DENVER — NIOSH investigators are stressing the need for team continuity when tackling fires following the death of a firefighter in May last year.

Lieutenant Richard Montoya, 61, from Denver Fire Department, was responding with his engine company to a report of a structure fire with a trapped person inside.

As Montoya progressed in the property, he was advanced a hose line with other firefighters to the second story. They reached the second level to find extreme smoke and heat and zero visibility.

Montoya was at the nozzle with two other firefighters behind him. While trying to determine the origin of the fire, Montoya and the other two firefighters became separated. When they regrouped again at the top of the stairs, Montoya was missing, but it was assumed that he was nearby.

The two firefighters returned to the downstairs portion of the house to regroup with the rest of the engine company. Moments later, other firefighters heard Montoya's PASS alarm when they were on a landing just below the top of the stairs.

The RIT was activated but the firefighters who had reported the alarm also took the initiative to locate him.

Montoya was found under a mattress on the second floor in cardiac arrest. He was extracted from the house, SPR was administered and he was taken to the hospital. A week later it was determined that the likelihood of his recovery would be minimal and he was taken off of life support. The final cause of death was smoke inhalation. At the time he was taken to the hospital, his blood CO level was at 23 percent.

According to the official NIOSH report, a number of things could have been done to have prevented Montoya's death.

First, NIOSH states that the team system could have been strengthened. During this incident, Montoya became separated from his crew. According to the report, the chance of injury is reduced when teams stay together throughout all stages of the fire fight.

Second, the NIOSH report found that Montoya donned his SCBA while already inside the structure when he and his team encountered moderate smoke. If he had put on his mask prior to approaching the structure, the amount of CO in his system would have been greatly reduced.

Additionally, the NIOSH report states that had there been better communication between firefighters and the home owner as well as between firefighters and the Incident Commander, time and energy could have been expended in a more efficient way. There was some indication that firefighters had not been properly trained in how to operate their radios with bulky gloves on and could not hear some of the commands issues by the IC. A proper size up of the incident by all parties would have shown additional entry ways that would have allowed for a more efficient approach.