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Report on the death of two West Roxbury firefighters

Box 4-281 Report is the Board of Inquiry report into the deaths of firefighters Paul Cahill and Warren Payne at the Tai Ho restaurant in West Roxbury on Aug. 29, 2007 (It's a 9M file, so it might take awhile to download; if you have trouble, I've put a copy here).

It contains a detailed timeline of the night, background on the building and firefighting equipment and photos from the night of the fire. And it concludes the fire was caused and worsened by the restaurant's failure to adequately clean accumulated grease out of ducts and that initial efforts to fight the fire (which firefighters did not realize was as bad as it was) helped contribute to "an intense fireball" that helped disorient Cahill, Payne and other firefighters by providing a sudden infusion of oxygen to the fire.

... The substandard construction, installation and maintenance of the kitchen hood, duct and exhaust system, along with the degradation of the duct work were the underlying factors involved in this fatal fire incident. ...

The board does not actually say the two firefighters were not impaired by either alcohol or drugs, but that:

... The Board of Inquiry could find no factual indications supporting that alcohol/drug impairment contributed to or caused these two firefighters to become disoriented or inhibited their ability to perform the firefighting duties assigned to them at the fatal fire incident. ...

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Comments

A lack of facts is not a substantiation of innocence or proof that if they were sober they would have still died. It seems like the board took the most conservative tact possible. After reading the report through, they mention that they didn't feel the issues of impairment due to alcohol or drugs was something they could address. They are probably right in that regard and I'd like to know who is doing an investigation that will result in a report that does have the ability to address these things.

If the "blowtorch" fire burst disoriented the crew such that 2 men died in action, then it only stands to reason that if they were further impaired, it certainly didn't help their ability to recover from the disorientation. As far as I understood the report, others on that fire line were able to clear out after the blast. The two that didn't just happened to have alcohol or drugs in their system in some way?

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Channel 4 reports:

Fire Commissioner, Roderick Fraser told reporters Friday that he plans to reconvene the board of inquiry so that they can consider results from toxicology reports.

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A fast and appropriate response. Awesome, thanks for pointing that out. Although in their haste to make the news, WBZ4 goes in the opposite direction of my complaint with the original report. They characterize the report as saying that drugs and alcohol "were not factors" in the firemen deaths.

That is not what the report says either. It said three things against that statement: 1) any conflicting information negated their ability to comment on it (i.e. if one fireman says Cahill was too impaired to properly serve that night and another says he noticed no impairment, then they don't give credence to either source and do not consider either as a fact of the case), 2) the disorientation from the blast led directly to the deaths (this does not state that alcohol/drugs DID NOT contribute, only that the blast DID), and 3) drugs/alcohol could not be tied to the cause of their deaths due to lack of positive evidence (again, that doesn't say that they WEREN'T impaired or that it DIDN'T contribute, only that the Board had no evidence to determine that it DID contribute or that they WERE impaired).

What the Board concluded and what the WBZ story states are two different things and an unfair characterization of the report by WBZ.

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That's one reason I posted a link directly to the report and why I'm a bit disappointed all the media outlets that had copies of the report yesterday didn't post it - and my original post made the same mistake, based on an incorrect Herald headline.

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"The tragic deaths of these brave firefighters have been used to politicize the ongoing negotiations between the City and Local 718."

Oh, yeah, it's all about you and your petty negotiations. Nevermind that their likely on-the-job impairment could have cost more than just their own lives AND that nobody's talking about this relative to your negotiations...except you. Then, you go and decry it's relativity as a plot against you. Way to tilt at your own windmill.

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You mean, Mumbles and his cronies illegally releasing medical information to the press that hadn't been discussed with the families (who legally control that information) and was not scientifically reviewed because his negotiations weren't going well isn't politicizing.

Well then Kaz, what the fuck IS politicizing? I want to know why somebody isn't in JAIL for leaking that information. I know enough about private medical information to know it wasn't acceptable to release it unless there was a public inquiry and a judge involved.

