On December 13, 1999, a 50-year-old male Fire Fighter responded to a barn fire. After setting up a portable tank and unloading water into the tank, the victim proceeded to a tanker filling site, where he had a witnessed collapse. Despite cardiopulmonary resuscitation (CPR) and advanced life support (ALS) administered on the scene and at the hospital, the victim died. The death certificate, completed by the County Coroner after the autopsy was performed, listed "fatal cardiac arrhythmia" as the immediate cause of death due to "acute thrombotic occlusion of the right coronary artery" (heart attack), "80-90% narrowing of the left anterior descending coronary artery, and severe coronary atherosclerosis." Other significant conditions were listed as "hypertrophy and dilatation of the heart, acute marked congestion of the lungs, and splenomegaly." Other agencies have proposed a three-pronged strategy for reducing the risk of on-duty heart attacks and cardiac arrests 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. Issues relevant to this Fire Department include: fire fighters should have annual medical evaluations to determine their medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others; individuals with medical conditions that would present a significant risk to the safety and health of themselves or others should be precluded from fire-fighting activities; phase in a mandatory wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity; and although unrelated to this fatality and not part of the three-pronged prevention strategy, fire departments should ensure that all fire fighters have communication access at all times.