NIOSH Fire Fighter Fatality Investigation and Prevention Program

F2019-13

Career Firefighter Killed, a Police 

Officer and a Civilian Wounded 

When They Were Shot During EMS 

Incident—Wisconsin 
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Summary

• On May 15, 2019, a career firefighter was killed. A police officer and civilian 

were also injured after being shot while on an emergency medical services 

(EMS) incident involving a patient who overdosed. 

• The firefighter was part of a three-person crew on engine 9321. 

• At approximately 5:30 p.m. the crew was dispatched with a private 

ambulance company to report to a patient who had a seizure on a public 

bus at a bus terminal. A police officer was first on scene. 

• The unconscious patient was successfully treated with naloxone on the bus 

by a paramedic and regained consciousness. 

• The patient and responders then exited the bus at 5:47 p.m. 

• A second police officer arrived after the patient walked off the bus. 
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Summary

• The police officers, fire, and EMS crews 

believed that the naloxone would wear 

off and were concerned for the patient’s 

continued well-being. 

• All the responders expressed their 

concerns for the patient’s well-being to 

the patient multiple times. 

• Because all the responders believed the 

patient would need additional medical 

assistance and should be transported to 

a local hospital for follow-up medical 

care, the police officers asked the 

patient repeatedly if he had anything 

on his person that could harm the fire 

and/or EMS responders. 

• During this conversation, the patient 

abruptly produced a concealed 

handgun and began firing at the 

responders. 

Incident scene. A career firefighter was killed, a police officer 

and a civilian were injured after being shot on an EMS incident 

after a patient who overdosed was revived and exited this bus. 

(Photo courtesy of local fire department, bus identification 

markings altered by NIOSH.)
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Summary

• Police officers immediately returned fire as they moved to cover. 

• The fire and EMS crews also ran for cover. 

• The patient/shooter and police officers exchanged gun fire. 

• Within 3 seconds of the handgun being produced by the patient, one 

firefighter was shot and collapsed while seeking cover. 

• He was found unresponsive approximately 80 seconds later. 

• He was treated at the scene and transported to a local hospital where he 

was pronounced dead. 

• A police officer was shot while returning gun fire. 

• The patient/shooter took a civilian bystander as a hostage and continued 

to fire until the patient/shooter was shot and fell to the ground. 
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Summary

• The civilian hostage was also shot. 

• The patient/shooter was secured, provided medical treatment for his 

injuries and transported to a local hospital where he was pronounced 

dead. 

• The wounded police officer was transported to a local hospital by a fellow 

police officer. 

• The wounded civilian was transported by ambulance to a local hospital. 

• Both the wounded police officer and civilian were treated at local 

hospitals and recovered. 

• The first gun shot was fired by the patient at 6:09 p.m. 

• This was 39 minutes after the arrival of emergency responders and 22-

minutes after exiting the bus.
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Contributing Factors

• Medical Emergency: When firefighters first responded to the scene, the 

patient (prior to the shooting) was not breathing adequately and 

required emergency medical attention. An autopsy confirmed the 

patient/shooter had methamphetamine, fentanyl, and 4-anilino-Nphenethylpiperidine (4-ANPP, a metabolite of fentanyl or fentanyl 

analogues) in his system. 

• Scene Safety and Situational Awareness: After being revived with 

intravenous naloxone and exiting the bus under his own power, the 

patient produced a concealed handgun and fired at numerous 

firefighters, law enforcement, EMS, other workers, and civilians. Prior to 

the shooting, police officers made multiple attempts but did not 

complete a search of the patient.
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Recommendations

• First responders and agencies who deliver medical assistance to patients 

who overdose should train staff on standard operating procedures 

(SOPs) for naloxone administration, including an understanding of the 

objective of naloxone therapy and the possibility, albeit uncommon, of 

agitation and combativeness from persons after receiving naloxone.

• Fire, EMS, and police departments and agencies who deliver medical 

assistance should develop SOPs that address the possibility of polydrug 

overdoses.

• Fire, EMS, and police departments should take steps to ensure scene 

safety including taking all necessary actions to protect themselves when 

providing lifesaving care to a patient. The fire service and standards 

setting organizations should consider developing scene safety SOPs and 

training that provide more detailed guidance on the specifics of keeping 

first responders safe while providing lifesaving care to patients.
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Recommendations

• Authorities Having Jurisdiction (AHJs) (e.g. municipalities, areas, or 

departments) should consider developing SOPs or guides that specify 

when (1) a patient should receive a pat down to identify information that 

might be useful for patient care or identify items that pose a threat to 

the patient or responders and (2) a patient might be restrained if the 

patient poses a threat to themselves or the responders. These SOPs 

should specify who determines when a pat down is necessary and who is 

authorized to perform it. These SOPs should be operationalized, trained, 

and exercised by law enforcement, the fire service, and EMS as part of a 

Unified Command response.

• Public or mass transportation companies should consider equipping 

their terminals/stations with transfer/evacuation devices that are capable 

of fitting down the aisles for patient removal.

• Fire, EMS, police departments and dispatch agencies should ensure that 

all responders have the information needed for their response and safety.
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Contact Us

Fire Fighter Fatality Investigation and Prevention Program

Surveillance and Field Investigations Branch

Division of Safety Research

NIOSH 1000 Frederick Lane, MS 1808

Morgantown, West Virginia 26505-2888

FFFIPP Webpage

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