# Presentation: 708699

## Medical Oversight ofNon-commercial Drivers

- Public  Hearing
- Washington, D.C.
- March 18-19 2003

**Notes:**
Good morning Member Goglia and the members of the Board of Inquiry. 

On November 3, 2002, a 1983 Chevrolet Caprice operated by a 55-year-old female was northbound on US Route 11 in Hagerstown, Maryland.  As the Chevrolet crossed the intersection of Bower Avenue, it struck the left rear of a 2000 Nissan Sentra operated by a 76-year-old female.

## Hagerstown, MD

- Grand Am at final rest
- Picture courtesy of the Maryland State Police

**Notes:**
The Chevrolet continued north and at the next intersection, struck the rear of a 1993 Pontiac Grand Prix operated by an 81-year-old female.  The Chevrolet engaged the Pontiac, and both vehicles continued north several hundred feet before striking a wooden utility pole.  The accident resulted in fatal injuries to the Pontiac driver and minor injuries to the Nissan driver. The Chevrolet driver, who was not injured, told the investigating Maryland State Police that she was taking seizure medication. 

Shortly after the accident, a team from the Safety Board’s Office of Highway Safety was dispatched to Hagerstown to conduct an investigation. The team spent 5 days on scene, documenting physical evidence from the roadway and vehicles, interviewing witnesses, obtaining medical and driver’s records, and working in cooperation with the Maryland State Police.  During the course of their investigation, the investigative team became aware of other recent, local accidents that also involved drivers with medical conditions, including:

## Washington County, MD

- Picture courtesy of the Maryland State Police

**Notes:**
Washington County, Maryland:  On June 7, 2001, a Windstar van westbound on I-70 failed to negotiate a curve, ran off the roadway, traveled through the median, and entered into the eastbound lanes, impacting several other vehicles, including a Chevrolet Lumina.  

## Washington County, MD

- Picture courtesy of the Maryland State Police

**Notes:**
The driver of the Lumina was fatally injured.  The van’s passenger told the investigating State Police that the driver had suffered a brain injury several years ago, experienced “black-outs,” and had a history of seizures. 

## Frederick, MD

- Picture courtesy of the Maryland State Police

**Notes:**
Frederick County, Maryland:  On March 23, 2002, a driver with a history of seizures failed to stop at a red traffic signal and ran into the rear of stopped vehicles, resulting in fatal injuries to a city official from Frederick and his three children. 

Investigation revealed that the driver had suffered from epilepsy in the past and had been involved in accidents in November 2000 and August 2001.  The driver had voluntarily surrendered his driver’s license to the Maryland authorities in October 2001 and was re-issued a license in February 2002. 

Accidents involving motor vehicle drivers with medical conditions are not new; the Safety Board has concluded that such conditions contributed to or caused a number of previous accidents, including:

## Buffalo, MTVisual Impairment (Keratoconus)

**Notes:**
Buffalo, MT:  On March 10, 1998, a 41-passenger school bus carrying 5 children, ages 7 through 15, was eastbound on Buffalo Canyon Road. The bus stopped at the highway/railroad grade crossing with the Burlington Northern Santa Fe railroad tracks. After stopping, the 36-year-old busdriver conversed with students and adjusted various on-board controls.  The bus driver then accelerated from the stop onto the tracks and was struck by an on-coming freight train. Two children in the bus received fatal injuries. 

Research following the accident revealed that the busdriver had a visual impairment - identified as keratoconus - that should have prevented him from meeting the visual requirements to drive a school bus as outlined in Federal and State law.

## Franklin, NCAcute Alcoholism

**Notes:**
Franklin, NC:  On October 16, 1997, a tractor-semitrailer was traveling downhill on a curve on U.S. Highway 64 when the load broke loose and struck a school bus. 

The tractor-semitrailer overturned and slid to a stop. The school bus driver and one passenger were killed; one school bus passenger sustained moderate injuries. The truck driver and seven bus passengers sustained minor injuries.  Witnesses stated that the truck was traveling in excess of the speed limit and on the wrong side of the road just before the accident.  The truckdriver was arrested for driving under the influence of alcohol, and investigation revealed he had been convicted twice before of driving commercial vehicles while intoxicated.  The Safety Board determined that the probable cause of the accident was the truck driver’s failure to control his truck due to alcohol impairment. 

## New Orleans, LACongestive Heart Failure

**Notes:**
New Orleans, LA: On May 9, 1999, a 1997 55-passenger motorcoach was traveling eastbound on Interstate 610.  The bus, carrying 43 passengers, was en route from La Place, Louisiana, to a casino approximately 80 miles away in Bay St. Louis, Mississippi.  As the bus approached an underpass in City Park, it departed the right side of the highway, went onto a grassy side slope, and struck an earthen embankment. 

