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NIOSH Cedar Fire Report



Investigation & Medical Findings

Recommendations / Discussions


Glossary of Terms

Maps and Photographs

CDF Cedar Fire Report

Table of Contents

Review Team Process

Overview of Accident

Summary of Events

Sequence of Events


Causal Factors

Contributory Factors


Site Conditions

Graphics – List of Illustrations Table

Description of Supporting Data and Supplementary Information

Novato FPD Investigation Analysis

Table of Contents


CDF Green Sheet


Lessons Learned

Draft Standard Operating Procedures

Inaja Fire Tragedy



California Department of Forestry and Fire Protection
Review Report of Serious CDF Injuries, Illnesses, Accidents and Near-Miss Incidents

Engine Crew Entrapment, Fatality, and Burn Injuries

October 29, 2003
Cedar Fire
Southern Region


On October 21, 2003 a series of fires began in Southern California that would eventually burn nearly 750,000 acres in six counties. These fires resulted in 20 fatalities (19 civilian and one fire service), 183 injuries to responding personnel, and destroyed over 3,500 residential structures. This fire siege created the largest mobilization of fire fighting resources in California history. At the peak of the mobilization there were over 16,000 personnel including 1,600 engine companies, nearly 300 fire crews, and over 160 aircraft assigned to the fires.

In the early evening of October 25, the Cedar Fire started in San Diego County. The fire, initially burning under a Santa Ana Wind condition eventually consumed 280,278 acres and destroyed 2,232 structures, 22 commercial buildings, and 566 outbuildings, damaging another 53 structures and 10 outbuildings. There was one fire fighter fatality, 13 civilian fatalities and 107 injuries.

On the evening of October 27 Novato Fire District Engine 6162, staffed with a crew of four (Captain, two Engineers, and a Fire Fighter/Paramedic) responded, along with three other engines, to the Cedar Fire as part of Task Force XAL-2005A. Once at the Cedar Fire a fifth engine was added and XAL-2005A was designated as a Strike Team.

The morning of October 29 the Cedar Fire was over 230,000 acres, 15% contained, and burning to the east and northeast now under the influence of onshore winds. For the October 29 operational period Strike Team XAL-2005A was assigned to Branch 3 / Division I in the Santa Isabel / Wynola area eventually deploying along Orchard Lane. Engine 6162 was assigned to 920 Orchard Lane and prepared to defend the residence at that location.

Shortly after noon the fire, that had crossed Highway 78/79 early in the morning, increased in intensity and overran the crew of Engine 6162 resulting in fatal injuries to Engineer Steven Rucker, serious burn injuries to Captain Doug McDonald, and minor burn injuries to Engineer Shawn Kreps and Fire Fighter/Paramedic Barrett Smith. During the burn over Engineer Kreps and Fire Fighter/Paramedic Smith were able to take refuge in the residence. After his attempts to assist Engineer Rucker were unsuccessful Captain McDonald, now seriously burned, was assisted into the residence by Engineer Kreps and Fire Fighter/Paramedic Smith.

Following the burn over Engineer Kreps and Fire Fighter/Paramedic Smith were able to assist Captain McDonald to the engine. Engineer Kreps then drove the engine from the accident site to the intersection of Highway 78/79 and Orchard Lane where medical treatment was provided. The injured personnel were then airlifted to the University of San Diego Burn Center.

There were also several near misses along Orchard Lane as resources at 902 Orchard and 1038 Orchard had their escape routes cut off by fire. They were eventually able to retreat without any injuries or damage to equipment.

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