On September 6, 2010, a 51-year-old male volunteer fire fighter (victim) died after being overcome by low oxygen and sewer gases while climbing down into a sewer manhole in an attempt to rescue a village utility worker. The utility worker had entered the manhole to investigate a reported sewer problem and was overcome by low oxygen and sewer gases (see diagram 1). The incident occurred behind the fire station in an underground sewer line that ran under the fire station. The local utility company contacted the chief of the village’s volunteer fire department and requested that a piece of fire apparatus be moved out of the station so they would not block it in while accessing a manhole. The fire chief responded to the station to move fire apparatus so it would not be blocked by the utility trucks. The victim and another fire fighter also arrived at the station to assist. A utility worker entered the manhole behind the station to clear a sewer backup and was overcome by a lack of oxygen and sewer gases and then fell unconscious inside the manhole. The victim then entered the manhole without any personal protective equipment to help the utility worker and was also overcome by the low oxygen level and sewer gases. The victim and the utility worker were later removed from the sewer manhole by fire department personnel and transported to a local hospital where they were pronounced dead. The medical examiner reported the cause of death as asphyxia due to low oxygen and exposure to sewer gases.