On January 6, 1998, a 58-year-old male career fire fighter with a 28-year service record with the employing fire department collapsed while responding to a residential oil heater fire. The ladder truck to which the fire fighter was assigned was the first piece of equipment to arrive at the fire scene and approached the dwelling from the street in front. After parking the vehicle, the fire fighter and three other fire fighters exited the truck wearing full protective gear and headed toward the front door of the dwelling. The homeowner stated that the fire was from an oil heater in the basement. Ground-level access to the basement was in the rear of the building. The fire fighter and his partner hurried to the back of the building, while the other two fire fighters began placing ladders to access the roof of the structure. When the fire fighter and his partner reached the basement access, he stopped, said, “Hold on, I’m tired,” and placed his hands on his knees. When his partner asked if he was okay, the fire fighter did not respond. The fire fighter then fell face-first to the pavement. His partner turned him onto his back, and noted that he was cyanotic. The partner immediately called for assistance from other fire fighters on the scene, cut the strap to the fallen fire fighter’s SCBA so it could be removed, and initiated cardiopulmonary resuscitation (CPR). Other fire fighters arrived and assisted with CPR administration and removal of gear. Resuscitation efforts of rescue unit fire fighters, advanced life support medics, and hospital emergency department personnel failed. The medical examiner listed cardiac tamponade due to a ruptured myocardial infarct as the cause of death. Arteriosclerotic cardiovascular disease was listed as a contributing factor.