Life Safety Initiative #9

LSI #9 Thoroughly investigate all firefighter fatalities, injuries, and near misses.

Philosopher George Santayana once said, “Those who cannot remember the past are condemned to repeat it.”

The importance of LSI #9 cannot be overstated. Lessons should be gleaned from every fatality, injury, and near miss. Often, these lessons translate into action items that may prevent future adverse events.

Recently, the McKinney Fire Department experienced a near miss involving a natural gas explosion in a single family residential structure. The house was struck by lightning, or the strike occurred very near the structure. Visible fire was extinguished using conventional means, but when an examination hole was opened in the wall, an explosion occurred that blew out sheetrock and ceiling. One firefighter received minor burns to his face. All firefighters successfully exited the structure.

A careful after action review (investigation has a negative connotation) was conducted to determine the cause of the explosion and if any operating policies should be amended. The likely cause of the explosion was due to an accumulation of natural gas in the void space. This was the result of a failure of the corrugated stainless steel tubing (CSST) following the lightning strike.  CSST is a material used to transport natural gas throughout a residential structure. The introduction of air after opening the examination hole placed the gas concentration within the explosive limits. The mixture reached an ignition source and caused the explosion.

A panel of experts was assembled to review the data. Representatives included plumbers, City Development Services, ATF, and operations firefighters not intimately involved in the event. The results were shared with the Fire Service.

As a result of this event, ordinances involving CSST were modified to meet NFPA standards. MFD reviewed internal policies to allow for adjustments in interior operations with structures known to contain CSST. One such adjustment includes complete PPE with SCBA on air while opening examination holes in similar scenarios.

This is but one event. The Texas State Fire Marshal’s Office and NIOSH investigate all firefighter line of duty deaths. Injuries and months without injury are now reported to the Texas Commission on Fire Protection. Near misses may also be reported to the TCFP, as well as entered into the national near miss reporting data base.

A fire chief once from the north east once shared with me an anecdote regarding a wind driven fire, line of duty death in his department that their event was very similar to an event experienced in Texas. The comment continued that had he known about the event in Texas, his department may have altered policies that possibly could have prevented the tragedy in his own department.

We must study these events, learn from them, and implement corrective action as appropriate. Part of what makes an industry professional is the ability to adapt as appropriate. The stakes are too high to ignore.

Danny Kistner

Fire Chief

McKinney Fire Department

dkistner@mckinneytexas.org
972.547.2850