Reporting a (probably) one time medical event to Driver's License Medical Board?

May 21, 2006 11:57 AM

Should I report a (probably) one time medical event to the driver's license medical board?

A few weeks ago I passed out and experienced several minutes of convulsions, most likely because I missed breakfast and my blood sugar level dropped. A bit of glucose solution perked me right up and I've been fine every since. I've since been cleared of any problems by a neurologist and my family MD. The attending in the ER told me not to drive until I reported the event to the local (Texas) department of public safety and was cleared by their medical board. Both doctors I consulted repeated told me they could not tell me not to report this event, in fact they told me so many times they were almost certainly implying otherwise. I wouldn't have been surprised if they had winked at me. Also, an attorney friend I consulted was surprised I was considering actually reporting it, but again he repeatedly told me that he could not advise me not to.

Has anyone else run into a similar situation? Anybody receive a straight answer? The Medical Board website is under construction still and isn't very helpful.

posted by anonymous to health & fitness (7 comments total)

A quick skim through Tex. Transportation Code Ch. 521 doesn't indicate any particular responsibility for you to self-report. I am not a lawyer, nor do have any prior experience in this area of the law, so I certainly could have missed something.

I imagine that the worst that could happen is that you could pass out while driving, kill some people, and be charged with criminally negligent homicide if this prior history came to light. Seems unlikely though, doesn't it? Or you could be sued for your negligence, although the insurance company would likely take care of that.
posted by grouse at 12:30 PM on May 21, 2006

(IANAL and IANA Doctor. I'm not giving advise, I'm just posting some links.)

I heard something on NPR talking about diabetes and CDL licenses. The story was about how the Department of Transportation is instituting a waiver program for individuals who take insulin to control their diabetes. I was suprised to learn there was a blanket ban on individuals who take insulin to control diabetes, and how much discrimination there was with people who had any kind of blood sugar control issues.

You might have a read through this for more information.
posted by jeversol at 12:43 PM on May 21, 2006

If you (and your doctors) are confident that this won't happen again, then personally, I wouldn't bother. If there is a chance that it will happen again without warning, then you have an obligation to the general public to not drive - the reporting is a side issue.

Years ago, I went through a couple of months of passing out on a regular basis, and once the cause had been identified and resolved and I had the all-clear from the medical profession, I started driving again and didn't report it.

Tip 1 - be super-careful when driving, making sure you are always in a position to pull over if you feel faint - just in case.

Tip 2 - always keep some dried fruit or a chocolate bar in your bag so you have something to get your blood sugar levels up if they drop.
posted by MaJumelleDiabolique at 12:54 PM on May 21, 2006

If you do report it, you can have your drivers license taken away for x amount of months. Since your doctors arent very concerned, I would advise not to report it. As MaJumelle said, pull over if you feel faint, and have some sugary snacks with you just in case.
posted by lain at 2:30 PM on May 21, 2006

Apparently this varies by state, and the AMA has a state-by-state list of policies and laws here. I could be mistaken, but the way I read the section on Texas, it appears incumbent on the physicians involved to use their best judgment, but there seems to be no legal reporting requirement. But again, IANAL and I don't live in Texas, so take it for what it's worth.

From the sound of it, the doctors you saw were trying to play it safe and avoid legal risk for themselves, but may have felt that it wasn't in your or the world's best interests to report this.

And now time for my own medical disclaimer: I don't know you, nor have I ever met you, and as such, I have no ability to judge your risk for potentially having a repeat event like this while driving, which would most certainly put others and yourself in danger. The safest advise anyone could give would be to report the event.

Also, if you're a diabetic and happen to take oral anti-hyperglycemics, consider talking to your doctor about changing your medications to ones less likely to cause hypoglycemia as alternatives may exist. If you require insulin, this is unfortunately not possible, but a good doctor should be able to work with you to control your blood sugar in a safer way and minimize the risk of hypoglycemia. And always have a source of sugar on hand.
posted by drpynchon at 3:49 PM on May 21, 2006

This is the best website I've seen on the topic - I am an epilepsy specialist, so I perhaps know a little bit about the topic. The law makes no distinction among provoked seizures, unprovoked seizures, and other events that cause impairment of consciousness.

Texas is not a mandated-reporting state, like California is. That means that in Texas, if a doctor learns that you have had an event that impairs consciousness, she is not mandated to report you to DMV. (In California, she is required to report you.)

However, drivers are required to report themselves in nearly every state, including Texas. Doctors who practice correctly will:

a) Inform the patient that they need to report themselves to DMV and that they should not drive until they do so.

b) Document this conversation in the permanent medical record, to cover their own ass when your next seizure causes you to plow your car into a sidewalk full of 6-year olds, killing 15 of them. Otherwise, the doctor can be found to share in criminal liability for these deaths.

Now you understand why you got the advice you've been given and why it was worded the way it was. You will hear it again from me at the bottom of this post; I have no wish to go to jail. But this is a tricky state of affairs, really. Draconian mandated-reporting laws deter sick people from seeking health care. That's well documented. However, lax self-reporting laws enable stupid people to retain their license and drive unsafely, resulting in the deaths of innocent people every year. There's no clear good answer to what should be done.

What happens when the DMV receives a report is that the report is reviewed by a medical officer of the DMV. Typically the driver's license is revoked when the diagnosis is, for example, uncontrolled epilepsy. In cases like your own, it depends on the judgment of the medical officer as to what will happen. Providing that officer access to your medical records from your seizure E/R visit might help your case.

To be quite clear on legal issues: I am a doctor. Anyone who has had a seizure should report the seizure to the DMV and abstain from driving before that time. I am not your doctor and I cannot provide you with advice as to what you should do.
posted by ikkyu2 at 2:29 AM on May 22, 2006

Since missing breakfast can cause you to careen down a crowded sidewalk and into a swapmeet for "several minutes" killing dozens of people it seems like you are one of the people that the law is designed to protect us from.
Alternately, you could just keep granola bars in your glove compartment and eat them if you forget breakfast.
posted by Megafly at 5:59 PM on May 22, 2006