On November 5, 2014, at 1653 hours, a 48-year-old male volunteer fire fighter (FF) was dispatched to an unattended trash fire. The FF assisted in advancing the hose line and extinguishing the fire. He then complained of chest pain and an ambulance was summoned. While being transported to the Emergency Department (ED) the FF became unresponsive.
Cardiac monitoring revealed ventricular tachycardia and the FF was defibrillated. The FF regained a sinus rhythm but his heart rhythm reverted to ventricular fibrillation again as care was being transferred to ED staff. He was transferred to the cardiac catheterization laboratory for angiography and a stent was placed.
The FF was transported by medical helicopter to a larger hospital for advanced cardiac care.
He was subsequently admitted to other long-term care facilities and a major state hospital. On February 22, 2015, at 0555 hours the FF died.
The death certificate, completed by the Forensic Supervisor of the County Medical Examiner, listed ischemic cardiomyopathy as the immediate cause of death with severe coronary artery disease as the underlying cause.
The autopsy revealed cardiomegaly, severe three vessel coronary artery atherosclerosis with diffuse calcification and greater than 75% luminal narrowing, prior stenting of the two coronary arteries, pulmonary congestion and edema, multiple organ failure, and clinical history of cardiac arrest (on November 5, 2014).
NIOSH investigators concluded that the physical stress of responding to and participating in fire suppression activities triggered a heart attack that resulted in his cardiac arrest and ultimately his death approximately 14 weeks later.
- Ensure that all fire fighters receive an annual medical evaluation consistent with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments
- Ensure fire fighters are cleared for duty by a physician knowledgeable about the physical demands of firefighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582
- Phase in a mandatory comprehensive wellness and fitness program for fire fighters