29-year old was very physically fit
Bill Carey
21 August 2021
CINCINNATI, Ohio – The NIOSH Fire Fighter Fatality Investigation and Prevention Program released the report on the death of a firefighter after working two 24-hour shifts in 2018.
The incident occurred on 1 April 2018 in Wisconsin and involved the death of Madison firefighter/paramedic Richard Garner, Jr. as recorded by the United States Fire Administration.
Age: 29
Rank: Firefighter – Paramedic
Classification: Career
Incident date: April 1, 2018 12:30
Date of death: April 1, 2018
Cause of death: Stress/Overexertion
Nature of death: Heart Attack
Activity type: Other
Emergency duty: No
Duty type: On-Scene Non-Fire
Fixed property use: Residential
On April 1, 2018, a 29-year-old male career firefighter (FF) suffered a sudden cardiac arrest after having brunch with family members following a 48-hour shift. Friends called 911 and initiated cardiopulmonary resuscitation (CPR). An ambulance was dispatched at 1504 hours and arrived on scene at 1508 hours and initiated advanced cardiac life support, which was continued en route to the hospital emergency department (ED). The ambulance arrived at the hospital ED at 1543. Personnel continued resuscitation efforts unsuccessfully for approximately 25 minutes. The FF was pronounced dead at 1609 hours.
The Medical Examiner’s report listed the cause of death as acute cardiac arrest with hypertensive heart disease as the underlying cause of death and obesity as a contributing factor. The autopsy report noted an enlarged heart (weight of 550 grams). National Institute for Occupational Safety and Health (NIOSH) investigators concluded that the FF suffered a sudden cardiac arrest from an unknown cause. The FF had an enlarged heart which may have made him more susceptible to an arrythmia. The FF was a 29 year old male, a non-smoker, and was very physically fit. The FF had a medical evaluation when he joined the fire department (FD) in 2012, and had an optional medical evaluation in 2013 and he received respiratory clearance every year. None of the available records indicate that the FF had elevated blood pressure or a diagnosis of hypertension. The FF was diagnosed with sleep apnea and used a continuous positive airway pressure (CPAP) machine.
Key Recommendations
NIOSH offers the following recommendations to reduce the likelihood of heart attacks and sudden cardiac arrest among firefighters at this and other fire departments across the country.
- Ensure that all firefighters receive an annual medical evaluation consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments.
- Ensure firefighters are cleared for duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by firefighters, and the various components of NFPA 1582.
- Phase in a mandatory comprehensive wellness and fitness program for firefighters.
This incident was investigated by the NIOSH Fire Fighter Fatality Investigation and Prevention Program, Cardiac and Medical Line-of-Duty Deaths (LODD) Investigations Team, located in Cincinnati, Ohio. Denise L. Smith, Ph.D., led the investigation and authored the report. Dr. Smith is Professor of Health and Human Physiological Sciences and Director of the First Responder Health and Safety Laboratory at Skidmore College, where she holds the Tisch Family Distinguished Professorship. She is also a member of the NFPA Technical Committee on Occupational Safety and Health. Dr. Smith was working as a contractor with the NIOSH Fire Fighter Fatality Investigation and Prevention Program, Cardiac and Medical LODD Investigations Team, during this investigation. Wendi Dick, MD, MSPH, provided medical consultation and contributed to the report. Dr. Dick is Lead for the Cardiac and Medical LODD Investigations Team in Cincinnati.
National Fallen Firefighters Foundation: Richard Garner, Jr.
Photograph courtesy of Unsplash.
Data Not Drama 
I don’t see reference anywhere in this report to what, if anything, the two 24-hr shifts had to do with this death. Was there a fire or other strenuous emergency response during the shift or shifts? Was it a 48-hour continuous “shift” or was there a break between the two 24-hour shifts? The headline implies the two 24-hour shifts had something to do with the cardiac arrest, but the details presented paint the picture of a hypertensive, obese person with other medical problems (sleep apnea, enlarged heart). What are we supposed to take from this article about 24-hour shifts? Thoughts and prayers to the family, friends, and co-workers of Mr. Garner. Way too young. 😦
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I’m not sure. When first seeing it I expected to see some statement regarding back to back shifts, OT, sleep deprivation, and even the statement used in the past where it is acknowledged that the contributing factors may have not actually led to the victim’s death but here are some recommendations anyway, but nothing. I can only reason that the shifts was used as the title for simplicity. Simplified titles have been used before instead of listing multiple activities.
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