On February 1, 2003, a 52 year-old male career Fire Fighter-Engineer (FF-E) was conducting trail maintenance behind his duty station (Station 18). The portion of the trail he was maintaining was very steep, approximately a 20% grade for a ¼ mile, and served a variety of Fire Department (FD) functions including a jogging path for physical training by FD members. The wild grasses of 1-2 feet high were encroaching on the trail, and the FF-E and his crewmember were cutting the grass using a lawn mower. After cutting the grass up the hill and starting back down, the FF-E suddenly collapsed. The collapse was witnessed by a crew member who ran up the hill to assist the FF-E. He noted the FF-E was unresponsive and not breathing. At 0900 hours the crewmember notified dispatch of a “fire fighter down” and “possible code blue” as he started cardiopulmonary resuscitation (CPR). Station 18’s Captain retrieved the Engine’s automated external defibrillator (AED) and shocked the FF-E twice without a successful change in the FF-E’s heart rhythm. Nineteen minutes later, other advanced life support (ALS) units began to arrive at the fire station and resuscitation efforts continued for an additional 25 minutes before departing for the nearest hospital. CPR and ALS continued for the 20 minute transport and for a few minutes in the Emergency Department (ED), before the FF-E was pronounced dead by the ED physician. The death certificate and autopsy, completed and performed by a pathologist with the County’s Coroner’s Bureau, listed “atherosclerotic coronary artery disease” as the immediate cause of death with “hypertension” listed as another significant condition. The physical stress of pulling the lawn mower up the hill and his underlying atherosclerotic coronary artery disease contributed to this fire fighter’s cardiac arrest and sudden death.