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54-Year-Old Interim Fire Captain Suffers Sudden Cardiac Event During Physical Ability Test – New Hampshire
Death in the Line of Duty…A summary of a NIOSH fire fighter fatality investigation
F2021-04 Date Released: March 1, 2021
Executive Summary
A 54-year-old career interim fire captain (CAPT) experienced chest pain and collapsed during a physical ability test that he was performing in order to be rehired as a fire captain after several years of retirement. Firefighters and paramedics on-scene immediately initiated care and the CAPT was defibrillated several times before a transport ambulance arrived. Continued resuscitation efforts en route and in the emergency department were unsuccessful.
The medical examiner’s report listed the cause of death as atherosclerotic coronary artery disease. The autopsy found advanced underlying cardiovascular disease with near total blockages by advanced plaque in each of the three main arteries of the heart, and evidence of two old heart attacks that had damaged the heart muscle. National Institute for Occupational Safety and Health (NIOSH) investigators concluded that the physical ability test triggered a sudden cardiac event in an individual with advanced coronary artery disease and pre-existing cardiac damage.
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: Phase in a comprehensive wellness fitness program.
Key Recommendation 2: Medical evaluations for rehires should occur within 3–6 months of the rehire date and before the candidate takes the pre-hire candidate physical ability test.