NIOSH Fire Fighter Fatality Investigation and Prevention Program

F2020-07

51-Year-Old Firefighter Suffers a 

Sudden Cardiac Event and 

Crashes Engine While 

Responding to a Residential 

Structure Fire - West Virginia
NIOSH Fire Fighter Fatality Investigation and Prevention Program 2

Summary • In 2020, a 51-year-old male volunteer 

firefighter responded to a mutual aid call for 

a residential structure fire. 

• While driving the department’s engine to 

the fire scene, the firefighter suffered a 

sudden cardiac event causing him to lose 

control of the apparatus approximately 1⁄2 

mile from the structure fire. 

• The engine left the roadway and began to 

roll down an embankment, but a small 

hillside tree prevented the engine from 

rolling all the way down the hill into a creek. 

• The engine came to rest on its roof in a very 

unstable position. Fire engine balancing on its roof after leaving the 

roadway and rolling down a hill.

(Photo courtesy of the Fire Department)
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Summary

• A firefighter from a neighboring fire 

department, also responding to the 

mutual aid call, came upon the crash 

site and notified dispatch. 

• Over the next 15 minutes, multiple 

emergency responders responded to 

the crash scene. 

• They found the firefighter 

unconscious, trapped inside the cab.

• The firefighter was wearing his 

shoulder and lap belt and had donned 

all his turnout gear except for his 

helmet. Damage to the front of Engine 22 stored at the 

wrecking/salvage yard.

(NIOSH photo)
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Summary • Emergency responders climbed into 

the engine’s cab to take the 

firefighter’s vital signs. 

• The firefighter was unresponsive, did 

not have a pulse, and was not 

breathing. 

• Due to firefighter’s grave condition 

and the engine’s unstable position, 

no cardiopulmonary resuscitation 

(CPR) was administered, and no 

immediate attempt was made to 

extricate the firefighter. Overturned Engine 22 with tire skid marks on the 

roadway where the driver lost control of the engine. 

(Photo courtesy of the Fire Department)
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Summary

• The wrecker crew arrived onscene approximately 45 to 60 

minutes after the crash.

• It took a significant amount of 

time to stabilize the engine 

which was then righted onto 

the roadway. 

• The roof of the engine’s cab 

had to be cut way to extricate 

the firefighter. Engine 22 righted onto the roadway after the deceased firefighter 

was removed. Rain was falling at the time of this photograph, about 

2 to 3 hours after the crash. 

(Photo courtesy of the Fire Department)
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Summary

• The Medical Examiner was called to the scene and pronounced the 

firefighter deceased. 

• The Chief Medical Examiner for the State of West Virginia performed the 

autopsy and completed the death certificate. 

• “Sudden death” was listed as the immediate cause of death, caused by a 

“likely dysrhythmia,” due to years of “hypertensive cardiovascular 

disease.” 

• “Positional asphyxia” could not be excluded as “contributory.”
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Contributing Factors

• Lack of fire department medical evaluations to screen firefighters for risk 

factors for cardiovascular (CV) disease

• Lack of exercise stress tests (ESTs) for firefighters at increased risk for CV 

disease

• Lack of annual medical clearance for unrestricted firefighting duties, 

including operations of fire department apparatus

• Stress of responding to a fire emergency.
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Recommendations 

• Fire departments should ensure pre-placement and annual medical evaluations are 

provided to all firefighters. 

• Fire department physicians should ensure symptom-limiting exercise stress tests (ESTs) 

are provided to firefighters at increased risk of CV disease.

• Fire department medical programs should be under the direction of a physician 

knowledgeable about the physical demands of firefighting, the personal protective 

equipment (PPE) used by firefighters, and the medical guidance provided by NFPA 1582.

• Fire department physicians should use the information from the annual medical 

evaluation to make final medical recommendations regarding medical clearance for 

unrestricted firefighting duties and tasks such as driving fire department apparatus. 
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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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