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The only people who would have had access to the autopsies were next of kin and agencies investigating the deaths (ME, DA). There's no reason to think that Menino had any involvement in this. To attribute it to a political move by Menino as a means of leveraging something against the union is purely conspiratorial fiction.

The privacy of public servants should stop when they impede on the rights of the public to know that its servants are risking the public's well being. The union should be concerned about all of the other firefighters who served with these guys while they were impaired and leading hose through a fire. Instead of fighting drug and alcohol testing, the firefighter's union should be interested in proving beyond reproach that they are a clean crew.

The reason no one is in jail is because the "crime" of releasing private records carries no penalty and for good reason. The public has a right to know its safety was being compromised by these two firefighters.

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There's no reason to think that Menino had any involvement in this.

Other than a huge silo of political hay in a contentious contract negotiation.

Please, are you that naive? Or just blindly loyal like only a hanger-on can be, expecting a dog cookie at any minute.

The reason no one is in jail is because the "crime" of releasing private records carries no penalty and for good reason. The public has a right to know its safety was being compromised by these two firefighters.

Just because certain people, like you, want to believe this DOES NOT MAKE IT SO.

See also, Belmont, Helsinki, HIPAA, and state and local and other federal regulations governing medical information on persons dead or alive. I used to handle medical records - I think I know the laws.

FURTHERMORE, NIOSH requested the information and the City blew them off and then briefed people who leaked the information to the press. Why? Because NIOSH would likely have called the tox testing into question - particularly the staggering near-poisoning readings, and the condition of the bodies. (I know some of the folks at NIOSH who handle these sorts of investigations and they were like "0.27? Yeah, right. Bad lab technique or broiled body".)

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Other than a huge silo of political hay in a contentious contract negotiation. Please, are you that naive? Or just blindly loyal like only a hanger-on can be, expecting a dog cookie at any minute.

As you say: Just because certain people, like you, want to believe this DOES NOT MAKE IT SO. What's good for the gander is good for the goose. Also, the last resort for someone without anything backing their stance: ad hominem attacks. I'm actually not loyal to Menino or anyone else at city hall. I just don't grasp at conspiratorial hoo-ha. Prove that the leak was intentional, not for the benefit of the public good but instead for leverage in union negotiations.

The crime doesn't carry a penalty. That's not a "belief", it's a fact. It's exactly what the DA said when asked if he'd investigate the leak: There's no point, there'd be no penalty. Also, I didn't say that the regulations governing medical info allow for someone to divulge the information for the greater public good. I simply said that by leaking the private information, the greater public good is served, even in opposition to the letter of the law for the privacy of the individual. This is akin to something like the Wikipedia rule: "Ignore all rules". The gist is that you ignore the rules when it's clear that they don't address the bigger problem adequately. It's far more important that we know there are significant problems with impaired firemen, whose abilities on the job our lives depend on, than knowing that the family and dead fireman's dirty secrets are kept private.

One last comment: NIOSH requested the autopsies from the FIRE DEPARTMENT, not the CITY. The BFD ignored NIOSH's requests, not Menino, not the DA, not the ME. The people who went to court to try and hide their shame were the ones hiding from NIOSH. If NIOSH was going to be so keen on providing a scapegoat to BFD such as "bad science", then why would BFD sit on the reports and not send them on?

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If I ever get pulled over for a DUI - I'm asking for these report writers to prepare my defense!

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The toxicology is questionable when a body has been dessicated.

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OMG SwirlyGrrl, Kaz kicks you *ss on the merits so you change the subject.

I've been following this story closely, I read the BOI report and all the press. No one has made the claim you made, that the .24 blood alcohol number is unreliable.

Look, the BOI IGNORED/made a choice to exclude the toxicolgy report. No matter their reason, doesn't that wave a big red flag about whether they're truly interested in coming to the best possible conclusions about the decisions that were made from the moment the firefighters arrived until they died? If it doesn't for you, it does for me.

