent with NFPA 1582. Reduce risk factors for cardiovascular disease and improve cardiovascular capacity by phasing in a mandatory wellness/fitness program negotiated between the Fire Department and the Union.