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Captain dies after extremely heavy physical exertion at building fire from complications of mitral valve surgery - Kansas.

Baldwin T; Hales T
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, FACE F2010-05, 2010 Jun; :1-13
On December 13, 2009, a 51-year-old male career Captain responded to a fire in a condominium complex clubhouse. On scene while wearing full turnout gear, he stretched a 2 1/2- and a 3-inch hoseline and cut a hole in the building exterior to access the crawl space. While in rehabilitation (rehab), the Captain experienced persistent shortness of breath and palpitations/tachycardia. These symptoms progressed over the next few days resulting in a subsequent diagnosis of mitral valve insufficiency/regurgitation. The Captain underwent surgery to repair his mitral valve on December 29, but suffered an intra-operative myocardial infarction (heart attack) from which he died 4 days later. The death certificate, completed by the pathologist, listed the cause of death as "massive acute myocardial infarction due to complications from mitral valve annulus placement due to severe mitral regurgitation aggravated by smoke/chemical inhalation." The autopsy, completed by the pathologist, listed "massive acute myocardial infarction secondary to kinking and obstruction of the circumflex coronary artery resulting from the mitral valve annulus placement during mitral valve surgery" as the cause of death. NIOSH investigators agree with these conclusions. In addition, NIOSH investigators believe that the Captain's acute mitral value insufficiency/regurgitation was due to a partial tear/rupture of his chordae tendineae. This tear/detachment was probably triggered by the heavy physical exertion expended during fire suppression activities on December 13, 2009. 1.) NIOSH investigators offer the following recommendations to address general safety and health issues. However, it is unlikely that any of these recommendations could have prevented the Captain's death. 2.) Provide annual medical evaluations to all fire fighters consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 3.) Discontinue routine pre-employment/preplacement exercise stress tests for applicants. 4.) Ensure fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. 5.) Phase in a comprehensive wellness and fitness program for fire fighters. 6.) Perform an annual physical performance (physical ability) evaluation. 7.) Provide fire fighters with medical clearance to wear self-contained breathing apparatus as part of the Fire Department's annual medical evaluation program.
Region-7; Accident-analysis; Biological-factors; Cardiac-function; Cardiology; Cardiovascular-disease; Cardiovascular-system; Cardiovascular-system-disease; Cardiovascular-system-disorders; Fire-fighters; Fire-fighting-equipment; Fire-protection-equipment; Heart; Medical-screening; Physical-examination; Physical-fitness; Physical-stress; Physical-therapy; Physiological-disorders; Physiological-factors; Physiological-function; Physiological-stress; Physiological-testing; Physiology
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Field Studies; Fatality Assessment and Control Evaluation
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Fiscal Year
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NIOSH Division
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Services: Public Safety
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National Institute for Occupational Safety and Health
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division