On-Duty Death Follow-up: Advancing Hoseline, Georgia

Cutting the grass listed as being physically active




The “On-Duty Deaths in Detail” posts will be partnered with posts providing NIOSH follow-up to the Unites States Fire Administration firefighter fatality announcement. Since it is common practice culturally that the majority of NIOSH firefighter fatality reports to be shared are ones involving firefighting, we’ll work to make readers aware of those involving the majority causes and natures of our on-duty deaths. This information may be subject to change.



Victim with undiagnosed myocarditis and coronary heart disease was engaged in exterior hoseline operations during a residential structure fire when he collapsed after moving to an opposite side of the structure. CPR and ALS treatment were provided during transport to a local hospital. The victim was later transported to an advanced care hospital for additional treatment.  After additional testing and family consultation, the victim was taken off of life support and moved to a hospice facility.  The victim had at least three underlying medical conditions in addition to those mentioned above.  The only fire department medical evaluation on record is an initial pre-placement screening done 27 years ago.  The department does not require periodic medical evaluations.  The victim did not participate in the voluntary wellness/fitness program but was “very active off-duty by mowing lawns.”



On 24 April 2015 a 54-year old career lieutenant suffered a heart attack during a residential structure fire.  He died 10 days later.  His death was the 32nd on-duty death of 2015 and the third of the month.


NIOSH Report

On 24 April 2015 a career lieutenant responded to a residential structure fire.  After completing initial driver duties the victim began assisting other firefighters with hoseline operations on the rear, exterior of the structure.  The victim moved to the front of the structure where he collapsed.  Treatment was immediately begun with CPR, AED use and ALS treatment.  The victim was taken to the hospital, stabilized and then flown to an advanced care hospital.  It was later determined that the victim had suffered brain damage and at the request of the family was removed from life support and transferred to a hospice setting where he died five days later.


Cause of Death, Autopsy

“Myocarditis in varying stages of healing” is reported as the cause of death with “atherosclerotic and hypertensive cardiovascular disease and diabetes mellitus” as contributing factors, according to the county coroner and the deputy state medical examiner.  An autopsy was performed and revealed several relevant factors.



54-year old male with severe, undiagnosed coronary heart disease.  The victim suffered from diabetes mellitus, hypertension, hyperlipidemia and obesity (according to CDC BMA calculation), under fail control since as far back as 2003.



The fire department requires new career fire fighter applicants to be 18 years of age; have a valid state driver’s license; and pass an oral interview prior to being offered conditional employment. The new hire must then pass a background check, a physical agility test, a preplacement medical evaluation, and a drug screening. Periodic medical evaluations are not required for members. The victim’s only fire department medical evaluation was his preplacement medical evaluation in March 1988. Medical clearance to wear a respirator is not required. Members injured on duty must be evaluated by either the city-contracted physician or the member’s primary care physician who forwards their determination for return-to-duty to the City human resources office.

The fire department has a voluntary wellness/fitness program; exercise equipment is available in each of the two fire stations. A candidate physical agility test is required for all fire fighter applicants and an annual physical agility test is required for all members (see Appendix B). The victim did not participate in the fire department’s voluntary wellness/fitness program. However, he was very active off-duty by mowing lawns.


NIOSH offers the following 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 coronary heart disease (CHD)

Perform symptom-limiting exercise stress tests (ESTs) on fire fighters at increased risk for CHD

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 self-contained breathing apparatus (SCBA) as part of the fire department’s medical evaluation program

Use a secondary (technological) test to confirm appropriate placement of the endotracheal tube


Contrast with USFA

There are no contrasts with the on-duty death notification.  The victim’s Activity Type is listed as Advancing Hoselines while operating a residential fire.  Specifically, the victim was involved in exterior hoseline operations, had left the hoseline and moved to another side of the structure when he collapsed.


Read the Report



“Advancing Hoselines” Carey, June 2015, BackstepFirefighter.com


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BillCareyBioPicBill Carey is the online public safety news and blog manager with PennWell Public Safety, or more specifically FireRescue Magazine/FirefighterNation.com, JEMS.com, and FireEMSBlogs.com. Bill started in the fire service, as a third generation firefighter in 1986, on the eastern shore of Maryland and then continued after moving to Prince George’s County. He served as a volunteer sergeant and lieutenant at Hyattsville. Bill’s writing has been on Firehouse.com, Fire Engineering, FireRescue Magazine, FirefighterNation.com, the Jones and Bartlett 2010 edition of “Fire Officer: Principles and Practice”, The Secret List and Tinhelmet.com. His recent writing on firefighter behavioral health was nominated for a 2014 Neal Award for Best Subject-Related Series.

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