Nasty diabetic driver accident in Edmonton, Alberta

There was a very bad semi crash here a few days ago. The driver of a semi went 20 km on the wrong side of a divided highway before crashing off an overpass. The semi landed upside down and then exploded. Amazingly, no-one was killed but the semi driver. He had T1 and apparently was prone to hypos and even seizures.
Driver in fiery crash had diabetes

What are the requirements for commercial licenses in other places wrt diabetics? I know that diabetics requiring insulin can obtain commercial licenses in Canada, but these licenses are not valid in the US (unlike most Canadian licenses).

I wonder if the rules in Canada will be revisited following this accident. There are very strict rules for all diabetic drivers here, and particularly for commercial drivers, but clearly the existing rules were not followed.

A couple of quotes from The Canadian Medical Association (CMA) driver’s guide, 7th edition:

Exclusion criteria for a commercial licence
To continue driving the patient must have
• No episode of hypoglycemia within the previous 6 months requiring intervention by a
third party for correction, or producing loss of consciousness, even if spontaneous recovery occurred.

Guidelines for commercial driving
• Blood-glucose concentration must be tested within 1 hour before driving and approximately every 4 hours while driving. Driving should be stopped if glucose level falls below 6 mmol/L (108 mg/dL) and not resumed until glucose level has risen following food ingestion.

The accident was caught on video by someone driving on the other (correct) side of the divided highway. That video has been widely distributed by news outlets. A link to the video has been posted by Barbara M in the TuDiabetes videos section. It’s probably a good thing that the driver crashed where he did, because if he had made over the overpass, he would have been in Edmonton proper, with higher traffic volumes, merge lanes. and even a few traffic lights still (I think). The chances of involving someone else in an accident and creating an even bigger tragedy would have been much higher.

People who knew the driver say that he was meticulous about testing his blood sugars, but I agree with rainbowgoddess that he should not have been in the trucking industry if he was prone to seizures. Of course, it’s possible that the reports of seizures were of events in the past and that he was now under better control and legally cleared for driving. I believe any driver (not just commercial) in Alberta has to be clear of seizures for a year before they can be licensed.

On the other hand, the driver may not have fully reported his condition during his mandatory driver’s medical, or even worse, he may never have reported his diabetes to the licensing board in the first place. We don’t know because , for now at least, his records are not being released due to privacy concerns.

The Alberta Medical Association seems to take the position that it does not want its doctors reporting conditions such as diabetes to the licensing board for fear that patients will withhold information from their doctors rather than risk losing their driver’s license. It’s probably a valid concern. Hands up anyone who has ever NOT told their doctor about a bad hypo because it would have resulted in an automatic loss of your driver’s license.

Sorry, forgot the URL. Barbara M posted her video link at:
Truck Crash

I’m not sure of what the regulations are in the US but I do worry about us all driving and maybe not knowing this can happen to us.

This is the third accident I have heard of involving a diabetic driver this year. The last one I heard about involved a diabetic woman who had her children in the car with her. They weren’t seriously injured thankfully.

I believe the media did report that she was in “diabetic shock” when she was driving.

It also worries me that our licenses will be yanked or harder to keep if there continue to be more accidents. I wish someone could come up with a medication that does not include hypos. A cure would be much better though.

It is problem for all of us. My job may be moving from the state of New Jersey to state of Maryland in a few years. Maryland is already very strict regarding people with type 1 driving. They require a physician’s written statement before some kind of review board to permit a type 1 to gain a driver’s license. Despite what efforts we take to prevent having low-related crashes, the public good will come first.

Steve, I wouldn’t worry too much about the medical requirement. Alberta has that type of review system for licenses. It’s a hassle getting annual eye exams (vision and dilated pupil) and medicals and filling out the forms, but driving is a privilege, not a right. (And no, I’m not saying I wouldn’t be getting my eyes checked and seeing my doctor regularly if not for the license requirement.) Anyone with good control can keep their license, but I have no experience with how tough it can be for those prone to bad hypos or who have side effects. I know that commercial drivers have to meet higher standards, for example, I think they have to provide a 6 month log of their blood sugar results. Having more than 10% of the readings below 4 (72) is grounds to lose a license even if there are no hypo effects.

