Calling for closer scrutiny of driver medical ailments

Concerned that drivers with certain serious medical conditions may pose a threat to traffic safety, the National Transportation Safety Board is calling for greater medical screening and evaluation of motorists with high-risk medical problems.

Because no hard data exist on how many accidents nationwide have involved drivers with medical conditions, the federal safety board is recommending a comprehensive effort to collect information and determine the scope of the problem.

While the NTSB’s goal is to improve traffic safety and save lives, the call for tougher scrutiny of drivers who suffer from conditions such as epilepsy, diabetes, sleep disorders, alcoholism, eye disease, cardiovascular disease and Alzheimer’s -- even arthritis -- could raise considerable controversy.

“They are opening a can of worms,” Susan Pietsch-Escueta, executive director of the Epilepsy Foundation, told The Times.

“It’s males between the ages of 16 to 25 who are most at risk for accidents ... not people with epilepsy.”

Whether people with medical conditions are too impaired to drive depends on the severity of the disease and treatment, she says.

“Some people with epilepsy, for example, have seizures only at night, or only if they stop medication.” Many drivers with medical problems are not at risk on the road, she says.

Nevertheless, the safety board is worried about the potential number and impact these drivers have on road safety.

“We don’t want to say people with diabetes shouldn’t drive,” says NTSB Chairwoman Ellen Engleman Conners. Yet she indicates that as many as one in four drivers could suffer from some medical condition that would raise concerns.

The NTSB’s report, issued last month, points to national statistics showing that there are 2.5 million people with epilepsy, 18.2 million with diabetes, and 40 million with arthritis.

Because the NTSB is not a rule-making agency, the board can only make recommendations to the National Highway Traffic Safety Administration and other federal safety agencies. The NHTSA has up to 180 days from the end of November to respond, according to Liz Neblett, NHTSA spokeswoman.

If the NHTSA adopts the board’s recommendations for greater oversight of medically impaired drivers nationwide, the plan will likely involve a delicate balance between the rights and privacy of individual drivers and more restrictive policies .

“We also want the roads to be safe and we want impaired drivers off the roads,” says Carol Shirley, spokeswoman for the American Assn. of Retired Persons.

“But we have been against testing that targets elderly people. Age isn’t necessarily an indicator of unsafe driving.” If this sort of medical screening is to be done, Shirley said, the tests should be designed to “actually measure the things that impair driving.”

Visual tests, for example, don’t tell you anything about a driver’s reaction time, she said.

It was the NTSB’s examination of six fatal accidents involving medically impaired drivers that prompted the safety board to hold hearings in March and make its recommendations in November to the NHTSA, as well as the American Medical Assn. and other safety agencies in Washington, D.C.

Among the cases studied was an accident in Frederick County, Md., in November 2002. A man and his three children were killed when a driver with a history of seizures and epilepsy failed to stop at a traffic signal and crashed into the back of other vehicles.

The investigation into the incident showed the driver had been involved in accidents in 2000 and 2001. The driver had voluntarily given up his license in 2001, but the license was reissued the following year, according to Ken Suydam, an NTSB investigator who testified at the hearings.

Sgt. Robert Ticer, a 12-year veteran from the Arizona Department of Public Safety, testified that officers have found drivers suffering from dementia driving the wrong way on interstates. “They didn’t know where they were going, where they were, or what side of the road they were supposed to be on,” he told the safety board.

One of the crucial issues in dealing with medically impaired drivers centers on whether there should be nationwide rules that would require doctors and other medical professionals to report patients who they believe may drive unsafely.

Many physicians are torn over whether to report patients to licensing agencies, claiming that it breaches the doctor-patient confidentiality and damages the relationship. Some argue that patients hide serious medical problems from their doctors if they fear they will be reported and lose their driver’s licenses.

Some professionals believe doctors should be granted immunity from liability if they do report an unfit driver. Another said physicians are afraid they would lose patients if they got a reputation for reporting people to the DMV.

Dr. Allan Krumholz of the Maryland Epilepsy Center testified that in states where reporting was mandatory, doctors found that “patients under-report seizures and don’t get optimal treatment” for their conditions.

However, Dr. Richard Marotolli of the Connecticut Veterans Administration argued that the “risk of not reporting someone who is at risk and not warning that individual of the risk ... is a greater risk to your liability than the breach of confidentiality.”

California is among only six states that require the reporting of drivers with conditions that could hinder their ability to drive.

Family members, law enforcement officers and acquaintances can alert the DMV if they believe a person is not healthy enough to drive. The DMV does act on anonymous referrals.

Jeanne Wright can be reached at jean.rite@aol.com.