Report: Firefighter’s death exposes information gap
March 2020 showed an abnormality, but there was no sign that anyone followed up, the report says.
Seventeen months later, on Aug. 10, 2021, McFadden fell onto a fellow firefighter after taking a break from putting water on a three-alarm fire, which required him to move and use a large hose.
He was rushed to the hospital, and tests showed he had acute promyelocytic leukemia, which caused a brain bleed and blood clots, according to the report.
Doctors intubated him, removed a mass of blood and a large clot from his brain and put him on dialysis when his kidneys began to fail, the report says.
Despite that and being on a ventilator with added oxygen, on Aug. 12, 2021, McFadden developed a fast heart rate, low blood pressure and low oxygen levels, it says.
His heart rate then dropped, and he went into cardiac arrest and could not be revived despite two hours of resuscitation efforts, according to the report.
Because of the long amount of time between the abnormal test result and McFadden’s collapse, investigators said in the report that “it is unlikely that the stool finding represented the initial onset of the APL.”
“However,” the report adds, “if there was blood in the stool, the FD should have arranged a follow-up medical evaluation to determine the source of the gastrointestinal bleeding” or, with McFadden’s consent, relayed the information to his primary care physician.
Michael Boucher, public information officer for the Burlington Volunteer Fire Department, said the company that examined McFadden in March 2020 passed along his abnormal test result to the young firefighter.
Boucher also said there were no abnormalities discovered during McFadden’s physical a year later — although the report says neither a stool test nor a blood test was done in 2021.
Noting the gap in time between the abnormal test result and the collapse, Boucher said last week “the 2020 test doesn’t correlate to what occurred.”
One symptom that did was a bruise McFadden had from a fall from his bike two weeks before his collapse, the report states.
It was still dark purple more than a week-andhalf after the fall, when it should have faded or disappeared, according to the report. McFadden showed the bruise to his mother, the report says, but apparently didn’t contact a doctor.
Because of its findings, NIOSH recommended that Burlington and all fire departments “educate members on the signs and symptoms of leukemia and other cancers with a young adult age of onset,” according to the report.
The second recommendation is to “ensure there is a communication protocol regarding abnormal results of a medical screening examination so that timely follow-up can occur.”
In a news release, Boucher said the department has expanded its educational efforts to include a comprehensive overview of cancer risks affecting all age groups.
And as a result of the second recommendation, he said fire officials are reviewing department communication protocol from March 2020, when a different administration was in charge, with an eye toward improvement.
“While follow-up communications have occurred, we acknowledge the need for improved documentation,” Boucher wrote.
After a separate review, McFadden’s death was determined to be in the line of duty because his exertion at the fire scene exacerbated his condition, Boucher said.