Barbara, I think there’s a big difference between this case and someone who unexpectedly has a problem. It sounds like it was only a matter time before the Edmonton driver had a problem. Reports in the media today say that the driver in the Edmonton crash was prone to suddenly falling into a zombie like state that could remain even after his blood suger recovered. It sounds like he shouldn’t have had a license to ride a moped, let alone drive a semi! I can’t believe the medical review board would ever have approved his license had they known of this problem, so I assume it was never reported on his medical. Still, his friends and family knew of his problems, so what were they thinking? If anyone knows of anyone who has problems such as this, get their license pulled. I’d rather lose a friendship than feel responsible for one or more deaths.

It’s possible that there are commercial drivers on the roads in Canada who have never been properly licensed in the first place. The Government of Alberta privatized registry operations several years ago and there have been cases where unscrupulous registry operatiors and drivers examiners simply sold commercial licenses without proper instruction or testing. There have also been cases where blank licenses were stolen and then forged. These fake licenses were then turned in to get real licenses in other provinces. Registries no longer hold blank licenses because of this problem; they issue temporary licenses and the Government issues the real licenses.

Ah, that good old “diabetic shock” that sneaks up on you with no warning. It’s no wonder people get confused when the media and Hollywood seem to know so little about hypoglycemia and diabetes. Remember Jodie Foster in “Panic Room”? Her kid had a countdown timer to when she needed her next insulin shot. If she was late she’d pass out and start to die.

Are you serious Lis? You don’t think BC has any medical restrictions for non-commercial driver’s licenses? Here’s a quote from the
ICBC FAQ page

Professional drivers, drivers approaching their 80th birthday or drivers who may have certain medical conditions affecting driving ability, are required to complete a driver medical when issued. Failure to do so can result in all driving privileges being cancelled.

I would be amazed if insulin dependant diabetes is not a reportable medical condition for any class of license in BC. It certainly is for commercial licenses. Here’s a quote from the ICBC page on commercial licenses. Note that some heart conditions are also included.

When you apply for your learner’s licence you must disclose any prescription medications you are taking and any known medical conditions that you have.

Certain medical conditions may prohibit you from getting a commercial licence. These include, but are not restricted to:

epilepsy
brain hemorrhage
Parkinson’s disease
multiple sclerosis
certain heart conditions
high blood pressure
certain diabetic conditions
obesity

You may think that unrestricted licensing of people with medical problems is “the way it should be”, but the authorities in BC don’t agree with you, and neither do I. I’m sure that if you read your insurance forms you’ll see that you are required to report medical conditions. That form is a legal contract, so failure to do so may well invalidate your insurance.

I don’t have any sympathy for people who kill themselves by driving when they know they should not be. I save it for the innocent people they injure or kill.

I am a type 1 with a commercial license in Alberta. I was diagnosed in 2003 but have been a professional driver since 2000. After my diagnosis i had to take some time off work to get my sugars back under control. During this time I found out I had to report my illness to Motor Vehicles otherwise I would face criminal charges if something were to happen and I had not reported my diabetes to them. After reporting my diabetes my class1 (commercial license) was revoked and I had to provide a drivers medical which asks if you have had any episodes of severe hypo, If I have hypo unawareness, any complications and results from eyes tests. They do not however require me to provide BG logs of any kind but I have heard if you are involved in a motor vehicle collision whether or not you are at fault they will ask for this. So after paying my doctor $80 and submitting my drivers medical to motor vehicles and paying their fee’s for renewal, I was surprised to find out that approval was made over the phone as I waited in the motor vehicles office. The lady at the counter called some top secret number and basically read my medical to someone on the other end and they make a decision weather or not I am fit to have a commercial license. Ten minutes later I walked out with my class 1 back in my hands but I must go through the whole thing every year.

I am very diligent in checking my BG when at work and on the road and ALWAYS carry candy and juice with me. I am not about to let my diabetes cost me my $90,000/yr job.

Do you know if the criminal charges for not reporting apply to any driver or just to commercial drivers? I know of diabetics who have never reported themselves and think they’re smart because they don’t have to pay for an annual medical.

Yes, that “read the medical over the phone” approach does seem odd, and really annoying when they read it in earshot of the 20 people in line behind you. My first medical was actually sent directly to the licensing board since I self reported and stopped driving until things were straightened out; my license was never pulled, probably because it was jsut a Class 5 (non-commercial).

I noticed a bit of a disconnect in the Alberta system too. When I was diagnosed, no one told me I had to inform the Motor Vehicle people. Not the emergency physicians, not my family physician, not my endo, not the diabetic nurse, not the dietician, and not even the diabetic educators who teach the diabetic boot camp. It’s surprisingly difficult to find the right people to report yourself to, and it’s easy to see how some diabetics don’t immediately realize that they are supposed to report themselves.