Twenty-two passengers were killed; the busdriver and 15 passengers received serious injuries.  Investigation revealed that the busdriver had suffered from congestive heart failure for several years prior to the accident and was receiving medical treatment 5 days a week for a number of deteriorating medical conditions.

## Jackson, TNSleep Apnea

**Notes:**
  Jackson, TN: On July 26, 2000, an eastbound truck tractor pulling a loaded semitrailer, traveling at an estimated speed of 65 mph, collided with the rear of a Tennessee Highway Patrol vehicle that was providing rear protection for a moving construction zone. Witnesses reported that the trooper’s vehicle exploded and caught fire at impact, resulting in fatal injuries to the trooper. 

Further investigation revealed that the same driver had been diagnosed with sleep apnea several years earlier following an accident in which he ran into the rear of a Utah State Police vehicle, injuring two troopers.  The Safety Board determined that the probable cause of the Tennessee accident was the driver’s incapacitation, owing to the failure of the medical certification process to detect and remove a medically unfit driver from service. 

Although the Safety Board has addressed medically related accidents in the past, clearly, we need to learn more about this complex issue.  Currently, there are approximately 42,000 deaths a year, or 115 deaths a day, on our Nation’s highways.  Drivers with impairing medical conditions contribute to these statistics.  Consider the following: 

## Epilepsy

- 2.5 million people in U.S.
- 80% report little/no relief from current treatments
- 300,000 new cases each year
- Costs estimated at $12.5 Billion/Year

**Notes:**
Epilepsy:
2.5 million people in the United States have epilepsy
80% of them report little or no relief from current treatments
300,000 new cases each year
Costs estimated to be $12.5 billion a year 

## Diabetes

- 17 million people in U.S.
- 1 million new cases a year in people over 20 years old
- Resulted in 450,000 deaths in 1999
- $98 Billion/year

**Notes:**
Diabetes
17 million people in the United States have diabetes
1 million new cases a year in people over 20
450,000 deaths in 1999
Costs of $98 billion a year 

## Sleep Apnea

- Second most common sleep disorder; est. 18 million Americans
- Persons with sleep apnea are 7x more likely to be involved in an auto accident
- Hospital costs of $42 million/year

**Notes:**
Sleep Apnea
Second most common sleep disorder
18 million Americans
People with sleep apnea are 7 times more likely to be involved in an auto accident
Hospital costs of $42 million a year 

## Cardiovascular Disease

- 61.8 million people in U.S.
- $329 Billion in 2002

**Notes:**
Cardiovascular Disease
61.8 million people in the United States have cardiovascular disease
Costs of $329 billion a year 

## Alzheimer's Disease

- 1 in 10 over 65
- 1 in 2 over 85
- 14 million cases by 2050
- $100 Billion a year

**Notes:**
Alzheimer’s Disease
1 in 10 people over 65
1 in 2 people over 85
14 million people in the United States will have Alzheimer’s disease by 2050
Costs of $100 billion a year 

## Alcohol

- 14 million people in U.S. abuse alcohol or are alcoholics
- Alcohol a factor in 8% of all auto crashes and 40% of fatal auto crashes
- 1.5 million arrested for DUI in 2000.
- 1 death every 32 minutes

**Notes:**
Alcohol
14 million people in the United States abuse alcohol or are alcoholics
Alcohol is a factor in 8% of all auto crashes and 40% of fatal auto crashes
1.5 million people were arrested for DUI in 2000
There is 1 death every 32 minutes in an alcohol-related auto accident. 

## National Issues

- The effectiveness and usefulness of State oversight of licensed drivers who suffer from impairing or debilitating medical conditions, including driver licensing and medical review boards.
- The differing State rules and restrictions regarding medical oversight.
- The identification of medically unqualified drivers through enforcement, State licensing, and reports by medical personnel.

**Notes:**
The effectiveness and usefulness of State oversight of licensed drivers who suffer from impairing or debilitating medical conditions, including driver licensing and medical review boards.

The differing State rules and restrictions regarding medical oversight.

The identification of medically unqualified drivers through enforcement, State licensing, and reports by medical personnel. 

## National Issues, continued

- Information available to the public, medical personnel, enforcement, and licensing authorities regarding impairing medical conditions.
- The lack of data available for determining the extent to which medical conditions are a factor in traffic accidents.

**Notes:**
Information available to the public, medical personnel, enforcement, and licensing authorities regarding impairing medical conditions.

The lack of data available for determining the extent to which medical conditions are a factor in traffic accidents. 

Over the next 2 days, this hearing will discuss:
Background and state of the research;
Collection and routing of information on drivers with impairing conditions;
The role of State oversight;
Programs to aid doctors, licensing authorities, law enforcement, and the drivers themselves;
Educational efforts; and
Public policy