Pump Operator/Engineer Suffers Heart Attack On Duty and Later Dies - Texas

Death in the Line of Duty...A summary of a NIOSH fire fighter fatality investigation

F2014-22 Date Released: July 14, 2015

Executive Summary

On July 16, 2013, a 53-year-old male career pump operator/engineer (PO/E) was serving as Acting Lieutenant for his crew’s 24-hour shift. When the shift started at 0800 hours, the PO/E put his turnout gear onto the engine and checked equipment. Twenty minutes later, the PO/E entered the office complaining of sudden shortness of breath. After the medical bag was retrieved and oxygen administered, the PO/E began having chest pain. Dispatch was notified and an ambulance was requested. Ambulance paramedics provided advanced life support on-scene and en route to the local hospital’s emergency department (ED). The PO/E had a long history of coronary heart disease (CHD) with bypass surgery in 2004. In the ED, a heart attack was confirmed and cardiac catheterization revealed the occlusion of two coronary artery grafts from the 2004 surgery. One of the grafts was opened and stented, but the PO/E remained unconscious in cardiogenic shock. Six days later he was transferred to a regional tertiary care hospital for a possible heart transplant. Over the next 19 days, the PO/E’s clinical condition deteriorated. On August 10, 2013, the PO/E died at 2330 hours.

The death certificate listed “multi system organ failure” due to “cardiac arrest” due to “systolic heart failure” due to “coronary artery disease” as the cause of death. No autopsy was performed. NIOSH investigators concluded that the PO/E’s death was a result of his underlying CHD.

Key Recommendations

• Provide preplacement and annual medical evaluations to all fire fighters consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, to identify fire fighters at increased risk for CHD
• Perform exercise stress tests on fire fighters at increased risk for CHD, or those who are known to have CHD

The following recommendations would not have prevented the PO/E’s death, but NIOSH investigators include them to address general safety and health issues:

• Ensure that 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 components of NFPA 1582
• Phase in a mandatory comprehensive wellness and fitness program for fire fighters
• Provide fire fighters with medical clearance to wear a SCBA as part of the Fire Department’s medical evaluation program.

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