Importance of Proper Physicals Noted by NIOSH after MD Firefighter LODD

On his second shift back on duty following hospitalization for a stroke, a Montgomery County Fire and Rescue lieutenant collapsed after throwing ladders at a house fire.

Despite immediate intervention, Lt. Christopher J. Higgins, 46, was pronounced dead at a local hospital.

During their probe of the Jan. 11, 2025 line-of-duty incident, NIOSH investigators learned that although Higgins was diagnosed with congestive heart failure while being treated for the stroke, the fire department's physician was never notified because he used shift substitution rather than medical leave for his recovery.

As result, a return-to-work medical evaluation was never conducted. A cardiologist had prescribed medications, but he feared it would end his career.

"Though it is not possible to determine conclusively if this contributed 
to the fatality, the lack of a return-to-work medical evaluation by a provider with occupational health expertise was a missed opportunity for promotion of firefighter safety," investigators wrote in their report.

To reduce the risk of firefighter deaths, NIOSH made the following recomendations:

• Ensure that a physician familiar with the essential tasks of 
firefighting as outlined by the NFPA and the physiologic requirements to complete them safely signs off on return-to-work physicals. 
• Evaluate department shift substitution and medical leave policies to ensure they are being applied appropriately.  
• Promote effective fireground communication with all mutual aid companies to ensure critical radio traffic is understood and relayed to on-scene personnel for incident stabilization and safety. 
• Continuously evaluate staffing and deployment strategy to plan for 
effective emergency response.  
• Work with automatic aid companies to establish a policy for clearing 
the fire scene following an incident of this nature.