On February 29, 2008, a 21-year old male volunteer fire fighter (the victim) and a 33-year old volunteer Lieutenant were injured during a structural fire. The fire fighters were attempting to locate and rescue a 44-year old female resident from a burning duplex. The fire fighters became trapped on the second floor when fire conditions deteriorated. The victim was rescued by the rapid intervention team (RIT) and both the victim and injured Lieutenant were transported to the hospital. The victim remained in critical condition for several days in the burn unit before succumbing to his injuries on March 5, 2008. The female resident of the structure did not survive the fire. Key contributing factors identified in this investigation include the lack of water supply, fire fighters advancing within the burning structure without the protection of a charged hoseline, inadequate training in defensive search tactics, non-utilization of thermal imaging camera by the search crew, lack of coordinated ventilation, size-up information about the structure was not relayed to fire fighters, and interior reports were not relayed to the incident commander. NIOSH has concluded that, to minimize the risk of similar occurrences, fire departments should: 1. be prepared to use alternative water supplies during cold temperatures in areas where hydrants are prone to freezing; 2. ensure that search and rescue crews advance or are protected with a charged hoseline; 3. ensure fire fighters are trained in the tactics of a defensive search; 4. ensure that fire fighters conducting an interior search have a thermal imaging camera; 5. ensure ventilation is coordinated with interior fireground operations; 6. ensure that Mayday protocols are developed and followed; 7. ensure the Incident Commander receives pertinent information during the size-up (i.e., type of structure, number of occupants in the structure, etc.) from occupants on scene and that information is relayed to crews upon arrival; 8. ensure that fire fighters communicate interior conditions and progress reports to the Incident Commander; 9. develop, implement, and enforce written standard operating procedures (SOPs) for fireground operations. Additionally: 1. fire departments and municipalities should ensure that citizens are provided information on fire prevention and the need to report emergencies immediately; 2. building owners and occupants should install smoke detectors and ensure that they are operating properly.