42-Year-Career Firefighter-Paramedic Died at Home after Leaving Work Following Transient Chest Pain – Missouri

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

F2020-05 Date Released: February 1, 2021

Executive Summary

A 42-year-old career firefighter-paramedic (FF-P) experienced transient episodes of not feeling well and chest pain during a regularly scheduled 48-hour on-duty shift. The FF-P performed an electrocardiogram (ECG) on himself on both days but did not see any evidence of ischemia. At approximately 1300 hours of the second shift day, he saw an orthopedic physician for a hand injury sustained at work the previous day. Following that appointment, he was told to go home and let the swelling in the hand resolve. The FF-P had no known communications after 1420 hours. On the following morning, the FF-P was found deceased in his bed.

The medical examiner’s report listed the cause of death as acute coronary artery thrombus in the right coronary artery with probable dissection complicating severe coronary atherosclerosis. The autopsy also found left ventricular hypertrophy and hyperemic areas in the left ventricle. National Institute for Occupational Safety and Health (NIOSH) investigators concluded that the FF-P died of a myocardial infarction and that symptoms had developed while on duty.

Key Recommendations

NIOSH offers the following recommendations to reduce the risk of heart attacks and sudden cardiac arrest among firefighters at this and other fire departments across the country.

Key Recommendation 1: Ensure that all firefighters are aware of the warning signs of a cardiovascular event and the atypical ways it can present.

Read the full report