I don't know who leaked the autopsy info but we all generally take is as fact so let's move on. Why didn;t the BOI include it? Isn't it fair to say however the negotiations have gotten off track both parties - city government, fire fighters union - are making bad decisions at this point?

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The BOI is made up of career firefighters, many of them Chief Officers. Do you know what they study to get to those positions? Toxicology? Physiology? Nope. They study fire behavior, building construction and firefighting strategies. Their expertise lies in the how the fire started, propagated without being detected and exploded when introduced to a sufficient mixture of air and flammable gases. They admitted they could not address the toxicology even if they had seen the reports. They said they would assist other agencies in that aspect. They even went on to say that while it was not in their purview, they strongly recommended a drug and alcohol testing program. These union firefighters strongly recommending a drug and alcohol testing program should not go unnoticed, but it does.

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Columnist Peter Gelzinis, one of the only people worth reading at the Herald, asks "Were two deaths avoidable?"

In the column he puts voice to a few of the questions that I was left with after reading the BOI report. Primarily, why did Cahill have his facemask off and why did he leave his radio at the firehouse? Why did other firemen get out through the disorienting environment and the two who died couldn't follow the hose out correctly?

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It comes down to this. Observe the pictures in the Herald. Warren Payne's helmet is pictured. The eye shields (Lexan plastic) are almost melted off. He got buried under debris when the oil soaked wood suddenly exploded (carbon monoxide from poor combustion, lack of oxygen) because of more oxygen entering the fire. CO is flammable, combines to produce CO2. He was caught in the full fury of the blast (there's a pic from a cell phone or something). Warren Payne was doomed, died a horrible death and what he did the week before (remember, it was trace amounts found in him) was largely irrelevant to events of that night.
Paul Cahill apparently wasn't wearing his facepiece. The fire was in the ceiling, but the room was relatively clear. Events developed in a hurry. The lack of a radio at that point was largely irrelevant. He apparently died of smoke and hot gas inhalation, the lack of respiratory protection obviously being a factor. Could he have made it? Who knows? Either way, it was Hollywood special effects gone wrong. They were in the middle of it, pure and simple. Someone five feet away from Warren Payne could come out without a scratch.
That's the nature of an ambush. That's what it was, the combination of physical forces in an unpredictable manner. The devil's own ambush.

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Here are some relevant comments from someone in the know. I just interviewed this individual and he's about as earnest as could be.

christopher-king.blogspot.com/2008/02/kingcast-presents-truth-about.html

Excerpt:

".....while it is obviously improper to be drunk on the job (Cahill), and while trace amounts of marijuana and cocaine were in Payne's body, there's no causal connection between those facts and their deaths.

Hint: In the first picture, that's a flashfire caught at that exact moment that Firefighter Payne died. Read the comments for more on this.

So this means the city needs to shell out for all of the benefits owed to the families, and meanwhile that doesn't excuse the lack of a contract between the city and the firefighters' union for more than a year, either. That having been said, if there is substance abuse occurring on the job then that most certainly DOES need to be addressed, but the current policy is woefully inadequate, as noted in the comments."

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Here are some relevant comments from someone in the know. I just interviewed this individual and he's about as earnest as could be.

http://christopher-king.blogspot.com/2008/02/kingc...

Excerpt:

".....while it is obviously improper to be drunk on the job (Cahill), and while trace amounts of marijuana and cocaine were in Payne's body, there's no causal connection between those facts and their deaths.

Hint: In the first picture, that's a flashfire caught at that exact moment that Firefighter Payne died. Read the comments for more on this.

So this means the city needs to shell out for all of the benefits owed to the families, and meanwhile that doesn't excuse the lack of a contract between the city and the firefighters' union for more than a year, either. That having been said, if there is substance abuse occurring on the job then that most certainly DOES need to be addressed, but the current policy is woefully inadequate, as noted in the comments."

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