That is strange. Are there any BC diabetics reading this who do have to get periodic medicals? Maybe the medical only applies to commercial licenses, or only to insulin dependant diabetics?

The problem probably isn’t as much with people not reporting their disease when first getting their license as it is with people who already have a license before being diagnosed or before starting to take insulin. From my experience, it’s not all that obvious in Alberta how to report yourself, or even that it is required.

I appreciate the conversation here - it makes me sad though, because I’ve had hypo unawareness. And the title sure does fit. You could have all the juice and candies in the world - right in front of you, but you wouldn’t grab 'em. You don’t feel the low - at all. The low comes and your mind goes - and there’s nothing you can do to help yourself. You don’t feel it at all. Occassionally, your mind comes back to you and you can fix it, but sometimes it doesn’t. And, if you’re alone - you’re in trouble. I’m not going to judge the guy because hypo unawareness can happen suddenly one day - I didn’t think it could until it happened to me. I think we all know, too, that it doesn’t take very long for our blood sugars to change so… I mean, he could have tested himself regularly but maybe there was a thirty minute period between his last test and it dropped - you never know. Regulations are good things - but I have to say, blood sugars can drop fast - so… what are you going to do? Until there’s a better system of monitoring (and I even mean better than the CGMsystem) or — a cure — we are going to be faced with low blood sugar being involved in automobile crashes.

First of all, I understand our doctor’s wishes to achieve “normal blood glucose levels” however, it is very difficult for many to achieve in this fast paced life when a lot of people are not paying “strict” attention to their levels at every single moment. I disagree with the “non diabetic blood glucose numbers”. Complications still remain an issue regardless.

Second of all, insulin is dangerous. Any form of it can be dangerous.

Third of all, hypoglycemia is too much insulin. Hypoglycemia is not normal and wait until a thorough and truthful study is done to find what is damaged because of it.

Finally, maybe our doctor’s can come up with “magic numbers” to keep our sugars at prior to and while driving.

There are innocent people on the road as well. Many people will be missed by their children, mothers, fathers, wives, husbands, etc if we do not come up with a solution to driving with this disease. Yes, a cure is the answer.

Tracy,

OK, I came across as too harsh. You’re right, hypos can hit anyone, and sometimes suddenly. Driving is such a fundamental activity that restricing someone’s eligibility to drive should not be done lightly.

The driver in this case was supposedly meticulous about testing and carrying food. I recently spoke with an emergency worker who was either at the accident scene or who spoke with coworkers who were, and preliminary blood tests do not support the idea that the driver was hypo when he crashed. Maybe this whole episode had nothing to do with his diabetes.

Of course, since the driver had supposedly had previous incidents of a zombie-like state, it does not sound to me like he should have been driving at all, let alone a semi, regardless of whether it was diabetes related.

The Edmonton police department has now (mid June) closed their investigation. The coroner has not yet released his/her report but the police department is satisfied that the crash was an accident due to a diabetic or other medical problem. The local newspaper reports that the driver had a history of “seizures” caused by low blood sugar.

More than 4 months after the accident the Chief Medical Examiner has determined that this accident was indeed the result of a hypo.

Didn’t she also have a small refrigerator instead of a night stand, full of juice? How much juice are we supposed to go through warding off DIABETIC SHOCK!?

In the US if you are a T1 you cannot get a pilots license ( I believe this applies to private or commercial & military) and you cannot get a commercial drivers license. If you hold these and are then diagnosed you have to surrender the license. A T2 can hold either if I am not mistaken. As far as I know this does not apply to a general driver’s license… This may vary by state (?) but I am not required (as far as I know) to report my T1…This may change upon renewal of my license though. I know when my daughter received her learner’s permit she was asked about medical conditions, but nothing about “specific” conditions…

I have a friend who is T2 and on insulin. A few months back she bottomed out in the car and crossed a parkway. She was the first one at the light so, no other car to stop her but a small stone bridge and the oncoming car from the parkway. Needless to say quite a few surgeries later and an extensive future in rehab and the poor girl is quite miserable. She feels horrid about what happened.She has a hard time dealing with diabetes to begin with but, this has really got her up in arms about her condition. For the record, she did test right before she started the car and was fine. As someone mentioned, she was unaware and out like a light. One of the firemen on call knew her and knew she has diabetes they got her back rather quickly but she was very confused about what happened because she didn’t have a clue when it did.

~Danielle

Amazingly nothing. Mark Robert Joseph Santos died that day, my fianncee.