Firefighter Autopsy Protocol - US Fire Administration - Federal ...

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■ Firefighter Autopsy Protocol ■ 151 ■ I: Background ■ NIOSH REP. # F2000-40 Aug 06, 2000 F2000-39 Apr 29, 2000 F2000-38 Aug 13, 2000 DATE OF INCIDENT Title CAUSE OF DEATH AUTOPSY AUTOPSY COMMENTS Firefighter collapses and dies during exercise training at his fire station—Missouri A lieutenant dies and three firefighters of a career department were injured when the truck they were responding in was struck by another vehicle—Illinois Firefighter/scuba diver dies during training evolution—Indiana Arteriosclerotic heart disease Multiple injuries sustained due to a motor-vehicle crash [Pulmonary] barotrauma Yes • No weight taken at the time of his autopsy • An enlarged heart weighing 570 grams • Left and right ventricular dilatation • Scar formation in the left ventricle (superior aspect of the posterior wall) • Arteriosclerotic heart disease • Fresh clot (thrombus) in the right coronary artery 2 cm from its origin – 80% narrowing of the distal right coronary artery – 60% narrowing of the circumflex artery – 80% narrowing of the left anterior descending artery • Illicit drug and alcohol tests were negative • Presence of a prescription heart medication (Papaverine) • Large white layer of lipid (fat) material [suggesting a recent meal or a lipid disorder Not mentioned None Yes • Extensive air emboli (air bubbles in lung, brain, and heart blood vessels) • Subcutaneous emphysema (air under the skin) and alveolar hemorrhage, as well as pulmonary edema with pink foam in the airways • No pneumothorax. • Toxicology reports listed no finding which contributed to his death PDF LINK
■ Firefighter Autopsy Protocol ■ 152 ■ I: Background ■ NIOSH REP. # F2000-37 Jul 18, 2000 DATE OF INCIDENT Title CAUSE OF DEATH AUTOPSY AUTOPSY COMMENTS Arson investigator dies from injuries sustained from a fall during an arson investigation—Illinois “Multiple organ system failure” due to, or as a consequence of, (b) “peritonitis with severe hypotension, ischemic necrosis of the liver and kidneys” due to, or as a consequence of, (c) “blunt force trauma of the left chest wall with splenic hematomas and a perforated stress ulcer.” Yes -two “Blunt force trauma of the left chest wall resulted in a massive intrasplenic hematoma and the development of a stress ulcer. The spleen was not ruptured. The stress ulcer perforated, releasing bowel contents into the peritoneal cavity, which resulted in fibrinous peritonitis. Hypotensive episodes secondary to the peritonitis led to multiple organ system failure, specifically generalized ischemic necrosis of the liver (superimposed upon hepatitis C-induced micronodular cirrhosis), acute tubular necrosis of the kidneys and infarction of the rectosigmoid colon. The combination of liver failure and renal failure constitutes so-called ‘multiple organ system failure’ and was the immediate cause of death. The underlying cause of death was blunt-force trauma of the left chest wall.” F2000-36 Jul 23, 1998 F2000-35 Jul 02, 2000 Captain suffers a heart attack at a structure fire and dies 12 days later—Illinois Junior firefighter killed responding to call in his privately owned vehicle (pov)—Pennsylvania Myocardial infarction (otherwise known as a heart attack) as the immediate cause of death, due to severe atherosclerotic cardiovascular disease Blunt-force trauma to the head and trunk Two days later, a second autopsy was performed by a forensic pathologist hired by the victim’s widow. This autopsy essentially confirmed the findings of the first autopsy with two additional points mentioned. A left-arm contusion (bruise), a left-trunk contusion, and a left-10th-rib fracture were noted, suggesting the initial fall on July 18 was quite severe. A second point in this autopsy was that postinjury medications, in addition to chronic hepatitis C virus (HCV) infection and cirrhosis due to HCV, contributed to his liver failure Yes • A large heart (cardiomegaly) weighing 535 grams • An old posterior MI • A recent anterior septal MI • Severe coronary artery disease (CAD) • Stent in the LAD with 60-75% focal occlusion proximally • 70-80% occlusion proximally of the circumflex artery • 50-60% occlusion of the right coronary artery Not mentioned None PDF LINK
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■■Acknowledgement This project
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