Lieutenant Suffers Sudden Cardiac Death at Apartment Fire - District of Columbia

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

F2015-09 Date Released: June 6, 2016

Executive Summary

On May 6, 2015, a 44-year-old male career Lieutenant (LT) was dispatched to a fire on the 9th floor of a 10-story apartment building. His engine company was assigned fire suppression duties. The crew arrived on-scene wearing full turnout gear. They donned their self-contained breathing apparatus (SCBA) and entered the building. The LT, for unclear reasons, entered the building across the street and went to the 9th floor. Finding no emergency, he returned to the street, and entered the building where the fire had been reported. He rode the elevator to the 8th floor. Going “on-air,” he climbed the stairs to the 9th floor and walked down the hall to the involved apartment where he joined his engine crew. The fire was declared under control a few minutes later. The LT and his crew walked down the stairs to the 7th floor and doffed their SCBA facepieces. The LT and his crewmembers continued down the stairs and exited the building. As the LT exited the building, he collapsed. On-scene paramedics began cardiopulmonary resuscitation (CPR) and advanced life support. They transported the LT to the hospital’s emergency department (ED) where CPR and cardiac resuscitation efforts continued for 70 minutes. Despite these efforts, the LT died.

The Office of the Chief Medical Examiner completed the death certificate and the autopsy report. Both listed “sudden death while fighting fire due to hypertensive atherosclerotic cardiovascular disease” as the cause of death. The autopsy report also listed obesity as a contributory factor. His blood carboxyhemoglobin level was 2.0%, suggesting carbon monoxide poisoning was not an issue. Prior to this incident the LT was not known to have coronary heart disease. Given the LT’s underlying heart disease, NIOSH investigators concluded that the physical stress of his activities at the structure fire probably triggered a cardiac arrhythmia, which resulted in his sudden cardiac death.

Key Recommendations

• Follow current Fire Department policies that restrict fire fighters who cannot reach 12 metabolic equivalents on exercise stress tests, a policy consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments
• Perform an annual physical ability evaluation
• Phase in a mandatory comprehensive wellness and fitness program for fire fighters
• Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of the fire department’s medical evaluation program

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