NIOSH: Insufficient tactics, training contributed to Boston restaurant LODDs

By Jamie Thompson FireRescue1 Editor

BOSTON — An ineffective incident management system and insufficient tactics and training contributed to the LODDs of two Boston firefighters in a restaurant fire, according to a NIOSH report. Investigators also listed an insufficient occupational safety and health program, insufficient incident management training and requirements and ineffective communications as other key contributing factors in the fatalities. Firefighters Paul Cahill, 55, and Warren Payne, 52, died while conducting an interior attack to locate, confine and extinguish a fire located in the cockloft of the restaurant in August 2007. The NIOSH report released Monday outlines 20 recommendations. The report says a rapid fire event occurred about five minutes after the first crew arrived on the scene. "Victim #1 (Firefighter Cahill) was separated from his crew and was later found on the handline under debris with trauma to his head," the report says. "Victim #2 (Firefighter Payne) had a lapel microphone with an emergency distress button which sounded a minute after the rapid fire event, likely from fire impingement. He was found in the area of the dining room where he was operating just before the rapid fire event occurred." In the wake of the deaths, NIOSH says departments should develop, implement, and enforce an occupational safety and health program in accordance with NFPA 1500 Standard for a Fire Department Occupational Safety and Health Program. Upon reviewing the Boston Fire Department's SOPs following the deaths, NIOSH investigators say they did not effectively cover areas such as risk management, competency in fireground operations, fitness for duty and training. "Operational procedures should be standardized, clearly written, and mandated to each department member. This will establish accountability and increase command and control effectiveness," the report says. It also recommends that departments ensure their members are thoroughly trained, understand, and utilize the incident management system at all emergency incidents. While Boston had an SOP that covered the implementation of the IMS, it was not followed and proved to be ineffective at this incident, according to the report. "NIOSH investigators identified several examples in this incident in which recognized guidelines for IMS were not followed," the report says. "Specific examples include: incident command was not established by the first arriving officer, incident command was never formally transferred, lack of an established accountability system to track firefighters on scene, no safety officer was assigned, and an RIT was not established before conducting interior operations." Local media had claimed after the deaths that autopsies showed Firefighter Cahill had a blood alcohol level three times the legal limit while Firefighter Payne had traces of cocaine in his system. "NIOSH repeatedly requested a copy of the autopsy reports through the fire department, district attorney’s office, and representatives of the families, but did not receive any toxicology report," the report says. "Therefore, NIOSH is not able to comment on the alleged condition of the victims."