On February 7, 2017, a 46-year-old male volunteer FF (fire fighter) responded to a motor vehicle accident as the driver of the engine. Upon returning to the fire station after the call, the FF reported to his Chief that he was not feeling well and left the station before other members. Approximately 4 minutes later, as he was driving home in his privately owned vehicle, he lost consciousness and his vehicle struck other vehicles. Members of the FF’s department, including paramedic-level EMS (emergency medical services) personnel, responded and initiated CPR (cardiopulmonary resuscitation). An ambulance was dispatched at 0049 hours and arrived on scene at 0105 hours. The FF received advanced cardiac life support care on scene and en route to the emergency department and regained a pulse several times. Hospital emergency department personnel continued resuscitation efforts until 0152 hours, when the FF was pronounced dead.

The autopsy report listed the immediate cause of death as atherosclerotic cardiovascular disease and listed diabetes mellitus, hypertensive cardiomegaly, and obesity as significant conditions contributing to his death. The report documented atherosclerosis with calcification and 95% stenosis (narrowing) of the left anterior descending and right coronary arteries. No coronary artery thrombi were found. NIOSH investigators conclude that the physical stress of the emergency response may have triggered the sudden cardiac event.

The motor vehicle accident was the first emergency the FF had responded to after being off duty for 3 months to recover from an injury to his leg. At the time of his death, he was being treated for type 2 diabetes, hypertension, high triglycerides, and obstructive sleep apnea. Approximately 7 months prior to his death, he was treated for a cholesterol embolism in his foot.